Coronavirus spread from people without symptoms is rare, says WHO

Beijing, Feb 9: After making sure everyone's face mask is on and sanitizer is to hand, the Qiao family heads out to Jingshan Park, a former royal sanctuary beside the Forbidden City in China's capital Beijing.

Snow has fallen for a second day, a rare event in the city of 21.5 million that would normally bring hundreds of thousands of people out to take photos and play. But the streets are empty and the parks are so quiet the only sound is of birds chirping.

It's not just Beijing. Shanghai, China's financial hub, and other cities in the world's most populous nation have turned into ghost towns after the government extended a holiday and asked residents not to go out because of the coronavirus.

"We know the situation of the coronavirus is severe. But the epicentre is far away, so we think it should be fine here ... It's a God-given chance to enjoy this family moment with snow and without work," said Mr Qiao, who has an 11-year-old daughter.

The epidemic has killed 722 people and infected nearly 32,000 in China as of February 8. More than three-quarters of the cases are in the central Hubei province where the virus originated - more than 1,000 km (620 miles) from Beijing.

Only a few people are brave enough to come out. A security guard at Jingshan Park said there were less than a third of the number of tourists than usual, even with the rare snowfall.

Even at one of the best spots for snapping photos of snowy Beijing just outside the Forbidden City, there's barely a crowd, while the usual tour buses and groups of people speaking different dialects are nowhere to be seen.

"Last year when it snowed, I took a few hours off work to come down here to take a picture and the crowd was several layers deep," said a man in his 30s who gave his surname as Yang. "But this year, I am not at all worried about finding a space to take a photo. The virus is keeping people indoors."

Security guards along Wangfujing street, a popular pedestrianised shopping area in downtown Beijing, said it was normally so crowded during the holiday period that it was hard to move around.

"Look at it now, there are more security guards and street cleaners than tourists!" said one of the guards.

Businesses, including shops, bars and restaurants, have been severely hit by the epidemic as the government has banned mass gatherings and even group meals in an effort to curb the spread of the coronavirus.

"You would have to wait outside for a table on a normal day," said a waitress at a restaurant with more than 50 tables. Just five were taken at the peak lunch hour.

Only a handful of the more than 100 restaurants along Beijing's famous food street, Guijie, were open, and the remaining outlets were wondering how long they can hold out.

May 30: Warning of the tightrope walk ahead as governments battle the coronavirus crisis, Nobel laureate Peter Charles Doherty has expressed concern about densely populated countries such as India relaxing lockdown norms while also describing a complete shutdown as “an economic and social impossibility”.

The Australian immunologist, who cautioned that the number of COVID-19 cases will rise in the coming days, said the earliest time frame for an effective vaccine “going into large numbers of people” is nine to 12 months.

"If all goes well with testing, we could know if some of the candidate vaccines are both safe and effective as early as September/October. Then, rolling a vaccine out will depend on the type of product and how quickly it can be made, put in vials and so forth," Doherty told PTI in an email interview from Melbourne.

The novel coronavirus, he added, does not change fast like influenza and, from what is known so far, “the same vaccine should work everywhere”.

Doherty, who is with the Department of Microbiology and Immunology at the Doherty Institute, University of Melbourne, won the Nobel Prize for Medicine in 1996 for his discovery of how the body’s immune system distinguishes virus-infected cells from normal ones.

Discussing the lockdown, he said, "If it was purely a matter of hard science, everywhere should stay locked down. But that’s pretty much an economic and social impossibility.”

The expectation, he said, is the numbers will rise and limiting spread will depend on people acting responsibly and the capacity for rapid response and extensive contact testing.

“And in a densely populated country like India I think that it will be very difficult," the scientist said.

Several countries, including India, began relaxing lockdown norms in mid-May despite the WHO’s warning about a second wave. India’s lockdown began on March 25 and has since been extended. The fourth phase ends on Sunday.

Asked whether there are any alternatives to a lockdown, the 79-year-old said, "There is no other option other than closing borders. South Korea, for example, conducted massive, intensive testing and contact tracing in a wealthy country with a very disciplined population. Otherwise, not till we have effective vaccines."

He added that he personally doesn’t see the point of closing borders for people coming in if there’s already a high incidence of disease in the community, “unless it’s to avoid the need to care for them and use scarce hospital beds".

According to Doherty, the coronavirus "is a new virus which has come straight out of nature".

“It (the virus) has moved so rapidly across the world because of people travelling on international planes as well as tourist ships," he added.

The immunologist also warned against the use of hydroxychloroquine to treat COVID-19, and said current and planned trials of the anti-malaria drug should be stopped.

“My understanding is that the use of the drug in severe disease is definitely contra-indicated, but it’s not yet clear whether, if taken under medical supervision, it could have some useful effect if taken early on, or as a preventive. Those trials just haven’t been done properly," Doherty noted.

The Indian Council of Medical Research (ICMR) has backed the use of hydroxychloroquine as a preventive against COVID-19 even after the WHO suspended clinical trials of the drug citing safety concerns.

Asked whether plasma therapy can be an effective treatment for COVID-19, Doherty said, "We lack good properly controlled trials but, especially if the plasma has been tested for antibody levels and there’s evidence of good activity, it could be helpful. If I had the disease and was offered plasma therapy I would certainly accept, but I would not take hydroxychloroquine."

Doherty is also very optimistic about herd immunity developing against the SARS-CoV-2 infection.

"We think that (herd immunity) will cut in and have an obvious effect when, say, 60 per cent of people have been infected. Best hope is to boost herd immunity with a vaccine," he stated.

Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, whether through vaccination or previous infections.

The number of COVID-19 cases have crossed 5.9 million and the fatalities 3,65,000, according to the Johns Hopkins University on Saturday. 

In India, the death toll has risen to 4,971 and the number of cases to 1,73,763, according to the Union Health Ministry on Saturday.

Several states, including Bihar, Uttar Pradesh, Madhya Pradesh, Jharkhand and Chhattisgarh, have reported a rise in number since lockdown norms were relaxed in early May and migrant workers reached home.

In Uttar Pradesh, for instance, the number of infections rose from around 3,000 on May 4 to 6,532 on May 26. Similarly, Bihar’s numbers increased from around 500 to over 2,700 in the period.

The death toll in China's coronavirus rose sharply to 425 with 64 deaths on Monday alone while 3,235 new confirmed cases were reported, taking the number of those infected with the deadly disease to 20,438, Chinese health authorities said on Tuesday.

The 64 people who died on Monday were all from the Hubei province, the epicentre of the virus, China's National Health Commission said.

Also, 3,235 new confirmed cases of novel coronavirus infection were reported, a big increase in a day.

Another 5,072 new suspected cases were reported on Monday, said the commission, adding that 492 patients became seriously ill.

The commission said that 2,788 patients remained in severe condition and 23,214 people were suspected of being infected with the virus, a pointer that it is increasingly turning virulent.

The overall confirmed cases on the Chinese mainland had reached 20,438 by the end of Monday, the commission said, noting that a total of 425 people had died of the disease.

A total of 632 people had been discharged from hospital after recovery, state-run Xinhua news agency reported As the virus spreads from human to human, 221,015 close contacts had been traced, with 171,329 others still under medical observation.

By the end of Monday, 15 confirmed cases had been reported in Hong Kong, eight in the Macao and 10 in Taiwan.

The Philippines reported the first overseas death from the virus on Sunday while 148 cases have been reported from abroad.

India has reported three cases of the coronavirus. All the three patients from Kerala recently returned from the affected Wuhan city.

Currently, 647 Indians and seven Maldivians who have been evacuated from Wuhan and Hubei are in 14-day quarantine at a medical camp in Manesar, near Delhi.

As the virus continued to spread at an alarming rate, Chinese President Xi Jinping on Monday warned officials of punishment if they shirked responsibility in tackling the virus outbreak.

On Monday, China has opened a 1,000-bed hospital built in record nine days in Wuhan city and started trials for new drug to contain the virus and is set to open another 1,300 bed hospital next to it on Wednesday.

The ruling Communist Party of China on Monday held its political bureau meeting presided by President Xi to review the steps being taken on various fronts to halt the spread of the deadly virus.

The outcome of the epidemic prevention and control directly affects people's lives and health, the overall economic and social stability and the country's opening-up, Xi said.

"Those who disobey the unified command or shirk off responsibilities will be punished," Xi was quoted as saying by the state-run Xinhua news agency.

Xi said that the party and government leaders supervising them would also be held accountable in severe cases.

Chinese armament firms, including those building aircraft carrier and military aircraft, have postponed planned work in order to concentrate on controlling the risk of coronavirus, state-run Global Times reported.

Noted Chinese health expert Zhong Nanshan has said that based on the fresh evidence, the novel coronavirus, which is spreading rapidly in China and the world, may reach its peak in the next 10 to 14 days, contrary to earlier estimates of climaxing sooner.

This means that the cases would drastically increase in the next two weeks before slowing down.

Also, China has begun clinical trials to test a drug to treat the patients of the coronavirus which till now has no cure.

Currently, patients are being treated with a combination of antivirals and other measures, as scientists race to find a vaccine.

Some reports said drugs to treat HIV too was being tried to treat the patients.

The experimental antiviral drug, Remdesivir, to be tested in field trials is developed by US-based Gilead Sciences. It is aimed at treating infectious diseases such as Ebola and SARS, South China Morning Post reported.

It was given to the first US patient last week - a 35-year-old man whose condition appeared to improve within a day, it said.