Transmission route for ‘cunning virus’ remains undecided

By GT staff reporters Source:Global Times Published: 2020/2/16 22:58:40

A cured COVID-19 patient waves goodbye to a medical worker at the "Wuhan Livingroom" makeshift hospital in Wuhan, central China's Hubei Province, Feb. 15, 2020. Photo: Xinhua


More encouraging signs have emerged outside of Central China's Hubei Province where the coronavirus originated, yet Chinese experts said it was too early to say that the nationwide battle had decisively turned for the better given no real diminution in infection rates and slow progress in development of antiviral drugs.

More importantly, the situation in Hubei continues to be serious. Frontline doctors and experts are cautious in expressing opinion on trend of the epidemic that has been unfolding into a third and fourth generation of cases, and now with a lon­ger-than-expected incubation period and an undecided transmission route. 

Some 142 new deaths and 2,009 new infections were reported by the National Health Commission (NHC) on Saturday. Recoveries reached 1,323, the fourth day over 1,000. 

Outside Hubei, regions recorded daily decline of new diagnosed infections for the 12th consecutive days since February 3, reflecting that the strict prevention and control measures in Wuhan as well as its surrounding areas have been showing results, according to analysts.

"The downward trend shows that strict measures adopted in the different regions helped contain virus spread in an effective way. The overall medical resources could handle the current situation outside Hubei," Wang Guangfa, a respiratory expert at Peking University First Hospital, told the Global Times on Sunday.

However, Wang noted that there has been no unified definition for the highly expected 'inflection point' amid the outbreak. 

Outside Hubei, the consecutive declines for more than 10 days could be seen as a turning point for the epidemic in these areas, said Wang.

Severe infection cases have all significantly declined in Wuhan, Hubei and nationwide, Mi Feng, NHC spokesperson, told a press conference on Sunday. The ratio in Wuhan has dropped from a peak of 32.4 percent on January 28 to 21.6 percent on Saturday, while the ratio in Hubei was down from 18.4 percent on January 27 to 11.1 percent on Saturday, according to the NHC figures. 

The overall ratio of severe infections in regions outside Hubei dropped from a peak 15.9 percent on January 27 to 7.2 percent on Saturday, the NHC said. 

Measures such as self-quarantining, extended Spring Festival holidays and postponing resumption of work have been implemented by provincial and municipality-level authorities over the past few weeks. 

Authorities used artificial intelligence and big data-empowered technologies to screen all possible cases and track down suspect patients and their close contacts via community registration and door-to-door inspection.

The consecutive declines in new infections indicated that the current prevention and control measures outside Hubei are effective, Yang Gonghuan, a former vice-director of the Chinese Center for Disease Control and Prevention (CDC), told the Global Times on Sunday. 

The inflection point will probably come when there are no more new cases reported on a daily basis, Yang said. 

Wang Xinghuan, director of the newly built Leishenshan Hospital, was quoted as saying in media reports that the inflection point had already arrived in Wuhan. "The real inflection point [of the outbreak] has come. Over the past 5 days, the number of fever cases has dropped. It is like a downward slope. It's not coming back, I'm confident," Wang said.


Staff members work in a laboratory in Wuhan, central China's Hubei Province, Feb. 13, 2020. (Xinhua/Xiong Qi)

Remaining challenges 

More recently infected patients appear to have milder symptoms, according to some online posts that cited frontline medical staff dispatched from East China's Shandong Province working in Wuhan.

These anecdotal articles have promoted online speculation that the virulence of novel coronavirus pneumonia, officially known as COVID-19, has been attenuating among the third and fourth generation of infected patients.

Doctors from his team had never published such opinions and such speculation was "irresponsible," Fei Jianchun, who leads the medical team of Qilu hospital from Shandong, was quoted as saying on Sunday after noticing the online trend. 

Some analysts noted that the alleged decline in severe cases did not derive from diminished infectivity but more likely from more timely and effective treatment. For now, there has been no evidence suggesting any further mutations of the virus. 

"Mutations cannot happen in such a short period and the virulence would not decrease along with its generation transmission," said Yang Zhanqiu, deputy director of the pathogen biology department at Wuhan University.

Scientists racing to learn more about COVID-19, which has reportedly killed 1,665 people in China and infected 57,416, describe it as a "cunning" virus. 

In another worrying anecdotal development about the mysterious behavior of the virus, reports emerged last week of a man who quarantined himself for 14 days in the Shandong city of Rizhao but later displayed classic COVID-19 symptoms of a fever and cough after quarantine period ended. Besides, he wife and two children were all tested positive for the coronavirus but showing no symptoms, Shandong media reported on Saturday. 

Meanwhile, the transmission route of the coronavirus has not been completely confirmed. The main routes - respiratory, contact, fecal-oral and aerosol transmission - are all still being studied, Yang said. 

Tough battle 

The government of Hubei, the province with more than 90 percent of reported new cases nationwide, on Sunday ordered all cities and counties, down to streets, communities and residential districts to seal themselves off. 

Daily necessities would be collectively purchased and delivered to those disease-stricken areas, the government statement said. All vehicles, except for ambulances, police vehicles and vehicles used for fighting the disease are banned from the roads.

The extreme measures were a necessary response to those virus-stricken regions which still face a severe situation, the provincial government said in its statement on Sunday. 

Wang Hesheng, a member of standing committee of Hubei provincial Communist Party of China (CPC) Committee and head of Hubei health commission, told a press conference Saturday that 25,633 medical staff have been dispatched from regions across the country to support Hubei, a larger number than all the medical personnel mobilized for 2008 Sichuan earthquake.

"Stricter sealed-off management of residential areas at such a critical moment is very important to make sure that all previous efforts don't end in vain," a resident surnamed Guo of Yichang, a Hubei city with the fourth-highest number of infected people, told the Global Times on Sunday. 

"We can't fight the virus like those frontline doctors and nurses. All we can do is follow the government's regulations and stay at home to help contain the spread of the virus," said the resident.
Newspaper headline: Quarantine effects promising


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