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Coronavirus: Suspicious new case in Northern California. Here’s what the latest science tells us

Coronavirus: Suspicious new case in Northern California. Here’s what the latest science tells us

To make sense of the fast-moving world of coronavirus science and policy, we've collected the latest information from U.S. and global press briefings, virologists and research studies.

Northern California has its first coronavirus infection in a person who was not at risk, according to the Washington Post, fueling concern that the illness could spread undetected in the community.

Unlike other cases, the person did not recently return from a foreign country or have contact with a person who was known to be sick or infected, according to the source within the U.S. Centers for Disease Control. The CDC confirmed the case but did not provide details about the route of transmission, where the patient is hospitalized, or other details.

If confirmed, this means that the U.S. joins other nations where the virus is appearing without a known source of exposure, such as Hong Kong, Italy, Iran, Singapore, South Korea, Taiwan, and Thailand.

The news came as President Donald Trump spoke at an evening news conference in which he was optimistic about the administration’s efforts to prevent the spread of the disease, predicting cases would drop “down to zero in a few days,” but vowing the U.S. is ready to handle an outbreak, should it come.

Does this mean that the coronavirus outbreak could pose a threat to you and your family?

Yes, no and maybe.

For the first time, the number of new coronavirus infections outside China has surpassed those inside the country, with new hotspots in several countries such as Italy and South Korea, where the illness was diagnosed in a South Korean flight attendant who may have serviced trips between Seoul and Los Angeles last week, according to several South Korean media outlets.

But 14 countries have not reported a new case in more than a week — and even more importantly, nine countries have not reported a case for more than two weeks.

Health officials insist the risk to Americans remains low. Hundreds of people who were airlifted from China to the U.S. last month were given a clean bill of health and allowed to leave quarantine. About 60 people have tested positive — most of them among passengers on a Diamond Princess cruise ship in Japan who were brought back to the U.S. earlier this month.

The vast majority of confirmed cases are considered mild, involving mere cold-like symptoms to mild pneumonia. But the illness can be catastrophic for five percent of patients, particularly the elderly.

To make sense of the fast-moving world of coronavirus science and policy, we’ve collected the latest information from U.S. and global press briefings, virologists and research studies.

Q: Why can’t my doctor diagnosis it?

A: The symptoms of coronavirus look a lot like every illness that circulates this time of year.  So it’s tough for doctors to make a diagnosis solely on the basis of the symptoms.

The only way to find out is to be tested. The California Department of Public Health’s state laboratory in Richmond is using the CDC’s detection test on people repatriated from overseas who are suspected to be infected, but there have been undisclosed problems with it — and that’s causing a delay. Tests that are positive must be shipped to Atlanta for confirmation.

It’s important to be fast, but it’s more important to be accurate. The CDC is fixing its test and will soon send out new version. When commercial tests are available, there will greater efficiency.

— California Department of Public Health and Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases

Q: If I’m exposed, how long before I develop symptoms?

A:  The period between exposure and symptoms is 5.2 days on average, but varies greatly among patients. A new analysis still supports a 14-day medical observation period for people exposed to the pathogen.

New England Journal of Medicine

Q: How sick would I get?

A: Across China, about 80% of cases are mild, involving mostly cold-like symptoms to mild pneumonia. Fourteen percent of cases have been “severe,” involving serious pneumonia and shortness of breath. Another 5 percent of patients developed critical respiratory failure, septic shock and organ failure.

Patients 80 years or older are most at risk, with 14.8 percent of them dying. Deaths occurred in every age group except in children under the age of nine.

For people with mild disease, recovery time is about two weeks, while people with severe disease recover within three to six weeks.

Chinese Center for Disease Control and Prevention

Q: Why are some people hit so hard?

A: Experts think it depends on a person’s immune response. It seems to trigger an overproduction of immune cells that flood into the lung, causing pneumonia.

Angela Rasmussen, a virologist at Columbia University’s Mailman School of Public Health

Q: How easily does it spread?

A: Each infected person infects an average of 2 to 3.1 other people. That’s higher than the seasonal flu (around 1.3) but much lower than the measles (12 or higher).

Maia Majumder, Boston Children’s Hospital 

Q: Can I spread it if I’m not sick?

A: Perhaps. In two patients, German researchers were able to isolate the virus from the nose and throat even before they showed any symptoms or had very mild symptoms.

— New England Journal of Medicine 

Q: Does a mask help or hurt?

A: The CDC does not recommend wearing masks. Health care workers who care for care for patients with coronavirus should take all precautions. So should household members or close contacts of a known or suspected infected person. But in terms of day-to-day interactions, hand washing is far more effective.

A surgical mask is designed to keep the surgeon’s germs off the patient.

An ‘N95’ respirator mask is better in terms protecting you, but can be difficult to fit correctly to the face. If a mask is ill-fitting, the virus can find a way in. If you wear that mask, it should be specially fitted.

— Virologist Dr. Warner C. Greene, professor of medicine, microbiology and immunology at UC San Francisco

Q: Can local hospitals treat patients?

A: Patients who require hospitalization can be cared for in any community hospital that is reasonably well prepared. Almost all hospitals have already trained for a flu pandemic — and should start practicing for coronavirus care now.

— Dr. Eric Toner of the Johns Hopkins Center for Health Security.

Q: What are my chances of dying?

A: The death rate — the percentage of known infected people who die — is about 2% in China’s Hubei province, where the virus first started, and 0.7% in other parts of China. The risk of death in those over age 80 is high, at 14%. For children and young people, it is very low.

That is comparable to the death rate of the 1918 Spanish Flu pandemic. It’s much higher than the 0.1 percent fatality rate for seasonal flu.  But it’s lower than SARS virus, at 9-10%, and much lower than the MERS outbreak, at 36%.

Dr. Bruce Aylward, World Health Organization

Q: There are no approved drugs to treat coronavirus. Are any being tested?

A: Yes. Trials have already started. The drug remdesivir, made by Gilead Biosciences of Foster City, is being tested on sick Americans at the University of Nebraska Medical Center in Omaha.  While small, this is a rigorous study; it is ‘blinded,” with some subjects getting the drug and others getting a placebo. It is also being tested in China.

— Dr. Anthony Fauci, National Institutes of Allergy and Infectious Disease

Q: There’s no vaccine. What’s in the pipeline?

It is likely to be a year or 18 months before the vaccine is widely available. But things are moving quickly.

The company Moderna Therapeutics has already already shipped some doses of an RNA vaccine to the NIH. Those could be given to volunteers in a safety test starting as soon as April.

— Dr. Anthony Fauci, National Institutes of Allergy and Infectious Disease

Q: What’s happening in China?

A: Astonishingly, the number of new cases is declining, thanks to the the country’s aggressive lockdown. The Chinese epidemic peaked between Jan. 23 and Feb. 2.

Dr. Tedros Ghebreyesus, World Health Organization  

Q: Is it a pandemic?

A: It meets two of three criteria for a pandemic: illness resulting in death and sustained person-to-person spread. It’s moving closer but has not yet met the third criteria: Worldwide spread.

— Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases

Q: Where did it start? Q: How does it make you sick? Q: Can be become immune? Answers to these questions and more: : https://www.mercurynews.com/2020/02/11/coronavirus-the-8-big-questions-that-scientists-are-asking/

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