The patient had developed fever and cough after shopping in a department store on January 22. The patient had a history of type 2 diabetes and hypertension.
Who was the carrier? 5 coronavirus cases traced to Chinese department store.
Chinese experts were left puzzled after five cases of the new coronavirus were linked to a department store in the northern megacity of Tianjin - until their investigations shed light on the extent of the rapidly spreading illness’ transmissibility.
Four women and a man, all of whom had shown symptoms then been confirmed as infected in the past two weeks, had one thing in common: their connections to the store, in the Baodi district in Tianjin.
But only when the fifth case was discovered did their ability to infect one another become apparent.
None of them had been to the city of Wuhan, where the virus is believed to have originated, nor did they have close physical contact with one another except for two who were a married couple, according to the city’s infectious disease prevention centre.
Their cases have helped to reveal the transmission pattern of the deadly virus, which has infected more than 20,000 people in mainland China, killing over 400, and spread to more than 20 countries.
It is known to be spreading primarily between people in close proximity, through respiratory droplets - such as saliva or mucus via coughs and sneezes - or by physical contact with viral material followed by its oral ingestion.
Of the five people in these Tianjin cases, the first two who sought medical help were a couple, of whom the woman was a salesperson in the store’s electronic appliances department. She had a fever on January 22, then her husband, who had not visited the store, had diarrhoea, also a symptom, two days later.
The next person was another member of sales staff who worked on the same floor as the first but had not had close contact with her. She showed symptoms on January 24, after leaving town for a business trip on January 18, during which she met a person who health experts have said had a fever.
Scientists previously thought this third Tianjin person was the original virus carrier, although her link to the couple was not fully explained.
However, Zhang Ying, a section head at Tianjin Centre for Disease Control and Prevention (CDC), said in a press briefing on the matter on Sunday: “The place this third case visited outside Tianjin also has infected cases recorded, but there is no confirmation whether the person this salesperson met was a confirmed case of the virus or not, because that person did not seek medical help. We therefore were not able to confirm the origin of the third case’s infection.”
Then a fourth person, also a salesperson at the department store, who sold shoes on the same floor, sought medical help. This patient, too, had left Tianjin, on January 12 to buy stock, and had shown symptoms of infection as early as January 21.
Health experts said this fourth person may have been infected on that trip, because her destination - which the experts did not disclose - had recorded confirmed infections. Nonetheless, they could not yet see a connection to the two other colleagues who became infected.
It was only when a fifth confirmed case related to the department store emerged on February 1 that the experts were able to map the spread of the virus among the five. The fifth person was a female shopper who spent three hours on January 23 shopping in the shoes and jewellery sections, on the floor where the third and fourth people were working.
Epidemiologists concluded that the shopper’s temporary exposure to the coronavirus showed it to be possible for the fourth person, bringing it back from her business trip, to have been the carrier who spread the disease to all three other women, the first of whom passed it on to her husband.
“Although the salespersons were working in different departments in the store, all the sections were on the same floor without any physical barriers separating them,” Zhang, the CDC official, said.
“They were neighbouring each other and were less than four to five metres away from each other most of the time, and sometimes they would even be at a proximity of one metre. In such an environment, a visiting customer was infected in just three hours, so imagine how unavoidable the environment would have been for someone who works there eight hours a day.”
As of 6am on Thursday, Tianjin had a total of 69 confirmed cases of the new coronavirus.
As of February 5th, there were no new confirmed cases of coronavirus-related pneumonia.
Until now, 69 cases of pneumonia diagnosed of coronavirus-related pneumonia have been reported in Tianjin, including 4 critical cases, 20 severe cases, and 42 common cases. 2 patients were discharged from the hospital and 1 died. 171 suspected cases.
The Hubei health authority reported that 70 more people died after contracting the coronavirus in Hubei province on Wednesday, raising the Hubei death toll since the beginning of the outbreak to 549. This brings the total number of deaths in mainland China to at least 563.
The global death toll is 565, with one death in Hong Kong and one death in the Philippines. Authorities confirmed an additional 3,694 cases of the virus in Hubei on Wednesday, which brings the total number of cases in the epicenter of the outbreak to 19,665.
There has been 14,314 patients have been hospitalized in Hubei, including 756 who are in critical condition, according to the health authority.
The number of confirmed cases in mainland China is at least 28,018. The global number of confirmed coronavirus cases now stands at 28,276.
It says there are 24,702 suspected cases. A total of 282,813 close contacts have been traced, and 186,354 close contacts are still in medical observation.
Of the deaths in the past 24 hours, of the 73 new deaths recorded, 70 were in Hubei Province, and one each in Tianjin, Heilongjiang, and Guizhou.
The vast majority of new infections were also in (Hubei 2,987 out of 3,694).
Newborn tests positive
just 30 hours after birth
An infant in Wuhan has reportedly tested positive for the coronavirus just 30 hours after birth, raising concerns that the infection could be contracted in the womb.
Citing sources from the city’s children’s hospital, two infants were infected with the virus, the youngest just 30 hours old. “The mother of the newborn was a confirmed patient of the coronavirus. At present, the infant’s vital signs are stable,”.
Zeng Lingkong, a senior physician at the hospital’s neonatal department, said the case was a signal that “we should be concerned about the possible new transmission route of the coronavirus”.
Zeng said pregnant women should stay away from infected patients. The Wuhan Children’s Hospital had set aside an area to treat pregnant women with suspected symptoms.
Chinese health authorities have identified a number of patients who have become carriers and transmitters of the coronavirus despite showing no outward symptoms of the disease.
Li Xingwang, chief infectious diseases expert at Beijing Ditan Hospital, said most of the “dormant” carriers were related to and had caught the virus from patients with symptoms.
“These [carriers] have the virus and can transmit it. The amount of virus correlates to the severity of the illness, which means these patients carry less of the virus and their ability to transmit disease is weaker,” Li said.
In new treatment and diagnosis guidelines released on Wednesday, the National Health Commission said people with milder symptoms, such as fever, fatigue, a cough but no lung infection, should be quarantined and treated to curb further infections.
The guidelines also said airborne and digestive tract infections were other possible modes of transmission after traces of the coronavirus were found in patients’ faeces.
Li said the two modes were still only possible routes and further investigation was needed to confirm them.
All travelers entering Hong Kong from mainland China will be placed under quarantine for 14 days, Hong Kong Chief Executive Carrie Lam announced at a news conference today. The rule includes Hong Kong and mainland residents, Lam said.
There are 21 confirmed cases of coronavirus in the semi-autonomous city, of which three are locally infected cases - suggesting transmission between the community, rather than being brought in from somewhere else.
Travel restrictions: The government suspended four more border crossings yesterday, which has seen entries by travelers from mainland China drop by 60%.
However, the city cannot close all borders because many of the arrivals from the mainland are Hong Kong residents who need to return into the city, she said. Besides, Hong Kong relies on the mainland for crucial supplies including food.
"Closing all borders is not workable and may affect the supply of food and daily necessaries. The measures we applied last few days proved that these measures can decrease the number of arrivals and decrease the risk of infection," Lam said.
What the government has done: The government will allocate over 10 billion Hong Kong dollars (about $1.3 billion) in resources to fight the outbreak, Lam said. It has already closed most of Hong Kong's borders with the mainland - but many in the medical field say that's not enough, and have been on strike for three days.
WHO: Asks for $675 million donation
to fight coronavirus
The World Health Organization (WHO) has called for $675 millions in donations as an investment to combat the 2019 novel coronavirus especially in countries “at risk.”
"We are requesting $675 million to fund the plan for the next three months. $60 million of that is to fund WHO’s operations – the rest is for the countries that are especially at risk,” said WHO Director-General Tedros Adhanom Ghebreyesus in a press briefing at Geneva, Switzerland.
The 2019-nCoV, which originated from Wuhan in Hubei, China, has already spread in more than 25 countries with 191 infected.
Ghebreyesus pointed out that the amount needed is part of the Strategic Preparedness and Response Plan, which aims to help countries prevent, detect, and diagnose transmission.
“Our message to the international community is: invest today, or pay more later,” he said. "$675 million is a lot of money, but it is much less than the bill we will face if we do not invest in preparedness now.”
The WHO also said that it has released a total of $9 million from its own contingency fund for emergency situations such as this coronavirus outbreak.
Further, the organization will be sending half a million masks; 350,000 pairs of gloves; 40,000 respirators; and almost 18,000 isolation gowns to the countries affected by the outbreak.