1/30/20, 11(14 AMWhat to Know About the New Chinese Coronavirus - WSJ

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Concerns are growing about the deadly new virus behind a fast-spreadingepidemic in China. The number of people ill with or dying of a viralpneumonia caused by the new coronavirus is rising rapidly, despitequarantines of millions of people and other measures to try to stop it. Thevirus has been carried by travelers to other countries, including the U.S.Stock prices have fallen as investors have grown worried about thepotential global impact if the epidemic can’t be stopped.

Very little is known about this virus, which for the moment carries thescientific name 2019-nCoV, meaning “novel coronavirus.” Scientists areracing to learn more. Key questions to answer are how long the incubationperiod is, how long someone is infectious, and whether or not people can beasymptomatic and spread the virus, says Ian Lipkin, director of the Centerfor Infection and Immunity at Columbia University’s Mailman School ofPublic Health.

Here is what scientists and public-health officials know so far.

How dangerous is the new coronavirus?It appears to be less deadly than a related pathogen — severe acuterespiratory syndrome, or SARS, which erupted in China in 2002 and spreadglobally in 2003. SARS killed about 10% of the people it infected, while about3% of the people confirmed to be infected with this new coronavirus havedied. Many of those who have died are elderly or have other illnesses such asdiabetes.

But the new virus may spread from one person to another more easily thanSARS, some early disease modeling suggests.

What is a coronavirus?This new virus belongs to a family of viruses known as coronaviruses.Named for the crown-like spikes on their surfaces, they infect mostly bats,

BUSINESS | HEALTH CARE | HEALTH

What to Know About the New ChineseCoronavirus

Coronaviruses mutate easily but there’s no sign of changes in this virus so far

Updated Jan. 29, 2020 1:18 pm ET

By Betsy McKay

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pigs and small mammals. But they mutate easily and can jump from animalsto humans, and from one human to another. In recent years, they havebecome a growing player in infectious-disease outbreaks world-wide.

Seven strains are known to infect humans, including this new virus, causingillnesses in the respiratory tract. Four of those strains cause common colds.Two others, by contrast, rank among the deadliest of human infections:SARS and Middle East respiratory syndrome, or MERS.

Where did this new coronavirus come from?The new virus likely came from bats, scientists say. It isn’t known exactlywhere or how it jumped to humans, though. Health officials believe theoutbreak originated in a large animal and seafood market in Wuhan, China.

Of the first 41 cases, 27 had some exposure to that market, according toa report in the medical journal the Lancet. But three of the first four

people to become ill, on Dec. 1 and Dec. 10, said they had no contact with themarket. Scientists say it will take some time to identify the exact source.

How is the virus spread among humans?It is likely spread through a cough, kiss or other contact with saliva, Chineseofficials say. MERS and SARS spread mainly through “respiratory droplets”produced when someone coughs or sneezes. Those two viruses spreadmostly through close contact.

Can face masks protect you?Health experts and mask makers say only a properly used reusable N95respirator mask certified by an independent agency can both guard againstthe virus and protect others. Paper or polyurethane foam masks don’t filterout smaller particles responsible for transmitting infectious agents.

How easily does the new virus spread?Disease-modeling experts at Imperial College London estimated late lastweek that on average, each infected person transmitted the virus to 2.6others. The World Health Organization said last week early indications werethat that rate is between 1.4 and 2.5. Those rates are higher than for someinfluenza viruses, but far lower than measles, in which one infected personcan transmit the virus to 12 to 18 other people.

Public-health experts caution that these estimates are very preliminary,change over time, and can be lowered by measures to prevent the virus fromspreading.

Is it safe to travel to China?The U.S. State Department has issued a travel advisory, urging Americans toreconsider travel to China due to the risk of infection in Wuhan as well asquarantines imposed in numerous cities around the country. The CDCrecommends avoiding all nonessential travel to China. Those individuals

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who do go should avoid contact with sick people, animals, animal marketsand uncooked meat from those markets, the CDC says.

Airlines are allowing people to change their flights to, from or throughChina. U.S. airlines haven’t broadened their change-fee waivers beyondChina.

Should foreigners who are working in China or planning onvisiting change their plans?Companies in China are trying to head off the spread in their offices.Smartphone maker Xiaomi Corp., based in Beijing, has asked employees towait for 14 days after traveling to Hubei to ensure they don’t have symptomsbefore going into the office. Those in Hubei should work from home untilfurther notice, the company said in an email to staff.

TikTok-owner ByteDance Inc. issued a notice urging employees in mainlandChina to work from home until a week beyond the extended holiday.Shenzhen-based games and social-media giant Tencent Holdings Ltd. sentout a note telling local staff to do the same.

Can you catch the virus from someone even before they havesymptoms?It’s possible. But little is known so far. In Macau, a 15-year-old resident ofWuhan, the epicenter of the outbreak, tested positive for the coronavirusdespite having no fever or cough, said that special administrative region ofChina. Scientists reported in the Lancet that they identified the coronavirusin a 10-year-old boy who developed no symptoms, even though others in thechild’s family fell ill. Chinese news outlets have reported a handful of otherpotential asymptomatic cases.

Patients who either have no symptoms or haven’t developed them yetappear to be able to spread the virus, according to Ma Xiaowei, head of

China’s cabinet-level National Health Commission.

A Public Health England sign warns passengers at London’s Heathrow Airport of the virus. PHOTO:DANIEL LEAL-OLIVAS/AGENCE FRANCE-PRESSE/GETTY IMAGES

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The U.S. Centers for Disease Control and Prevention says it hasn’t seenevidence of patients being infectious before symptom onset, but ismonitoring for them in the U.S.

What are the symptoms of illness and how do you know if youhave it?The virus infects the lower respiratory tract. Patients initially develop afever, cough and aches, and can progress to shortness of breath andcomplications from pneumonia, according to case reports. Some patientsbecome only mildly ill. Others are mildly ill for a few days, then rapidlydevelop more severe symptoms of pneumonia.

Some patients have not had a fever initially or develop a “walkingpneumonia,” meaning they may spread their infection to others becausethey aren’t sick enough to be in a hospital.

What is the incubation period?People become ill between two and 14 days after infection, according to theU.S. CDC.

Is there a test?Public-health officials have developed and distributed diagnostic tests,which are being used to confirm whether a patient has the new coronavirusor another infection. The growing availability of tests is one reason morepeople are being diagnosed.

Who is most at risk?Adults of all ages have been infected. Nearly three-quarters of the initial 41patients were male. Many of the first patients who died were over 60 yearsold, had other illnesses such as diabetes and were admitted to hospitalswhen their illness was advanced. Few children have been reported with theinfection, but that could change.

Is the virus mutating, particularly in a way that would make itmore contagious?No. The virus has remained stable genetically thus far, according to theWorld Health Organization and the U.S. CDC.

What is being done to contain the spread of the virus?China imposed quarantines on Wuhan, the epicenter of the outbreak, and

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several other cities, affecting millions of citizens. Officials are also buildinga large field hospital in Wuhan to isolate and care for patients, andinvestigating chains of transmission. But these measures are failing to slowthe spread.

Many people left ahead of the quarantine. The new virus hit during a heavytravel period for China, when tens of millions of people visit family andsometimes tack on additional leisure travel. The mayor of Wuhan, whosepopulation is 11 million, said Sunday that five million people had left. It isn’tknown how many of those people were fleeing the virus or just embarkingon holiday trips.

Other countries are screening passengers arriving from China.

Hong Kong now requires visitors from mainland China to fill out healthdeclaration forms before entering the city through the airport or high-speedrail station and is working to implement that at other points of entry,according to city authorities. Hong Kong Chief Executive Carrie Lam saidSaturday that health authorities are also working to screen moreaggressively for fevers at the border.

The U.S. is screening passengers arriving from Wuhan at five major airports.Those who have a fever are then screened for other symptoms. U.S. officialsare considering expanding the screening, but haven’t provided details.

Are there drugs to treat coronaviruses?There aren’t any drugs or vaccines approved specifically for the new virus.No antiviral treatment has proven effective against coronaviruses. But onehospital in Wuhan has started a clinical trial using a combination of twodrugs that had been tested on MERS patients in Saudi Arabia. The therapy,sold under the brand name Kaletra in the U.S., is normally used to treat HIVpatients and belongs to a class of drugs known as protease inhibitors, whichblock a key enzyme that helps viruses replicate. Researchers are alsoinvestigating other antivirals. In addition, a few vaccine makers are

A health official watches travellers on a thermographic monitor at the Sultan Iskandar MudaInternational Airport in Indonesia. PHOTO: ZIKRI MAULANA/ZUMA PRESS

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developing products targeting the virus.

How at risk is someone in the U.S.?The risk to the U.S. public is low, the CDC says. In addition to screeningarriving international passengers, the agency has urged health-careproviders around the country to be on the lookout for patients withsymptoms and a history of travel to China. More than 100 potential caseshave been screened, with five cases confirmed. There has been no human-to-human transmission in the U.S.

Could goods imported from China carry the virus?That’s unlikely, the CDC says. Coronaviruses generally don’t survive long oninanimate surfaces, according to the agency.

—Lucy Craymer, Fanfan Wang, Qianwei Zhang, Lekai Liu and Wenxin

Fan contributed to this article.

Write to Betsy McKay at betsy.mckay@wsj.com

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