15 February 2020

Vox: Why the coronavirus outbreak might be much bigger than we know

“In the last few days,” Lee Hsien Loong said on February 8 in a Facebook video, “we’ve seen some cases which cannot be traced to the source of infection. These worried us because it showed that the virus is probably already circulating in our own population.” If the virus is even more widespread, he added, “it’s futile to try to trace every contact.” Instead of trying to contain the disease, health officials in Singapore will have to accept that it’s gone everywhere and shift to mitigating its impact.[...]

The documented cases of community spread in other countries outside of China have been limited to date, but there’s good reason to believe they’re just the tip of the iceberg. And once more cases are confirmed, the threat of a pandemic (the disease spreading around the world) increases, and so does the number of people the virus will infect and the length of the battle against it. A look at the small outbreaks in five countries — with strong public health systems like the US — helps explain why.[...]

More and more, these include examples of “secondary transmission” of the virus: people who haven’t traveled to China getting sick from someone who has traveled there, or, in the case of Singapore, from an unknown source. Sometimes, these people pass on the virus to others, what’s known as tertiary spread. And, again, this is happening in places with some of the strongest disease surveillance and public health systems in the world.[...]

For now, it’s important to remember that a disease can spread widely, and even become a pandemic, and not be particularly severe. In his Facebook video, Prime Minister Lee repeatedly asked Singaporeans not to panic, reminding them that this virus already appears to behave more like seasonal flu than SARS: While it’s more contagious than SARS, it looks much less deadly — a point Fauci recently reaffirmed.

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