There are 15 confirmed cases in the United States, more than 1,700 Chinese healthcare workers have been infected, and thousands remain quarantined on a cruise ship near Tokyo.

A Coronavirus outbreak that originated in China continues to spread rapidly, and has now infected more than 73,000 people and claimed 1,873 lives.

Chinese health officials Reported last week that more than 1,700 healthcare workers in China have contracted the virus, six of whom died from it. Almost 90 percent of these workers are in the Hubei province, where Wuhan, the epicenter of the virus, is located.The number of cases in the province jumped significantly last week, with close to 15,000 more cases reported — a drastic increase due largely to the implementation of new and faster diagnostic methods, the World Health Organization (WHO) reported on Thursday. In addition to lab tests, computerized tomography (CT) scans are now being used there to detect lung infections caused by the virus. Outside of the Hubei province, laboratory confirmation for reporting of the virus is still required.

Officially named COVID-19 by the WHO, the virus was responsible this week for the first death of a person in Japan, the third to be reported outside mainland China. The others occurred in the Philippines and Hong Kong.

Two more cases in the United States were confirmed by the Centers for Disease Control and Prevention (CDC), with one each in Texas and California, bringing the total in the country to 15. Both patients are currently under federal quarantine and had recently been repatriated from Wuhan. A case was also reported in a patient in London for the first time, bringing the total number of cases in the United Kingdom to nine.

More than 3,700 passengers and crew members remain stranded on a cruise ship in Yokohama, Japan, under a quarantine that is planned to end on February 19. Japanese health officials confirmed dozens of more cases aboard the ship this week, bringing the total to 218, reported the WHO. Those who’ve tested positive for the virus are being evacuated off the ship to nearby hospitals.

The number of cases of the coronavirus has far surpassed the 8,000-plus cases of severe acute respiratory syndrome (SARS) confirmed during that outbreak in 2003. At least two dozen countries have been affected by COVID-19.

At a press conference on Monday, February 10, WHO Director-General Thedros Adhanom Ghebreyesus, PhD, said there have been concerning instances of onward transmission from people with no travel history in China, like recent cases reported in France and the United Kingdom.

“The detection of this small number of cases could be the spark that becomes a bigger fire,” he says. “But for now, it’s only a spark. We call on all countries to use the window of opportunity to prevent a bigger fire.”

As of this week, the CDC has been investigating 467 potential cases across 42 states. U.S. Health and Human Services Secretary Alex M. Azar II has declared the outbreak a public health emergency in the United States, and the WHO has declared the situation to be a public health emergency of international concern.

The U.S. Department of State has issued a “Level 4: Do Not Travel” advisory to China, but according to CDC Director Robert R. Redfield, MD, the immediate risk of the disease to the American public is still “low.” Dr. Ghebreyesus says most cases are mild, with roughly 2 percent resulting in death.

In a new study from a single hospital published February 7, 2020, in the Journal of the American Medical Association, more than 40 percent of patients were suspected to have contracted the virus through hospital-related transmissions. The study reported a death rate of more than 4 percent, with around one-quarter of the cases requiring ICU care.

The virus has spread to at least 24 countries, included among them Australia, Belgium, Cambodia, Canada, Finland, France, Germany, Hong Kong, India, Japan, Macao, Malaysia, Nepal, Singapore, South Korea, Sri Lanka, Taiwan, Thailand, Vietnam, and the United States.

Around 60 million people are under lockdown in China, and 20 U.S. airports are screening for the coronavirus in people who have traveled to affected areas, the CDC and U.S. Department of Health and Human Services reported. In Australia, people evacuated from Wuhan have been flown to Christmas Island, a remote island around 2,000 miles away, where they will be quarantined for two weeks.

The CDC issued orders that U.S. citizens who have been evacuated from China be quarantined for 14 days. Meanwhile, United, American, and Delta airlines announced plans to suspend flights to and from mainland China.The uptick in cases raises questions about how easily and rapidly the coronavirus can spread between humans. A case involving the spouse of an Illinois woman who had been previously diagnosed with the virus marked the first instance of human-to-human transmission in the United States, and a second case of person-to-person transmission, in California, was reported in early February. The virus had previously been detected in the country only among patients who had recently traveled from Wuhan.

What Is a Coronavirus?

The strain 2019-nCoV is part of the family of coronaviruses that range from the common cold to Middle East respiratory syndrome (MERS) and SARS, according to William Schaffner, MD, professor of preventive medicine in the department of health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee.

During a SARS outbreak between November 2002 and July 2003, there were 8,098 probable cases reported to the WHO, including 29 cases from the United States, according to the CDC. There were also 774 SARS-related deaths, none of them among the U.S. cases.

Coronaviruses commonly circulate in animals, which experts estimate are responsible for about 60 percent of human infectious diseases, noted an article published in March 2018 in TuftsNow. When a virus is transmitted between animals and humans, it’s called a spillover event. In fact, some researchers believe that the new strain may have been passed from bats to humans via an intermediary animal, the pangolin.

“Although these viruses have similarities, it’s like an extended family. You can distinguish among your different cousins even though they are part of the same family,” says Dr. Schaffner. “This new virus is part of the ‘family,’ but we’re just beginning to learn about how much it’s the same or different from these other coronaviruses.”

For example, SARS was more easily transmitted from person to person than MERS, which is not as transmissible between people, he says. “People seem to acquire MERS largely from camels,” says Schaffner.

“We’ve been concerned and actually expecting that there would be some person-to-person transmission [of this coronavirus],” Schaffner says.“There is a reported episode of a patient who seems to have transmitted this new coronavirus to 14 healthcare workers,” he adds. “We would designate that person a ‘super-spreader’: someone who is very readily able to spread through close contact. How common that is, we don’t know. That’s usually a pretty unusual event, so we hope that that’s not the norm. However, we don’t know how frequently human-to-human transmission is occurring. There are all kinds of little question marks that have come up.”

2019 Coronavirus Origins

Known as 2019-nCoV, the coronavirus appears to have originated in the central Chinese city of Wuhan. Chinese health officials suspect that the outbreak began at a large seafood and animal market in Wuhan, suggesting that the virus began as an animal-to-person spread, according to the CDC, and then began to transmit from person-to-person. Two people in the Guangdong province in southern China had contracted the virus from family members, and some medical workers also tested positive for the virus.

“The major source of the virus is thought to be this live animal market, which has subsequently closed,” Schaffner says. “But there are a number of patients who have already been reported who have not had direct contact with this market.”

Do I Need to Take Extra Precautions Because of the New Virus?

For people who are concerned about their risk due to travel or potential contact through visitors, extra precautions can be taken. In a WHO video about the coronavirus, Maria Van Kerkhove, MD, an infectious-disease epidemiologist and technical consultant for WHO, makes the following recommendations:

• Because coronavirus typically causes respiratory symptoms, basic hand hygiene, such as washing your hands with soap and water, is recommended.
• Practice respiratory hygiene by sneezing into your elbow.
• Protect yourself against a potential animal source by avoiding unnecessary unprotected contact with live animals. Make sure you wash your hands thoroughly after contact with an animal.
• Make sure meat is cooked thoroughly before consuming.

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