China issues 'urgent' appeal for protective medical equipment - as it happened

We’re learning more about this coronavirus each day, but a month since it emerged, there remain some important holes in our understanding — what the former US secretary of defence, Donald Rumsfeld, might have called known unknowns. I’ve just spoken to Ian Mackay, a virologist at the University of Queensland about what some of those might be.

1. How many cases are mild and how many are severe?

The disease appears to spreading more efficiently than its cousins Sars or Mers. That’s probably down to the fact that the world is much more dense and interconnected than in 2003, when Sars emerged, and because this coronavirus is more easily transmitted. “It’s more like the flu, which can whip around the world in no time,” says Mackay.

It appears that China will not be able to contain its spread within the country, but that doesn’t necessarily mean the death toll will spike, he says. “One big hole in our understanding is whether the disease is more dangerous than Sars,” he says. “That part is hard to answer because we’re missing a big important number, which is how many people are confirmed cases but haven’t gone to the hospital and are being quarantined at home, and how many have recovered.”

That matters, because it will tell us how many people have gotten only mildly or moderately sick, and therefore how deadly the disease is. If we take the cases that have been reported outside China, the death rate is less than 1%. But understanding the full spectrum of infections inside China will give us a much better idea.

2. How many of those infected are kids?

“Usually with respiratory viruses we see the young end of town as the virus spreaders,” says Mackay. Think of the way that kids go to school, spread a cold, then take it home to their parents, who in turn might carry the virus to work.

“So I’m wondering why we’re not seeing kids among the cases,” Mackay says. He speculates it might be because we’re focusing on the most severely infected people, who are presenting to hospital, and missing the fact that many people, including children, might have the coronavirus but are only presenting with relatively minor symptoms and recovering at home.

3. Is the virus mutating?

Viruses are “relentless replicating adaptive machines” that are constantly evolving, and this coronavirus will be no exception, Mackay says. Virologists need to see a larger selection of genome sequences of the virus than are currently available “to see more of what’s happening with the virus as it’s passing through thousands, possibly tens of thousands of hosts”.

Chinese officials have made comments suggesting that the virus is now transmitting more easily. Scientists will want to see evidence of those new cases “just to make sure that there aren’t consistent changes building up in the virus over time that might have an effect” on how it should be fought, he says.

Hello, this is Michael Safi, I’ll be updating you with the latest developments in this story over the next hours.

We’re getting a little more now from the press conference (given online, not in person) by the Chinese foreign ministry. The government has been at pains to emphasise that it has the tools to control the spread of this coronavirus outbreak, but this morning did concede it needs help – in the form of protective medical equipment.

“What China urgently needs at present are medical masks, protective suits and safety goggles,” the foreign ministry spokeswoman Hua Chunying said in a press briefing on Monday morning.

China’s factories can produce 20 million masks a day, but panic over the virus has prompted people in the country of 1.4 billion to stock up on them, while frontline medical personnel have reported equipment shortages.

Agence France-Presse provides this context:

At full capacity, China’s factories are only able to produce around 20m masks a day, according to the ministry of industry.

The foreign ministry said countries including South Korea, Japan, Kazakhstan and Hungary had donated medical supplies.

Tian Yulong, of the industry ministry, said earlier on Monday that authorities were taking steps to bring in masks from Europe, Japan and the US, adding that supply and demand in China remained in “tight equilibrium” as factories returned to production after the lunar new year break.

He said they were now operating at between 60% and 70% capacity.

In addition to Hubei, the province of more than 50 million people at the centre of the outbreak, several other provinces and cities across China have made it compulsory to wear masks in public.

These include Guangdong – China’s most populous province – plus Sichuan, Jiangxi, Liaoning and the city of Nanjing, with a combined population of more than 300 million.