Here Is What WHO Experts Are Watching on the Coronavirus' Spread

By Stephanie Nebehay

February 11, 2020

GENEVA (Reuters) - The World Health Organization (WHO) is tracking the epidemic of the new coronavirus in China and how it is spread abroad, as its advance team of international experts travel there to help investigate the outbreak.

Here are some issues that WHO epidemiologists are probing to deepen understanding of the virus, believed to have jumped the species barrier at a seafood market in Wuhan in December, to help accelerate development of drugs, diagnostics and vaccines.

- Human-to-human spread. WHO says that an infected person transmits the respiratory virus through droplets or close contact, but that it can stay on surfaces for short periods. It has a maximum incubation period of 14 days.

"There've been some concerning instances of onward #2019nCoV spread from people with no travel history to China. The detection of a small number of cases may indicate more widespread transmission in other countries; in short, we may only be seeing the tip of the iceberg," WHO director-general Tedros Adhanom Ghebreyesus said in a tweet on Sunday night.

- To what extent people who have mild disease, which according to Chinese data on 18,000 cases is some 82%, shed the virus and potentially expose others. Some 15% of cases are severe and 3% critical, according to its data shared with WHO.

- So-called 'clusters' of cases where there has been secondary or tertiary onward spread of the virus among people in countries including China, Germany and France. Tracing contacts exposed to the virus is key to stopping transmission chains.

"The overall number of people associated with those clusters has been very, very limited," Dr. Mike Ryan, WHO's top emergencies expert, said on Saturday. "Those clusters also can teach us a lot about the nature of the dynamics of disease transmission."

- Spread of the virus in hospitals and health care facilities, where the WHO advises medical staff to take standard infection prevention and control measures including wearing gloves, masks and gowns.

"From the start when we knew about this new respiratory pathogen, and it was a coronavirus, we thought that there was going to be the possibility of an amplification event, or 'super-spreading' events," said Dr. Maria van Kerkhove, a WHO epidemiologist.

"We have only one instance of an outbreak in a hospital that we are aware of, in Wuhan, involving 15 health workers," she said.

- Why some people die. People who are older or have underlying medical conditions - including cancer, diabetes, and hypertension - are most at risk. The overall death rate among reported cases is some 2%. People above 80 have the highest death rates, WHO says, citing Chinese data. WHO wants more data about the disease that can cause pneumonia and organ failure.

"We have recently released a clinical case report form which we are encouraging hospitals and clinicians to use so that standardised data collection can be captured from patients who are hospitalised," van Kerkhove said.

This will provide a better picture of disease progression and what severe disease looks like, she said.

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