A newly identified coronavirus called 2019-nCoV has been spreading in China, and has now reached multiple other countries. Here's what you need to know.
Update on Monday, Feb. 10 (ET):
—A 60-year-old U.S. citizen in Wuhan has died after being infected with the coronavirus.
—About 40,573 individuals globally (primarily in mainland China) have been confirmed to have the new coronavirus, according to the Johns Hopkins virus dashboard.
—The virus gets a temporary name, Chinese officials announced.
—910 deaths linked to the virus. Deaths worldwide exceed those from SARS.
—A phase 1 trial of a new vaccine against 2019-nCoV is on track to begin in 2.5 months, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Friday (Feb. 7). There have been "no glitches so far" in the steps to prepare the vaccine, which involves initial studies in lab dishes and animals, Fauci said.
—More than 800 Americans have been evacuated from Wuhan on four flights.
—The U.S. is prepared to spend up to $100 million to assist China and other countries in combating the virus, according to U.S. Secretary of State Mike Pompeo.
—About 3,700 people are being quarantined on the Diamond Princess cruise ship off Japan due to the coronavirus, with 130 individuals testing positive so far, the Times reported.
—The 34-year-old Chinese doctor who was silenced by police for warning about the coronavirus outbreak has died after contracting that virus. China's Communist Party has said it will send a team to investigate the death, The New York Times reported.
—Wuhan officials plan to round up those suspected of being infected into mass quarantine camps, The New York Times reported.
—Two deaths linked to the virus outside of mainland China to date.
— U.S. citizens, permanent residents and immediate family who have visited China's Hubei province will now undergo a mandatory two-week quarantine.
Number of coronavirus cases
Mainland China: 37,232
Japan: 25 (plus 70 on cruise ship off coast)
Hong Kong: 29
South Korea: 25
United Arab Emirates: 7
Sri Lanka: 1
Coronavirus quarantine in Wuhan
Wuhan plans to round up those suspected of having the virus to be placed in isolation, in some kind of mass quarantine camps, The New York Times reported. China's Vice Premier Sun Chunlan said that city officials should go door to door to check residents' temperatures and to interview those in contact with infected individuals, the Times reported.
"Set up a 24-hour duty system. During these wartime conditions, there must be no deserters, or they will be nailed to the pillar of historical shame forever," Sun said, according to the Times.
The Times is reporting a shortage of medical supplies, coronavirus-testing kits and hospital beds due to the lockdown in the city and surrounding area, leading to people walking on foot from hospital to hospital, only to be turned away.
Who will be quarantined in the US?
Officials announced on Friday (Jan. 31) that the U.S. will be enforcing quarantines on citizens who have traveled to the Hubei Province (where the outbreak originated) in the last 14 days. If U.S. citizens have been to China in the last 14 days, they will be rerouted to one of eleven airports (see above) across the country to be screened for the new coronavirus, according to the Department of Homeland Security (DHS).
If passengers who have traveled to China are showing symptoms of the virus (which include a cough, trouble breathing or fever) they will be subject to mandatory quarantines. If passengers who have traveled to China (outside of the Hubei province) show no symptoms after being screened at one of the 11 airports, they will be re-booked to their destinations within the U.S. and asked to self-quarantine at home, according to the DHS.
Other travelers who haven't been to China but are found to be on the same flight of passengers that have been to China might also be rerouted to one of the 11 airports, according to the DHS. What's more, in general "foreign nationals" who have traveled to China in the past 14 days won't be allowed in the U.S.
The details of those quarantines, such as where people will stay, are not yet clear, Dr. Nancy Messonnier, the director of CDC's National Center for Immunization and Respiratory Diseases said during a teleconference on Feb. 3.
The only people currently under quarantine are the 195 passengers that the U.S. flew back from Wuhan on Jan.29. They are staying at the March Air Reserve Base in Riverside, California. The last time such a quarantine was put in place was over 50 years ago for a smallpox scare.
What is a coronavirus?
Coronaviruses are a large family of viruses that can cause respiratory illnesses such as the common cold, according to the Centers for Disease Control and Prevention (CDC). Most people get infected with coronaviruses at one point in their lives, but symptoms are typically mild to moderate. In some cases, the viruses can cause lower-respiratory tract illnesses such as pneumonia and bronchitis.
These viruses are common amongst animals worldwide, but only a handful of them are known to affect humans. Rarely, coronaviruses can evolve and spread from animals to humans. This is what happened with the coronaviruses known as the Middle East respiratory syndrome coronavirus (MERS-CoV) and the severe acute respiratory syndrome coronavirus (SARS-Cov), both of which are known to cause more severe symptoms.
Where did the new coronavirus come from?
Since the virus first popped up in Wuhan in people who had visited a local seafood and animal market (called the Huanan seafood market), officials could only say it likely hopped from an animal to humans. In a new study, however, the researchers compared the 2019-nCoV genetic sequence with those in a library of viral sequences, and found that the most closely related viruses were two coronaviruses that originated in bats; both of those coronaviruses shared 88% of their genetic sequence with that of 2019-nCoV.
Based on these results, the authors said the 2019-nCoV likely originated in bats. However, no bats were sold at the Huanan seafood market, which suggests that another yet-to-be-identified animal acted as a steppingstone of sorts to transmit the virus to humans.
A previous study suggested snakes, which were sold at the Huanan seafood market, as a possible source of 2019-nCoV. However, some experts have criticized the study, saying it's unclear if coronaviruses can infect snakes.
Does the coronavirus have an official name?
The Chinese government announced a name for the new coronavirus, ordering local authorities and state news media to start using it, the Times reported. In English, the name translates to novel coronavirus pneumonia, or N.C.P. The International Committee on Taxonomy of Viruses is tasked with giving the virus an official name.
On Jan. 30, WHO had proposed calling the disease "2019-nCoV acute respiratory disease," and the virus "2019-nCoV." (In these names, the "‘n" stands for novel and "CoV" is for coronavirus.) WHO will need to seek approval for the name from the World Organization for Animal Health (OIE) and Food and Agriculture Organization (FAO). The final decision on the virus' official name will be made by the International Committee on Taxonomy of Viruses, according to WHO.
In a report published on Jan. 29, researchers in China referred to the disease as novel coronavirus (2019-nCoV)–infected pneumonia, or NCIP.
WHO discourages naming new viruses after geographic locations, people, species or classes of animals or foods, according to the organization's Best Practices for the Naming of New Human Infectious Diseases. Rather, WHO encourages use of descriptive terms of a disease, such as "respiratory disease" and "neurologic syndrome," as well as "severe" or "progressive." The organization also says that if a pathogen is known, it should be used as part of the disease's name.
How does the coronavirus spread between people?
On Jan. 30, the CDC identified the first case of person-to-person spread in the United States. As of Feb. 2, cases involving individuals who had not recently traveled to China have been confirmed in: the U.S., Thailand, Taiwan, Germany, Vietnam, Japan and France, the Times reported.
In terms of how one would catch the virus, the CDC says that human coronaviruses are most commonly spread between an infected person and others via:
—the air (from viral particles from a cough or sneeze);
—close personal contact (touching or shaking hands);
—an object or surface with viral particles on it (then touching your mouth, nose or eyes before washing your hands);
—and rarely from fecal contamination.
Deaths from coronavirus outside China
A 44-year-old man in the Philippines has become the second person there infected with the novel coronavirus and the first known death linked to the virus outside of China, according to the Department of Health of the Republic of the Philippines. The man died on Feb. 1, the DOH said in a statement, adding: "Our thoughts are with his family at this difficult time."
On Feb. 4, a 39-year-old man died from 2019-nCoV in Hong Kong, according to the New York Times. It's the first death in Hong Kong and the second outside mainland China.
Though not outside mainland China, the first U.S. citizen with the coronavirus has died, according to The New York Times. According to people familiar with the case, the individual was a 60-year-old woman said to have had underlying health problems, the Times reported.
Could this virus cause a pandemic?
In order for this virus, or any, to lead to a pandemic in humans, it needs to do three things: efficiently infect humans, replicate in humans and then spread easily among humans, Live Science previously reported. Right now, its unclear how easily the virus spreads from person to person.
To determine how easily the virus spreads, scientists will need to calculate what's known as the "basic reproduction number, or R0 (pronounced R-nought.) This is an estimate of the average number of people who catch the virus from a single infected person, Live science previously reported. A study published Jan. 29 in the New England Journal of Medicine (NEJM) estimated an R0 value for the new coronavirus to be 2.2, meaning each infected person has been spreading the virus to an average of 2.2 people. This is similar to previous estimates, which have placed the R0 value between 2 and 3. (For comparison, SARS initially had an R0 of around 3, before public health measures brought it down to less than 1.)
In general, a virus will continue to spread if it has an R value of greater than 1, and so public health measures to stem the outbreak should aim to reduce R0 to less than one, the authors of the NEJM paper said.
The CDC says outbreaks of new viruses are always concerning. However, the agency says the immediate risk to the American public remains low, given the small number of cases and limited spread of the virus here.
Still, an individual's risk of infection "depends on exposure," the CDC said. Some people, including health care workers and those with close contacts infected with 2019-nCoV, are at increased risk of infection, the agency said.
On Jan. 30, the World Health Organization (WHO) declared that the new coronavirus outbreak is a public health emergency of international concern. The main reason for the declaration is concern that the virus could spread to countries with weaker health systems, WHO said.
How does coronavirus compare to SARS and MERS?
As of Feb. 9, a reported 814 individuals have died from the coronavirus (two of those outside of mainland China), exceeding the death toll from SARS — which killed 349 people in mainland China and 774 individuals worldwide, according to The New York Times.
MERS and SARS have both been known to cause severe symptoms in people. It's unclear how the new coronavirus will compare in severity, as it has caused severe symptoms and death in some patients while causing only mild illness in others, according to the CDC. All three of the coronaviruses can be transmitted between humans through close contact.
MERS, which was transmitted from touching infected camels or consuming their meat or milk, was first reported in 2012 in Saudi Arabia and has mostly been contained in the Arabian Peninsula, according to NPR. SARS was first reported in 2002 in southern China (no new cases have been reported since 2004) and is thought to have spread from bats that infected civets. The new coronavirus was likely transmitted from touching or eating an infected animal in Wuhan.
During the SARS outbreak, the virus killed about 1 in 10 people who were infected. The death rate from 2019-nCoV isn't yet known. In the beginning of an outbreak, the initial cases that are identified "skew to the severe," which may make the mortality rate seem higher than it is, Alex Azar, secretary of the U.S. Department of Health and Homeland Security (HHS), said during a news briefing on Tuesday (Jan. 28). The mortality rate may drop as more mild cases are identified, Azar said.
Currently, most of the patients who have died from the infection have been older than 60 and have had preexisting conditions.
What are the symptoms of the new coronavirus and how do you treat it?
Symptoms of the new coronavirus include fever, cough and difficulty breathing, according to the CDC. It's estimated that symptoms may appear as soon as two days or as long as 14 days after exposure, the CDC said. The NEJM study published on Jan. 29 estimated that, on average, people show symptoms about five days after they are infected.
There are no specific treatments for coronavirus infections and most people will recover on their own, according to the CDC. So treatment involves rest and medication to relieve symptoms. A humidifier or hot shower can help to relieve a sore throat and cough. If you are mildly sick, you should drink a lot of fluids and rest but if you are worried about your symptoms, you should see a healthcare provider, they wrote. (This is advice for all coronaviruses, not specifically aimed toward the new virus).
There is no vaccine for the new coronavirus, but researchers at the U.S. National Institutes of Health confirmed they were in preliminary stages of developing one. Officials plan to launch a phase 1 clinical trial of a potential vaccine within the next three months, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, said in a news conference on Jan. 28.
Researchers are also working on gathering samples of the virus to design a therapy that will train patients' immune cells to detect and destroy the virus, Facui said.
What is being done to stop the spread of the coronavirus?
The Chinese government put Wuhan and many other nearby cities on "lockdown," meaning people are not allowed in or out of the area, according to The New York Times.
The governments of both Taiwan and Hong Kong have said they would not allow in anyone from the Hubei Province (where Wuhan is located).
Major airports in the U.S. are conducting screenings to try to check for symptoms of the virus. On Jan. 28, CDC officials announced that 15 additional U.S. airports will begin screening travelers for the virus, bringing the total number of airports conducting screening in the U.S. to 20. The CDC also recommends that Americans avoid all nonessential travel to China.
The Chinese government has banned the sale of wildlife in markets, restaurants and online.
Also, starting Feb. 2, U.S. citizens, permanent residents and immediate family who have visited China's Hubei province will undergo a mandatory two-week quarantine. And "foreign nationals" who have traveled to China in the past 14 days won't be allowed in the U.S., officials said. If Americans visited any other part of China, they will be screened at airports and asked to self-quarantine for 14 days.
Australia is also barring entry to non-citizens who have recently visited China.
Flights carrying passengers from China will be rerouted to one of 11 U.S. airports, according to the U.S. Department of Homeland Security; Those airports are: John F. Kennedy International Airport in New York, O'Hare International Airport in Illinois, San Francisco International Airport, Seattle-Tacoma International Airport, Daniel K. Inouye International Airport in Honolulu, Los Angeles International Airport, Hartsfield-Jackson Atlanta International Airport, Dulles International Airport in Virginia, Newark Liberty International Airport in New Jersey, Dallas/Fort Worth International Airport in Texas and Detroit Metropolitan Wayne County Airport in Michigan.
How can people protect themselves and others?
The best way to prevent infection with 2019-nCoV is to avoid being exposed to the virus, according to the CDC. In general, the CDC recommends the following to prevent the spread of respiratory viruses: Wash your hands often with soap and water for at least 20 seconds; avoid touching your eyes, nose, and mouth with unwashed hands; avoid close contact with people who are sick; stay home when you are sick and clean and disinfect frequently touched objects and surfaces.
If traveling to China, you should avoid contact with sick people, avoid dead or alive animals, animal markets or products that come from animals such as uncooked meat, the CDC said.
People who traveled to China and became sick with fever, cough or difficulty breathing within the following two weeks should seek medical care right away, and call ahead to inform medical staff about their recent travel, the CDC said.
Jeanna Bryner, Rachael Rettner, Yasemin Saplakoglu and Nicoletta Lanese contributed reporting.
Originally published on Live Science.