Death toll from coronavirus is 10 TIMES higher than average in Hubei
Death toll from killer coronavirus is 10 TIMES higher than average in China’s Hubei province because thousands of patients with mild symptoms are not seeking help, scientists claim
- Officials have repeatedly claimed the death toll in China is around two per cent
- But virologists tracking the outbreak say the case-fatality ratio is higher in Hubei
- Imperial College London researchers believe it is closer to the 18 per cent mark
- This is because only the most severe patients are coming forward to be treated
- More than 40,000 patients have been infected, with at least 900 patients dead
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Just under a fifth of cases of the killer coronavirus in Hubei – the deserted Chinese province at the centre of the outbreak – result in death, leading scientists have today claimed.
Officials have repeatedly claimed the death toll is around two per cent, making the SARS-like infection far less deadly than similar coronaviruses and more severe than the flu.
But virologists tracking the escalating outbreak say the case-fatality ratio is much higher in Hubei than elsewhere in China because only the most severe patients are coming forward to be treated.
Figures show the actual toll in Hubei – the province home to Wuhan – is 871 deaths from 29,631 infected patients. But Imperial College London researchers believe it will be closer to the 18 per cent mark.
More than 40,000 people across the world have now caught the unnamed infection, with eight cases now recorded in the UK, 12 in the US and 15 in Australia. The virus is spread on surfaces and through coughs and sneezes.
It comes as the World Health Organization chief today warned the coronavirus crisis publicised so far could ‘only be the tip of the iceberg’ amid fears that thousands of cases are going missing.
Nearly 100 people died from coronavirus in China yesterday on the deadliest day of the six-week outbreak so far. But the number of new patients diagnosed appears to be dropping day-by-day.
More than 40,000 people have been infected with the virus and 910 are confirmed to have died, all but two of them in China
More than 40,000 people have now caught the killer coronavirus – nearly 99 per cent of the cases have been recorded in China
What is this virus?
The virus has been identified as a new type of coronavirus. Coronaviruses are a large family of pathogens, most of which cause mild lung infections such as the common cold.
But coronaviruses can also be deadly. SARS, or severe acute respiratory syndrome, is caused by a coronavirus and killed hundreds of people in China and Hong Kong in the early 2000s.
Can the Wuhan coronavirus kill?
Yes – 910 people have so far died after testing positive for the virus.
What are the symptoms?
Some people who catch the Wuhan coronavirus may not have any symptoms at all, or only very mild ones like a sore throat or a headache.
Others may suffer from a fever, cough or trouble breathing.
And a small proportion of patients will go on to develop severe infection which can damage the lungs or cause pneumonia, a life-threatening condition which causes swelling and fluid build-up in the lungs.
How is it detected?
The virus’s genetic sequencing was released by scientists in China and countries around the world have used this to create lab tests, which must be carried out to confirm an infection.
Delays to these tests, to test results and to people getting to hospitals in China, mean the number of confirmed cases is expected to be just a fraction of the true scale of the outbreak.
How did it start and spread?
The first cases identified were among people connected to the Huanan Seafood Wholesale Market in Wuhan.
Cases have since been identified around China and are known to have spread from person to person.
What are countries doing to prevent the spread?
Countries all over the world have banned foreign travellers from crossing their borders if they have been to China within the past two weeks. Many airlines have cancelled or drastically reduced flights to and from mainland China.
Is it similar to anything we’ve ever seen before?
Experts have compared it to the 2003 outbreak of severe acute respiratory syndrome (SARS). The epidemic started in southern China and killed more than 700 people in mainland China, Hong Kong and elsewhere.
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In comparison to other coronaviruses, the new strain, first found in Wuhan and thought to have spread to humans from a traditional wet market, is much less deadly.
Figures show the highly contagious severe acute respiratory syndrome (SARS), which also began in China, killed around 10 per cent of the 8,000 patients it struck during a worldwide epidemic in 2002/03.
And the World Health Organization says the death rate for Middle East respiratory syndrome coronavirus (MERS) is even higher – at around 34 per cent. It was first reported in Saudi Arabia in 2012.
One of the world’s deadliest diseases, Ebola, kill around half of all patients it strikes. Ebola is much different to this new coronavirus because it is caused by a separate family of viruses.
The Imperial College London team, who has tracked the coronavirus outbreak first began six weeks ago, said they estimate the overall case-fatality ratio is still likely to be around one per cent.
Experts have repeatedly said potentially thousands of patients may not go to their doctor for treatment because they may have such minor symptoms – such as a cough and fever – that they do not need to seek help.
Professor Neil Ferguson, who led the Imperial team, wrote: ‘Outside mainland China, countries alert to the risk of infection being imported via international travel have instituted surveillance for 2019-nCoV infection with a broader set of clinical criteria for defining a suspected case, typically including a combination of symptoms (cough and fever) combined with recent travel history to the affected region (Wuhan/Hubei).
‘Such surveillance is therefore likely to pick up clinically milder cases as well as the more severe cases also being detected in mainland China.
‘However, by restricting testing to those with a travel history or link, it is also likely to miss other symptomatic cases (and possibly hospitalised cases with atypical pneumonia) that have occurred through local transmission or through travel to other affected areas of China.’
The researchers added: ‘It is important to note that the differences in these estimates does not reflect underlying differences in disease severity between countries.
‘CFRs seen in individual countries will vary depending on the sensitivity of different surveillance systems to detect cases of differing levels of severity and the clinical care offered to severely ill cases.
‘All CFR estimates should be viewed cautiously at the current time as the sensitivity of surveillance of both deaths and cases in mainland China is unclear.’
Figures also show 910 people have now died across the world, with all but two deaths recorded in mainland China
HOW THE VIRUS HAS SPREAD OVER TIME
The vast majority of coronavirus cases have been in mainland China, but more than 25 other countries and territories have declared infections:
- Belgium: 1 case, first case February 4
- Spain: 2 case, first case January 31
- Sweden: 1 case, first case January 31
- Russia: 2 cases, first case January 31
- UK: 8 cases, first case January 31
- India: 3 cases, first case January 30
- Philippines: 3 cases, first case January 30
- Italy: 3 cases, first case January 30
- Finland: 1 case, first case January 29
- United Arab Emirates: 7 cases, first case January 29
- Germany: 14 cases, first case Jan 27
- Sri Lanka: 1 case, first case Jan 27
- Cambodia: 1 case, first case Jan 27
- Canada: 7 cases, first case Jan 25
- Australia: 15 cases, first case Jan 25
- Malaysia: 18 cases, first case Jan 25
- France: 11 cases, first case January 24
- Nepal: 1 case, first case January 24
- Vietnam: 14 cases, first case Jan 24
- Singapore: 43 cases, first case January 23
- Macau: 10 cases, first case Jan 22
- Hong Kong: 36 cases, first case January 22
- Taiwan: 18 cases, first case Jan 21
- USA: 12 cases, first case January 20
- South Korea: 27 cases, first case January 20
- Japan: 156 cases, first case January 16
- Thailand: 32 cases, first case Jan 13
Professor Ferguson added: ‘It’s not more severe in Hubei than elsewhere. It’s just that they’re only detecting and reporting the most severe cases there. We estimate there are at least 10 times more cases than reported in Hubei. Most of which likely have rather milder symptoms.’
In other developments today, police in the UK have been given the power to seize people trying to escape coronavirus quarantine and force them back into isolation in handcuffs.
A law-change was revealed after an patient staying at Arrowe Park Hospital on the Wirral tried to leave before completing the 14-day stay after his return from China.
Government sources said those who returned to the UK on the evacuation flights on January 31 were given a ‘very clear choice’ and had to sign contracts saying they would remain in isolation for a fortnight.
But a source involved with the Arrowe Park incident said: ‘We found we didn’t have the necessary enforcement powers to make sure they didn’t leave.’
Police will now be able to force people to remain in the units and, if they leave, to arrest them for committing an offence and take them back to the quarantine facility, MailOnline understands.
The new rule comes as England today announced its fifth, sixth, seventh and eighth cases of the virus – all of the three men and a woman are linked to the fourth patient, who has now been dubbed a ‘super-spreader’.
The fourth patient was a businessman who returned to the UK from a conference in Singapore via a ski chalet in France, where other Britons were subsequently taken ill with the virus.
The Department of Health today declared the outbreak a ‘serious and imminent’ threat to the British public as it announced new powers to fight the spread.
In other developments to the outbreak today:
- World Health Organization chief warns coronavirus outbreak could ‘only be the tip of the iceberg’ amid fears thousands of cases are going missing
- Just under a fifth of known cases of the new coronavirus in China may be resulting in death, a new report estimates
- The coronavirus can survive on door handles and bus or train poles for up to nine days – more than four times longer than flu, according to research
- London’s FTSE 100 weakened after Mr Hancock declared the coronavirus outbreak a serious and imminent threat to public health
- Nearly 100 people died from coronavirus in China yesterday on the deadliest day of the six-week outbreak so far
- Amazon and Sony are the latest companies to pull out of this month’s Mobile World Congress, due to be held in Barcelona, because of the coronavirus outbreak
- Sixty-six more passengers on a cruise ship in Japan have been diagnosed the killer infection, taking the ship’s toll to around 136
A total of five people have now been diagnosed in Brighton. The four new cases have been linked to the first man who was diagnosed there after returning from the Alps
WHAT DO WE KNOW ABOUT THE DEADLY CORONAVIRUS IN CHINA?
Someone who is infected with the Wuhan coronavirus can spread it with just a simple cough or a sneeze, scientists say.
At least 910 people with the virus are now confirmed to have died and more than 40,640 have been infected in at least 28 countries and regions. But experts predict the true number of people with the disease could be 100,000, or even as high as 350,000 in Wuhan alone, as they warn it may kill as many as two in 100 cases. Here’s what we know so far:
What is the Wuhan coronavirus?
A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.
The coronavirus from Wuhan is one which has never been seen before this outbreak. It is currently named 2019-nCoV, and does not have a more detailed name because so little is known about it.
Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals.
‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses).
‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’
The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started seeing infections on December 31.
By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.
The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000.
Just a week after that, there had been more than 800 confirmed cases and those same scientists estimated that some 4,000 – possibly 9,700 – were infected in Wuhan alone. By that point, 26 people had died.
By January 27, more than 2,800 people were confirmed to have been infected, 81 had died, and estimates of the total number of cases ranged from 100,000 to 350,000 in Wuhan alone.
By January 29, the number of deaths had risen to 132 and cases were in excess of 6,000.
By February 5, there were more than 24,000 cases and 492 deaths.
Where does the virus come from?
According to scientists, the virus has almost certainly come from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.
The first cases of the virus in Wuhan came from people visiting or working in a live animal market in the city, which has since been closed down for investigation.
Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat.
A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent similar to a coronavirus they found in bats.
There may have been an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human, researchers suggested, although details of this are less clear.
Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.
‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’
So far the fatalities are quite low. Why are health experts so worried about it?
Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.
It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs.
Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.
Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.
‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’
If the death rate is truly two per cent, that means two out of every 100 patients who get it will die.
‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.
‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’
How does the virus spread?
The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.
It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky.
Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person.
There is now evidence that it can spread third hand – to someone from a person who caught it from another person.
What does the virus do to you? What are the symptoms?
Once someone has caught the virus it may take between two and 14 days for them to show any symptoms – but they may still be contagious during this time.
If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients – at least 97 per cent, based on available data – will recover from these without any issues or medical help.
In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.
What have genetic tests revealed about the virus?
Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world.
This allows others to study them, develop tests and potentially look into treating the illness they cause.
Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.
However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, yesterday said the virus was mutating and adapting as it spread through people.
This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.
More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.
How dangerous is the virus?
The virus has so far killed 910 people out of a total of at least 40,640 officially confirmed cases – a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.
However, experts say the true number of patients is likely considerably higher and therefore the death rate considerably lower. Imperial College London researchers estimate that there were 4,000 (up to 9,700) cases in Wuhan city alone up to January 18 – officially there were only 444 there to that date. If cases are in fact 100 times more common than the official figures, the virus may be far less dangerous than currently believed, but also far more widespread.
Experts say it is likely only the most seriously ill patients are seeking help and are therefore recorded – the vast majority will have only mild, cold-like symptoms. For those whose conditions do become more severe, there is a risk of developing pneumonia which can destroy the lungs and kill you.
Can the virus be cured?
The Wuhan coronavirus cannot currently be cured and it is proving difficult to contain.
Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.
No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.
The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.
Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.
People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.
And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).
However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.
Is this outbreak an epidemic or a pandemic?
The outbreak is an epidemic, which is when a disease takes hold of one community such as a country or region.
Although it has spread to dozens of countries, the outbreak is not yet classed as a pandemic, which is defined by the World Health Organization as the ‘worldwide spread of a new disease’.
The head of WHO’s global infectious hazard preparedness, Dr Sylvie Briand, said: ‘Currently we are not in a pandemic. We are at the phase where it is an epidemic with multiple foci, and we try to extinguish the transmission in each of these foci,’ the Guardian reported.
She said that most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.
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