RIO DE JANEIRO, BRAZIL – The Covid-19 outbreak detected two weeks ago in northeast China surprised doctors who treated the original pandemic outbreak in Wuhan, central China. The incubation of the disease is more prolonged, it shows somewhat different symptoms, and affects the internal organs differently. Patients also need longer to recover.
Qiu Haibo, an intensive care physician at the National Health Commission who moved to Wuhan at the start of the pandemic to fight the coronavirus, explained this in an interview with China CCTV. Qiu is now in the northeast of the country, where almost 50 cases have been detected in three cities (Shulan, Jilin, and Shenyang) in two provinces, with a total population of 100 million. The new outbreaks, albeit much smaller in scale than the one that caused the pandemic, have forced the reinstatement of confinement measures and restriction of mobility in the affected areas.
In Wuhan, it took patients no more than two weeks to develop the first symptoms after becoming infected, but in Heilongjiang and Jilin, the two provinces currently affected, they are taking longer, according to the expert. This longer asymptomatic period “has led to infection outbreaks within families,” he said.
The patients’ clinical symptoms are slightly different from those in Wuhan: there is not as much fever, but a sharply sore throat and general discomfort. The consequences for the internal organs are, therefore, different. In the original outbreak, the patients suffered damage to their kidneys, intestines, heart, and lungs. Patients in the Northeast tend to show more considerable damage to the lungs, while the other organs are barely damaged.
And although incubation and recovery times are slower (they take longer to be negative for coronavirus CRA tests), the disease’s virulence seems to be lower, and a smaller percentage of patients reach critical condition, only ten percent. Little more than half of all cases in the Northeast need hospitalization.
The genetic analysis of the virus strain in the northeast has led experts to believe that these are related to cases imported from Russia, one of the countries most affected by the pandemic. Both Heilongjiang and Jilin border the neighboring nation.
The data provided by the Chinese expert are preliminary, partial, and have not been published or reviewed by independent researchers, so they still do not allow conclusions to be drawn. Some genetic experts are skeptical that SARS-CoV-2 – a virus with a low mutation rate compared to other pathogens- may have changed to such an extent that the incubation period, virulence, or its presence in different organs is different from that observed in other areas. Most likely, what is being seen in China is not clearly correlated with mutations in the virus, Keiji Fukuda, director of the Hong Kong University School of Public Health, explained to Bloomberg. The virus cannot be said to have changed until there is “unequivocal evidence,” he added.
The differences detected may be due to the fact that doctors have more time and means to observe patients. In Wuhan, at the start of the pandemic, the hospitals were overcrowded and lacked supplies, which is why only the most critical cases could be assisted. Now China has virtually brought the epidemic under control, and the new outbreaks are much smaller.
On Wednesday, the National Health Commission recorded five new cases, one less than the preceding day. Four of them were infected locally; the fifth was a traveler who came from abroad. In total, China has recorded 82,965 cases since the start of the pandemic, 4,634 of which have died, according to official data. The majority of infections in the crisis were detected in the Hubei province, where Wuhan is located, and some 68,000 cases were identified.
The outbreaks in northeast China have underlined the challenge to fully control the spread of the disease, even in countries better equipped to detect cases. “People should not assume that the peak has passed and let their guard down,” Wu Anhua, an infectious disease expert, told Chinese television. “It is entirely possible that the epidemic will persist for a long time.”
In a demonstration of Beijing’s commitment to containing the outbreaks in the northeast, Deputy Prime Minister Sun Chunlan, who led the government’s working group to contain the virus in Wuhan, traveled to the region last week. In this area, the cities of Jilin and Shulan closed their borders, and only those who tested negative for the coronavirus no more than 48 hours before their travel are allowed to leave the cities.
Shulan, with a population of 700,000, went further on Monday and enforced strict confinement of its residents. Only one person per family is allowed out once every two days and only for two hours to buy groceries. In residential areas where cases have been confirmed, this cannot be done: it is the stores that take foodstuffs to these building blocks, and the residents’ committee is in charge of distributing it floor by floor.
Source: El País