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China Coronavirus Outbreak


(OPEN)
ON Plugged In:
Dozens of cities on lockdown.
The world…
on high alert…
After the discovery..
of a highly contagious virus…
In the Chinese city of Wuhan.

The death toll…
Is rising…
with new cases…
diagnosed daily…
in China…
In the US…
And around the globe.

This…
As Beijing attempts to limit
Travel during China’s largest…
holiday celebration.

What are scientists...
and health experts doing…
to stop the deadly virus?

And what do you need to know…
to protect yourself?

On Plugged In…
“China and the Corona-virus Outbreak”


(WELCOME)
Hello and welcome to Plugged in. I'm Greta Van Susteren.

The World Health Organization says it is still too soon to call it a global public health emergency.
But the new virus, first discovered in a food market in the central Chinese city of Wuhan is spreading.

The death toll from the new Coronavirus is rising dramatically in China and the numbers of people infected around the world keeps rising.

China is locking down entire cities, creating a quarantine of nearly 60 million people.

All this as China's largest holiday migration - the Chinese lunar new year, gets underway.

What do we know about this deadly virus? And what do you need to know to protect yourself?
We begin with VOA Health reporter Carol Pearson.
((NARRATOR))
People from China are being screened at airports, both in their country and abroad. They're being checked for fever and other symptoms of a new respiratory virus.

The virus is a coronavirus, so-called because it appears to be surrounded by a crown.

The common cold is one example of a coronavirus and so are deadly respiratory viruses.

SARS - severe acute repertory syndrome first infected people in 2002. It originated from animals at a food market in China.

Then eight years ago another coronavirus came along --- the Middle East Respiratory Virus -- known as MERS.

((Matthew Freiman, University of Maryland School of Medicine))
"MERS probably was from bats, but now is endemic in camels all over the Middle East, and spreading from camels to humans. For all of these emerging coronaviruses, they have an intermediate host that allows the virus to jump from animals to people."

((NARRATOR))
This latest coronavirus is associated with a food market in Wuhan, a city of 11 million people. Respiratory viruses are airborne, transmitted by coughing or sneezing, touching an infected surface and then touching your mouth, nose or eyes. Freiman says it's easier to catch a coronavirus than it is to catch Ebola, which spreads by bodily fluids.

So far, this new virus doesn't seem to target any one group, but age has its disadvantages.

((Dr. Anthony Fauci, National Institutes of Health))
"If you're elderly, 65 or older, you have a greater chance of complications, but there's no age restriction on this."

((NARRATOR))
Complications can include pneumonia, bronchitis, kidney failure, fluid buildup in the lungs and death.

((Dr. Anthony Fauci, National Institutes of Health))
"If you wind up getting a secondary bacterial infection, you can get put on an antibiotic. If you have respiratory distress and you need help breathing, you could be put on a respirator. But, there is no proven, specific, effective treatment for the novel coronavirus."

((NARRATOR))
Scientists around the world are studying this virus.

((Matthew Freiman, University of Maryland School of Medicine)) ((4:58-4:59))
"What we need to know next is where the virus comes from."
"And then, the next steps are really looking at what this virus does, how it causes disease. Can we develop diagnostics so we can better know how it spreads in the community."

((NARRATOR))
In the meantime, the CDC recommends frequent hand-washing, coughing into your elbow or a tissue, and if you suspect you have the virus, contacting a doctor. ((Carol Pearson, VOA News Washington))

(GRETA)
US health officials say they expect more coronavirus cases worldwide but they say the threat level to the American public remains low.

Those same health officials also say that China's response to the outbreak has been good.

But they added that having US medical teams on the ground to help the Chinese is strongly recommended:

(Robert Redfield, CDC Director)
“There is no spread of this virus in our communities here at home. This is why our current assessment is that the immediate health risk of this new virus to the general public is low in our nation. The coming days and weeks are likely to bring more confirmed cases here and around the world, including the possibility of some person to person spread. But our goal of the ongoing US public health response is to contain this outbreak and prevent sustained spread of the virus in our country.”

(Alex Azar, HHS Secretary)
“So first, having lived through the SARS episode, I can say that the the posture of the Chinese government levels of cooperation and interaction with us is completely different from what we experienced the 2003 and I want to commend them for that. They are still obviously learning just as we are about a rapidly emerging infectious disease situation, but getting who CDC experts on the ground to be able to assist the Chinese experts. This is a major, major issue, major public health issue and we basically just need the best public health people we have in the world working on this right now.”

(GRETA)
As you have heard, the epicenter of this outbreak is a wild game market in Wuhan, one of the largest cities in central China.

Since then Chinese authorities have ordered a temporary ban on the sale of wildlife.

It is not the first time wildlife markets have bred new diseases and experts say it won't be the last.

VOA Science Reporter Steve Baragona explains.

(NARRATOR)
Wild animals are spared from dinner tables for now, as Chinese authorities crack down on game markets.

Officials are temporarily closing markets that sell wildlife for food.

The same thing happened in 2002, after civet cats at a live animal market in southern China infected people with SARS. That outbreak ultimately killed 800 people.

((William Karesh, EcoHealth Alliance))
"It's very disconcerting that we can't seem to learn this lesson about where this risk is coming from."

(NARRATOR)
Veterinarian William Karesh ((KAH-resh)) is vice president of EcoHealth Alliance.

He says live-animal markets pack lots of stressed-out animals together in a small space. It's a perfect environment for spreading disease.

((William Karesh, EcoHealth Alliance))
"Now, most animals of course are not infected and are not shedding viruses. But it only takes one or two. And as they come to a market where it's crowded, there's other like animals there. They can start spreading it around. It's like kids going to kindergarten. One of them shows up sick. And next thing you know, everybody else is taking it home to their parents."

((NARRATOR))
Karesh says game markets especially can breed new diseases because they bring together animals and their germs that would normally never mix.

It's a golden opportunity for a germ to find a new species to infect.

Thousands of animals pass through these markets every day. And there are thousands of these markets around the world, with millions of shoppers. With numbers like that, Karesh says...

((William Karesh, EcoHealth Alliance))
"The chances of one virus making it through winning the lottery and getting into people is pretty high."

((NARRATOR))
People don't always shop at live markets by choice, Karesh says. When there's no refrigeration, it's the best way to know your meat is fresh.

((William Karesh, EcoHealth Alliance))
"It's almost safer to see an animal that's live. It's alive. It's healthy, you know. No one found it dead on the road and now is trying to sell it to you as 'good meat.' So there's rational reasons why that exists. But that world is also changing."

((NARRATOR))
Around the world, Karesh says, supermarkets are replacing live markets.

Their offerings may be less exotic. But, he adds, they're safer for everyone. STEVE BARAGONA, VOA NEWS.

(GRETA)
What is becoming evident is the CRITICAL role science and new technology are playing to help LIMIT the spread of this newly discovered strain.

First in identifying the pathogen and second developing effective treatments.

GVS: Steve joins me. Steve, I'm gonna first talk about your reporting. Your reporting says SARS had about 800 deaths or 200 deaths killed 200…

SB: 800 worldwide…

GVS: Or 800. And then, and then this is a between the new Coronavirus is just a little over 100 right now. And the CDC estimates the flu season - this is an estimate. We wiill have 8200, estimated deaths. So, are we, you know, we're preparing ourselves or are we scaring ourselves?

SB: I think this is a tightrope that health officials always walk. They're always on the lookout for the next big one. And you never know where it's going to come from. But at the moment, this is not spread in the same way that, you know, let's say, measles is. It doesn't spread as…

GVS: That’s way more contagious. Measles is more contagious.

SB: Way more contagious. The death rate is high for an infectious disease but it's, you know, not as high as Ebola, for example. It's, you know, I think the biggest concern with this is that there's just a lot we don't know at the moment. You know, I mean, you put it in perspective, rightly I think, it has not killed as many people as the flu does every single year. But, you know, we feel like just because we see the flu every year that we're familiar with it and we kind of discount the overall toll that it has, this is all new.

GVS: Alright, so what are we doing? The US is helping but the world is helping and they're able to identify this actually quite quickly, that it's the coronavirus.

SB: Quite quickly. That was kind of remarkable. They, it was first announced on, I believe it was the 31st of December. That was the first time that China told everybody “okay we've got this new disease.” A week later on January 7 they announced they had the sequence. The DNA code of the virus. Once you've got that DNA code you can get to work on developing treatments and in vaccines.

A week is – that is super fast. Still no treatments, still no vaccines, but the pace of discovery at this point has been, has been pretty fast.

GVS: And China has quarantined the city, Wuhan.

SB: They tried. They did say that when they first quarantined the city, before they were able to kind of really clamp down - about 5 million people got out, which is, you know, not…

GVS: Not insignificant…

SB: Not insignificant. But at the moment they seem to be locking things down pretty tight.

GVS: Now how much is the world helping on this? I realized United States, we got the CDC, we've got a lot of our scientists working on it, China's working on it. What about the rest of the world?

SB: The World Health Organization is really in the lead on this. And just yesterday, the director general of the W.H.O and the leader of China met and China agreed to allow international experts in, which is something that they have not done to this point, and that you know, that's a big step. This you know, there's a lot of experts around the world who are very good with this stuff, who have been through this many times and having them on the ground should be a big help.

GVS: But there was criticism I remember during SARS that, for instance, China wasn't completely candid about the crisis, and about the, the magnitude of it. Is there a sense that China is, you know, is playing it straight, telling us everything they know, notifying the rest of world when this was identified as a potential crisis?

SB: Yes and no. They've gotten a lot of praise for the way that they've handled it so far compared to the way they handled SARS. But there still are a lot of concerns that I think partly because the you know transparency is not, you know one of China's strong suits. There's still a lot of concerns that we're not getting everything, all the information that we need to know. Health officials yesterday were asking the Chinese for more cooperation with things like - they want to see the raw data of how this virus is spreading from person to person. And China, at least as of yesterday had not shared that data yet.

GVS: And why wouldn't they share that data? I mean, any known reason why they wouldn't give that share that?

SB: I don't know.

GVS: And the interesting thing about the report is that Ebola is less - this is more contagious than Ebola.

SB: Oh yeah, absolutely. I mean Ebola is hard to get. You got to get in touch with somebody’s blood. This is…

GVS: or touch their bodily fluids…

SB: Yeah…

GVS: This is just droplets it's sneezing…

SB: Droplets, not airborne and that's important. It's, you know, it's in your sneezes or your coughs or something. But it's not just floating through the air. That's one of the things that makes measles so contagious. This is not the case with, with this virus now. Which really needs a better name. It's droplets right now and if you don't come in contact with those droplets – it doesn't seem to be likely that you're going to get the disease.

GVS: Steve, thank you. Steve Baragona, VOA science correspondent.

(GRETA)
So, is the world doing enough to stop this Coronavirus from spreading further? And what is the United States' role in developing safe and effective treatments?

Dr. Anthony Fauci, the Director of the National institute of Allergy and Infectious Diseases says the outbreak is serious.

And he says scientists around the world are doing everything they can to control the virus before it is too late.

Dr. Fauci spoke with Plugged In's Mil Arcega.

AF: The outbreak is very serious. There are travel related cases in multiple countries throughout the world, including the United States, that has five travel related cases. Fortunately, we've been able to handle them in a way of identifying them, isolating them, and doing contact tracing, so there's no spread from one person to another. And that doesn't appear to be spread from person to person outside of China. Although there are several travel related cases.

MA: Dr., is still too early to call this a global public health emergency?

AF: You know, it really becomes almost semantic. It certainly is an emergency in China. And as you get cases, outside of China, you're going to wind up having more spread because there's no reason to believe that the virus is going to act differently in Thailand, Japan, Singapore and South Korea than it's acting in China. So I don't want to outguess the W.H.O. and when and if they declare a public health emergency of international concern. But they're going to have to meet again and reevaluate this because things really look very serious there.

MA: Dr. I want to get back to your points about China. It has received some criticism for not being transparent enough. But from what I've seen so far, China seems to have taken sort of a more proactive stance than it has in the past. I'm talking about the response to SARS for example, and the bird flu.

AF: Well I think you're absolutely correct. You know I have been involved with interacting with them way back for many years, including the 2002 SARS outbreak, as well as the pre pandemic flu outbreaks. If you compare what the transparency is now with the novel coronavirus - with what it was in 2002-03 with SARS is orders of magnitude different. They were egregiously non-transparent back then, leading to a major delay in an adequate response. That's not the case now. They are definitely much, much more transparent than they were back then but we still don't have first-hand knowledge of what's going on there because it still is very much a closed situation. They’re reporting on a day by day, real-time basis, what's going on. But as a scientist, I would like to see the data myself so I can't guarantee, and confirm what's going on there. I can only say comparatively speaking, they've been much more transparent now than they were then.

MA: What about the US response so far Dr. Fauci? Limiting ports of entry for example. Is that enough?

AF: The airports here in the United States that are doing active screening, which captures, not all but a substantial percentage of the people that are coming in from Wuhan, which is the area that's predominantly involved in China. Those are the kind of things that have worked in the past. That kind of active airport screening is called entry screening. The Chinese are doing exit screening. In fact what they have done is something even more dramatic than that they've cut off all transportation: air, train, and ferry out of Wuhan.

MA: What do you think the US contribution to this health crisis is going to look like when all is said and done?

AF: Well we have always been, throughout most outbreaks and pandemics, the leaders in developing countermeasures and diagnostics therapeutics, and importantly – vaccines. We’re not the only ones that are doing that but we are a major player when it comes to developing these countermeasures in response to the outbreak. This is a moving and evolving situation that could turn out to be much worse than it currently is at the present time.
MA: So, what do people need to know about Coronavirus? Who's at risk and what can they do to protect themselves?

AF: Well right now, if you're in China, particularly in Wuhan, you're at a considerable risk. The risk for the American public right now is low. That could change if we start getting a lot of cases that spread human to human. So right now the evaluation is that the risk is still low, but we have to take it very seriously, because it could evolve into something that's much more difficult to control. Obviously we're making a vaccine we have the sequence, we have the specimens now from five people who are in this country and we're doing research based on that information in that material.

MA: Okay, this is going to be broadcast to a global audience, Dr. Fauci. Is there anything else in your mind that you think our viewers should be aware of?

AF: Well, I think that this is still a threat, and we need to pay serious attention to it and take it very, very seriously. I mean hopefully it will be contained but it could turn into a global pandemic.

(GRETA)
Hong Kong, a city of 8 million has temporarily closed some of its borders to mainland China.

It has also stopped issuing travel permits to Chinese tourists...

But the travel bans and the lockdowns at the height of China's busiest travel season is having an impact on local economies and workers at tourist destinations throughout Asia.

Reporter Steve Sanford has more from Southern Thailand.

((NARRATOR))
Last year, Thailand's tourism industry welcomed nearly 11 million Chinese visitors, boosting a sluggish economy.

But signs of caution are evident on the faces of some tourism workers worried about the spread of the coronavirus.

((Fadilah Che-Useng, Travel receptionist, Ao Nang Beach, (Female in Thai) ))
“Some foreigners saw the mask and were afraid to come because they thought I was sick but now they understand the situation. I wear a mask to protect myself not because I am sick. Right now when I see a Chinese customer I’m ok and I don’t reject them because I am providing a service.”

((NARRATOR))
Despite a clampdown on people leaving Wuhan and neighboring Chinese cities, some airlines were still flying passengers home Monday to see their families.

((Zhang Long, Wuhan tour guide, (Male in Chinese) ))
“I will just stay home for now because it’s still a critical situation out there so I’m really worried about this problem and so is my family.

((NARRATOR))
Despite a rising number of suspected cases along with news that the virus can lay dormant for up to 14 days, government officials remain confident that the crisis is still under control.

((Wittaya Watthana Reongkovit, Krabi Public Health Director (Male in Thai) ))
“Right now we’re at the second level of five. If there are any increases in Thailand of human-to-human transfer of the virus, we will bring the danger level up.”

((NARRATOR))
Still, many of the seasoned tour guides who experienced the harsh financial effects of the 2003 SARS crisis say that safety should comes before profits.

((Sunad Srimad, Tour guide (Female in Thai) ))
“The owners of the tourist company should understand this situation. If we only worry about the income of the country or businesses or even for myself, this is not the right thing for us to be concerned about - otherwise bad things will happen.”

((Steve Sandford, for VOA News, in Krabi, Thailand)

(GRETA)
Aggressive strategies - like travel bans and quarantines may seem the right thing to do but my next guest warns such actions can also bring unintended political financial and social consequences.

((BIO BOX))
Lawrence Gostin is a professor of Medicine at Georgetown University.

He is Founding Chair at the O'Neill Institute for National and Global Health Law.

He is a member of the World Health Organization's advisory committee on pandemic diseases and served on two global commissions on the 2015 Ebola epidemic.

GVS: Welcome to Plugged in.

LG: Pleasure. Thank you for having me.

GVS: The key word is unintended consequences. Let me focus first on the China US trade deal. We're into phase one. But will this outbreak have any impact on that?

LG: Well, it shouldn't. In fact, if it were possible for the US CDC, to go in force in China. I think it actually could have a wonderfully beneficial approach from not just from public health but diplomacy. It would signal to China and the world that you can have different politics, different ideologies, but we come together as a nation, as a world community - together. And so I would love to see the U.S. involved. And I think it could, If we played this right, it could improve our relationship.

GVS: Well, we see that often like with world catastrophes, whether it's you know a typhoon in some other country, wiping out some city or some Island or with the Japanese – we’re there helping them with the tsunami - so we see a lot of that diplomacy in the face of a conflict. Is China not welcoming U.S. help on this?

LG: Well, China just announced, very, very recently that it would allow foreign help. But it's not, it hasn't specified that. W.H.O.’s health emergencies program - probably in going forward, will have a presence. But how much of a presence is is yet to be seen. President Trump has offered U.S. assistance to China, but it's very, very unclear to what extent there will be a real cadre, a surge of international experts in China, that have real, you know, power and authority and expertise on the ground.

GVS: Well the clock seems to be ticking while they're all thinking about whether or not you know China will accept more help and whether what the other nations are going to do. The clock is ticking.

LG: It certainly is. You know in China, you have to - from their point of view, there's probably nothing more important to Xi Jinping and the Chinese government than projecting an air of “I've got this under control.” Competence, you know, technical capacity. And so to get it to let a large cadre of foreign experts in, or if the W.H.O. declared an emergency, I think that it would tarnish the image that China has.

GVS: We've got several issues. One of course is the quarantine of an entire city of 11 million. I mean you've got that social consequence. You've got British Airlines, they've pulled their flights in and out of mainland China. The US has evacuated people. Other nations are evacuating people. And then also in our reporting that China is doing exit screening which, when I hear exit screening, I thought, well, what if you're in that 2 to 14 day incubation period. What good is exit screening going to do?

LG: Well you know in fact, exit screening will not pick up people who are asymptomatic. And so…

GVS: Who don't show they’re sick…

LG: Who don't show their sick. That's right. And as far as the mass quarantine in Wuhan and Huabei province - I mean, this is unprecedented in the history of the world and could only happen in China. If you think about it more than 50 million people are trapped in a zone of contagion. It could provoke fear, panic. And the first rule of public health is to gain the trust and cooperation of the population. And I think these kind of mass restrictions of won't do that.

GVS: Well I imagine people are so worried about food because in a quarantine things have a difficult time getting in and out. Supposedly nobody supposed to get out of a quarantine. But is food being brought in and services? I mean is the city, is Wuhan still running like a city but for the fact you can't get out?

LG: No, it's anything but running normally. I mean there are some supermarkets are well stocked others aren't but food prices have gone up. Clinics are overrun. There's shortages of essential medicines and medical equipment. I think the Chinese government is doing all it can to actually bring reinforcements.

GVS: But that's where you get into that, they need help. If you know, a country is willing to help, you know, would it be willing to accept it?

LG: Yeah, I mean I think the help that China really needs is technical public health capacity to do testing, screening, treatment, isolation. And really to find out, have a genuine idea who's been exposed. It's shocking that so many hundreds, if not thousands, maybe millions of people have left China that were not on any known contact list.

GVS: What do you make of the fact that the CDC projects, 8200 deaths from the flu season. That's not, as I said, the ordinary flu - it's probably, nothing’s ordinary. And this has only killed – only, killed over 100 and some. I don't mean to demean it by saying only a hundred, but the numbers are dramatically different. 100 and a few with Coronavirus and 8200 projected with the flu.

LG: Yes, I mean that's a very good point. I mean, certainly SARS, MERS influenza have much higher death rates. So far, the death rate as far as we know it with the Wuhan Coronavirus is relatively low, but nonetheless, we expect flu. Flu comes every year, it sweeps the globe, we try to get a vaccine and do the best we can. This is an entirely new, novel virus that could mutate, and we really do need to take it extraordinarily seriously.

GVS: That's what Dr. Fauci said and others said. Just as a sort of personal note is that, you know, always in these situations, as a journalist I don't want to scare people. I don't want to overhype something. I want to make sure that they have the right information so that they can take precaution but you know we're all sort of in uncharted waters trying to figure out what to do now.

LG: Absolutely.

GVS: Anyway, thank you very much for joining us, sir.

LG: Pleasure.

GVS: Lawrence Gostin, Professor of Medicine, Georgetown University.


(CLOSING THOUGHTS)
Before we sign off - we want to pause to reflect on the tragic death of a sports icon known around the world.

On Sunday US basketball star Kobe Bryant and his 13 year old daughter Gianna and 7 other passengers died in a helicopter crash near Los Angeles.

Bryant played his entire 20-year career with the Los Angeles Lakers. He retired in 2016.

His accomplishments were extraordinary, including 5 NBA championships and 2 NBA Finals Most Valuable Player awards. He was an 18-time NBA All-Star and he won 2 Olympic Gold medals.

In retirement, he did more.

He became a succesful businessman, writer and production executive including winning an Emmy award and an Oscar.

Having spent his childhood in Europe, Bryant was fluent in Italian and Spanish and loved international soccer.

Kobe Bryant was 41 years old. He is survived by his wife and 3 daughters and the millions of fans around the world who loved him.

That's all the time we have for today.

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