Effects of corrona virus on the world community

EFFECTS OF CORRONA VIRUS ON THE WORLD COMMUNITY
(A Case Study of China Wuhan and Hubei Provinces)
Dr.Naushad Khan
Email:-
Institute of Development Studies, The University of Agriculture Peshawar
Mahnoor Naushad
Student of Agriculture University Peshawar

ABSTRACT
The study was carried out since Feb, 2020. The major objective was that to examine the effect of
corona virus on the world community. Total fourteen articles were downloaded from the net and read
10 to 20 times in depth and analyzed the situation and draw the conclusion. The result indicates that
corona virus problem was raised in late December 2019 in Wuhan and Hubei provinces in China. The
hub of the center was Huanan Seafood Wholesale Market and the source of the virus was bat soup. A team
at the Wuhan Institute of Virology led by virologist Zheng-Li Shi isolated the virus from a 49-year-old
woman, who developed symptoms on 23 December 2019 before becoming critically ill. Doctor, Li Wenliang
on 31 December told that an unknown virus has been developed in the province of Wuhan and Hubei
provinces as like SARS and MERS. The symptoms were found fever, throat sore and sneezing by woman in
the hospital. The Doctor Li has shared the knowledge on E-Chat while police department has declared the
rumors against the country and told to Dr.Li to delete the said statement from the E-Chat and keep the data
in secrecy while latter on 20, January, 2020 it was announced by government media that Corona Virus has
killed many people in the provinces of Wuhan and Hubei . Due to late coverage in the mean time the virus
was spread to the whole world which has damaged majority people in their area and emergency was
announced by China and world Health Organization. They have sealed majority airports and visas were
cancelled by different countries in the world. Globally 4594 cases of the corona Virus was confirmed. China
total confirmed cases number was 4537 while 6973 were suspected and 976 were found severe and 106
deaths were recorded. Similarly outside of China 57 cases were confirmed and 16 countries were declared
affected. According to data Japan affected number was 6, Republic of Korea 4, Viet Nam 2 ,Singapore 7.
Australia 5, Malaysia 4, Cambodia 1, Thailand 14, Nepal 1, Sri Lanka 1, United States of America 5
,Canada 2, France 3, Germany 1 and Pakistan 1. World Health Organization has tried best for its controlling
and the Director General did meeting with the President Xi Jiping for overcoming this problems in the

emergency in china. World Pathologists’ were informed for Vaccine preparation. Similarly world economy

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has been damaged and the economy of the China was highly affected by this virus and the new year
program was halted on the spot The China has struggled best and its program was highly appreciated for
this virus controlling. The review further shows that the people of the China are very patriotic and they made
hospital in day night for treatment of the affected people by virus. The review further explains that through
sneezing and human contact the virus were spread to whole community of the world. So for protection
purpose Wuhan and Hubei provinces were sealed for further spreading this virus. Masks were prepared in for
protection of community. On the basis of problems the following recommendations were suggested for its
controlling in future. Mostly Halal food should be provided to China community in future. World wise
Quarantines should be developed by each country for different germs protection.; Good hospital and quality
Doctors should be produced by each country; Give freedom to media for awareness of community to take
action in time to protect the world from the epidemic disease; Safety net should be provided by WHO in the
developing countries in time. More funds should be provided to health department in the world. Similarly
research fund should be increased in all hospital of the world for conducting research on the medical
background. Testing laboratories and food inspectors should be multiplied for protection of different diseases
in the world
Key Words:- Effects, Corona Virus, , World, Community

1. INTRODUCTION
Virus is the micro organism and with the help of microscope it is seen. It has many types in the world but
now a day Corona Virus has ruined the economy of the China. Majority people are died by this virus. All
airports of the world have been sealed and the business in China has been stop from December 2019. Corona
Virus has killed many people in the Province of Wuhan and Hubei and in different countries of the world.
Health emergency was declared by WHO. The world microbiologist are busy for Corona Virus Vaccine for
protection of this disease. Million students are studying in the University of Wuhan and other University of
China. All tried to come out of China while they have spread this disease to world community. So this
alarming situation has disturbed the whole world. Daurat(January 31, 2020) reported that China has absorbed

most of the economic shock from the corona virus known as 2019-nCoV, which has killed more than 210
within its borders and infected over 9,950 globally. Wuhan, the city with 11 million residents where the virus
came to light, remains closed off from the world. Under a government-mandated extension of the Lunar New
Year holiday, provinces generating at least two-thirds of economic output will be shuttered through next
week, including Shanghai and key eastern manufacturing hubs. All the while, the virus’s toll continues to
rise -- and with it the worry. China’s essential role in the global supply chain means business owners and
executives around the world are being forced to contemplate what will happen in a prolonged

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crisis.“Everyone is waiting to see how this evolves,” said Miguel Patricio, the chief executive officer of Kraft
Heinz Co. The food giant has a couple thousand employees in China, including a small sales team in Wuhan.
“The danger, of course, is that if this continues and people have to stay home, then problems in terms of
distribution, production will be started.” An interconnected global economy is feeling the strain of China’s
viral outbreak -- and the potential $160 billion hit in lost growth that may be on the way. Already SARS in
2003 has also disturb the economy of the China. Seeing to its importance the present study was arranged to
fully know the situation which is going on in China and other part of the world and to see the effects of
corona virus on the world community.

2. METHODS AND MATERIALS
The study was carried out since Feb,2020 and the major objective was that to examine the effect of
the Corona Virus on the world community. The main target in this study was the Wuhan and the
Hubei province of China. Total 14 articles were downloaded from the net and read 10 to 20 times in
depth and analyzed the situation which is presently going in China.

3.

REVIEW OF CORRONA VIRUS EFFECT ON THE WORLD COMMUNITY

A.

On 15 January 2020, the Ministry of Health, Labour and Welfare, Japan (MHLW) reported an
imported case of laboratory-confirmed 2019-novel corona virus (2019-nCoV) from Wuhan, Hubei
Province, China. The case-patient is male, between the age of 30-39 years, living in Japan. The casepatient travelled to Wuhan, China in late December and developed fever on 3 January 2020 while
staying in Wuhan. He did not visit the Huanan Seafood Wholesale Market or any other live animal
markets in Wuhan. He has indicated that he was in close contact with a person with pneumonia. On 6
January, he traveled back to Japan and tested negative for influenza when he visited a local clinic on
the same day. On 10 January 2020, due to his continued symptoms of cough, sore throat and fever, he
visited a local hospital and was found to have abnormal chest x-ray with infiltrates. He was admitted
to the hospital on the same day and had remained febrile until 14 January. On 14 January, his
attending doctor notified the case to a local public health authority under the surveillance system for
“Unidentified Serious Infectious Illness”. Samples were collected and sent to the National Institute of
Infectious Diseases (NIID), and at NIID, polymerase chain reaction (PCR) testing and sequencing
was performed twice, which identified very small amount of 2019-nCoV RNA on 15 January 2020.
On 15 January, the case-patient was a febrile and was discharged from hospital. Currently, he is
staying at home in a stable condition. Contact tracing and other epidemiological investigations are
underway by the local health authorities in Japan; The Japanese Government has scaled up a whole-

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of-government coordination mechanism on the 16 January; The MHLW has strengthened
surveillance for undiagnosed severe acute respiratory illnesses since the report of undiagnosed
pneumonia in Wuhan, China; From 6 January, MHLW requested local health governments to be
aware of the respiratory illnesses in Wuhan by using the existing surveillance system for serious
infectious illness with unknown etiology; NIID is supporting local authorities on epidemiologic
investigations including contact tracing; Quarantine and screening measures have been enhanced for
travelers from Wuhan city at the point of entries since 7 January; NIID established an in-house PCR
assay for

in Corona Virus on 16 January; Revision of the risk assessment by NIID is being

conducted, including case definition of close contacts; The public risk communication has been
enhanced; A hotline has been established among the different ministries in the government; The
MHLW is working closely with WHO and other related Member States to foster mutual
investigations and information sharing. This was the second of three exported cases of novel corona
virus from Wuhan city, China. Since the initial report of cases in Wuhan city on 31 December 2019,
and as of 12 January 2020, 41 laboratory-confirmed cases of in Corona Virus infection, including 2
deaths in cases with underlying medical conditions have been reported to WHO. Two cases have
been reported from Thailand. The source of the outbreak is still under investigation in Wuhan.
Preliminary investigations have identified environmental samples positive for in Corona Virus in
Huanan Seafood Wholesale Market in Wuhan City, however some laboratory-confirmed patients did
not report visiting this market. To date, there is no reported infection among healthcare workers in
China, Thailand or Japan. No additional cases have been reported since 3 January in China.
Additional investigations are needed to determine how the patients were infected, whether human-tohuman transmission has been observed, mode(s) of transmission, the clinical spectrum of disease, and
the extent of infection, including presence of subclinical cases that are undetected with current
surveillance. It is critical to review all available information to fully understand the extent of
transmissibility between people and likelihood of zoonotic spillover. Although the source of the
novel corona virus causing this cluster of pneumonia and the mode(s) of transmission are unknown, it
would be prudent to remind populations and health workers of the basic principles to reduce the
general risk of transmission of acute respiratory infections: Avoiding close contact with people
suffering from acute respiratory infections; Frequent hand-washing, especially after direct contact
with ill people or their environment; Avoiding unprotected contact with farm or wild animals; People
with symptoms of acute respiratory infection should practice cough etiquette (maintain distance,
cover coughs and sneezes with disposable tissues or clothing, and wash hands); Within healthcare
facilities, enhance standard infection prevention and control practices in hospitals, especially in

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emergency departments; WHO does not recommend any specific health measures for travelers. In
case of symptoms suggestive of respiratory illness either during or after travel, the travelers are

encouraged to seek medical attention and share their travel history with their health care provider.
Travel guidance has been updated. Health authorities should work with travel, transport and tourism
sectors to provide travelers with information to reduce the general risk of acute respiratory infections
via travel health clinics, travel agencies, conveyance operators and at points of entry. WHO has
provided interim guidance for novel corona viruses. WHO advises against the application of any
travel or trade restrictions on Japan based on the information currently available on this
event.( />Downloaded on 3/02/2020
B.

Yan (Jan. 22, 2020) told that Beijing has responded faster to the new threat than it did with SARS,
but it still silences and punishes those who veer from the official line, with potentially damaging
consequences. The SARS disaster was supposed to drag China into a new era of openness and
responsibility. The deadly disease rippled across the world 17 years ago, abetted by a Chinese
government that covered up its spread. As the scope of it became clear, China’s journalists,
intellectuals and other critics helped shame Beijing into opening up about the problem.“SARS has
been our country’s 9/11,” said Xu Zhiyuan, then a young newspaper columnist and a fierce critic of
the government’s handling of SARS, in a 2003 interview with The New York Times. “It has forced
us to pay attention to the real meaning of globalization.”Today, China faces the spread of another
mysterious disease, a corona virus, which so far has killed 17 people and infected more than 570.
And while Beijing’s response has improved in some ways, it has regressed in others. It is censoring
criticism. It is detaining people for spreading what it calls “rumors.” It is suppressing information it
deems alarming. Though China’s censors are busily scrubbing the Chinese internet, the country’s
online community is registering its disappointment and alarm over Beijing’s handling of the new
virus that has spread since December from the city of Wuhan to other countries, even the United
States.“I thought SARS would force China to rethink its governance model,” Mr. Xu, now a video
talk show host, wrote on social media on Tuesday, also posting a screenshot of his 2003 quote in The
Times. “I was too naïve.” In many ways, China has changed for the better since the SARS epidemic.
Its economy has grown eightfold. It has built more skyscrapers, subways and high-speed rail lines
than any other country. Its tech companies rival Silicon Valley’s giants. A more responsive
bureaucracy provides more people with health care, social services and even quality-of-life

improvements like parks. When it comes to handling diseases, the public health system has greatly
improved. Wuhan, the epicenter of the outbreak, is also home to one of the most advanced epidemic

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disease research laboratories in the world. Those improvements have come at a price. The
government has tightened its grip on the internet, the media and civil society. It has deeper pockets
and a greater ability to control the flow of information across the country. As a result, many of
the media outlets, advocacy groups, activists and others who held the government accountable in
2003 have been silenced or sidelined “The system is successful in that it destroyed the people with
integrity, the institutions with credibility and a society capable of narrating its own stories,” Mr. Xu
said on social media. “What’s left is an arrogant power, a bunch of messy information and many
fragile, isolated and angry individuals.”Even as the new virus spread through Wuhan, the government
took pains to keep up appearances. The first case was reported Dec. 8. As the disease spread, Wuhan
officials insisted that it was controlled and treatable. The police questioned eight people who posted
on social media about the virus, saying they had spread “rumors.”On Saturday, two days before
Wuhan told the world about the severity of the outbreak, it hosted apotluck banquet attended by more
than 40,000 families so the city could apply for a world record for most dishes served at an event. On
the day it broke the news to the world, it also announced that it was distributing 200,000 free tickets
to residents for festival activities during the Lunar New Year holiday, which begins this Saturday.
The central government backed Wuhan’s officials. Wang Guangfa, a prominent government
respiratory expert, told the state broadcaster China Central Television on Jan. 10 that the Wuhan
pneumonia was “under control” and mostly a “mild condition.” Eleven days later, he confirmed to
Chinese media that he might have contracted the virus himself during an inspection in Wuhan.
Recognizing an outbreak can take time, and China is not the first government caught flat footed by a
disease. But the choices made by government officials had an impact on a major commercial and
transportation hub. Wuhan is a city of 11 million people, including nearly one million college
students from across the country. By the time it disclosed the seriousness of the outbreak, the 40-day
Lunar New Year travel season, when Chinese people take an estimated three billion trips combined,
had already begun. People might have made different decisions had websites and headlines described

growing worries. Instead, they traveled. On Tuesday, all five confirmed cases in Beijing were people
who had traveled to Wuhan in January for business, study or leisure. Until a week ago, some people
in China called it the “patriotic virus." Cases appeared in Hong Kong, Thailand, Vietnam, Japan and
elsewhere in Asia. No other Chinese city but Wuhan reported infection cases. It was not until the
Hong Kong news media reported over the weekend that the virus had been found in other cities did
officials elsewhere come forward. Some critics see parallels to SARS. In 2003, the Guangzhou
newspaper Southern Metropolis Daily first reported the SARS outbreak. A military doctor, Jiang
Yanyong, came forward with what he knew. Only then did officials act.“The way this virus came into

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the public view is the same as that of SARS 17 years ago,” said Rose Luqiu, an assistant journalism
professor who covered SARS as a reporter for the Hong Kong-based Phoenix Television. Many of
those brave voices in 2003 are gone. Like almost all Chinese media outlets that were active in the
1990s and 2000s, the Southern Metropolis Daily has lost its freedom to pursue coverage that holds
local governments, if not Beijing, accountable. Only a few mainland news media outlets are covering
the current crisis critically, and then only with an analytical tone. In 2003, Phoenix Television called
Ms. Luqiu, then a star reporter, back from Iraq to report on SARS in Beijing. She shadowed the
newly appointed Beijing mayor, Wang Qishan, for a week to cover how the government dealt with
the crisis. Mr. Wang later became the vice president of China. That kind of openness is unimaginable
now. Last week, when a group of Hong Kong journalists went to the Wuhan hospital that took in
most corona virus patients, the police detained them for a few hours. They were asked to delete their
TV footage and hand in their phones and cameras for inspection. On Tuesday, Ms. Luqiu wrote an
article for qq.com, the news site owned by the internet giant Tencent, about the measures the Hong
Kong government has taken in dealing with the virus. The article was deleted 10 hours later. Dr.
Jiang, the military doctor who became a whistle-blower in 2003, has been put under periodic house
arrest and forbidden to visit the United States to collect a human rights award. He is also portrayed as
a bad role model. A multiple-choice question posed by a test-prep school in 2017 asked about Dr.
Jiang’s decision. The correct answer was B: It was wrong because it harmed the interests of the
nation, the society and the community and should be subject to legal punishment. China’s disclosures

have improved in many ways since SARS. The government admitted the problem faster. Beijing
officials have shown determination to be more transparent. A top party committee said on Tuesday
that it would not tolerate any efforts to hide infections.“Whoever deliberately delays or conceals
reporting for the sake of their own interests will be forever nailed to history’s pillar of shame,” the
committee said in a post on We Chat. The post was later deleted. But when the government is the
only source of information, wise advice and valuable clues can be lost. A police bureau in eastern
Shandong Province posted on the Twitter-like social media platform Weibo on Wednesday that it had
detained four residents who spread rumors that there was a suspected corona virus patient in the
district. In that environment, others dare not speak out.“The authorities are sending a signal, which is
that only the government agencies can talk about the epidemic,” Yu Ping, a former Southern
Metropolis Daily reporter, wrote on his personal blog. “All other people should just shut up.”“It’s not
public

disclosure,”

Mr.

Yu

added.

“It’s

a

naked

information

monopoly.”( />

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C.

Sheikh eat al told that the scale of an outbreak depends on how quickly and easily a virus is
transmitted from person to person. While research has just begun, scientists have estimated that each
person with the new corona virus could infect somewhere between 1.5 and 3.5 people without
effective containment measures. That would make the virus roughly as contagious as SARS, another
corona virus that circulated in China in 2003 and was contained after it sickened 8,098 people and
killed 774. Respiratory viruses like these can travel through the air, enveloped in tiny droplets that are
produced when a sick person breathes, talks, coughs or sneezes. These droplets fall to the ground
within a few feet. That makes the virus harder to get than pathogens like measles, chickenpox and
tuberculosis, which can travel a hundred feet through the air. But it is easier to catch than H.I.V. or
hepatitis, which spread only through direct contact with the bodily fluids of an infected person.
Corona viruses like the Wuhan virus can travel only about six feet from the infected person. It’s
unknown how long they live on surfaces. Some other viruses, like measles, can travel upto 100 feet
and stay alive on surfaces for hours. If each person infected with the new corona virus infects two to
three others, that may be enough to sustain and accelerate an outbreak, if nothing is done to reduce it.
Here’s how that works. In the animation below, a group of five infected people could spread the virus
to about 368 people over just five cycles of infection. Compare that with a less contagious virus, like
the seasonal flu. People with the flu tend to infect 1.3 other individuals, on average. The difference
may seem small, but the result is a striking contrast: Only about 45 people might be infected in the
same scenario. But the transmission numbers of any disease aren’t set in stone. They can be reduced
by effective public health measures, such as isolating sick people and tracking individuals they’ve
had contact with. When global health authorities methodically tracked and isolated people infected
with SARS in 2003, they were able to bring the average number each sick person infected down to
0.4, enough to stop the outbreak. Health authorities around the world are expending enormous
effort trying to repeat that. So far, the number of cases outside China has been small. But in recent
days, cases have turned up in several countries, including the United States, with people who have
not visited China. And the number of cases within China has accelerated, far surpassing the rate of

new SARS cases in 2003. This is one of the most important factors in how damaging the outbreak
will be, and one of the least understood. It’s tough to assess the lethality of a new virus. The worst
cases are usually detected first, which can skew our understanding of how likely patients are to die.
About a third of the first 41 patients reported in Wuhan had to be treated in an I.C.U., many with
symptoms of fever, severe cough, shortness of breath and pneumonia. But people with mild cases
may never visit a doctor. So there may be more cases than we know, and the death rate may be lower
than we initially thought. At the same time, deaths from the virus may be underreported. The Chinese

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cities at the center of the outbreak face a shortage of testing kits and hospital beds, and many sick
people have not been able to see a doctor.“There’s still a lot of uncertainty about what this virus is
like and what it is doing,” said Dr. Allison Mc Geer, an infectious disease specialist at Mount Sinai
Hospital in Toronto, who was at the frontlines of the Canadian response to SARS. Early indications
suggest the fatality rate for this virus is considerably less than another corona virus, MERS, which
kills about one in three people who become infected, and SARS, which kills about one in 10. All of
the diseases appear to latch on to proteins on the surface of lung cells, but MERS and SARS seem to
be more destructive to lung tissue. As of Jan. 31, fewer than one in 40 of the people with confirmed
infections had died. Many of those who died were older men with underlying health problems. Here’s
how the new corona virus compares with other infectious diseases. Pathogens can still be very
dangerous even if their fatality rate is low, Dr. Mc Geer said. For instance, even though influenza has
a case fatality rate below one per 1,000, roughly 200,000 people end up hospitalized with the virus
each year in the United States, and about 35,000 people die. The time it takes for symptoms to appear
after a person is infected can be vital for prevention and control. Known as the incubation period, this
time can allow health officials to quarantine or observe people who may have been exposed to the
virus. But if the incubation period is too long or too short, these measures may be difficult to
implement. Some illnesses, like influenza, have a short incubation period of two or three days. People
may be shedding infectious virus particles before they exhibit flu symptoms, making it almost
impossible to identify and isolate people who have the virus. SARS, however, had an incubation
period of about five days. In addition, it took four or five days after symptoms started before sick

people could transmit the virus. That gave officials time to stop the virus and effectively contain the
outbreak, Dr. McGeer said. Officials at the Centers for Disease Control and Prevention estimate that
the new corona virus has an incubation period of 2 to 14 days. But it is still not clear whether a
person can spread the virus before symptoms develop, or whether the severity of the illness affects
how easily a patient can spread the virus.“That concerns me because it means the infection could
elude detection,” said Dr. Mark Denison, an infectious disease expert at Vanderbilt University in
Nashville, Tenn. Wuhan is a difficult place to contain an outbreak. It has 11 million people, more
than New York City. On an average day, 3,500 passengers take direct flights from Wuhan to cities in
other countries. These cities were among the first to report cases of the virus outside China. Wuhan is
also a major transportation hub within China, linked to Beijing, Shanghai and other major cities by
high-speed railways and domestic airlines. In October and November of last year, close to two
million people flew from Wuhan to other places within China. China was not nearly as wellconnected in 2003 during the SARS outbreak. Large numbers of migrant workers now travel

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domestically and internationally — to Africa, other parts of Asia and Latin America, where China is
making an enormous infrastructure push with its Belt and Road Initiative. This travel creates a high
risk for outbreaks in countries with health systems that are not equipped to handle them, like
Zimbabwe, which is facing a worsening hunger and economic crisis. Over all, China has about four
times as many train and air passengers as it did during the SARS outbreak. China has taken the
unprecedented step of imposing travel restrictions on tens of millions of people living in Wuhan and
nearby cities. But experts warned that the lockdown may have come too late and limited access to
food and medicine. Wuhan’s mayor acknowledged that five million people had left the city before the
restrictions began, in the run-up to the Lunar New Year.“You can’t board up a germ. A novel
infection will spread,” said Lawrence O. Gostin, a law professor at Georgetown University and
director of the World Health Organization Collaborating Center on National and Global Health Law.
“It will get out; it always does.” In addition to closing off transportation, officials shut down a market
in Wuhan selling live poultry, seafood and wild animals, which was thought to be the origin of the
corona virus, and later suspended the trade of wild animals nationwide. Schools have been closed,
Beijing’s Great Wall is off limits and tourist packages from China have been halted. World Health

Organization officials have praised China’s aggressive response to the virus. But the measures have
also had unintended effects. Residents in Wuhan who are unwell must walk or cycle for miles to get
to hospitals. There, many complain that they are being turned away because of shortages of hospital
beds, staff and supplies that have been made worse by the lockdown. Until recently, researchers
abroad were also concerned by the fact that China was not admitting experts who could help track the
virus and prevent its spread. On Thursday, the W.H.O. declared the outbreak a global health
emergency, acknowledging that the disease represents a risk beyond China. The United States and
Australia are temporarily denying entry to noncitizens who recently traveled to China, and several
major airlines said they expect to halt direct service to mainland China for months. Other countries —
including Kazakhstan, Russia and Vietnam — have temporarily restricted travel and visas. But critics
fear that these measures will not be enough. A corona virus vaccine could prevent infections and stop
the spread of the disease. But vaccines take time. After the SARS outbreak in 2003, it took
researchers about 20 months to get a vaccine ready for human trials. (The vaccine was never needed,
because the disease was eventually contained.) By the Zika outbreak in 2015, researchers had brought
the vaccine development timeline down to six months. Now, they hope that work from past outbreaks
will help cut the timeline even further. Researchers have already studied the genome of the new
corona virus and found the proteins that are crucial for infection. Scientists from the National
Institutes of Health, in Australia and at least three companies are working on vaccine candidates.“If

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we don’t run into any unforeseen obstacles, we’ll be able to get a Phase 1 trial going within the next
three months,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious
Diseases. Dr. Fauci cautioned that it could still take months, and even years, after initial trials to
conduct extensive testing that can prove a vaccine is safe and effective. In the best case, a vaccine
may

become

available

to

the

public a

year

from

now.

( />D.

A World Health Organization (WHO) senior leadership team, led by Director General Dr Tedros
Adhanom Ghebreyesus, today met President Xi Jinping of the People’s Republic of China in Beijing.
They shared the latest information on the outbreak and reiterated their commitment to bring it under
control. The discussions focused on continued collaboration to improve containment measures in
Wuhan, to strengthen public health measures in other cities and provinces, to conduct further studies
and transmissibility of the virus, to continue to share data, and for China to share biological material
with WHO. These measures will advance scientific understanding of the virus and contribute to the
development such as vaccines and treatments. WHO is launching a
Global 2019-nCoV Clinical Data Platform to allow Member States to contribute anonymized clinical
data in order to inform the public health clinical response. WHO is continually monitoring
developments and the Director-General can reconvene the Emergency Committee on very short
notice as needed. Committee members are regularly informed of developments. SITUATION IN
NUMBERS Globally are 4593 confirmed. China total case number confirmed is 4537 and 6973 are
suspected while 976 severe and 106 deaths, Outside of China 56 confirmed 14 countries were
encircle in involved in this game. Similarly Japan 6, Republic of Korea 4, Viet Nam 2 ,Singapore 7.

Australia 5, Malaysia 4, Cambodia 1, Thailand 14, Nepal 1, Sri Lanka 1, United States of America 5
,Canada 2, France 3, Germany 1. Limit human-to-human transmission including reducing secondary
infections among close contacts and health care workers, preventing transmission amplification
events, and preventing further international spread from China; Identify, isolate and care for patients
early, including providing optimized care for infected patients; Identify and reduce transmission
from the animal source; Address crucial unknowns regarding clinical severity, extent of transmission
and infection, treatment options, and accelerate the development of diagnostics, therapeutics and
vaccines;

Communicate critical risk and event information to all communities and counter

misinformation; Minimize social and economic impact through multisectoral partnerships. This can
be achieved through a combination of public health measures, such as rapid identification, diagnosis
and management of the cases, identification and follow up of the contacts, infection prevention and

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control in healthcare settings, implementation of health measures for travelers, awareness- raising in
the population and risk communication. WHO has been in regular and direct contact with Member
States where cases have been reported. WHO is also informing other countries about the situation and
providing support as requested. WHO has developed interim guidance for laboratory diagnosis,
clinical management, infection prevention and control in health care settings, home care for patients
with suspected novel corona virus, risk communication and community engagement. WHO has
provided recommendations to reduce risk of transmission from animals to humans. WHO has
published an updated advice for international traffic in relation to the outbreak of the novel corona
virus 2019-nCoV. Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics.
WHO has developed an online course to provide general introduction to emerging respiratory viruses,
including novel corona viruses. WHO is providing guidance on early investigations, which are
critical to carry out early in an outbreak of a new virus. The data collected from the study protocols
can be used to refine recommendations for surveillance and case definitions, to characterize the key

epidemiological transmission features of 2019-nCoV, help understand spread, severity, spectrum of
disease, impact on the community and to inform operational models for implementation of
countermeasures such as case isolation, contact tracing and isolation. The first protocol that is
available is a: Household transmission investigation protocol for 2019-novel corona virus (2019nCoV) infection. WHO is working with its networks of researchers and other experts to coordinate
global work on surveillance, epidemiology, modeling, diagnostics, clinical care and treatment, and
other ways to identify, manage the disease and limit onward transmission. WHO has issued interim
guidance for countries, updated to take into account the current situation. WHO is working with
global expert networks and partnerships for laboratory, infection prevention and control, clinical
management and mathematical modeling. During previous outbreaks due to other corona virus
(Middle-East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS),
human-to-human transmission occurred through droplets, contact and fomites, suggesting that the
transmission mode of the 2019-nCoV can be similar. The basic principles to reduce the general risk
of transmission of acute respiratory infections include the following: Avoiding close contact with
people suffering from acute respiratory infections. Frequent hand-washing, especially after direct
contact with ill people or their environment.
animals.

Avoiding unprotected contact with farm or wild

People with symptoms of acute respiratory infection should practice cough etiquette

(maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands).
Within healthcare facilities, enhance standard infection prevention and control practices in hospitals,
especially in emergency departments. WHO does not recommend any specific health measures for

This preprint research paper has not been peer reviewed. Electronic copy available at: />

travelers. In case of symptoms suggestive of respiratory illness either during or after travel, travelers
are encouraged to seek medical attention and share their travel history with their healthcare provider.
Travel

guidance

was

updated

on

24

January.

/>
source/coronaviruse/situation-reports/20200128-sitrep-8-ncov-cleared.pdf
E.

Westman (Jan 30, 2020) reported that public health experts around the globe are scrambling to
understand, track, and contain a new virus that appeared in Wuhan, China at the start of December.
You can see where and how many cases have been reported in this map created by US researchers.
So far, there have been nearly 15,000 confirmed cases and 305 deaths. Over 300 people have
recovered from the illness. The majority of the illnesses are in China, but cases have been reported in
nearly two dozen other countries, including the US. No deaths related to the illness have been
reported outside of China. As this important story continues to unfold, The Verge will update this
page with all the latest news and analysis. Our hope to answer all your questions as people work to
understand this virus and contain its spread. At the end of December, public health officials from
China informed the World Health Organization that they had a problem: an unknown, new virus was
causing pneumonia-like illness in the city of Wuhan. They quickly determined that it was a corona
virus, and that it was rapidly spreading through and outside of Wuhan. Corona viruses are common in
animals of all kinds, and sometimes can evolve into forms that can infect humans. Since the start of

the century, two other corona viruses have jumped to humans, causing the SARS outbreak in 2002
and the MERS outbreak in 2012.Scientists think this new virus first became capable of jumping to
humans at the beginning of December. It originally seemed like the virus first infected people at a
seafood market in Wuhan and spread from there. But one analysis of early cases of the illness,
published January 24th, found that the first patient to get sick did not have any contact with the
market. Experts are still trying to trace the outbreak back to its source. The type of animal the virus
originated from is not clear. One team of researchers in China published a report arguing that it came
from snakes, based on the genetic code of the virus. However, scientists are very skeptical of that
conclusion. Another analysis found that the genetic sequence of the new virus is 96 percent identical
to one corona virus found in bats. Both SARS and MERS originated in bats. The new virus isn’t
SARS, although that also began in China. Because it comes from the same viral family as SARS, it
has some similarities, but it’s an entirely new virus. However, the commonalities mean scientists and
public health officials can use what they’ve learned from the past outbreak to try to stop this one.
During the SARS outbreak, Chinese officials attempted to conceal cases from WHO inspectors and
limit information, both internally and externally. This time, officials quickly reported the outbreak of
the new virus to the WHO, which praised their quick response and transparency in a press

This preprint research paper has not been peer reviewed. Electronic copy available at: />

conference. China is also allowing a team of WHO experts to assist Chinese public health officials
with the ongoing work, the organization announced January 28th.The US Department of Health and
Human Services also said China has been more transparent than they were with SARS. “The Chinese
government’s level of cooperation is completely different from what we experienced in 2003,” said
department Secretary Alex Azar during a press conference. But critics and Chinese citizens are
skeptical: there are concerns that Chinese officials are undercounting the number of illnesses and are
classifying deaths that might have been from the virus as being from pneumonia. Wuhan police
also investigated citizens for spreading what it called rumors online a few weeks ago.(It’s important
to note that China isn’t the only country known for concealing the extent of public health problems.
In the US, for example, dozens of cities have concealed the amount of lead in their public water
supply.) It takes information about both how severe an illness is and how easily it can spread to

determine how “bad” it can be. Epidemiologists often use this tool to assess new flus, for example,
and guide decision-making: If an illness isn’t very severe (and kills only a small percentage of
people), but it’s highly transmissible, it can still cause devastating effects — if something affects
millions, the small percentage it kills will still be a high number of fatalities. Researchers are still
trying to understand the symptoms of the corona virus, which have ranged from mild, like those in a
cold, to severe. Around 20 percent of confirmed cases have been severe, according to the WHO.
That’s 20 percent of the cases that we know about — it’s still possible that there are many more mild
cases of the illness that haven’t been flagged, which would shrink the percentage of cases that are
severe. So far, the fatality rate for the new corona virus is around 2 to 3 percent, though that could
continue to change as the outbreak progresses. The fatality rate for SARS was about 14 to 15 percent.
Most deaths in this outbreak have been in older people who have underlying health issues, like heart
disease, hypertension, and diabetes. (That’s the same demographic who is most at risk of dying from
illnesses like the flu.) We don’t yet know how rapidly or easily the virus can spread. In China, sick
people have been infecting others through person-to-person transmission since the start of January,
and the WHO has reported that there have been sustained chains of people passing the virus along
for at least four generations: one person got sick (probably from an animal), passed the virus to
another person, who passed it to another person. People in four countries outside of China —
the US, Germany, Japan, Vietnam — were infected with the corona virus by other people, and not
from direct travel to China. Early evidence suggested that, like other corona viruses, the virus jumps
between people who are in very close contact with each other, and probably spreads when an infected
person sneezes or coughs. But Chinese officials have said that they have seen cases where people
with the virus infected others before they start showing symptoms. A letter to The New England

This preprint research paper has not been peer reviewed. Electronic copy available at: />

Journal of Medicine also details a case where people who didn’t feel sick appeared to infect others in
Germany. If that’s happening regularly, containing the spread of the virus will be more complicated.
There’s still only limited evidence that asymptomatic people can spread the virus, though. And even
if it was happening, it probably wouldn’t significantly affect the outbreak, said Anthony Fauci,
director of the National Institute of Allergy and Infectious Diseases, in a press conference. “Even if

there is some asymptomatic transmission, in all the history of respiratory borne illness, asymptomatic
transmission has never been the driver of outbreaks,” he said. “An epidemic is not driven by
asymptomatic carriers.”The WHO says that researchers think each sick person will go on to infect, on
average, between 1.4 and 2.5 additional people, though that’s only a preliminary estimate. Other
teams of researchers have published their own estimates, with most saying a sick person will infect an
average of around two or three people. Those numbers are called the virus’s R0 (pronounced “Rnaught”). The R0 is the mathematical representation of how well an infection might be able to spread.
The higher the number, the more potentially spreadable it can be. For comparison, the R0 for SARS
was between two and five. But that doesn’t mean each sick person will actually infect that many
people; quarantines and other actions taken to control outbreaks of a virus can bring down the
number of people a sick person infects. If you haven’t recently been to Wuhan, China, or been in
close contact with someone who is sick and has recently been to Wuhan, China, it’s very unlikely you
have this virus. It’s totally normal to feel anxious, though — and there are ways to reduce that
anxiety, like by distracting yourself with other activities, or keeping the risks in perspective.If you
live in the US, it’s far more likely that you have the flu or the common cold. It’s still flu season, and
high levels of flu activity aren’t expected to die down anytime soon. (It’s not too late to get a flu
shot!) If you’re feeling sick and have been to Wuhan, China, or been in close contact with someone
who has, tell your doctor about your symptoms. Based on what we know so far, you can protect
yourself with the same measures you’d take (and should be taking) to protect yourself against the flu:
wash your hands, cover your mouth when you cough, and stay away from people who are sick.The
US State Department raised the travel advisory for China to a level 4, saying Americans shouldn’t
travel to China because of the virus. Level 4 is the most severe warning issued. It applies only to
areas with a “greater likelihood of life-threatening risks.” US citizens currently in China should
“consider departing using commercial means,” the alert said. On January 22nd, officials in Wuhan
shut down all transportation in the city, which is home to over 11 million people. They closed buses
and subways, and canceled all flights and trains in and out of the city. The director general of the
WHO applauded the decision, saying that it would help control the outbreak and slow the spread into
other countries. Fifteen other cities, home to a total of 46 million people, are locked down as

This preprint research paper has not been peer reviewed. Electronic copy available at: />

well, The New York Times reported.However, other officials weren’t sure if these quarantines would
be effective: “To my knowledge, trying to contain a city of 11 million people is new to science,”
Gauden Galea, the World Health Organization’s representative in China, told the Associated Press.
“It has not been tried before as a public health measure. We cannot at this stage say it will or it will
not work.”Major cities across the country canceled celebrations for the Lunar New Year, a huge
holiday in China. Until we know how easily the virus spreads, it’s hard to say how significant of an
effect it could have in the United States. The CDC says the risk to people in the US is currently low.
There have been eight confirmed cases in the US: one in Massachusetts, one in Washington state,
two in Chicago, three in California, and one in Arizona. Seven had recently traveled to Wuhan. One
of the patients in Chicago had not traveled to China and caught the virus from his wife (the other
patient in Chicago), who had traveled there. So far, there have been 241 people under
investigation for the new corona virus in the United States. As of January 29th, 114 of those cases
had tested negative. Testing is still underway for the remaining cases. The agency said it expects to
have more people under investigation and to see more cases in the US as the outbreak progresses.US
Secretary of Health and Human Services Alex Azar declared a public health emergency in response
to the corona virus. All flights from China to the US are being diverted to seven airports, and any US
citizen who has traveled to China will be asked to self-quarantine for 14 days. Any US citizen who
has been in the Hubei province (where Wuhan is, and where the virus originated) will be held under a
formal quarantine for 14 days. In addition, any foreign national who has traveled to China in the past
14 days will not be allowed to enter the US, unless they have immediate family members there,
according to a proclamation from President Trump. That decision is not supported by the WHO,
which said countries should not restrict travel or trade in their response to the virus. A number of
airlines, including United Airlines, British Airways, and Air Canada, are canceling some or all flights
to and from China. United Airlines said their decision to do so was due to a drop in demand for those
flights. Tech companies like Apple started limiting employee travel to China even before the US
State Department and CDC warned people against traveling there. South Korea’s LG banned travel to
China completely, and both Facebook and Razer told employees who had recently returned from
China to work from home. Foxconn, the Taiwanese electronics company that has factories in China
and makes products for tech companies like Apple, said the virus won’t impact their production. But
China has officially extended the recent Lunar New Year holiday in an effort to curb the virus’

spread, which could delay normal production schedules. In a recent earnings call, Apple says it’s
accounted for

this

uncertainty

as

it

looks

ahead

to

the

next

quarter

This preprint research paper has not been peer reviewed. Electronic copy available at: />

( />F.

Callaway (31 JANUARY 2020) reported that with no sign that an outbreak of a new corona
virus is abating, virologists worldwide are itching to get their hands on physical samples of the virus.
They are drawing up plans to test drugs and vaccines, develop animal models of the infection and

investigate questions about the biology of the virus such as how it spreads. “The moment we heard
about this outbreak, we started to put our feelers out to get access to these isolates,” says Vincent
Munster, a virologist at the US National Institute of Allergy and Infectious Diseases in Hamilton,
Montana. His lab is expecting to receive a sample in the next week from the US Centers for Disease
Control and Prevention in Atlanta, Georgia, which has led the response to US cases of the virus. The
first lab to isolate and study the virus, known provisionally as 2019-nCoV, was at the epicenter of the
outbreak: in Wuhan, China. A team at the Wuhan Institute of Virology led by virologist Zheng-Li Shi
isolated the virus from a 49-year-old woman, who developed symptoms on 23 December 2019 before
becoming critically ill. Shi’s team found1 that the virus can kill cultured human cells and that it
enters them through the same molecular receptor as another corona virus: the one that causes SARS
(severe acute respiratory syndrome).A lab in Australia announced on 28 January that it had obtained
virus samples from an infected person who had returned from China. The team was preparing to
share the samples with other scientists. Labs in France, Germany and Hong Kong are also isolating
and preparing to share virus samples they obtained from local patients, says Bart Haagmans, a
virologist at Erasmus Medical Center in Rotterdam, the Netherlands. “Probably next week we will
get isolates from one of the different labs,” he says. The first genome sequence of the virus was made
public in early January, and several dozen — taken from various people — are now available. The
sequences have already led to diagnostic tests for the virus, as well as efforts to study the pathogen’s
spread and evolution. But scientists say that sequences are no substitute for virus samples, which are
needed to test drugs and vaccines, and to study the virus in depth. “It is essential that viruses are
shared,” said Maria Van Kerkhove, an infectious-disease epidemiologist at the World Health
Organization in Geneva, Switzerland, in a 29 January press conference. Munster says that his lab’s
first priority will be to identify animals that experience the infection in a similar way to humans. Such
animal models will be useful for testing vaccines and drugs. The team first plans to look at a mouse
genetically engineered to contain a human version of the receptor that SARS virus and the new
corona virus uses to infect cells. Future work could involve exposing mice and, later, non-human
primates to the virus and testing whether vaccines can prevent infection, he adds. Munster’s lab is
also eager to start gauging how long the virus can survive in the air or in saliva droplets. This could

This preprint research paper has not been peer reviewed. Electronic copy available at: />

help epidemiologists to understand whether the virus can be transmitted through the air, or only
through close contact. Munster’s study will involve aerosolizing virus particles using a container
called a Goldberg drum, and then measuring their ability to infect human cells after periods of time in
the air. Such experiments will be conducted under strict containment measures — known as biosafety
level 3 — to prevent lab workers from becoming infected and to avoid accidental release of the
pathogen. Thousands of such labs exist around the world, but Munster notes that much of the
research on the virus can be done under less stringent biosafety conditions, which should speed the
research.Tracking the spread One of Haagmans’ first priorities will be to develop a blood test for
antibodies against the virus. This will allow researchers to identify people who have been exposed to
2019-nCoV, but are no longer infected and may have never developed symptoms. His team also
hopes to see whether another animal can serve as a model for human infections — ferrets.
Researchers use the animals to study influenza and other respiratory illnesses because their lung
physiology is similar to that of humans, and they are susceptible to some of the same viruses.
Haagmans hopes to test whether they can transmit the virus between them, seeking insights into the
pathogen’s spread between humans. Many of the questions virologists plan to ask about 2019-nCoV
are based on findings from previous studies on the viruses behind SARS and the related Middle East
respiratory syndrome. For instance, there have been signs that a protein needed for the SARS virus to
infect cells has adapted to enter human cells more easily. Although for now Haagmans is scrambling
to get his hands on just one virus sample, he hopes to eventually have multiple samples from over the
course of the outbreak to see whether and how the virus evolves. “We need to get a better
understanding of the biology of the virus, especially compared to viruses that we already know,” he
says. “That’s what we’re going to do( />G.

On 15 January 2020, the Ministry of Health, Labour and Welfare, Japan (MHLW) reported an
imported case of laboratory-confirmed 2019-novel corona virus (2019-nCoV) from Wuhan, Hubei
Province, China. The case-patient is male, between the age of 30-39 years, living in Japan. The casepatient travelled to Wuhan, China in late December and developed fever on 3 January 2020 while
staying in Wuhan. He did not visit the Huanan Seafood Wholesale Market or any other live animal
markets in Wuhan. He has indicated that he was in close contact with a person with pneumonia. On 6
January, he traveled back to Japan and tested negative for influenza when he visited a local clinic on

the same day. On 10 January 2020, due to his continued symptoms of cough, sore throat and fever, he
visited a local hospital and was found to have abnormal chest x-ray with infiltrates. He was admitted
to the hospital on the same day and had remained febrile until 14 January. On 14 January, his
attending doctor notified the case to a local public health authority under the surveillance system for

This preprint research paper has not been peer reviewed. Electronic copy available at: />

“Unidentified Serious Infectious Illness”. Samples were collected and sent to the National Institute of
Infectious Diseases (NIID), and at NIID, polymerase chain reaction (PCR) testing and sequencing
was performed twice, which identified very small amount of 2019-nCoV RNA on 15 January 2020.
On 15 January, the case-patient was a febrile and was discharged from hospital. Currently, he is
staying at home in a stable condition. Contact tracing and other epidemiological investigations are
underway by the local health authorities in Japan; The Japanese Government has scaled up a wholeof-government coordination mechanism on the 16 January; The MHLW has strengthened
surveillance for undiagnosed severe acute respiratory illnesses since the report of undiagnosed
pneumonia in Wuhan, China; From 6 January, MHLW requested local health governments to be
aware of the respiratory illnesses in Wuhan by using the existing surveillance system for serious
infectious illness with unknown etiology; NIID is supporting local authorities on epidemiologic
investigations including contact tracing; Quarantine and screening measures have been enhanced for
travelers from Wuhan city at the point of entries since 7 January; NIID established an in-house PCR
assay for n Co V on 16 January; Revision of the risk assessment by NIID is being conducted,
including case definition of close contacts; The public risk communication has been enhanced; A
hotline has been established among the different ministries in the government; The MHLW is
working closely with WHO and other related Member States to foster mutual investigations and
information sharing. This was the second of three exported cases of novel corona virus from Wuhan
city, China. Since the initial report of cases in Wuhan city on 31 December 2019, and as of 12
January 2020, 41 laboratory-confirmed cases of n CoV infection, including 2 deaths in cases with
underlying medical conditions have been reported to WHO. Two cases have been reported from
Thailand. The source of the outbreak is still under investigation in Wuhan. Preliminary investigations
have identified environmental samples positive for n Co V in Huanan Seafood Wholesale Market in
Wuhan City, however some laboratory-confirmed patients did not report visiting this market. To date,

there is no reported infection among healthcare workers in China, Thailand or Japan. No additional
cases have been reported since 3 January in China. Additional investigations are needed to determine
how the patients were infected, whether human-to-human transmission has been observed, mode(s)
of transmission, the clinical spectrum of disease, and the extent of infection, including presence of
subclinical cases that are undetected with current surveillance. It is critical to review all available
information to fully understand the extent of transmissibility between people and likelihood of
zoonotic spillover. Although the source of the novel corona virus causing this cluster of pneumonia
and the mode(s) of transmission are unknown, it would be prudent to remind populations and health
workers of the basic principles to reduce the general risk of transmission of acute respiratory

This preprint research paper has not been peer reviewed. Electronic copy available at: />

infections: Avoiding close contact with people suffering from acute respiratory infections; Frequent
hand-washing, especially after direct contact with ill people or their environment; Avoiding
unprotected contact with farm or wild animals; People with symptoms of acute respiratory infection
should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues
or clothing, and wash hands); Within healthcare facilities, enhance standard infection prevention and
control practices in hospitals, especially in emergency departments; WHO does not recommend any
specific health measures for travelers. In case of symptoms suggestive of respiratory illness either
during or after travel, the travelers are encouraged to seek medical attention and share their travel
history with their health care provider. Travel guidance has been updated. Health authorities should
work with travel, transport and tourism sectors to provide travellers with information to reduce the
general risk of acute respiratory infections via travel health clinics, travel agencies, conveyance
operators and at points of entry. WHO has provided interim guidance for novel coronaviruses. WHO
advises against the application of any travel or trade restrictions on Japan based on the information
currently available on this event.( Downloaded on 3/02/2020
H..

THUBURN, (28 JAN 2020) reported that the World Health Organization, which has sometimes been
criticized for its handling of past disease outbreaks, admitted an error on Monday in its risk

assessment of China's deadly virus. The Geneva-based UN agency said in a situation report late
Sunday that the risk was "very high in China, high at the regional level and high at the global
level."In a footnote, the WHO explained that it had stated "incorrectly" in its previous reports on
Thursday, Friday and Saturday that the global risk was "moderate”. The correction of the global risk
assessment does not mean that an international health emergency has been declared. The WHO on
Thursday stopped short of declaring the novel corona virus a public health emergency of international
concern - a rare designation used only for the worst outbreaks that would trigger more concerted
global action. The virus, which was first identified in the city of Wuhan in China on December 31,
has since infected more than 2,700 people worldwide, including a few cases identified in over a
dozen other countries. Eighty-one people have died - all of them in China. WHO chief Tedros
Adhanom Ghebreyesus, who is visiting China this week to discuss ways of containing the outbreak,
came under intense questioning from reporters on Thursday over his decision not to declare the
emergency. Some reporters asked whether the decision was politicized. At the briefing at WHO
headquarters, however, Tedros had said that the designation could be changed at any moment and
that the global risk from the outbreak was "high"."This is an emergency in China but it has not yet
become a global health emergency. It may yet become one," he said."WHO's risk assessment is that

This preprint research paper has not been peer reviewed. Electronic copy available at: />

the outbreak is a very high risk in China, and a high risk regionally and globally."WHO said the
categorization was "a global evaluation of risk, covering severity, spread and capacity to cope". The
agency added that the mistake made in three of its situation reports had been an "error in the
wording". Asked about the correction, Antoine Flahault, co-director of the Swiss School of Public
Health, told AFP: "It's a mistake. It's definitely a sizeable one... but I really think it's a mistake that
has now been corrected ".WHO's cautious approach to the outbreak, which has been challenged by
some critics, can be seen in the context of past criticism over its slow or too hasty use of the term,
first used for the deadly 2009 H1N1 swine flu pandemic. During that outbreak, the UN health agency
was criticized for sparking panic-buying of vaccines with its announcement that year that the
outbreak had reached pandemic proportions, and then anger when it turned out the virus was not
nearly as dangerous as first thought. But in 2014, the WHO met harsh criticism for dragging its feet

and downplaying the severity of the Ebola epidemic that ravaged three West Africa countries,
claiming more than 11,300 lives by the time it ended in 2016( />I.

Buckley (Feb, 1, 2020) reported that at critical turning points, Chinese authorities put secrecy and
order ahead of openly confronting the growing crisis and risking public alarm or political
embarrassment. A mysterious illness had stricken seven patients at a hospital, and a doctor tried to
warn his medical school classmates. “Quarantined in the emergency department,” the doctor, Li
Wenliang, wrote in an online chat group on Dec. 30, referring to patients.“So frightening,” one
recipient replied, before asking about the epidemic that began in China in 2002 and ultimately killed
nearly 800 people. “Is SARS coming again?”In the middle of the night, officials from the health
authority in the central city of Wuhan summoned Dr. Li, demanding to know why he had shared the
information. Three days later, the police compelled him to sign a statement that his warning
constituted “illegal behavior.” The government’s initial handling of the epidemic allowed the virus to
gain a tenacious hold. At critical moments, officials chose to put secrecy and order ahead of openly
confronting the growing crisis to avoid public alarm and political embarrassment. A reconstruction of
the crucial seven weeks between the appearance of the first symptoms in early December and the
government’s decision to lock down the city, based on two dozen interviews with Wuhan residents,
doctors and officials, on government statements and on Chinese media reports, points to decisions
that delayed a concerted public health offensive. In those weeks, the authorities silenced doctors and
others for raising red flags. They played down the dangers to the public, leaving the city’s 11 million
residents unaware they should protect themselves. They closed a food market where the virus was
believed to have started, but didn’t broadly curb the wildlife trade. Their reluctance to go public, in

This preprint research paper has not been peer reviewed. Electronic copy available at: />

part, played to political motivations as local officials prepared for their annual congresses in January.
Even as cases climbed, officials declared repeatedly that there had likely been no more infections. By
not moving aggressively to warn the public and medical professionals, public health experts say, the
Chinese government lost one of its best chances to keep the disease from becoming an
epidemic.“This was an issue of inaction,” said Yanzhong Huang, a senior fellow for global health at

the Council on Foreign Relations who studies China. “There was no action in Wuhan from the local
health department to alert people to the threat.”The first case, the details of which are limited and the
specific date unknown, was in early December. By the time the authorities galvanized into action on
Jan. 20, the disease had grown into a formidable threat. It is now a global health emergency. It has
triggered travel restrictions around the world, shaken financial markets and created perhaps the
greatest challenge yet for China’s leader, Xi Jinping. The crisis could upend Mr. Xi’s agenda for
months or longer, even undermining his vision of a political system that offers security and growth in
return for submission to iron-fisted authoritarianism. On the last day of 2019, after Dr. Li’s message
was shared outside the group, the authorities focused on controlling the narrative. The police
announced that they were investigating eight people for spreading rumors about the outbreak. That
same day, Wuhan’s health commission, its hand forced by those “rumors,” announced that 27 people
were suffering from pneumonia of an unknown cause. Its statement said there was no need to be
alarmed.“The disease is preventable and controllable,” the statement said. Dr. Li, an ophthalmologist,
went back to work after being reprimanded. On Jan. 10, he treated a woman for glaucoma. He did not
know she had already been infected with the corona virus, probably by her daughter. They both
became sick. So would he. Hu Xiaohu, who sold processed pork in the Huanan Seafood Wholesale
Market, sensed by late December that something was a miss. Workers were coming down with
nagging fevers. No one knew why but, Mr. Hu said, several were in hospital quarantine. The market
occupies much of a block in a newer part of the city, sitting incongruously near apartment buildings
and shops catering to the growing middle class. It is a warren of stalls selling meats, poultry and fish,
as well as more exotic fare, including live reptiles and wild game that some in China prize as
delicacies. According to a report by the city’s center for disease control, sanitation was dismal, with
poor ventilation and garbage piled on wet floors. In hospitals, doctors and nurses were puzzled to see
a cluster of patients with symptoms of a viral pneumonia that did not respond to the usual treatments.
They soon noticed that many patients had one thing in common: They worked in Huanan market. On
Jan. 1, police officers showed up at the market, along with public health officials, and shut it down.
Local officials issued a notice that the market was undergoing an environmental and hygienic cleanup
related to the pneumonia outbreak. That morning, workers in hazmat suits moved in, washing out

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stalls and spraying disinfectants. It was, for the public, the first visible government response to
contain the disease. The day before, on Dec. 31, national authorities had alerted the World Health
Organization’s office in Beijing of an outbreak. City officials struck optimistic notes in their
announcements. They suggested they had stopped the virus at its source. The cluster of illnesses was
limited. There was no evidence the virus spread between humans. “Projecting optimism and
confidence, if you don’t have the data, is a very dangerous strategy,” said Alexandra Phelan, a faculty
research instructor in the department of microbiology and immunology at Georgetown University.“It
undermines the legitimacy of the government in messaging,” she added. “And public health is
dependent on public trust.”Nine days after the market closed, a man who shopped there regularly
became the first fatality of the disease, according to a report by the Wuhan Health Commission, the
agency that oversees public health and sanitation. The 61-year-old, identified by his last name, Zeng,
already had chronic liver disease and a tumor in his abdomen, and had checked into Wuhan Puren
Hospital with a raging fever and difficulty breathing. The authorities disclosed the man’s death two
days after it happened. They did not mention a crucial detail in understanding the course of the
epidemic. Mr. Zeng’s wife had developed symptoms five days after he did. She had never visited the
market. About 20 miles from the market, scientists at the Wuhan Institute of Virology were studying
samples from the patients checking into the city’s hospitals. One of the scientists, Zheng-Li Shi, was
part of the team that tracked down the origins of the SARS virus, which emerged in the southern
province of Guangdong in 2002. As the public remained largely in the dark about the virus, she and
her colleagues quickly pieced together that the new outbreak was related to SARS. The genetic
composition suggested a common initial host: bats. The SARS epidemic began when a corona virus
jumped from bats to Asian palm civets, a catlike creature that is legally raised and consumed. It was
likely that this new corona virus had followed a similar path — possibly somewhere in or on the way
to the Huanan market or another market like it. Around the same time, Dr. Li and other medical
professionals in Wuhan started trying to provide warnings to colleagues and others when the
government did not. Lu Xiaohong, the head of gastroenterology at City Hospital No. 5, told China
Youth Daily that she had heard by Dec. 25 that the disease was spreading among medical workers —
a full three weeks before the authorities would acknowledge the fact. She did not go public with her
concerns, but privately warned a school near another market. By the first week of January, the

emergency ward in Hospital No. 5 was filling; the cases included members of the same family,
making it clear that the disease was spreading through human contact, which the government had said
was not likely. No one realized, the doctor said, that it was as serious as it would become until it was
too late to stop it. “I realized that we had underestimated the enemy,” she said. At the Institute of

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Virology, Dr. Shi and her colleagues isolated the genetic sequence and the viral strain during the first
week of January. They used samples from seven of the first patients, six of them vendors at the
market. On Jan. 7, the institute’s scientists gave the new corona virus its identity and began referring
to it by the technical shorthand 2019-nCoV. Four days later, the team shared the virus’s genetic
makeup in a public database for scientists everywhere to use. That allowed scientists around the
world to study the virus and swiftly share their findings. As the scientific community moved quickly
to devise a test for exposure, political leaders remained reluctant to act. As the virus spread in early
January, the mayor of Wuhan, Zhou Xianwang, was touting futuristic health care plans for the city. It
was China’s political season, when officials gather for annual meetings of People’s Congresses — the
Communist Party-run legislatures that discuss and praise policies. It is not a time for bad news. When
Mr. Zhou delivered his annual report to the city’s People’s Congress on Jan. 7 against a backdrop of
bright red national flags, he promised the city top-class medical schools, a World Health Expo, and a
futuristic industry park for medical companies. Not once did he or any other city or provincial leader
publicly mention the viral outbreak. Stressing politics is always No. 1,” the governor of Hubei, Wang
Xiaodong, told officials on Jan. 17, citing Mr. Xi’s precepts of top-down obedience. “Political issues
are at any time the most fundamental major issues.”Shortly after, Wuhan went ahead with a massive
annual potluck banquet for 40,000 families from a city precinct, which critics later cited as
evidence that local leaders took the virus far too lightly. As the congress was taking place, the health
commission’s daily updates on the outbreak said again and again that there were no new cases of
infection, no firm evidence of human transmission and no infection of medical workers.“We knew
this was not the case!” said a complaint later filed with the National Health Commission on a
government website. The anonymous author said he was a doctor in Wuhan and described a surge in
unusual chest illnesses beginning Jan. 12. The government’s efforts to minimize public disclosure

persuaded more than just untrained citizens.“If there are no new cases in the next few days, the
outbreak is over,” Guan Yi, a respected professor of infectious diseases at the University of Hong
Kong, said on Jan. 15. The World Health Organization’s statements during this period echoed the
reassuring words of Chinese officials. It had spread. Thailand reported the first confirmed case
outside China on Jan. 13.Officials told doctors at a top city hospital “don’t use the words viral
pneumonia on the image reports,” according to the complaint, which has since been removed. People
were complacent, “thinking that if the official reports had nothing, then we were exaggerating,” the
doctor explained. Even those stricken felt lulled into complacency. When Dong Guanghe developed a
fever on Jan. 8 in Wuhan, his family was not alarmed, his daughter said. He was treated in the
hospital and sent home. Then, 10 days later, Mr. Dong’s wife fell ill with similar symptoms.“The

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news said nothing about the severity of the epidemic,” said the daughter, Dong Mingjing. “I thought
that my dad had a common cold.” The first deaths and the spread of the disease abroad appeared to
grab the attention of the top authorities in Beijing. The national government dispatched Zhong
Nanshan, a renowned and now-semiretired epidemiologist who was instrumental in the fight against
SARS, to Wuhan to assess the situation. He arrived on Jan. 18, just as the tone of local officials was
shifting markedly. A health conference in Hubei Province that day called on medical workers to
make the disease a priority. An internal document from Wuhan Union Hospital warned its employees
that the corona virus could be spread through saliva. On Jan. 20, more than a month after the first
symptoms spread, the current of anxiety that had been steadily gaining strength exploded into public.
Dr. Zhong announced in an interview on state television that there was no doubt that the corona virus
spread with human contact. Worse, one patient had infected at least 14 medical personnel. Mr. Xi,
fresh from a state visit to Myanmar, made his first public statement about the outbreak, issuing a brief
set of instructions. It was only with the order from Mr. Xi that the bureaucracy leapt into action. At
that point the death toll was three; in the next 11 days, it would rise above 200.In Wuhan, the city
banned tour groups from visiting. Residents began pulling on masks. Guan Yi, the Hong Kong expert
who had earlier voiced optimism that the outbreak could level off, was now alarmed. He dropped by
one of the city’s other food markets and was shocked by the complacency, he said. He told city

officials that the epidemic was “already beyond control” and would leave. “I hurriedly booked a
departure,” Dr. Guan told Caixin, a Chinese news organization. Two days later, the city announced
that it was shutting itself down, a move that could only have been approved by Beijing. In Wuhan,
many residents said they did not grasp the gravity of the epidemic until the lockdown. The mass
alarm that officials feared at the start became a reality, heightened by the previous paucity of
information. Crowds of people crushed the airport and train stations to get out before the deadline fell
on the morning of Jan. 23. Hospitals were packed with people desperate to know if they, too, were
infected.“We didn’t wear masks at work. That would have frightened off customers,” Yu Haiyan, a
waitress from rural Hubei, said of the days before the shutdown. “When they closed off Wuhan, only
then did I think, ‘Oh, this is really serious, this is not some average virus.’”Wuhan’s mayor, Zhou
Xianwang, later took responsibility for the delay in reporting the scale of the epidemic, but said he
was hampered by the national law on infectious diseases. That law allows provincial governments to
declare an epidemic only after receiving central government approval. “After I receive information, I
can only release it when I’m authorized,” he said. The official reflex for suppressing discomforting
information now appears to be cracking, as officials at various levels seek to shift blame for the
government’s response. With the crisis worsening, Dr. Li’s efforts are no longer viewed as

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