Special report: Fighting the coronavirus

PHOTOS: REUTERS, EPA-EFE

A month after China reported to WHO about a string of pneumonia-like cases in Wuhan, the outbreak has spread through the country and the globe. Insight looks at how Singapore and the rest of the world have been battling the worst global medical crisis since Sars.


Singapore well prepared to fight the Wuhan virus



Singapore Armed Forces servicemen packing face masks at Safti Military Institute on Friday in preparation for their distribution to households islandwide. PHOTO: REUTERS

At 7am on the cold, wintry morning of Jan 30, a Singapore Scoot flight left Wuhan city in China.

On board the Boeing 787 to Singapore were 92 Singaporeans, the crew, and several Ministry of Foreign Affairs consular officers.

The plane can sit 375 people, which meant there were many empty seats. Everyone was wearing a face mask and the mood was sombre.

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Wuhan virus: Timeline of events so far



A seafood market in Wuhan is suspected to be at the centre of the coronavirus outbreak. PHOTO: ST FILE

Dec 31, 2019: Chinese authorities flag a series of Sars-like pneumonia cases in the city of Wuhan, in Hubei province, to the World Health Organisation (WHO), which then makes the information public

Jan 1: A seafood market in Wuhan suspected to be at the centre of the outbreak is closed.

Jan 9: WHO says the outbreak of pneumonia in Wuhan is linked to a novel (new) coronavirus from the same broad family as Sars.

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Scientists scramble to find out more about new coronavirus



Preparation is key in the fight against new viruses, says Professor Wang Linfa, director of Duke-NUS' emerging infectious diseases programme, who put himself on home quarantine after a recent visit to Wuhan. PHOTO: COURTESY OF WANG LINFA

Is the Wuhan coronavirus a gun-toting villain for all to see and fear, or a terrorist strapped with hidden bombs who strikes when people least expect it?

 

The outbreak has claimed more than 200 lives in the month since the world first heard of it, but whether it has done its worst, or the worst is yet to come, is still unclear.

To piece together the answer, the world first needs to know how contagious it is, its incubation period, and at what stage patients become infectious to others.

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Experts: Singapore's ability to deal with threat has improved since Sars


Singapore was quick to take precautions after China informed WHO on Dec 31 last year of the emergence of an unknown bug that causes pneumonia. ST PHOTO: NG SOR LUAN

Singapore's medical community and the nation as a whole are far better prepared to deal with the Wuhan coronavirus than they were in 2003, when the severe acute respiratory syndrome (Sars) emerged, say experts.

"There is a good chance that there will be no, or very limited, community spread in Singapore if we keep up with what we are doing thus far," says Professor Chia Kee Seng, a senior epidemiologist from the Saw Swee Hock School of Public Health at the National University of Singapore.

He also praised China for being forthcoming with information. As a result, "we also know much more very early in the outbreak".

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How Singapore tackled previous epidemics



Cleaners disinfecting the floors of all the classrooms at Bowen Secondary School in an attempt to reduce the risk of infection during the Sars outbreak in Singapore, which lasted from March to July 2003. ST FILE PHOTO

The severe acute respiratory syndrome (Sars) outbreak in Singapore lasted from March to July 2003. The Ministry of Health (MOH) formed a task force to handle the situation on March 15, 2003.

Temperature screening was implemented in schools, workplaces and medical institutions, as well as at border checkpoints. Primary and secondary schools, junior colleges and centralised institutes were shut from late March to mid-April. Home quarantine orders were issued to hundreds.

A dedicated Sars channel was set up to broadcast news and information relating to the disease. It ran from May 21 to July 9, when all countries were taken off the World Health Organisation's (WHO) Sars list.

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How viruses spread from animals to humans


Customers buying meat at a market in Beijing, on Jan 23, 2020. PHOTO: AFP

Viruses are everywhere, and in almost every living thing on the planet.

But there are several barriers that normally prevent their jump from animals to humans.

One of these species barriers, as scientists call them, is the mismatch between the "shape" of the virus and that of the binding receptors on the host cell. These receptors are located on the surface of the cell.

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China's response to Wuhan virus outbreak is a stunning exercise in mass mobilisation



A man wearing two protective masks and gloves walking his dog last Friday past a government propaganda poster in Beijing that reads "Everyone is a witness of the new era". PHOTO: AGENCE FRANCE-PRESSE

Build a hospital in 10 days? No problem. Build two hospitals in under two weeks? Done.

 

Compel companies to recall workers to work through the Chinese New Year holiday? Sure.

Quite possibly no other country in the world can mobilise the resources of an entire nation the way China can when it comes to dealing with a gigantic crisis. The epidemic coursing through China has already killed more than 250 people and infected over 11,000 worldwide.

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City lockdown brings out Wuhan's best and worst



Dr Zhang Jixian overseeing the arrival of meals for patients and medical staff at a hospital in Wuhan on Thursday. One restaurant owner and her family have been "delivering meals non-stop" to hospitals all over the city. PHOTO: EPA-EFE

Meal deliveries for medical workers, free rides to hospital, and even mass singalongs from apartment windows - the lockdown of Wuhan city has brought out a certain esprit de corps among its people, who have tried to cope the best they can.

In the wee hours last Saturday, the first day of Chinese New Year, Madam Qiu Beiwen lay wide awake. Like much of Wuhan, the 28-year-old fashion merchandiser has slept fitfully since a mysterious Sars-like virus surfaced in the city, initially infecting what health officials said were dozens, before numbers suddenly spiked, prompting the government to put the metropolis under an unprecedented lockdown.

Much of the city of 11 million was living in fear, with even the ubiquitous food delivery riders avoiding hospitals for fear of catching the disease, leaving medical workers with only instant noodles for sustenance.

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Race to contain outbreak amid criticism



A man wearing a protective mask at Jingshan park in Beijing on Jan 25, amid the coronavirus epidemic. Critics have blamed the contagion on a lack of transparency, a slow start to quarantining suspected carriers and officials initially playing down, if not covering up, the virulence of the virus. PHOTO: AGENCE FRANCE-PRESSE

China has pulled out all the stops to try and contain the Wuhan virus outbreak, but for detractors it is too little, too late.

The epidemic has spread to over 20 countries and territories outside mainland China, infecting more than 11,000 people worldwide and killing over 250.

Critics blamed the contagion on a lack of transparency, a slow start to quarantining suspected carriers and officials initially playing down, if not covering up, the virulence of the virus.

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Leaders still reluctant to loosen grip on info



Unlike during the Sars outbreak, China acted swiftly to inform the World Health Organisation about the 2019-nCoV virus. But inside the country, information about the outbreak was not made available as quickly. PHOTO: REUTERS

Inevitably, parallels are being drawn between the Chinese government’s handling of the Wuhan virus outbreak and that of Sars, another deadly coronavirus epidemic that began in China and spread to 26 countries 17 years ago.

The first cases of Sars broke out in Guangdong province in November 2002, but the World Health Organisation (WHO) was notified only in February 2003. The severity of the situation was made known only in April, by which time the Sars virus had claimed many victims, in China and overseas.

Fast-forward to December last year and, unlike in 2002 to 2003, there was swift action by the Chinese government to inform WHO. They were told three weeks after the first case of the 2019-nCoV was detected on Dec 8. By Jan 11, China could share with the world the genetic sequence of the virus.

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Nervous neighbours shut borders, impose travel curbs



Passengers arriving from Guangzhou waiting in line at immigration at the Ninoy Aquino International Airport in Manila on Jan 22. The Philippines has cancelled direct flights to Wuhan and stopped issuing visas on arrival to Chinese nationals. Flights to other parts of China continue under tight watch. PHOTO: EPA-EFE

Several of China's 14 neighbours have banned inbound Chinese tourists and taken other measures to prevent the spread of the Wuhan coronavirus, which has infected more than 9,000 people worldwide.

 

North Korea, which is economically reliant on China for tourists, trade and investment, was the first neighbouring country to ban Chinese tourist arrivals. The ban went into effect on Jan 22.

Bilateral relations were once described as being "as close as lips and teeth" when North Korean troops and Chinese "volunteers" fought shoulder to shoulder against American-led United Nations and South Korean forces during the 1950 to 1953 Korean War. But the hermit state's fragile health system would have difficulty coping if the virus spreads there.

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A rough year ahead for China's economy


Passengers arrive from Beijing ahead of Lunar New Year celebrations, after a 26-hour journey, at a train station in Hanzhong, on Jan 19, 2020. PHOTO: AFP

Even though China's economy is today more than eight times as large as it was when it battled the severe acute respiratory syndrome (Sars) in 2003, it is more vulnerable to dislocations caused by the Wuhan coronavirus because of domestic and global economic conditions.

 

The external impact of a Chinese economic slowdown will also be greater, given that China accounts for about 17 per cent of global gross domestic product (GDP) today, compared with 4.3 per cent in 2003, and is far more integrated with the world economy.

Sars had a mortality rate of 9.6 per cent, which means that roughly one in 10 patients died after being infected. The Wuhan coronavirus appears to be less deadly, with a mortality rate of about 3 per cent so far, but it spreads faster.

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