Today, Explained - Coronavirus

Episode Date: January 23, 2020

A SARS-like virus has killed at least 17 people, quarantined millions in China, and made its way to the United States. Vox’s Julia Belluz explains what's known and what's next. (Transcript here.) Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Visit connectsontario.ca. There's a new virus in town. They're calling it coronavirus. People are dying. People are freaking out. And Vox's Julia Blues has been covering it day and night. But she still made time to explain to me what exactly is going on this morning. So on December 31st, China announced that they were dealing with an outbreak of what seemed like a mysterious new virus in a city called Wuhan. And at the time, Chinese authorities were suggesting that almost everyone affected by the virus had come into contact with animals at a food market in Wuhan. And as of last week, it looked like there were only about 50 cases of the disease.

And now today, there are more than 600. And the virus has spread across China and to at least five other countries. This virus isn't just spreading directly from people exposed to animals in a market. It's spreading from person to person. And the outbreak looks a lot more severe than it did just a week ago. What exactly is this thing? So right now it has only a placeholder name, 2019 N-C-O-V. 2019, the year that it was discovered, N for new, and coronavirus for the family of viruses that it comes from.

Corona like the beer. Just like the beer. Yeah, exactly. No, they're respiratory viruses. They mostly affect animals. And a few of them have evolved to infect humans, including SARS, which as a Canadian, you might remember. I was at SARS stock, Julia. So was I. They came here because they love you and they love this city, they are Mick Jagger, Keith Richards, Charlie Watts, Ron Moore, the Rolling Stones. Two Canadians realized they were at the same party. Yeah, I played hooky from work to go to that. But yeah, so these viruses mainly affect animals.

A few have evolved to infect humans. We know that they attack the respiratory system, but the way that they sicken people can look like anything from the common cold to causing severe pneumonia and death like SARS did. And we don't know yet where this new virus falls on that spectrum. We don't know how deadly it is. How many people has it killed so far? As of this morning, there are more than 600 cases and 17 people have died. And how should we think about those numbers?

How deadly is a virus if for every 600 infected, 17 die? So it's way too early to figure out the case fatality, which is the number of deaths a virus causes among the number of people affected. Because it's possible that there are thousands more people with this virus who don't have symptoms, who've never gone to the doctor, and therefore they're not counted as cases. So right now we have this 600 as the denominator, but it's likely to change drastically in the coming days. And it's also possible that it could mutate to spread even more effectively than it's already spreading. So there's a lot of unknowns. But we know, for example, that SARS killed about one in 10 of the people that it affected. And then again, there are these other coronaviruses that act more like

the common cold. So it'll take a little bit of time to understand where this new one falls on that spectrum. Do we have any idea how the virus is spreading? We don't know exactly how the virus is spreading yet or how easy it is to catch, but we know that human coronaviruses, again, the respiratory viruses, so they're passed through the air through coughing and sneezing. And you can also pick up these viruses through touching surfaces that have been contaminated. You mentioned that this was discovered in China, but there were reports earlier this week that it made it to the United States. Where else is it right now? So yeah, right now we know that most of the cases are in Wuhan,

that city we were talking about at the beginning of 11 million on mainland China. But since then, cases have turned up in at least 30 other provinces in China. And we also know that travelers to the U.S., Thailand, Japan, Taiwan, and South Korea have also turned up with the virus. And there are additional cases being investigated in other countries. So if you think about the fact that this outbreak was only declared on December 31st and only a few weeks later, we have at least six countries affected and more than 600 cases. It's a pretty fast escalation.

So it's so much unknown. I mean, how is China responding to this? At first, the government was telling people to stop traveling in and out of Wuhan. And then this morning, they took this extraordinary measure of quarantining the entire city. This morning, the Chinese city of Wuhan on lockdown. Flights canceled, trains halted. It's not just travel in and out of the city that's affected. It's everything within Wuhan as well. Wuhan is in virtual lockdown. You're not

allowed to enter any public space without a mask. The city of 11 million people at the epicenter of a viral outbreak. So that's more people than live in New York City, for example, or an entire country like Greece. They just shut down travel within the city and travel out of the city. Wow. And by this evening in China, they'd extended the travel restrictions to two other cities just east of Wuhan. Huanggang and Ezhou, with a combined population of 8.5 million, are 70 kilometers away from Wuhan, where 11 million residents have been told to stay put. So the response is escalating really fast as well.

And part of that is driven by the fact that China is now undergoing the biggest annual human migration for Chinese New Year on Saturday. This crackdown might also suggest that they know more than they're telling us, that maybe the virus is even more transmissible than it seems right now. Maybe it's in more places than we know. Maybe there are more cases. But the public health people I talked to said that quarantining a city of 11 million and imposing trade restrictions on 20 million people in these three cities, that that's totally unprecedented.

I wonder, does China have an incentive to sort of slow play the severity of this disease or to conceal information from the public? So we know that these types of outbreak declarations can come with devastating economic losses to the cities and countries involved. So that's always an incentive not to report. And we also know that China has a history of not being very transparent about outbreaks, which we learned during SARS, like their delayed reporting of the outbreak to the international community definitely led to more spread and more cases because countries didn't have a warning and they couldn't put in measures to contain the virus and stop it from spreading. So, you know, the more honest Chinese authorities are, the more quickly the international community can respond and the more effectively we'll be able to stop the outbreak. So they also

have an incentive to report honestly. And I'm not sure anybody knows exactly how honestly China is reporting right now. You mentioned the international community, the global health community. I mean, have outfits like the World Health Organization stepped in or stepped up to sort of help China with this outbreak? WHO yesterday convened a group of experts to deliberate about whether they should declare this virus a global public health emergency. So that's this official designation that WHO can give to outbreaks to sort of sound the global alarm, to galvanize attention and resources, and to help the international community coordinate in response to a disease that's spreading in a way that poses a real threat. And they did this unprecedented thing yesterday, which was instead of declaring or not

declaring, which they usually do after a day of deliberations, they delayed their decision until today. So today the WHO declared this was not a public health emergency yet, but this could change in the coming weeks or days. They might meet again very soon and decide that it is. Why would they delay that kind of decision? What's the decision-making process for them? They said they needed more information, but I suspect part of the reason might have been politics. China is a very powerful country and maybe they're trying to weigh the political repercussions of declaring this a

public health emergency. But on the other hand, it's also, yeah, again, we're dealing with this new virus. There are lots of unknowns. The situation's rapidly evolving. So maybe they genuinely wanted a few more hours to figure out whether they should declare this type of emergency. So we know this still isn't an official global health emergency yet. Is there a chance that this outbreak could still spread even more, though? I think there's a good chance. Yeah, we're seeing the number of cases increasing so rapidly. Last week, there were only about

50 cases that China was reporting. Today, we have more than 600. That's a pretty rapid spread of this virus. So it's very possible it continues on that trajectory, but that'll depend on what we learn about the virus. And yeah, most importantly, how easily it's spreading from person to person and how deadly it is. More with Julia in a minute. I'm Sean Ramos for him. This is Today Explained. Support for Today Explained comes from Ramp is the corporate card and spend management software designed to help you save time and put money back in your pocket. Ramp says they give finance teams unprecedented control and insight into company spend. You're able to issue cards to every employee with limits and restrictions and automate expense reporting so you can stop wasting time at the end of every month. And now you can get $250 when you join Ramp. You can go to ramp.com slash explained.

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due to abnormal brain development, a devastating neurological condition that doctors suspect is linked to a Zika virus infection during pregnancy. Hey, sweetie. There's breaking news now on the Ebola outbreak. The Centers for Disease Control and Prevention in Atlanta has just released a new alert.

A chance to get the hard-to-find H1N1 vaccine produced a polite stampede of parents and not-so-happy children in Fairfax, Virginia this morning. A slum in West Delhi. For many residents, what is already a hard life has gotten tougher since a major outbreak of dengue and chikungunya in the city. Are there more of these public health emergencies in the, you know, 21st century than there used to be? Absolutely. When researchers have looked at the rise of infectious diseases in recent decades,

they found that they have become more common. Do we know why? I think there are four major reasons we can point to. So the increase in travel and trade, urbanization, population growth, and climate change. Okay, well, let's go through those because some of them seem pretty obvious to me and some of them seem a little more worthy of explanation. So, I mean, travel. More people are flying from China to the United States and Canada,

so we have a higher risk of the spread of disease. Before the advent of mass air travel, people were getting on boats or trains and they couldn't go very far very fast. And now you can bring a new disease to an entirely new continent within hours. Okay, so that one seems kind of obvious. But to me, urbanization feels almost like it could help because people are interacting with animals less

on a daily basis. Is that not the case? With urbanization, we have these like densely packed cities. So if you think about China, right, the cities are massive. Like we're talking tens of millions of people living in very, very close quarters. And when you have a respiratory virus that just spreads through coughing or sneezing, you're packed on subways or in cafes and apartment buildings, it becomes pretty easy to spread that virus. And does that go hand in hand with population growth? Absolutely. It means we have more people living in closer proximity than ever before.

And that's just paradise for a virus, right? It has more hosts to infect and to propagate itself. So that's what we're up against. Does this then affect like poor people living in cities more than people with resources? Right now, the way we think this outbreak started was people interacting with animals, carrying the virus in food markets in this very densely populated city. But we know that when viruses hit impoverished or weakened health systems, they tend to spread much more easily and people just have fewer defenses against them. So they might be less likely to be vaccinated against the disease or to be able to access

doctors who can help them. In the case of the West Africa Ebola epidemic a few years ago, basically every American infected with the virus in that period of the outbreak survived. And the same wasn't true for West Africans. You know, more than 11,000 people died there. And lastly, climate change. Are these viruses just always happier and healthier in warm places? Actually, sort of. So we know that as temperatures rise across the planet,

we know that the animals and insects that can spread diseases that affect humans, that the places that they live is changing along with the temperature. So for example, with Zika virus and dengue, they're carried by a certain type of mosquito. And one of the reasons researchers think that mosquito might be reaching new places and reaching more people lately is because of climate change, because, you know, mosquitoes thrive in warm and moist environments. Okay, so we've got climate change and urbanization, population growth, global travel, all factors

leading to this greater risk of the spread of these infectious diseases. But isn't global health and science as advanced as it's ever been? Is that helping counter these factors? Yes, science is definitely advancing at a dramatic pace. Like if you just watch this outbreak unfolding, you can see papers being published and shared open access every day, researchers gaining new knowledge of this virus. And obviously a country like China already has this recent experience with SARS. So the general agreement is that even though right now things aren't looking so great, that they're much more

prepared than they were during SARS. But on the other hand, these outbreaks are happening at a more rapid pace and sometimes we're caught off guard. In an ideal world, we'd already have a handle on the pathogens that are circulating in animals that could pose a risk to humans. And we'd be able to predict those outbreaks and have, you know, things like vaccines ready for when they happen. And obviously, we're not quite there yet. Are humans doing something wrong other than, you know, living closer to each other and causing climate change?

Yeah, and getting on planes all the time, which Greta isn't happy about for environmental reasons and something that's also not great for health reasons. A lot of people in public health talk about public health being a victim of its own success. So we've had these near misses with outbreaks in recent years and, you know, people become complacent and think that the next pandemic really isn't going to come because we have done such a good job generally of stopping outbreaks before they go pandemic and they spread around the world. In the U.S. context, spending on public health has been falling in recent years, but obviously we have to be vigilant and these diseases can catch us completely off guard.

And that's what we're seeing right now in China with this new virus. Is part of the problem here the way that world leaders respond to these viruses? They don't necessarily respond with intentions of protecting the world, but maybe protecting their own country's interests? That is also part of the problem.

So one bit of political theater we see trotted out again and again with every outbreak, and it's happening now in China and with other countries around China, is putting people under quarantine and doing screening at airports. 100 experts from the CDC are descending on JFK, Los Angeles and San Francisco airports this weekend. They are taking the temperatures of passengers arriving from Wuhan, China. Even though those efforts might sound like they'd be effective at stopping a virus from spreading, researchers have found again and again that they don't work. They fail to find sick people and sometimes they even increase the odds of an outbreak getting worse by driving people underground.

So that means, like, you know, people might be less likely to show up in hospital and report their disease. They hurt economies. They make it harder for foreign aid and experts to reach the places that are affected in an outbreak and help. But yeah, history repeats itself. There were lots of travel restrictions and quarantines during SARS. You might remember in Toronto, there were like 25,000 people quarantined. It was an epidemic that caught health officials off guard. In 2003, SARS, a previously unknown respiratory illness, spread to Canada.

Nowhere were the effects felt more acutely than in the city of Toronto. And we also had travel restrictions and airport screenings in Toronto. And when the Public Health Agency of Canada did analyses of how effective these measures were, they basically found they were totally ineffective in that they didn't catch a single case of the disease. So, yeah, we'd be much better off if instead of imposing those sorts of measures, we tried to educate the public about, in this case, an entirely new virus and encourage people to report their disease to authorities.

The CDC determined that the risk of this virus spreading in the U.S. is really low, but we can see it spreading rapidly in China, and China has really deep connections to other major cities in Asia. So that's where the problem lies, and we need to put our resources and our money and our efforts into controlling the outbreak there. With every outbreak, we definitely learn. And with this one, I'm absolutely mind-boggled by the pace at which new discoveries are being made. So again, while you were partying on New Year's, China was only discovering or announcing this outbreak. And within like two weeks, they had both found the virus that was causing it

and they had released its genetic sequence to the public and countries around the world quickly prepared diagnostic tools to be able to find cases that's just like a mind-bogglingly fast pace when you compare it to other outbreaks of new viruses so yeah we're definitely learning more with every outbreak but you just hope that this one will come under control and that we'll have the opportunity to apply this knowledge again to prevent the next one from harming people. Julia Balouze is covering coronavirus for Vox.

You can follow along at Vox.com. And she's also on Twitter at Julia of Toronto. As of publishing time, the WHO still hasn't declared this virus a global public health emergency, but they have shared some information on things you can do to reduce your risk of catching it. The list includes keeping your hands clean, covering your ish when you're coughing and sneezing, thoroughly cooking your meat and eggs, and avoiding unprotected contact with live, wild, or farm animals. I'm going to go ahead and say that these are good guidelines for your life generally, unless you're like a farmer, in which case, thank you for your service.

We are back with more useful information tomorrow on Today Explained. Thank you.