virus

Coronavirus outbreak in China January to April 2020

The current outbreak of coronavirus was first reported on the last day of 2019 (coincidentally 31st December). A cluster of people with severe pneumonia had made health professionals suspicious and tests showed a new virus was at work. It seems to have spread from a seafood and live animal market in the city Wuhan, Hubei province. It is officially designated as Covid-19 or SARS-CoV-2 and is a new form of Corona virus. Corona-viruses are so called because their genetic material is protected by a spiky envelope. There are a wide range of different corona-viruses. SARS from 2013 caused similar severe respiratory problems. It is now thought that the market was where people became infected but not the original site of transmission. The virus seems to have transferred from bats now that DNA sequence comparisons have been done.

What makes this virus hard to tackle is that some people become infectious before they display any obvious symptoms. It currently seems most life-threatening to people with other serious health issues rather than the young and fit.

NOTE: This page is updated with the latest statistics.

spread of coronavirus

Chart of the number of people infected with the virus in China, and also those that have died and those that have fully recovered.
The large step on 13th Feb is because Hubei province included probable infected cases as well as definite cases, it does not represent a huge number of new infections. Since 27th Feb the blue columns are the number still infected (total infected - (deaths+recoveries)) which reached a peak on 17th Feb and has since declined.

Spread

From its initial origin the virus spread quickly within the city of Wuhan. To contain the outbreak the Chinese government put the whole province of Hubei on lock-down on 23rd January - severely restricting the free movement of potentially infected individuals. As at 30th March 0.4% of cases were in Hubei, 0.2% in the rest of China and 99.4% in all other countries put together. New cases in China are currently running at only one or two per day. Wuhan has a population of 10 million people and the province of Hubei 58 million so the number of people infected is still a very small proportion of the population (less than 0.01% for Wuhan) so the chance of meeting someone infected is extremely low. It is easily spread to anyone by close contact with someone infected: family, health care workers and friends.

daily change of statistics for coronavirus
Chart of the daily change of people in China in the confirmed still infected/died/recovered categories. The number of new confirmed cases needs to go down to zero for at least a fortnight before the outbreak can be considered contained. Most of the new cases are people already in quarantine who have traveled back to China from other countries.
status of coronavirus location
Chart showing the proportion of infected people in Hubei province compared to the rest of China (excluding Hubei), the rest of the world and the grand total. As of 30th March only 0.6% of people still infected are located inside China. The status indicates the containment measures have so far proved pretty effective.
medical testing

Symptoms

The incubation period of the virus is when people do not display any symptoms but still be infectious. This seems to vary between 1 day and 12 days, on average 5 days. Because of this a quarantine period of two weeks is necessary to be sure someone is not infected. During the incubation period a carrier can not be detected by thermal image scanning as they do not have an elevated temperature.

Many people will begin with 'flu like symptoms - a cough, sneezing and elevated temperature. Severity of symptoms of the coronavirus varies substantially between different individuals. Most people, particularly the young, will experience a few days of 'flu like symptoms and then recover. Some will develop 'pneumonia' as lung inflammation and build up of fluid in the lungs caused by the virus lead to shortness of breath. People may then suffer from a secondary bacterial infection in the lungs. Some people develop kidney failure.

As of 30th March 4.0% of those infected in China have so far died but some of those infected are still under observation and may will fully recover but could potentially die. As of 30th March 92% of those infected have made a full recovery. Many news outlets were stubbornly reporting a 1% or 2% death rate, our figure is simply the official total number of infected people divided by those who have died from the disease. It is possible that the WHO statistics we use are using a broader definition of death due to Covid-19 and are not counting those who have very mild symptoms and have not been tested. It does seem to be less fatal than Ebola and SARS but far more infectious.

If you feel unwell, stay at home making a note of everyone you have recently come into contact with. People on the list can then be made aware of the risk and quarantined. Only if you begin to develop severe symptoms (kidney or lung) should you contact health care professionals by phone. Attending clinics is not advisable as this may spread the infection.

status of coronavirus location
Chart showing where the reported cases are located in China with rest of world added for comparison.

New cases of the Coronavirus reported 30th March by location in China

Rest of world59,288
ChinaHong Kong80
ChinaGuangdong8
ChinaShanghai7
ChinaTianjin5
ChinaBeijing4
ChinaJiangsu3
ChinaZhejiang3
ChinaGansu2
ChinaLiaoning2
ChinaSichuan2
ChinaChongqing1
ChinaFujian1
ChinaHenan1
ChinaInner Mongolia1
ChinaJiangxi1
ChinaJilin1
ChinaShanxi1

Diagnosis

The official test for coronavirus known as a kind of PCR (Polymerase Chain Reaction) test that looks for the specific genetic fingerprint of the virus.

status of coronavirus infection

Chart showing the proportion of people still considered infected compared to those who have fully recovered and those who have died. For safety a long quarantine period is being imposed (two weeks) to ensure people are fully recovered and can then go back home. Many of those infected may be showing only mild symptoms and will soon fully recover.

Antibodies and vaccines

As it is a new virus among humans no-one will have antibodies that would quickly detect and kill virus particles.

Developing a specific vaccine has begun but will take months to develop and test and so is not a quick solution. Antibiotics will have no effect on the virus, they may be used for secondary infections when someone is very ill with the virus.

The media is awash with stories that certain medicines, foods or vaccines will give immunity. Nothing so far has been proven. Keeping fit and healthy is the best advice at present as a healthy natural immune system should deal with the virus without extra medication. Vitamin C, garlic, sesame oil and herbal teas are not going to help except perhaps contribute to general health.

pills

Myths about coronavirus

  • Hot air hand dryers do not kill the virus.
  • Spraying with alcohol or bleach is both dangerous and will not kill the virus.
  • Boxes and packages can not harbor the virus - a package from China is not dangerous.
  • Garlic and 'Miracle mineral water' are not effective in stopping or curing infection.
  • Face masks provide full protection from the virus. The masks can help infected people spreading the virus there is no evidence it helps uninfected people becoming infected.
  • A thermal imaging only spots people who have begun to develop symptoms not when virus is incubating.
  • Regular nasal washing with saline or gargling with mouthwash does not help.
  • The virus actually escaped from a top secret Chinese research lab in Wuhan. There is no evidence from this. The DNA shows it came from bats.
  • Pets can pick up and spread the virus. This myth has led to some cases of people killing their pets.

Map of cases of Coronavirus in China
Map showing the density of infected people in China. It uses a percentage of population scale to take account of relative population density. Even in the most infected province Hubei the proportion of the population infected is less than 0.1% (less than 1 infected for every 1,000 people).

Coronavirus Timeline

Monday 30th March

The restrictions in China are now gradually easing with only 4% of those originally infected still in recovery. Some of the temporary Hospitals have been closed. The concern of the authorities is now to prevent the virus coming back in with travellers put into 14 day quaratine. There are reports of foreigners now being treated as if infected and denied access to services . Rather silly rumours and blame for the virus continue to circulate. Some Chinese think it was deliberately spread by the Americans, while soem Americans continue to belive it was a Chinese bio-weapon that got out.

Wednesday 18th March

With only one new case reported in Hubei the Chinese outbreaks looks under firm control. The spread in Europe and elsewhere is now the predominate concern with 92% of people still infected located outside China. The border controls are now putting most foreign travellers into quarantine to try to prevent the inward transmission of the virus. North Korea still claims to have not had even one case which is hard to believe. If the current trend continues Hubei will start coming out of lockdown ina week or two.

Monday 9th March

Cases in China continue to decrease. We now list new cases by Chinese province in total there are 849 active infected people outside Hubei province.

Sunday 8th March

Another landmark was reached yesterday, over 50% of infected people are now outside China. Also China has slipped to 8th in the table of countries with new infections. As the focus switches from China to other countries we plan to restrict future reporting to concentrate on China. Sadly yesterday also saw fatalities at Quanzhou, Fujian at a hotel that collapsed , the hotel was being used to keep coronavirus patients under observation.

Friday 6th March

The straight run of 16 days of decreasing infected people comes to an end due to rapid spread elsewhere in the world. The proportion of infected people in the rest of the world has risen to 38%. The situation in China is calming down with some province's schools planning to open in a few weeks. In Hubei a rare leaked video critical of government handling suggests the actual situation is a lot worse according to the this story .

Thursday 5th March

We've changed the graphs so they only go back to 10th February so that the recent trends are easier to see. Would you believe it, the total number of infected people continues to fall day by day. This is because more people are recovering in Hubei province (2,349) than catch the coronavirus outside of China (2,155). Contrary to many other news web sites there are not over 95,000 people infected with the virus there are now 40,699 - quite a difference. Some reports are claiming there are two strains of the virus, one causing mild symptoms and the other, more recent to develop, causing more fatalities.

Wednesday 4th March

A downward trend of new cases in Hubei suggest the infection within China remains under control. Elsewhere in the world there were 2,410 new cases and the upward trend continues. Four new countries join the list of 74, it will soon be easier to list those that are free of infection!

Tuesday 3rd March

Today a major milestone was reached which you won't see reported much elsewhere - there are more people who have fully recovered than people who are still infected with the coronavirus. However it is really only China that is recovering, the cat is very much out of the bag elsewhere. The number of new cases within Hubei yesterday dropped to 196 and the rest of China was 11th in the countries with new cases. No new deaths occurred in China outside Hubei yesterday. As this web site is focused on China we will start to tone down our coverage now it is more of a global than a Chinese issue. Countries to report their first infected people yesterday are: Armenia, Indonesia, Portugal, Andorra, Latvia, Morocco, Saudi Arabia and Senegal.

Monday 2nd March

New countries who have infected people yesterday are: Ecuador, Azerbaijan, Czech Republic, Armenia and the Dominican Republic. The number of new cases outside China continues to accelerate with the proportion in the rest of the world up 4% to 18%. Only six new cases are reported in China outside Hubei province this is less than the number of cases in Switzerland.

Containment has not attained, most experts expect the best scenario is a slow spread to everywhere - already on all continents apart from Antarctica. Looking at the statistics shows that mid-February was the crucial time when the number of new cases was slowing down, this is now accelerating as it did in China in late January. The whole world can not be placed in lockdown like Hubei province.

Sunday 1st March

New countries who have infected people yesterday are: Luxembourg, Monaco and Qatar. The number of new cases outside China continues to accelerate with the proportion in the rest of the world up 3% to 14%. New cases in Hubei provinces are stubbornly stuck at 400 per day but on the plus side 2,500 people each day are classed as fully recovered.

Saturday 29th February

We've started lumping together all Chinese provinces except for Hubei as over the last week new cases are only in low single figures. This is very good news as it shows the virus can be contained. The extra leap day of the year sees another percentage point increase in the cases outside China. Many news sites are ignoring the statistics of those recovered. They give a figure of 85,000 but the actual figure of those infected continues to decline sharply as people in Hubei are given the all clear. The number of active cases is 44,546 - quite a difference! Nearly half the people originally infected have recovered.

Friday 28th February

The trend continues. Even with the heavy restrictions imposed on Hubei province about 400 new cases are reported each day. Only 13 new cases elsewhere in China which suggests containment within Hubei is working well. Elsewhere in the world it is a different story, the disease has spread to Denmark, Estonia, Netherlands and San Marino. Japan has a widely scattered number of cases and schools have been closed for a month. The Olympic Games planned for Japan in July may have to be curtailed. For the first time there are more infected people in the rest of the world than the rest of China (excluding Hubei).

Thursday 27th February

It continues to be a two different stories: successful containment in China but steady spread elsewhere. Apart from Hubei province only three other provinces reported new cases yesterday. The overall total of number of still infected people continues to fall as more people in Hubei are considered recovered - this is a totally different picture to that spread in most media outlets: relentless increase in numbers! An alarming number of new countries join the list today: Israel, Pakistan, Brazil, Georgia, Greece, North Macedonia, Norway and Romania. Some international firms are splitting their staff into separate teams so that if one team becomes infected the others can continue work.

Wednesday 26th February

Hubei province goes back to the top of the list for new infections. Four more new countries join the list: Austria, Algeria, Croatia and Switzerland. Commentators are now putting the focus on countries other than China and yet Hubei reported yesterday 499 of the 845 new cases that is 59%. In terms of deaths the situation is even starker, Hubei had 68 of 79 deaths which is 86%. It is easy to think from the coverage that the disease has burned itself in Hubei while in fact 99.9% of the population have not been infected and are still vulnerable. The uneven reporting of Hubei cases can only be viewed over a whole week where the average is still 450 new cases each day and no clear sign of a decrease.

Tuesday 25th February

As expected the cases reported in China increased today balancing the suspiciously low figure for yesterday (24th). Five new middle eastern countries join the list but with only one infection each: Iraq, Oman, Afghanistan, Bahrain and Kuwait. The WHO believe the disease has peaked in China but is spreading elsewhere. Reports currently do not distinguish infections among those already quarantined and so at low risk of spreading to those in the general populace.

Monday 24th February

With no new cases reported in Hubei and only 21 in the rest of China the statistics look suspect as on Saturday will need to wait until tomorrow for a clearer picture. South Korea has moved up from 7th to the 3rd location with the most infections.

Sunday 23rd February

Another blip in the statistics. The number of new cases per day has tripled in China going from 644 to 1756 and so no longer indicates a downward change. The number regarded as recovered has jumped up from 713 to 3996 and deaths from 4 to 207, both these suggests the figures for 22nd were inaccurate and the data for Saturday and Sunday should be taken together and averaged to look for any trends. Elsewhere the number of new cases outside China has almost doubled to 305. The real fear must be that it may have reached countries where it is not yet being recorded as coronavirus. For example would North Korea want to admit it has an outbreak? The good news is that the overall total of number of people still infected continues to fall.

Saturday 22nd February

For the first time no deaths have been recorded in China yesterday, and just four elsewhere in the world. The worrying spread to new locations continues with Lebanon and Israel added to the list (this may in part be due to repatriation of patients from the Diamond Princess cruise ship). There is a low number of new infections but they are widely scattered. South Korea continues to be a concern with numbers doubling in one day. It now seems the South Korean cases are related to the Shincheonji Church of Jesus whose members meet in secret in China because their activities have been suppressed. The group continued to meet in secret in Wuhan in December.

Friday 21st February

There is both good and bad news today, the cases in China and particularly Hubei continue the downward trend but new cases in South Korea, Japan and Iran suggest that containment within China may not have been achieved. Over 2,000 people are classed as recovered on 20th Feb for the first time.

Wuhan, Hubei, Yangzi River, river
Wuhan, from the Yellow Crane Tower. October 2005.
Image by CraigTheBrit available under a Creative Commons license

Thursday 20th February

On the previous day a landmark was reached - the total number of currently infected people reduced slightly. Thursday's figures continue the trend of overall reduction. The total number of new infections in Hubei has dropped dramatically from 1,693 to just 349 (the lowest number here since 27th January). This may be due to a problem with classification of cases, only time will tell. Elsewhere, it is only Japan that is showing a worrying accelerating trend in new cases.

Also a round-up from various news items recently reported in the South China Morning Post .

Studies are showing that the corona-virus is much more infectious than similar viruses, it seems to bind very easily to human cells. Autopsies of those that have died show the virus principally attacks the lungs but also the liver. Some people are being treated with corticosteroids and some results show that their use may lead to damage of the liver and kidneys so these steroids are not recommended for widespread use. There continues to be reports that herbal medicines based on Traditional Chinese Medicine (TCM) are effective. It looks like that some herbs can significantly aid recovery but will not prevent people becoming infected.

The knock-on effects of the virus are showing in China and other countries. With many people either forced (as in much of Hubei province) or voluntarily staying at home the impact on all sorts of businesses is showing. With far fewer people traveling the airlines are canceling flights and laying off staffs. Tourist destinations are pretty much deserted. As people are not out shopping many businesses are struggling, book shops seem badly hit, people are ordering by post to avoid going out. Restaurants are badly affected and some are quickly turning to offering take-away and delivery services to keep the businesses going. Farms are hard hit with livestock markets closed. Imports of frozen chicken, beef and pork are being held up at the ports due to a shortage of truck drivers to distribute them inland.

On a somewhat lighter note, a popular video game is letting people play at killing off the virus at least in the virtual world. With many millions stuck at home having something useful to do must becoming increasingly hard.

Tuesday 18th February

The number of new cases has remained steady at 2,000 a day with very few in other countries. The total number who have made a full recovery continues to grow and the daily number of recovered cases is very nearly the same as new infections. When that cross-over is reached the net number of people still infected will start to fall. All the professionals must be concerned that now is not the time to relax measures as people continue to be unable to work or do pretty much anything. All the occasional needs like plumbers, electricians, builders and so on must be causing real hardship. Yesterday it was reported how one group of volunteers in Hubei are rescuing pets that had to be left on their own - because their owners were unexpectedly put into enforced quarantine.

Sunday 16th February

After statistical adjustments the new figures show new infections running at same rate as 11th February and suggest a downward trend. Malaysia and Singapore are looking the other countries that need watching closely. The continuing spread on the 'Ocean Princess' cruise ship seems to show how easy it is to spread the virus in an enclosed area even though in quarantine.

Friday 14th February

In Hubei an error was found in the statistics - around 100 deaths had been counted twice so this figure for 14th should be about 226 to reflect the actual 'new' deaths since yesterday. Now Hubei is using a new wider definition of virus infection and deaths it should be expected that the daily rate of 4,000 new infection is the normal baseline figure. Apart from cruise ships no new cases have been reported outside China. People are continuing to recover with

Thursday 13th February

There has been a large peak in the number of cases reported today in Hubei both for those infected (+14,840) and deaths (+242). This is because of a change to the way cases are designated rather than an underlying huge spike in cases. From now on the 'infected' figure reflects people showing the symptoms not just those who have had a positive test result for the virus. Similarly the figure for deaths is now including cases where the virus may have been a factor rather than only those as the definite direct cause. Health professionals elsewhere in the world had been concerned that the figures looked too low and so less strict criteria are now applied.

At the same time the Hubei provincial governor Jiang Chaoliang has been replaced by former Shanghai mayor Ying Yong. Jiang Chaoliang had faced severe criticism over the handling of the outbreak in its first few weeks.

Monday 10th February

The cruise ship “Diamond Princess” is quarantined. It has 3,700 people on-board and 135 have been infected, this makes it the largest cluster of cases outside China. It is moored at Yokohama, Japan and will not move before this local outbreak has been contained.

Thursday 6th February

One of the whistle-blowers who alerted the wider public about the virus in its early stages Li Wenliang dies of the virus. When he reported a cluster of cases of a SARS -like virus in mid December on social media he was told by officials in no uncertain terms to shut up and stop creating malicious rumors. It now looks like that if his suspicions had been taken seriously the outbreak could have been much better contained.

Wednesday 5th February

It is estimated that Wuhan will need 11 makeshift hospitals to cope with all those infected. There are now about 17,000 confirmed cases in the city, all of which need to be quarantined. World coverage followed the rapid construction of the first one 'Huoshenshan Hospital' but others are now being built.

Thursday 30th January

The World Health Organization (WHO) Director General declared the outbreak of the novel coronavirus “2019-nCoV” as a Public Health Emergency of International Concern (PHEIC).

Thursday 23rd January

The Chinese government imposes a 'lockdown' on the city of Wuhan and other major cities in Hubei province. There were 800 cases confirmed with most of them in Hubei but also in other Chinese provinces. This was the eve of the Chinese Spring Festival when many people travel to be with their families. All public transport was suspended: planes, trains, coaches and major roads. This was the largest lockdown in modern times affecting over 11 million people.

Friday 10th January

The virus is sequenced and identified as a new coronavirus '2019-nCoV' related to MERS and SARS .

Tuesday 6th January

China’s National Centre for Disease Control and Prevention issue a Level 2 emergency warning. However it appears this warning was not immediately actioned or widely reported.

Tuesday 31st December 2019

The World Health Organization (WHO) designates the outbreak as a “pneumonia of unknown cause”.

Tuesday 1oth December 2019

First person dies in Wuhan from the then unknown virus. 41 other people test positive for the same infection. The first cases seem to be from the Wuhan South China Seafood Market. Later analysis show that the confined and busy market was where an early cluster of cases developed but not where the virus first infected humans.

Late November or early December

The coronavirus first infects a human, place and date currently unknown.

face mask

Face masks

Many photographs of people with face masks has lulled people into thinking that a face mask offers full protection. It can only contribute to protection but does not offer a full solution. Protection is only effective if it is used very carefully. In particular it must be taken off without touching the cloth area as it is here that virus particles may have accumulated. More important is the frequent washing of hands with soap and avoiding touching the face with hands. It is recommended to sneeze into a tissue covering mouth and nose, and dispose of the tissue with minimal contact and then wash hands with soap or medicated hand-rub.

Future Strategy

The first strategy available to control the outbreak of coronavirus is containment. The idea is to stop the virus spreading, it will be particularly hard to tackle it is spreads to countries with poor medical care knowledge and facilities. If the contacts of everyone infected are checked out and if necessary put in quarantine this could all be contained and naturally disappear as an outbreak within as little as a month. Vigilance is key, any relaxation of quarantine risks a widespread infection. Europe has now moved into mitigation phase, when containment has failed it aims to limit the rate of growth so that the health services can cope.

The outbreak will be under control when the number of new cases each day starts to fall and the number of people considered fully recovered becomes the majority.

containment clinic

Notes

This information is based on the World Health Organization (WHO) web pages with some additional sources. The statistics are from John Hopkins CSSE .

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