Sun, Feb 09, 2020 - Page 7 News List

US prepares for coronavirus pandemic that some experts now see as likely

While the disease can cause severe cases that prove fatal, many of those infected only have mild cold-like symptoms, increasing the chance that they could pass it on before they are aware of the situation

By Robert Langreth and Michelle Cortez  /  Bloomberg

“So many people are coming in ill, it is hard to keep track of the numbers,” Frieden said.

Epidemiologists are struggling to predict how the outbreak might evolve over time. The lack of tests to detect the disease, the potential for patients to be infected with only mild or no symptoms and the overwhelmed healthcare system in China has cast doubt on the accuracy of the numbers that the government is providing.

One set of researchers from the University of Hong Kong estimated in The Lancet medical journal that there were more than 75,000 cases in Wuhan as of Jan. 25, with cases doubling every 6.4 days.

Another group estimated that only 5 percent of cases in the outbreak’s center in Wuhan have been identified.

This group, led by researcher Jonathan Read, from the Center for Health Informatics, Computing and Statistics at Lancaster Medical School in the UK, estimated that more than 100,000 people in Wuhan were infected by Wednesday last week.

The estimate was posted on the Web site medRxiv and has not been reviewed by other experts.

The likely higher number of cases is good and bad. Bad because more people have it and are spreading it, good because the case-fatality rare — now at about 2 percent, based only on confirmed patients — is likely to come down substantially as mild cases are accounted for.

What makes the new coronavirus hard to stop is that it is somewhat between the common cold, which is often caused by coronaviruses, and SARS in severity. The SARS epidemic — the first coronavirus to spark a deadly outbreak — started in China in late 2002, eventually infecting more than 8,000 people and killing nearly 800 worldwide before it burned itself out.

Like SARS, the new coronavirus sometimes causes severe case that can kill, although it appears to do so at a much lower rate.

Unlike SARS, many who appear to get the new coronavirus have mild cold-like symptoms. That makes it much harder to stop, as people might have passed it on before the realized what they had.

Of the confirmed cases in the US, most people contracted the virus in the Wuhan area. Illustrating how easily the disease spreads, two others — a man in Illinois and a woman in California — acquired it from their spouses after they returned from China. While some of these patients are being treated in hospitals, others have been asked to stay home and self-isolate, keeping the virus out of medical centers.

Hospitals are on alert. Providence St Joseph Health, a chain of 51 hospitals and more than 1,000 clinics in seven western US states, treated the first US coronavirus case at one of its hospitals.

“As soon as we got our initial patient it was our wake-up call,” said Amy Compton-Phillips, chief clinical officer of Providence St Joseph Health.

The hospital system has set up alerts in its electronic medical records system, prompting staff to ask potential patients about travel to China, or if they have been in touch with somebody who has. The initial patient has been discharged, but remains in isolation.

“We are working very hard to prevent another flu-like illness from becoming endemic in the US,” Compton-Phillips said.

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