Thursday, 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.)

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Full Transcript

Sean [00:00:01]
There's a new virus in town. They're calling it Corona virus. People are dying, people are freaking out and boxes. 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.

Julia [00:00:15]
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 Woo Ha, and that 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.

Julia [00:00:34]
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 the virus has spread across China and to at least five other countries.

Julia [00:00:48]
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.

Sean [00:00:59]
What exactly is this thing.

Julia [00:01:00]
So right now it has only a placeholder name. 2019 n. C. O. V. 2019 the year that it was discovered. And for new and Corona virus for the family of viruses that it comes from.

Sean [00:01:14]
Corona like the beer.

Julia [00:01:15]
Just like the period. Exactly. Um, though their respiratory viruses, they mostly affect animals, and a few of them have have evolved to infect humans, including SARS, which, as a Canadian, you might remember.

Sean [00:01:29]
I was at stars stock. Julia. So was I.

Sean [00:01:32]
Way to Canadians Realize there at the same party.

Julia [00:01:51]
Yeah, I I played hookey from work to go to that.

Julia [00:01:55]
But yes. Oh, these viruses mainly affect animals. A few have evolved if infect humans.

Julia [00:02:01]
We know that they attacked the respiratory system.

Julia [00:02:05]
But the way that they sicken, people can look at, 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.

Sean [00:02:19]
How many people has it killed so far.

Julia [00:02:21]
Has it. This morning there are more than 600 cases in 17 people have died.

Sean [00:02:26]
And how should we think about those numbers? How deadly is a virus? If for every 600 infected, 17 die, So.

Julia [00:02:34]
It's way too early to figure out the case fatality, which is the number of deaths of 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 have never gone to the doctor and therefore they're not counted his cases. So right now we have this 600 is the denominator, but it's likely toe changed drastically in the coming days.

Julia [00:02:59]
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 Corona viruses 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.

Sean [00:03:22]
Do we have any idea how the virus is spreading? We don't.

Julia [00:03:25]
Know exactly how the virus is spreading out or how easy it is to catch, but we know that human corona viruses 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.

Sean [00:03:42]
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.

Julia [00:03:50]
So yeah, right. Right now, we know that most of the cases are in Wuhan that that city we're 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.

Julia [00:04:12]
And there are additional cases being investigated in other countries. So.

Julia [00:04:17]
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.

Sean [00:04:30]
So it's so much unknown. I mean, how is China responding to this? At.

Julia [00:04:35]
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.

Julia [00:04:46]
This morning, the.

Sean [00:04:47]
Chinese city.

Julia [00:04:47]
Of Wuhan, on lock down flights, cancelled trains, halting.

Sean [00:04:51]
Its not just travel in and out of the city that's affected. It's everything within Woo. Hannah's well.

Sean [00:04:57]
Is in virtual lock down. You're not allowed to enter any public space without a mask.

Julia [00:05:03]
The city of 11 million people at the epicenter of a viral open. So that's more people then 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.

Julia [00:05:17]
And by this evening in China, they had extended the travel restrictions. Thio, two other cities just east of Wuhan, Yangon.

Sean [00:05:24]
And ER Joe, with a combined population of.

Julia [00:05:27]
Eight and 1/2 1,000,000 are 70.

Sean [00:05:29]
Kilometers away from Wuhan, where 11 million residents have been told to stay put.

Julia [00:05:34]
So the response is escalating really fast as well, and.

Julia [00:05:38]
Part of that is driven by the fact that China is now undergoing the biggest annual human migration.

Julia [00:05:45]
For Chinese New Year on Saturday.

Julia [00:05:48]
This crackdown might also suggest that they know more than they're. They're telling us that that may be 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 quarantine in a city of 11 million and imposing trade restrictions on 20 million people in these three cities that that's totally unprecedented.

Sean [00:06:16]
I wonder, Does China have an incentive to sort of slow play the severity of this disease or to conceal information from the public.

Julia [00:06:26]
So we know that these types of outbreak declarations concomitant devastating economic losses to the cities and countries involved, so that's always an incentive not to report.

Julia [00:06:37]
And we also know that China has a history of not being very transparent about outbreaks, which we learned during SARS. Like they're they're delayed reporting of the outbreak to the international community. Definitely let lead Thio more spread and more cases cause 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.

Julia [00:07:06]
Quickly the international community can respond in the more effectively will be able to stop the outbreak, so they also have an incentive to report honestly. And I'm I'm not sure anybody knows exactly.

Julia [00:07:18]
How honestly China is reporting right now.

Sean [00:07:20]
You mentioned the international community, the global health community. I mean.

Sean [00:07:25]
Have outfits like the World Health Organization stepped in or stepped up to sort of.

Sean [00:07:30]
Help China with this outbreak.

Julia [00:07:33]
W H O 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 W. H. O 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 in a way that poses a real threat.

Julia [00:08:01]
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 W. H. O declared this was not a public health emergency yet. Ah, but this could change in the coming weeks or days. They might meet again very soon and and decide that it is.

Sean [00:08:27]
Why would they delay that kind of decision? What's what's the decision making process for them? They said they.

Julia [00:08:33]
Needed more information, but I suspect.

Julia [00:08:37]
Part of the reason might have been politics. China's a very powerful country, and.

Julia [00:08:43]
Maybe they're there, you know, trying tow way, the political re progressions of declaring this a public health emergency.

Julia [00:08:51]
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 toe figure out whether they should declare this type of emergency.

Sean [00:09:08]
So we know this still isn't a official global health emergency yet. Is there a chance that this outbreak could still spread even more? Though.

Julia [00:09:18]
I I think there's a good chance. Yeah, we're seeing the number of cases increasing so rapidly. Last week there were there were only about 50 cases that China was reporting. Today we.

Sean [00:09:31]
Have more than 600.

Sean [00:09:33]
That's a pretty rapid spread of this virus, so it's.

Julia [00:09:36]
Very possible that continues on that trajectory. But that will depend on what we learn about the virus and yeah, most importantly, how easily it's spreading from person.

Sean [00:09:45]
To person and how deadly it is.

Sean [00:09:50]
More with Julia in a minute. I'm Sean Ramos room. This is today explained.

Sean [00:10:13]
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Sean [00:11:39]
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Sean [00:12:43]
Three month old Anna Be a trees cools like any normal baby.

Sean [00:12:48]
But Anna was born with microcephaly, an extremely small head due to abnormal brain development, a devastating neurological condition. The doctor suspect is linked to a Zika virus infection during pregnancy.

Sean [00:13:07]
There's breaking news now on the Ebola outbreak of the Centers for Disease Control and Prevention in Atlanta has just released a new alert. A chance to get the hard to find a tch one n one vaccine produced a polite stampede. Parents and not so happy Children in Fairfax, Virginia, this morning.

Sean [00:13:25]
Slum in West Eddie.

Sean [00:13:27]
For many residents, what is already a hard life has gotten tougher since a major outbreak of dengue and chikungunya in the city.

Sean [00:13:37]
Are there Maur of these public health emergencies in the 21st century than there used to be.

Julia [00:13:45]
Absolutely. When researchers have looked at the rise of infectious diseases in recent decades, they found that they have.

Sean [00:13:51]
Become more common. Do we know why.

Sean [00:13:54]
I think there.

Julia [00:13:54]
Are four major reasons we can point to sew the increase in travel and trade, organization, population growth and climate.

Sean [00:14:02]

Sean [00:14:05]
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 of the spread of disease.

Julia [00:14:21]
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.

Sean [00:14:34]
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.

Julia [00:14:46]
With urbanization? We have these like, densely packed cities. So if you think about China right, that the city's air 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, air in cafes, in apartment buildings. It becomes pretty easy to spread that virus.

Sean [00:15:11]
And does that go hand in hand with population growth.

Julia [00:15:14]
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 host, in fact, and Thio propagate itself. So.

Julia [00:15:28]
That's what we're up against.

Sean [00:15:30]
Does this, then affect, Like poor people living in cities, Maur than people with resource is.

Julia [00:15:36]
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 Ted 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.

Julia [00:16:12]
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.

Sean [00:16:21]
And lastly, climate change Are these viruses just always happier and healthier and warm places.

Julia [00:16:26]
Actually sort of. So we know that as temperatures rise across the planet.

Julia [00:16:31]
We know that the animals and insects that that can spread diseases that affect humans.

Julia [00:16:36]
That there were the places that they live is changing along with the the temperature. So, for example, with Zika virus and done gay, they're carried by a certain type of mosquito. And one of the reasons researchers think that mosquito might be reaching new places in reaching more people lately is because of climate change, because, you know, mosquitoes thrive in warm and moist environments.

Sean [00:17:01]
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.

Sean [00:17:14]
Isn't like global health and science as advanced as it's ever been? Is that helping counter these factors.

Julia [00:17:23]
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. Um, 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.

Julia [00:17:53]
But on the other end, these outbreaks are happening at a more rapid piece, and sometimes were caught off guard. In an ideal world, we already have a handle on the pathogens that air circulating in animals that could pose a risk to humans. And we'd be ableto predict those outbreaks and have, you know, things like vaccine's ready.

Julia [00:18:13]
For when they happen. And obviously we're not quite there yet.

Sean [00:18:18]
Are humans doing something wrong other than you, no living closer to each other and causing climate change.

Julia [00:18:24]
Yeah, I'm getting on planes all the time, which credit 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 help breaks before the gold 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.

Sean [00:19:11]
Is part of the problem. You're 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.

Julia [00:19:23]
That is also part of the problems. The one bit of political theater we see trotted out again and again with every outbreak, and it's happening now in China. On with other countries around China is putting people under quarantine and doing screening.

Sean [00:19:38]
At airports. 100 experts.

Julia [00:19:40]
From the CDC are descending on JFK, Los Angeles and San Francisco Airport this weekend. They're.

Sean [00:19:47]
Taking the.

Julia [00:19:47]
Temperatures of passengers arriving from Wuhan, China. Even though those efforts might sound like then be effective at stopping a virus from spreading. Researchers have found again and again that they don't work. They failed 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 heard. Economies humbly make it harder for foreign aid and experts to reach the places that are affected in an outbreak and help.

Julia [00:20:24]
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.

Julia [00:20:34]
It was an epidemic that caught health officials off guard. In 2003 SARS, a previously unknown respiratory illness, spread to Canada, nowhere where the effects felt more acutely than in the city of Toronto. And and we also had travel restrictions in 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 and that they didn't catch a single case of the disease. So yeah, it would be much better off if, instead of.

Julia [00:21:06]
Imposing those sorts of measures, we tried to educate the public about, in this case an entirely new virus.

Julia [00:21:14]
And encourage people t 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 in our money and our efforts and today.

Julia [00:21:38]
To controlling the outbreak there.

Julia [00:21:40]
With every outbreak we definitely learn. And with this one, I am 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.

Sean [00:22:49]
Julia Blues is covering Corona Virus for box. You can follow along at box dot com, and she's also on Twitter at Julia of Toronto. As of publishing time, the W H O still hasn't declared this virus of 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 gonna go ahead and say that these air 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.

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