Summary:

  • In China there are now 2,744 confirmed cases as of 1200am on Jan 27, an increase of 39% resulting in 80 deaths, up 43%.

  • This is  triple the 916 mainland China cases reported late on Friday.
  • Across the globe, there are now 2,807 confirmed cases and 80 Chinese fatalities, as so far nobody outside of China has died from the disease (that we know of).
  • Some very unpleasant math: in China’s Hubei province where Wuhan is located, epicenter of the coronavirus breakout, there have been 1,423 cases and 76 deaths, resulting in a mortality rate of over 5%.
  • 5th US Coronavirus infection confirmed by CDC in 4 states (AZ, CA, IL, WA)
  • CDC calls the virus an  “emerging public health threat,” adding that the threat is “serious.”
  • Incubation is asymptomatic, contagious, and can be as long as 14 days
  • 5M may have left Wuhan for Lunar New Year
  • 1st case was Dec 1 NOT Dec 31 so infect pop may be much bigger
  • US, Russia, Thailand begin plans for evacuation
  • Premier Li Keqiang charged with leading government’s task force
  • 3 Beijing hospitals using AIDS drugs to treat virus

*  *  *

Update (1910ET):According to China’s Global Times, as of 12:00am on Jan 27, there have been 2,744 confirmed cases of Coronavirus on the Chinese mainland, resulting in 80 deaths. We are now waiting for the latest global numbers.

Update (1510ET): CDC reports that a fifth infection has been confirmed in the US (in Arizona), calling the coronavirus an “emerging public health threat,” says threat is “serious.”

Situation Summary

CDC is closely monitoring an outbreak of respiratory illness caused by a novel (new) coronavirus (termed “2019-nCoV”) that was first detected in Wuhan City, Hubei Province, China and which continues to expand. Chinese health officials have reported more than a thousand infections with 2019-nCoV in China, including outside of Hubei Province. Infections with 2019-nCoV also are being reported in a growing number of international locations, including the United States, where 5 cases in travelers from Wuhan have been confirmed in four states (AZ, CA, IL, WA) as of January 26, 2020.

Source and Spread of the Virus

Chinese health authorities were the first to post the full genome of the 2019-nCoV in GenBank  El , the NIH genetic sequence database, and in the Global Initiative on Sharing All Influenza Data (GISAID Z ) portal, an action which has facilitated detection of this virus. On January 24, 2020, CDC posted in GenBank the full genome of the 2019-nCoV virus detected in the first U.S. patient from Washington state. The virus Chinese health authorities were the first to post the full genome of the 2019-nCoV in GenBank  El , the NIH genetic sequence database, and in the Global Initiative on Sharing All Influenza Data (GISAID Cl ) portal, an action which has facilitated detection of this virus. On January 24, 2020, CDC posted in GenBank the full genome of the 2019-nCoV virus detected in the first U.S. patient from Washington state. The virus genetic sequence from the patient in Washington is nearly identical to the sequences posted from China. The available sequences suggest a likely single, recent emergence from a virus related to bat coronaviruses and the SARS coronavirus. The available sequence information does not provide any information about severity of associated illness or transmissibility of the virus.

Early on, many of the patients in the outbreak in Wuhan, China reportedly had some link to a large seafood and animal market, suggesting animal-to-person spread. However, a growing number of patients reportedly have not had exposure to animal markets, and there is evidence that person-to-person spread is occurring. At this time, it’s unclear how easily or sustainably this virus is spreading between people. Learn what is known about the spread of newly emerged coronaviruses.

Illness Severity

Both MERS and SARS have been known to cause severe illness in people. The complete clinical picture with regard to 2019-nCoV is still not fully clear. Reported illnesses have ranged from infected people with little to no symptoms to people being severely ill and dying. Learn more about the symptoms associated with 2019- nCoV.

There are ongoing investigations to learn more. This is a rapidly evolving situation and information will be updated as it becomes available.

Risk Assessment

Outbreaks of novel virus infections among people are always of public health concern. The risk from these outbreaks depends on characteristics of the virus, including whether and how well it spreads between people, the severity of resulting illness, and the medical or other measures available to control the impact of the virus (for example, vaccine or treatment medications).

Investigations are ongoing to learn more, but person-to-person spread of 2019-nCoV is occurring. Chinese officials report that sustained person-to-person spread in the community is occurring in China. Person-to-person spread in the United States has not yet been detected, but it’s likely to occur to some extent. It’s important to note that person-to-person spread can happen on a continuum. Some viruses are highly contagious (like measles), while other viruses are less so. It’s important to know this in order to better assess the risk posed by this virus. While CDC considers this is a very serious public health threat, based on current information, the immediate health risk from 2019-nCoV to the general American public is considered low at this time. Nevertheless, CDC is taking proactive preparedness precautions.

CDC recommends getting vaccinated, taking everyday preventive actions to stop the spread of germs, and taking flu antivirals if prescribed.

And the poiliticking has begun…

Update (1400ET): It’s official: The Wuhan coronavirus has arrived in America’s second-largest city. The LA County Department of Public Health just confirmed what is now the fourth case discovered in the US.

As we noted earlier, California has dozens of suspected cases, many of which have been tested and cleared. But some still remain. We suspect this won’t be the last case in Cali (they’ve already confirmed 2, this one and a case in nearby Orange County). The virus has also been discovered in Illinois and Washington state. State health officials told CBS Los Angeles that the individual recently traveled to Wuhan, and is receiving ‘appropriate care’ at a local hospital.

Remember when Trump said the Chinese had things ‘under control’?

Oh and one more thing before we go: The other day we joked that China’s decision to send hundreds of PLA ‘medics’ to help stabilize the situation in Wuhan was code for placing the PLA in charge and declaring de facto martial law.

Well, guess what”

Communists – they’re not as full of surprises as they used to be.

Every time there’s a problem it’s ‘send in the tanks’…

* * *

Update (1240ET): Just as we expected, the outbreak-related news out of China went from bad to worse on Sunday, as Wuhan’s Mayor not only informed the public that he suspects the number of cases in the city to increase by a considerable margin (as we mentioned below), but also that some 5 million residents of Wuhan – roughly half of the city’s population – had already left the city before the quarantine was fully implemented. Some left early last week for the lunar new year holiday, while others fled after learning about Beijing’s plans to cut off the city from the outside world (except for the flow of personnel and supplies needed to fight the outbreak).

Anybody who tries to leave Wuhan on Sunday will find the roads blocked and guards ordering them to turn back.

The barricade, at one of the tolls for highways exiting the city, was blocked with red and yellow plastic barriers and cones.

“Nobody can leave,” a policeman told AFP.

But that’s far from the only disturbing news to emerge in the past few hours.

To try and assuage citizens’ frustration about the virus overshadowing the LNY holiday, Beijng announced an extension of the holiday. That should take a bigger bite out of China’s GDP as factories, offices and government services will remain shuttered – but ideally China’s battered travel and tourism industry might be able to make up for some of the hit. As we noted earlier, Suzhou, a factory hub, was the first city to announce a holiday-like shutdown of industry until Feb. 8. China’s top transportation official confirmed on Sunday that travel has plummeted for the holiday. On Saturday, overall transportation dropped by 28.8% from the same day last year. Railway transportation fell by 41.5%, roads 25% and passenger flights 41.6%.

After the third case was confirmed in California on Sunday, health officials in Virginia have announced that three patients suspected to have contracted the virus are under observation, according to Fox. More alarmingly, a student at Connecticut’s Wesleyan University is being monitored for the virus after reporting a fever and a cough. Though it has yet to be confirmed, this underscores the difficulty in stopping the spread of the virus to the US, as Chinese students return to their American schools for the new semester, as the Hartford Courant reports. More suspected cases have been reported in California and Texas (though the Texas cases have mostly been cleared). University officials at Wesleyan said they’ve been in touch with everyone that the sick student – whose name was not released – has been in contact with.

In a sign that the WHO is facing pressure to finally declare the outbreak a global health emergency (which it declined to do last week), WHO Director-General Tedros said in a tweet that he was on his way to Beijing to “confer” with top Chinese officials and health experts about the outbreak. Underlining the gravity of the situation, President Xi has placed his No. 2, Premier Li Keqiang, to lead the team monitoring the coronavirus as the outbreak worsens.

On Sunday, Ma Xiaowei, China’s National Health Commission, revealed that the incubation period for the virus is around 10 days – though the shortest case was 1 day, and longest 14 – and, more importantly, that those who have contracted the virus might be contagious before symptoms emerge. That wasn’t the case for the SARS outbreak in 2003, and it will make the virus much more difficult to contain. Ma added that there are signs the virus is adapting to spread even more quickly from human to human, per the SCMP.

Ma Xiaowei, the minister in charge of China’s National Health Commission (NHC), told a press conference that battling the outbreak was complicated, particularly as it had been discovered that the new virus could be transmitted even during incubation period, which did not happen with Sars (severe acute respiratory syndrome).

“From observations, the virus is capable of transmission even during incubation period,” Ma said, adding that the incubation period lasted from one to 14 days.

“Some patients have normal temperatures and there are many milder cases. There are hidden carriers,” he said.

Ma said also that the virus had adapted to humans and appeared to have become more transmissible.

“There are signs showing the virus is becoming more transmissible. These walking ‘contagious agents’ [hidden carriers] make controlling the outbreak a lot more difficult.”

The authorities had also not ruled out the possibility of the virus mutating in the future, he said, which meant it could spread to different age groups.

To date, most of the people infected are in the 40-60 age range, health officials said earlier.

SARS had an incubation period of 2-7 days, and was not infectious during that time. And it still killed more than 800 people after infecting more than 8,000 around the world.

Circling back to the mad rush to leave Wuhan, while the city has 11 million official residents, it also hosts millions more guest workers, noted CNBC’s Eunice Yoon. Interestingly, as more cities declared travel bans on Sunday, Shantou, a city in Guangdong Province, overturned its decision, saying it will monitor people, vehicles and ships entering and city, but said there will be no travel restrictions on buses, ride-shares, and taxis. Yoon speculated that the city pulled the plan after being contacted by senior party officials so as not to set a “every-town-for-itself” precedent.

And in a few areas, vigilantes have apparently taken on the responsibility of guarding the perimeter.

Fortunately, few new deaths have been reported so far on Sunday. But the count of confirmed cases had climbed to 2082, and – as the mayor said – many more cases will likely be confirmed by Monday morning local time. Meanwhile, the US, Russia, Thailand and South Korea are still plotting an evacuation for citizens stuck in Wuhan.

As doctors desperately search for a cure or vaccine, three Beijing hospitals designed as coronavirus treatment centers have reportedly started treating patients with a combination of anti-HIV drugs Lopinavir and Ritonavir. The two powerful retrovirals are sold in a combination under the brand name Kaletra, which is produced by AbbVie. Research on 41 Wuhan cases published in Friday’s edition of The Lancet medical journal noted that the drugs were useful in treating SARS, which was also a coronavirus, per SCMP.

“Online rumors say that an anti-Aids drug has been used and proved to be effective in treating the coronavirus,” according to a statement by Beijing Municipal Health Commission. “The National Health Commission has recommended the rumored names to treat the coronavirus before and we have Lopinavir/Ritonavir in stock in Beijing,”

Three Beijing hospitals designated to treat confirmed coronavirus cases – Beijing Ditan Hospital, Beijing Youan Hospital, and No 5 Medical Center of PLA General Hospital – have begun using this therapy for treatment, the statement added.

The two drugs are antiretrovirals, which block the ability of HIV to bind with healthy cells and reproduce, and are often used in combination to treat the illness.

CNBC’s Yoon shared another treatment strategy that relies on even more common medications, including Tamiflu.

Still, not enough research has been done to definitively confirm that these medications are effective in combating the virus. At last check, Beijing has reported 51 cases of the virus, 49 of which remain hospitalized, while two have been cured and one remains in critical condition.

Scientists are still racing to produce a vaccine. Hopefully, one will be found before the worst-case scenario projected by some epidemiologists becomes a reality. Until then, looks like Abbvie will see a substantial bump in sales. But in the meantime, maybe officials in Beijing can send some of those AIDS drugs down to Wuhan. Or they could at least send over a few truckloads of Tamiflu.

* * *

Update (0950ET): As the world is on edge with the rise of the number of officially reported coronavirus infections (and deaths), the mayor of Wuhan said Sunday that he expects new cases to jump by 1,000.

Mayor Zhou Xianwang told Reuters and other journalists in a briefing that Wuhan, the epicenter of the outbreak, could soon report an additional 1,000 new cases, which will push total cases across Mainland China to about 3,000.

Xianwang said the city is constructing several new hospitals to deal with infected patients.

He said the city had received new supplies of protective gear including biological suits, masks, and glasses, which have been in short supply.

If Xianwang is correct about the increase of new cases, this could mean by the end of Sunday, a total of 3,000 cases could be confirmed across the world, and suggest that Jonathan Read’s model of 250 thousand infected in the next several weeks could become a reality.

* * *

Hundreds of medical personnel are rushing to Wuhan following yesterday’s tragic death of Doctor Liang Wudong, of the ENT department of Hubei Xinhua Hospital, who died Saturday while fighting to suppress the virus. The South China Morning Post reports that 1,350 medics (presumably from the PLA) have already arrived in the city, and another 1,000 are expected to arrive soon.

As the number of confirmed cases surges past 2,000, China is scrambling to build not one, but two, SARS treatment-model hospitals in Wuhan (remember, Wuhan is a massive city of 11 million). Authorities have told the press that they expect both hospitals and their combined 2,300 beds to be operational within half a month.

Even though researchers have purportedly cast doubt on the theory that the coronavirus didn’t make the jump from animals to humans thanks to a shady food market that trafficking in live wild animals, officials in Beijing on Sunday banned the sale of live wild animals, including bats and snakes, at markets, supermarkets, restaurants and e-commerce platforms across the country. But we thought eating bats was a delicacy and an ingrained cultural practice not to be criticized or stifled?

As we reported last night (Sunday morning in Beijing), health officials in Hubei Province confirmed thirteen more deaths on Saturday, while another was reported in Henan Province. Perhaps most alarmingly, last night, we learned that a patient has reportedly succumbed to the virus in Shanghai as well. In that case, the victim was an 88-year-old man who was suffering from preexisting health issues. AFP adds that 40 cases have been confirmed in the city: 37 stable, one critical, one recovered, and one (88yo man with comorbidities) died. They are also investigating 95 additional suspected cases. These weren’t the first deaths outside of Hubei, but, according to the New York Times, “the death in Shanghai, which is among China’s most populous cities and a major commercial hub, is likely to add to anxieties about the disease’s spread.”

Over in the US, officials confirmed a third case of nCoV early Sunday. The patient is being treated in isolation at a hospital in Orange County, Calif., a wealthy suburban California county known for its (relative) conservatism. The CDC notified health officials in the county that the patient had tested positive on Saturday, according to a statement obtained by CNN. The individual is said to be in “good condition”. State and federal officials are tracking down anybody who might have had contact with the patient, who recently traveled from Wuhan to the US. Two previous cases were confirmed in Illinois and Washington state.

Additionally, Japan confirmed its fourth case of infection, Thailand confirmed its 8th case, Hong Kong confirmed its sixth case and Macau confirmed three new cases overnight. Paris has cancelled a Lunar New Year parade

AFP reported the Shanghai cases late yesterday in the US, but the American press has, for some reason, neglected to emphasize, or even mention, this alarming factoid. We suspect it could have something to do with the stock market.

Across China, 688 new cases of the virus were diagnosed on Saturday. Some experts suspect that Beijing is concealing the true number of confirmed cases for fear of sparking ‘social panic’, just like the leadership did during the SARS outbreak in 2003 (which is what necessitated all of their promises of “transparency” in the first place).

This would also partially explain the vast discrepancies in case counts between the WHO, and media organizations like SCMP, which has consistently led the world in confirming new cases.

Regardless of the circumstances, Beijing’s first priority will always be ‘maintain social stability’ – no matter the cost, in lives or money. As one twitter wit argued, it looks like the medical field is going to have to learn this lesson the hard way.

Despite all this, Pope Francis weighed in on the outbreak on Sunday, praising China’s efforts to contain the outbreak, and praying for the dead and the sick.

“I would like also to be close and to pray for the people who are sick because of the virus that has spread through China,” Francis told tens of thousands of onlookers gathered in St. Peter’s Square for his weekly homily and blessing. “May the Lord welcome the dead into his peace, comfort families and sustain the great commitment by the Chinese community that has already been put in place to combat the epidemic.”

Across Asia, prices of protective facemasks have stayed elevated amid rampant price-gouging.

There were a few updates on China’s expanding lockdown overnight. The eastern province of Shandong, with a population of 100 million, is the latest to announce that it will suspend long-distance bus service, following similar announcements in Tianjin, Beijing and Xi’an. Sunday marks the beginning of a ban on all private vehicles traveling through Wuhan as authorities expand the quarantine/lockdown, which will remain in place indefinitely until the outbreak is truly ‘contained’. Amid the lockdown, South Korea, the US, Russia, France and other governments have hatched plans to evacuate their citizens from Wuhan.

At least two Chinese provinces and three cities have ordered citizens to wear face masks in public, according to Al Jazeera.

And Reuters reports that a manufacturing hub in Suzhou expects its businesses to remain closed until at least Feb. 8, the latest reminder that when all is said and done, this outbreak will likely take a bite out of Chinese GDP (though whether the leadership decides to publicize the true extent of the deceleration in growth remains to be seen).

And as Wuhan continues to suffer from a withering shortage of medical supplies, one resident told the AFP that the entire city has been infected with a pervasive despair.

“In the past week, we’ve not been able to go out and buy anything to eat,” Mashal Jamalzai, a political science student from Afghanistan told AFP. “We want to be evacuated as soon as possible, because their the virus, the hunger or the fear will kill us.”

The measure is required in the provinces of Guangdong in the south and Jiangxi in the centre, plus the eastern city of Nanjing, Ma’anshan city in Anhui province and Xinyang city in Henan, according to local authorities.

After Friday’s selloff, we imagine investors will be paying close attention to news out of Wuhan as it completely overshadows other ‘important’ domestic news stories, like the Dems impeachment debacle, or the fact that Bernie Sanders is now on track to win Iowa and New Hampshire.

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