Wuhan has a population of 10 million, and many had begun to travel in advance of the Chinese New Year this week. Experts at Imperial College London have estimated infected population numbers to be already at around at 100,000.
We can therefore expect more cases around the world as infected individuals travel and transmit the disease. However, once again, the question emerges of what the reported fatalities so far are among this large number of infected individuals. Could it be that the virus is spreading but not causing too many deaths?
Nepal has seen regular outbreaks of respiratory diseases including seasonal influenza, ‘avian influenza’ and ‘swine flu’. The Nepali media often reports cases of ‘unknown viral disease’. The Nepal government had established screening centres for the coronavirus at airport and border checkpoints even before the first infected person was diagnosed in Tibet on Monday.
The National Public Health Laboratory is working with private hospitals and laboratories to provide timely and accurate diagnostics of the Wuhan coronavirus with technical support from the World Health Organization (WHO).
Cases are being referred to Sukraraj Tropical Infectious Diseases Hospital as the focal center and the Epidemiology and Disease Control Division is monitoring signs of possible outbreaks in country. The Ministry of Health and Population has directed all private hospitals around country to have ventilator supported ICUs to be on standby should those be required.
The state mechanism appears to have learnt from weaknesses is showed during the SARS and H1N1 (swine flu) outbreaks of the past. However, accurate clinical diagnosis of this disease is going to be a challenge given the likelihood of infected individuals arriving at checkpoints showing no symptoms and because individuals infected with other viruses like influenza or other weaker strains may show similar symptoms as those infected by the Wuhan coronavirus.
Screening is the only way of identifying the maximum number of cases entering the country and preventing those from infecting the population. There have been no further coronavirus infection cases reported in Nepal since 25 January. The first case, reported on that day, is so far the only one.
Global media reporting of this outbreak has focused on fatality rather than recovery, and appears to have failed to notice that the WHO, with its expertise and access to data, has not yet declared the Wuhan coronavirus outbreak a public health emergency.
The experience of having made the ‘premature and hasty’ decision to term the 2009 influenza A (H1N1) – or swine flu – outbreak a pandemic still being fresh, this time WHO has decided to monitor the situation closely before making any decision in this regard.
The WHO has focused on China as a priority for action while observing rest of the world. This does not mean we can be complacent, as the threat of the virus mutating into a more severe form is real. However, it also does not help to panic. We need to look at the numbers, listen to experts in the field and move ahead accordingly.