Contagious Before Symptoms Appear: Expert Weighs in on Challenges to Control China Coronavirus’ Global Spread

Penny Zhou
Laurie Garrett was in Beijing when the Chinese authorities finally admitted the truth about the SARS virus in 2003.

In an interview with NTD on Jan. 27, the journalist and health analyst who covered over 30 epidemics said that about a quarter-million people had fled the city within 48 hours, dispersing all over the country, taking a SARS virus with them.

She said in the end, China had no choice but to basically put the whole nation on lockdown. Every single human being with a fever was placed in quarantine. That’s what eventually prohibited the spread of SARS since there is no vaccine or treatment available for the disease.

But this time, the same approach may not work.

The new coronavirus outbreak that started in Wuhan, China, has spread to at least 13 other countries or regions as of Jan 28. Chinese authorities have put over 56 million people from four entire cities under quarantine.

Airports across the globe, including 20 in the United States, are screening passengers arriving from China for fever.

There is one problem. Some infected patients of the new virus only show mild symptoms—or no symptoms at all. They have normal body temperatures, and fever screenings would not be able to detect potential virus carriers.

China’s Health Commission said these asymptomatic patients can still be infectious, calling them “walking sources of infection.”

“If...people are capable of transmitting to others before they have a fever, then a lot of these measures are kind of false assurance,” Garrett said, “They'll miss huge numbers of people.”

“We’re deluding ourselves into believing that we’re stopping the epidemic by taking people’s temperatures,” she said.

The mayor of Wuhan, the epicenter of the outbreak, said that 5 million residents had fled the city before the lockdown went into effect on Jan 23.

Although the number of cases confirmed outside of China grows, Garrett said it would be hard to imagine other nations implementing a similar quarantine as China did.

“There are a lot of economic pressures to keep the flow of humanity going, to keep trading moving,” she said, “It’s going to be very hard to sustain over a period of time for any big quarantines.”

Secondary Transmission Outside of China, “Phenomenally Dangerous”

Garrett said on Monday that she is very concerned if this spreads into secondary and tertiary transmission outside of mainland China.

This may have already happened. On Tuesday, Taiwan reported its first case of domestic coronavirus transmission.

The new patient, a man in his 50s, was infected by his wife after she returned from working in China before she was subsequently diagnosed.

“If you start to see two, three, four generations of transmission in other countries,” Garrett said, “then I think we could be in the kind of territory we haven’t seen in my lifetime.”

“This could really be a phenomenally dangerous epidemic,” she said.

Another Coverup, Once Again

18 years ago, the Chinese communist regime covered up the SARS epidemic for weeks, leading to the virus’ global spread. Garrett said the Chinese communist regime may be concealing information once again.

She said the Chinese communist regime was slow to take action in December to prevent the spread of the virus. They failed to take control measures such as issuing warnings to all Wuhan hospitals, putting out protective gear and strict protection requirements for all healthcare workers, setting up special entry procedures for people with fevers for rapid hospital access, etc.

“In fact, they didn’t really start...until, you know, two weeks later,” she said.

In an article on Foreign Policy, Garrett shared her tips on how to stay safe in the outbreak. It also has been translated into Chinese.

“I think we’re in an incredibly dangerous place right now. Because we don’t know enough about the virus to make absolutely certain decisions about what action to take,” she said.

Penny Zhou is a senior special report producer for NTD based at the network's global headquarters in New York City. Penny has produced and directed NTD Original documentaries, including the award-winning documentary, "Hollywood Takeover: China's Control in the Film Industry." Penny previously worked as a correspondent for NTD covering China news.
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