A new coronavirus, designated 2019-nCoV,[6] was identified in Wuhan, the capital of China's Hubei province, after 41 people developed pneumonia without a clear cause in early December 2019.[3][7] The virus has shown evidence of human-to-human transmission,[8] with the number of cases climbing into the thousands by late January 2020[9][10] and several countries across Europe, North America and especially the Asia-Pacific reporting cases.[11] Its incubation period (time from exposure to onset of symptoms) ranges from 2 to 14 days,[12] but there is evidence that it may be contagious during this period[13] and possibly also for several days after recovery.[14] Symptoms include fever, coughing and breathing difficulties, and it can be fatal[15], with an estimate Case Fatality Rate of 0.02.
As of 4 February 2020, approximately 20,655 cases have been confirmed,[4][16] including in every province-level division of China.[4] The first confirmed death occurred on 9 January[17] and since then, as of 4 February 2020, 427 deaths have been confirmed.[4] A larger number of people may have been infected, but not detected (especially mild cases).[18][19] The first local transmission of the virus outside China occurred in Vietnam between family members,[20] with the first local transmission not involving family occurred in Germany, on 22 January, when a German man contracted the disease from a Chinese business visitor at a meeting.[21] The first death outside China was reported in the Philippines, in a 44-year-old Chinese male on 1 February.[22] Many New Year events and tourist attractions have been closed to prevent mass gatherings, including the Forbidden City in Beijing and traditional temple fairs.[23] Hong Kong raised its infectious disease response level to the highest and declared an emergency, closing schools until March and cancelling its New Year celebrations.[24][25]
A number of countries have issued warnings against travel to Wuhan and Hubei.[26] Travelers who have visited Mainland China have been asked to monitor their health for at least two weeks and contact their healthcare provider to report any symptoms of the virus.[27] Anyone who suspects that they are carrying the virus is advised to wear a protective mask and seek medical advice by calling a doctor rather than directly visiting a clinic in person.[28] The travel sector has been providing refunds and no-fee cancellations for reservations in China or by people from China.[29] Airports and train stations have implemented temperature checks, health declarations and information signage in an attempt to identify carriers of the virus.[30]
The outbreak has been declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO), based on the possible effects the virus could have if it spreads to countries with weaker healthcare systems. The declaration was the sixth time that the measure has been invoked since the H1N1 pandemic in 2009.[31][32][33][34] Xenophobia and racism against people of Chinese and East Asian descent have been noted due to the outbreak, fuelling fear and hostility across various countries.[35][36][37][38] Misinformation spread primarily online about the coronavirus has led the WHO to declare an "infodemic" on 2 February.[39]
In Wuhan, during December 2019, a cluster of cases displaying the symptoms of a "pneumonia of unknown cause" was linked to Huanan Seafood Wholesale Market, which had a thousand stalls selling fish, chickens, pheasants, bats, marmots, venomous snakes, spotted deer, and other wild animals (ye wei, bushmeat). The immediate hypothesis was that this was a novel coronavirus from an animal source (a zoonosis)
Coronaviruses mainly circulate among other animals but have been known to evolve and infect humans as in the cases of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) together with four further coronaviruses that cause mild respiratory symptoms similar to the common cold. All coronaviruses known to infect humans have been shown to spread between people.[48][49] Transmission of coronaviruses is primarily thought to occur among close contacts via respiratory droplets generated by sneezing and coughing
Areas affected
the virus spread to other Chinese provinces in early and mid-January 2020, helped by the Chinese new year migration. Cases started to be detected in other countries, carried by international travellers, typically to major trade partners: Thailand (13 January); Japan (15 January); South Korea (20 January); Taiwan and the United States (21 January); Hong Kong and Macau (22 January); Singapore (23 January); France, Nepal and Vietnam (24 January); Australia and Malaysia (25 January); Canada (26 January); Cambodia (27 January); Germany (28 January); Finland, Sri Lanka and the United Arab Emirates (29 January); India, Italy and Philippines (30 January); the United Kingdom, Russia, Sweden and Spain (31 January); Belgium(4 February).[68][64] As of 4 February, more than 20,629 cases have been confirmed worldwide, 99% in China proper.[68]
While spread between people has been confirmed,[69][70] no active centres of propagation have been confirmed outside China so far. On 30 January, citing 7,711 cases essentially in China and 83 cases abroad across 18 countries on 29 January, the World Health Organization declared the novel coronavirus outbreak to be a Public Health Emergency of International Concern.[71]
Signs and symptoms[edit]
Those afflicted may be asymptomatic, although those manifesting symptoms may have fever, cough, shortness of breath,[15][86] and diarrhoea,[87] and may vary from slight to very severe.[15][86]
The number of severe cases as of 4 February 2020 is 2,298 out of 20,629 with 644 having recovered.[4] Cases of severe infection can result in pneumonia, kidney failure, and death.[88][89] On 3 February 2020 Anthony Fauci of the National Institutes of Health stated that 25% of China’s coronavirus cases require intensive treatment.[90] Upper respiratory symptoms such as sneezing, a runny nose or sore throat are less frequent.[58][59]
The time from exposure to onset of symptoms is estimated at 2 to 10 days by the World Health Organization[91] and 2 to 14 days by the US Centers for Disease Control and Prevention (CDC).[12]
Among the first 41 confirmed cases admitted to hospitals in Wuhan, 13 (32%) individuals had another chronic condition, like diabetes or hypertension. Overall, 13 (32%) individuals required intensive care, and 6 (15%) individuals died.[58] Many of those who died had other conditions such as hypertension, diabetes, or cardiovascular disease that impaired their immune systems.[92]
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