Saturday, January 25, 2020

UPDATED
Scientists Now Think They Know What Started China's Deadly Coronavirus: Bats

BATS ARE THE MOST COMMON CARRIER OF ZOONOTIC VIRUSES THAT CAN JUMP FROM THEM AS A HOST TO OTHER MAMMALS THE BATS ARE IMMUNE
Based on swabs and blood from patients at Jinyintan Hospital in Wuhan, they found the genetic sequence closely matched a virus known to live in bats.

By David Gilbert
Jan 24 2020,


The first people who contracted the deadly new coronavirus sweeping through Asia were infected when the virus jumped from animals to humans, and a new report points to the original animal source: bats.

Scientists from the Wuhan Institute for Virology — located in China’s epicenter of the outbreak, now under quarantine — published a paper Thursday that confirmed the fast-spreading virus is in the same family as the severe acute respiratory syndrome (SARS) virus that hit Asia in 2003 and killed almost 800 people, and Middle East respiratory syndrome (MERS).

Based on oral swabs, anal swabs, and blood collected from seven patients at Jinyintan Hospital in Wuhan, the scientists were able to genetically sequence the virus. Then they tested it against a database of known viruses and found a 96.2% match with a coronavirus known to live in bats, which is also believed to be the source of the SARS and MERS outbreaks.

Ebola, the deadly virus that killed more than 11,000 people in West Africa between 2013 and 2016, is also believed to have originated from bats.

The researchers found that the new virus uses the same receptors as SARS to hack into a victim’s lungs, causing symptoms such as coughing, headaches, and pneumonia. This paper is the first to describe the new virus, dubbed nCoV-2019, in detail.


The outbreak is believed to have originated at a meat and seafood market in Wuhan where live animals were slaughtered and wild animals were also sold.

Another report from China earlier this week claimed that the coronavirus may have originated in snakes, which were reportedly sold in the Wuhan market. However, that report also suggested that since snakes hunt bats in the wild, they could have been the original source of the virus.

The new coronavirus, like SARS and MERS, is a zoonotic viral disease, meaning the first patients who were infected acquired these viruses directly from animals.

Since it emerged last month, the new virus has killed 26 people and infected 830, most of whom are in Wuhan, where authorities are trying to fast-track a new, 1000-bed hospital in just six days.

The outbreak has come at the worst time for China as hundreds of millions of people will travel long distances this weekend to celebrate Lunar New Year, making the task of containing the spread of the virus much harder.


In a bid to stop the virus spreading, authorities have imposed strict travel restrictions on 10 cities in the central province of Hubei, effectively locking down some 30 million people.

But these efforts come after the virus has already spread to almost all areas of China, and internationally to Thailand, Hong Kong, Taiwan, Macau, Vietnam, South Korea, Japan, and the U.S., where a second confirmed case was reported in Chicago on Friday.

Cover: 21 August 2019, Saxony, Wermsdorf: A pug bat (Barbastella barbastellus) is kept in the Wermsdorf forest by a scientist from the specialist office "hochfrequent". Photo by: Sebastian Willnow/picture-alliance/dpa/AP Images








zoonosis (plural zoonoses, or zoonotic diseases) is an infectious disease caused by bacteria, viruses and parasites that spread between animals (usually vertebrates) and humans. Major modern diseases such as Ebola virus disease and salmonellosis are zoonoses.
Specialty: Infectious disease
Other names: Zoönosis
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Wuhan coronavirus: we still haven’t learned the lessons from SARS
We have to hope that the Wuhan outbreak is a wake-up call for regulation of wildlife trade and animal health, action that is urgently needed to protect human health and the environment

The SARS outbreak in 2002-2003 was the first global pandemic of the 21st century. There were 8,422 reported cases and 11% of those infected with the virus died. Its cause was a newly identified coronavirus (a type of virus that causes respiratory infections): SARS Co-V. Early cases were linked to wildlife markets and restaurants in Guangdong, China, where researchers found SARS-like coronaviruses in animals including masked palm civets and a racoon dog.


A Chinese government team subsequently reported that 66 out of 508 wildlife handlers tested in other markets across Guangdong were positive for antibodies to the SARS virus. The Chinese authorities responded by imposing a temporary ban on the hunting, sale, transportation and export of all wild animals in southern China. They also quarantined or culled civets reared for human consumption in the many civet farms across the area.
 
Civet cats await their fate in the Xin Yuan animal meat market,
 Guangzhou, China. Paul Hilton/EPA

We happened to be working on wildlife trade and biodiversity conservation, including rare species of civets in neighbouring Vietnam, and were aware that many different species of animal were kept close to each other

My colleagues and I suggested that civets testing positive for SARS may have secondary infections rather being than the source of the virus. They were probably infected during the “speed dating” of zoonotic viruses circulating among the jumble of different animal species packed together at markets or while being transported to markets, often in China.



At the Royal Society’s international conference on “Lessons from SARS” in 2004 and in the related publication, we emphasised that wildlife trade was a threat to human health and a primary cause of biodiversity decline in China and South-East Asia.

But here we are again, 17 years later, with another novel zoonotic coronavirus, this time in Wuhan, China. Once again, initial human cases were linked to a market selling a variety of live animals.

A constantly changing range of species have been selected as the culprits in the past few days, including bats and snakes, (the latter results were quickly refuted), and even crickets and wolf cubs.

But, as yet, there is no scientific evidence that the virus has been isolated from any of these, although a recent report stated that “15 environmental specimens collected in the western section (of the Huanan Seafood Wholesale Market) were positive for 2019-nCoV virus through RT-PCR testing and genetic sequencing analysis.” The report continues: “Despite extensive searching, no animal from the market has thus far been identified as a possible source of infection.”

It is not evident what “environmental specimens” refers to here and a complete list of those animals present in, or available from, the market would be appropriate to release together with details of which and how many of these have so far been tested.

Wild rodents, which are often present in these markets, should also have been collected and tested as SARS-like coronaviruses have also been isolated from wild rats in China.

Perfect conditions for pandemics

But we may be chasing our tails, as animals testing positive may not be the source of the current outbreak. We need to step back and learn the broader lessons here.

The perfect conditions for the emergence of human pandemics from previously unknown zoonotic pathogens has been created as a result of three things. First, the shift from subsistence hunting of wildlife to its sale into an international trade network largely driven by demand in China. Second, the extensive cross-exposure within this wildlife trade of species and species populations, which would not mix or be in contact in the wild. And, third, the exploitation of new source populations as areas become depleted of target species.

It is also important to emphasise that these wild animals are typically now more expensive to buy (sometime a status symbol) than domestic livestock, so the demand that perpetuates wildlife trade in the region is a dietary choice and not driven by low income.

The solution is collective action to remove the demand and also the supply chains to these wildlife markets and “farms” (often laundering animals from the wild rather than breeding them). The call to close wildlife markets across China – which started following the SARS outbreak – has also been echoed by experts in China and in external organisations worldwide, such as the Wildlife Conservation Society.

January 24, 2020

Author


Professor of Conservation Biology, University of East Anglia
THE CONVERSATION


ON THE OTHER HAND IT MAY NOT HAVE BEEN BAT'S BUT IT WAS STILL ZOONOTIC TRANSMISSION  VIA ANOTHER FORM OF BUSHMEAT 
BATS TRANSMITTED THE VIRUS TO SNAKES 

Snakes Are The Likely Source of China's Deadly Coronavirus. Here's Why
HAITAO GUO ET AL., THE CONVERSATION
23 JAN 2020
Snakes – the Chinese krait and the Chinese cobra – may be the original source of the newly discovered coronavirus that has triggered an outbreak of a deadly infectious respiratory illness in China this winter.

The illness was first reported in late December 2019 in Wuhan, a major city in central China, and has been rapidly spreading. Since then, sick travelers from Wuhan have infected people in China and other countries, including the United States.

Using samples of the virus isolated from patients, scientists in China have determined the genetic code of the virus and used microscopes to photograph it. The pathogen responsible for this pandemic is a new coronavirus.

It's in the same family of viruses as the well-known severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), which have killed hundreds of people in the past 17 years. 

The World Health Organization (WHO) has named the new coronavirus 2019-nCoV.
We are virologists and journal editors and are closely following this outbreak because there are many questions that need to be answered to curb the spread of this public health threat.

What is a coronavirus?
The name of coronavirus comes from its shape, which resembles a crown or solar corona when imaged using an electron microscope.

Coronavirus is transmitted through the air and primarily infects the upper respiratory and gastrointestinal tract of mammals and birds. Though most of the members of the coronavirus family only cause mild flu-like symptoms during infection, SARS-CoV and MERS-CoV can infect both upper and lower airways and cause severe respiratory illness and other complications in humans.

This new 2019-nCoV causes similar symptoms to SARS-CoV and MERS-CoV. People infected with these coronaviruses suffer a severe inflammatory response.
Unfortunately, there is no approved vaccine or antiviral treatment available for coronavirus infection. A better understanding of the life cycle of 2019-nCoV, including the source of the virus, how it is transmitted and how it replicates are needed to both prevent and treat the disease.


Zoonotic transmission

Both SARS and MERS are classified as zoonotic viral diseases, meaning the first patients who were infected acquired these viruses directly from animals. This was possible because while in the animal host, the virus had acquired a series of genetic mutations that allowed it to infect and multiply inside humans.

Now these viruses can be transmitted from person to person. Field studies have revealed that the original source of SARS-CoV and MERS-CoV is the bat, and that the masked palm civets (a mammal native to Asia and Africa) and camels, respectively, served as intermediate hosts between bats and humans.
In the case of this 2019 coronavirus outbreak, reports state that most of the first group of patients hospitalized were workers or customers at a local seafood wholesale market which also sold processed meats and live consumable animals including poultry, donkeys, sheep, pigs, camels, foxes, badgers, bamboo rats, hedgehogs and reptiles.
However, since no one has ever reported finding a coronavirus infecting aquatic animals, it is plausible that the coronavirus may have originated from other animals sold in that market.

The hypothesis that the 2019-nCoV jumped from an animal at the market is strongly supported by a new publication in the Journal of Medical Virology. The scientists conducted an analysis and compared the genetic sequences of 2019-nCoV and all other known coronaviruses.

The study of the genetic code of 2019-nCoV reveals that the new virus is most closely related to two bat SARS-like coronavirus samples from China, initially suggesting that, like SARS and MERS, the bat might also be the origin of 2019-nCoV.

The authors further found that the DNA coding sequence of 2019-nCoV spike protein, which forms the "crown" of the virus particle that recognizes the receptor on a host cell, indicates that the bat virus might have mutated before infecting people.

But when the researchers performed a more detailed bioinformatics analysis of the sequence of 2019-nCoV, it suggests that this coronavirus might come from snakes.

From bats to snakes

The researchers used an analysis of the protein codes favored by the new coronavirus and compared it to the protein codes from coronaviruses found in different animal hosts, like birds, snakes, marmots, hedgehogs, manis, bats and humans. Surprisingly, they found that the protein codes in the 2019-nCoV are most similar to those used in snakes.

Snakes often hunt for bats in wild. Reports indicate that snakes were sold in the local seafood market in Wuhan, raising the possibility that the 2019-nCoV might have jumped from the host species – bats – to snakes and then to humans at the beginning of this coronavirus outbreak.

However, how the virus could adapt to both the cold-blooded and warm-blooded hosts remains a mystery.

The authors of the report and other researchers must verify the origin of the virus through laboratory experiments. Searching for the 2019-nCoV sequence in snakes would be the first thing to do. However, since the outbreak, the seafood market has been disinfected and shut down, which makes it challenging to trace the new virus' source animal.

Sampling DNA from animals sold at the market and from wild snakes and bats is needed to confirm the origin of the virus. Nonetheless, the reported findings will also provide insights for developing prevention and treatment protocols.

The 2019-nCoV outbreak is another reminder that people should limit the consumption of wild animals to prevent zoonotic infections.

Haitao Guo, Professor of Microbiology and Molecular Genetics, University of Pittsburgh; Guangxiang "George" Luo, Professor of Microbiology, University of Alabama at Birmingham, and Shou-Jiang Gao, Professor of Microbiology and Molecular Genetics, University of Pittsburgh.

These articles are republished from The Conversation under a Creative Commons license.

The outbreaks of both the Wuhan coronavirus 
and SARS started in Chinese wet markets. 
Photos show what the markets look like.
Customers in a Chinese wet market on January 22, 2016. 
Edward Wong/South China Morning Post/Getty
A coronavirus that originated in Wuhan, China, has killed 26 people and infected more than 900.

The Huanan Seafood Market in Wuhan is thought to be the starting point for the virus outbreak. It was shuttered on January 1.


At wet markets, meat is sold alongside live animals like dogs, hares, and civets.
On Wednesday, Wuhan authorities banned the trade of live animals at wet markets.
Here's what the markets look like.

The coronavirus spreading in China and the SARS outbreak of 2003 have two things in common: Both are from the coronavirus family, and both started in wet markets.

At such markets, outdoor stalls are squeezed together to form narrow lanes, where locals and visitors shop for cuts of meat and ripe produce. A stall selling hundreds of caged chickens may abut a butcher counter, where uncooked meat is chopped as nearby dogs watch hungrily. Vendors hock skinned hares, while seafood stalls display glistening fish and shrimp.

Wet markets put people and live and dead animals — dogs, chickens, pigs, snakes, civets, and more — in constant close contact. That makes it easy for a virus to jump from animal to human.

On Wednesday, authorities in Wuhan, China — where the current outbreak started — banned the trade of live animals at wet markets. The specific market where the outbreak is believed to have begun, the Huanan Seafood Market, was shuttered on January 1. The coronavirus that emerged there has so far killed 26 people and infected more than 900.

"Poorly regulated, live animal markets mixed with illegal wildlife trade offer a unique opportunity for viruses to spillover from wildlife hosts into the human population," the Wildlife Conservation Society said in a statement.

Coronaviruses are zoonotic diseases, meaning they spread to people from animals. In the case of SARS, and likely this Wuhan coronavirus outbreak as well, bats were the original hosts. The bats then infected other animals, which transmitted the virus to humans.

Here's what Chinese wet markets look like.

The Huanan Seafood Market in Wuhan closed on January 1 after it was found to be the most likely starting point for the outbreak of this coronavirus, also called 2019-nCov.

 
Huanan Seafood Market in Wuhan, China, on 
January 12, 2020. NOEL CELIS/AFP via Getty Images



A 61-year-old man was the first person to die from the virus. According to Bloomberg, he was a regular shopper at the Huanan wet market, which sold more than seafood.

Reports indicated that before the Huanan market closed, vendors there sold processed meats and live animals, including chickens, donkeys, sheep, pigs, foxes, badgers, bamboo rats, hedgehogs, and snakes.
A wet market in Beijing on July 3, 2007. 
Teh Eng Koon/AFP via Getty


Wet markets like Huanan are common around China. They're called wet markets because vendors often slaughter animals in front of customers.

"That means there's a lot of skinning of dead animals in front of shoppers and, as a result, aerosolizing of all sorts of things," according to Emily Langdon, an infectious disease specialist at University of Chicago Medicine. 

On Wednesday, Wuhan authorities banned the trade of live animals at wet markets.

DOGS AS FOOD STILL OCCURING

A wet market in Guilin, China, on June 19, 2014. 
David Wong/South China Morning Post/Getty


Police in Wuhan began conducting checks to enforce the rule among the city's 11 million residents, the BBC reported, citing state media reports.

This type of intervention could help stop the spread of zoonotic viruses like the Wuhan coronavirus.
 
A wet market in Beijing on July 3, 2007. 
Teh Eng Koon/AFP/Getty


"Governments must recognize the global public health threats of zoonotic diseases," Christian Walzer, executive director of the Wildlife Conservation Society's health program, said in a statement. "It is time to close live animal markets that trade in wildlife, strengthen efforts to combat trafficking of wild animals, and work to change dangerous wildlife consumption behaviours, especially in cities."

The close proximity of shoppers to stall vendors and live and dead animals in wet markets make them prime breeding grounds for zoonotic diseases.
A Chinese wet market.
 Felix Wong/South China Morning Post/Getty


Between 2002 and 2003, SARS killed 774 people across 29 countries. It originated in wet markets in the province of Guangdong.

In the case of SARS, humans caught the virus from weasel-like mammals called masked palm civets.
An Asian palm civet. Oleksandr Rupeta/NurPhoto/Getty


But the civets weren't the original hosts of the disease.

Researchers figured out that SARS originally came from a population of bats in China's Yunnan province.

 
A greater horseshoe bat, a relative of the 
Rhinolophis sinicus species from China that was the 
source of the SARS virus. De Agostini/Getty


"Coronaviruses like SARS circulate in bats, and every so often they get introduced into the human population," Vincent Munster, a virologist at the Rocky Mountain Laboratories, told Business Insider.

Bats can pass along viruses in their poop: If they drop feces onto a piece of fruit that a civet then eats, the civet can become a disease carrier.

Experts haven't yet confirmed the animal species that enabled the Wuhan coronavirus to spread to people.
 
A worker with a slaughtered pig at a wet market
 in Manila, Philippines. Romeo Ranoco/Reuters


"There's an indication that it's a bat virus, spread in association with wet markets," Munster said. 

But according to a group of scientists who edit the Journal of Medical Virology, the culprit in this case could be the Chinese cobra.
A Chinese cobra. Thomas Brown


Scientists in China have figured out the genetic code of the Wuhan coronavirus. When researchers compared it with other coronaviruses, they found it to be most similar to two bat coronavirus samples from China.

But further analysis showed that the genetic building blocks of the Wuhan coronavirus more closely resembled that of snakes. According to the researchers, the only way to be sure of where the virus came from is to take DNA samples from animals sold at the Huanan market and from wild snakes and bats in the area. 

The H7N9 and H5N9 bird flus — also zoonotic viruses — were likely transmitted to humans in wet markets, too.
wet market ducks china
Ducks on top of chickens at a wet market in Shanghai.
In Pictures Ltd./Corbis/Getty

According to the World Health Organization, people caught those bird flus via direct contact with infected poultry in China. The diseases killed 1,000 people globally. 

Bats and birds are considered reservoir species for viruses with pandemic potential, according to Bart Haagmans, a virologist at the Erasmus Medical Center in Rotterdam, Netherlands.
A chicken vendor on top of chicken cages at a wet market
 in Kowloon City, China. Dickson Lee/South China Morning Post/Getty


"Because these viruses have not been circulating in humans before, specific immunity to these viruses is absent in humans," Haagmans told Business Insider.

"There have been plenty of eminent epidemiologists predicting 'pandemic X' for a number of years now," Adrian Hyzler, the chief medical officer at Healix International, told Business Insider.
Live chickens in a wet market in Guangzhou, China. 
K. Y. Cheng/South China Morning Post/Getty


These pandemics "are more likely to originate in the Far East because of the close contact with live animals [and] the density of the population," Hyzler added. His firm offers risk-management solutions for global travelers.

The Wuhan coronavirus outbreak isn't considered a pandemic, however.
A seafood stall in a wet market in Hong Kong. Isaac Lawrence/AFP/Getty


Since December 31, more than 900 cases of the Wuhan coronavirus have been reported across 10 countries, including the US. Symptoms include sore throats, headaches, and fevers, as well as pneumonialike breathing difficulties.

Haagmans said one of the challenges in containing this outbreak was that a substantial portion of infected people show only mild symptoms.

These people "may go unnoticed in tracing the virus and fuel the outbreak," he said. "It seems that this actually may be the case now." 

Aria Bendix contributed reporting to this story.

Read more about the Wuhan virus:




China has put 33 million people on lockdown because of the coronavirus outbreak. An urban planner says there's no way to seal off a city.
Aria Bendix
Guards wearing face masks stand at Hankou Railway Station 
on January 22, 2020, in Wuhan, China. Xiaolu Chu/Getty Images)

At least 12 Chinese cities have been put on lockdown as a deadly coronavirus spreads across the country.

The virus has killed 41 people and infected nearly 1,300. It has spread to at least 10 countries outside China, including France, Australia, and the US.

The city where the virus originated — Wuhan, China — has been quarantined since Thursday. 

An urban planner said there's no way to completely seal off a city, but shutting down transportation significantly reduces the chances that people will leave.


Most urban planners don't design a city with the idea of sealing it off. Many advocate for the opposite: making cities as free-flowing as possible to encourage tourism and attract workers.

But on Thursday morning, officials in Wuhan, China — the 11-million-person city where a fast-growing coronavirus outbreak started — put the city under quarantine.

"If you live in cities, your movement can be controlled through public transport," Fei Chen, an urban-design lecturer at the University of Liverpool, told Business Insider. "Wuhan has an international airport. It has highways and railways. So if you close all of them, then you basically cut off the means for people to get out."

That is indeed what officials did. All forms of public transportation were halted, including buses, metros, and ferries. No trains or airplanes are coming in or out of the city, and roadblocks were installed to prevent private cars from leaving.

Wuhan residents were told not to leave the city, barring special circumstances.

The virus, which scientists call 2019-nCoV, has killed 41 people and infected nearly 1,300. It has spread to at least 10 other countries: France, Australia, Thailand, Japan, South Korea, Taiwan, Vietnam, Singapore, Nepal, and the US. The outbreak likely originated at a wet market in Wuhan that sold live animals such as chickens, pigs, snakes, and civets. The market was shuttered on January 1.

Chen said there's no way to completely seal off a city, however.
Wuhan shut down its major entry points

The coronavirus outbreak started in Wuhan December 31. The family of viruses is also responsible for pneumonia, the common cold, and SARS, which affected about 8,000 people and killed 774 in China between 2002 and 2003.

The new coronavirus causes fever, chills, coughing, sneezing, and a sore throat. It appears to spread person-to-person more easily and quickly than SARS, but it is far less deadly.

As a major Chinese transportation center, Wuhan's high-speed rail lines connect to Shanghai and Guangzhou (cities with populations of 24 million and 13 million people, respectively). The city's Tianhe International Airport also serves more than 20 million passengers annually.

"Chinese cities currently are really connected, especially regionally," Chen said. "It's really easy to travel from one city to another."
A largely empty train travels to Wuhan from Shanghai on 
January 23, 2020. HECTOR RETAMAL/AFP via Getty Images

Many of Wuhan's neighboring cities have been closed off as well. As of Friday, at least 11 additional cities had imposed their own travel restrictions. The restrictions so far affect an estimated 33 million people in the Hubei province, where Wuhan is located.

"It's a wise thing to do because it's Chinese New Year," Chen said. "Chinese people, we have this custom to go back home to spend time with family, and there's a big population movement."
 
A nearly deserted expressway in Wuhan, China, on
 January 24, 2020. Associated Press

Prior to the outbreak, hundreds of millions of people were expected to travel to and within China for the Lunar New Year celebration, which begins Saturday and lasts until February 8.

Now, Chen said, it's almost impossible to leave Wuhan.

"The chance you can get out of Hubei province is quite slim," she said. "If you want to go out of the province, normally it's through the major highways and high-speed railways."

Many of China's newly constructed highway networks, she added, have tolls that are patrolled under normal circumstances, making it easy to monitor the entry and exit of cars.
But the city's quarantine isn't foolproof

Chen said it could be more difficult to quarantine small towns and villages that don't rely on major transportation systems. These towns connect to major cities through road networks.

That means the quarantine isn't foolproof.

"I wouldn't say it's 100% effective, but to a very large extent they have controlled or kept people within the region," Chen said.
Wuhan residents wear masks while buying groceries on
 January 23, 2020. Getty Images

Quarantines are probably easier to enforce in China, she added, because of the nation's centralized political system.

"All the police forces obey those higher orders," Chen said. "The public transport is public, so it's controlled by the government. If you compare with the UK, where public transport is sometimes owned by private companies, it's much more difficult to do something like this."

Kristin Stapleton, an urban historian who studies Chinese history at the University of Buffalo, told Business Insider she thinks "many people are probably staying put out of fear, both of the coronavirus and of the high-tech community surveillance that has become pervasive in Chinese cities."

Should cities be designed for lockdown?

Chen said some urban planners are starting to discuss what it would take to seal off a city — but they have climate change in mind, not a potential virus.
Medical staff wear protective suits at the Zhongnan hospital in Wuhan. 
STR/AFP via Getty Images

"I wouldn't say we have exactly thought about how to close down a whole city, because that's really rare," she said. "But we're talking about how a city could be resilient to natural disasters like flooding and earthquakes and sea level-rise."

Still, she said urban planners would be wise to consider the services that citizens might need if their city were on lockdown — such as healthcare clinics for individual neighborhoods so people don't have to travel far from their homes for treatment.

Doctors in Wuhan are reporting that there aren't enough resources to treat patients, and people are waiting for hours in line to receive medical care. Thus far, test kits have been reserved for patients with the most severe symptoms, so diagnoses can be delayed.

The city is rushing to build a brand-new hospital with 1,000 beds in just six days.

"What really should be considered in urban planning is how you could provide the best, most efficient healthcare to residents," Chen said. "I don't think a quarantine is really something we should make a priority when we plan a city.


Chinese people are turning on the government as the coronavirus outbreak spirals into the Lunar New Year
Sarah Gray
 
Medical staff, in Wuhan, China, during a coronavirus outbreak
 that has pushed the city to breaking point. THE CENTRAL 
HOSPITAL OF WUHAN VIA WEIBO /via REUTERS
Friday and Saturday are meant to be the most festive days of China's year. Instead they are stalked by fear and anxiety. 
As the coronavirus outbreak centered in Wuhan has spread, ordinary Chinese people are increasingly turning of local officials — a rare step in the authoritarian nation. 
They cite hardship from a massive, 12-city lock down, as well as a complacent early response from officials. 
Many are calling on the central government in Beijing to intervene.Such an outbreak is a challenge for Chinese authorities, and has hamstrung the government in the past.
#NewYear'sEveInICU was the top trend on Chinese social media Friday on what is usually the most festive day of the year. 
According to the Guardian, the gallows-humor hashtag topped the Twitter-like Weibo platform as China entered the Lunar New Year, a grim reminder of a fast-spreading viral outbreak.
Novel coronavirus, or 2019-nCoV as it is known scientifically, has killed 41, sickened nearly 1,300, and spread to 12 countries.

The trend is also an example of frustrations bubbling over on China's social media, including the microblogging site Weibo and the app WeChat.

Those frustrations are being lobbed at local government, despite the censorship regime which makes criticizing anybody in power a risky business.

"Can you please send a responsible leader to Hubei?" reads a comment on the Chinese social media platform Sina Weibo, the Guardian reported, seemingly calling for China's central Communist Party to intervene from Beijing.

The comments are a sign that the government's quarantine of 35 million people across 12 cities could backfire, as both the healthy and the infected remain cut off from the outside.

"The first and golden rule of public health is you have to gain the trust of the population," said Lawrence O. Gostin, a professor of Global Health Law at Georgetown University who spoke to The Washington Post. He said the extreme measure is instead likely to "drive the epidemic underground."

The virus is thought to have originated at a wet market in Wuhan, a city of roughly 11 million in the Hubei province. The first case was reported in December.

Wuhan, where a majority of the cases have been located, has been quarantined since Thursday. Travel in or out is prohibited to stop the spread, and authorities have made it mandatory to wear protective masks. Eleven more cities were added to the lock-down on Friday.

Wuhan's mayor admitted this week that initial "warnings were not sufficient" — and understated acknowledgement that the early phase of the outbreak was botched.

Officials initially said the virus could not be transmitted from human to human. Screenings were also not immediately put into place.
Passengers who just arrived on a train from Wuhan, China 
are screened for coronavirus in Beijing. Kevin Frayer/Getty Images

But with the spread, central government is trying to seize back momentum.

On Monday, President Xi Jinping stressed "the importance of informing the public to safeguard social stability." Major attractions including Disneyland in Shanghai and the Forbidden City were closed, and Lunar New Year celebrations were cancelled.

The virus is a dangerous challenge for China's leaders, historian Maura Cunningham told the Guardian: "The coronavirus is a problem for the Chinese Communist party because the CCP has historically not handled epidemics and other large-scale disasters well.

"The party has shown a knee-jerk tendency to clamp down on information and not be forthcoming with accurate statistics."

In 2002 and 2003, the SARS epidemic sickened 8,000 and killed 744 — an outbreak that was also born in China. The government largely tried to cover up the illness until a whistleblower revealed the true scale of the disease.

There are signs that the government has learned from the SARS epidemic. This week the Worth Health Organization said the Chinese government was being cooperative and transparent with the organization.

However, as Wuhan faces shortages of hospital supplies and protective gear, plus overcrowding at medical facilities, discontent is beginning to foment online.


The New York Times cited multiple instances of frustration posted to Sina Weibo: "I hope the central government can take over before dawn," one commenter wrote. "It's almost like anarchy."

"Wuhan's party secretary and governor cannot soothe the people's anger," another wrote.

The perceived incompetence of local officials is contrasted unfavorably with support for medical professionals on the front line.

In response to an image shared by doctors, The Times reported that one commenter said, "The Wuhan government is not worthy of such good medical staff."

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