china is stepping up efforts to contain a new corona virus outbreak but people abroad have already been affected so are these efforts enough or is the world witnessing the start of a global epidemic this is inside story. hello and welcome to the program. china's reporting people of coronavirus outside the epicenter of the outbreak have now died this is health authorities fear around the world the infection rate could increase during what's usually china's busiest travel period of the year hundreds of millions of chinese are preparing to celebrate the lunar new year although beijing has canceled all 'd public celebrations and as the death toll rises more countries are taking their own precautions scott hi there has more from beijing. rushing to catch the last trains before the lunar new year many of these passengers at the beijing west railway station i thinking of the coronavirus you know i don't think this virus has been properly controlled i just came back to china i read a lot of news i'm too ned i'm not very satisfied with how the government prevented him control the disease they're afraid of getting infected i am really afraid of those people were relieved and left but i do hope the situation will be improved soon. and those inside the city of will han are becoming more frustrated because medical supplies are running short and hospitals are short staffed many festivals for the lunar new year holiday have been canceled across china and not just in the central province the epicenter of the virus in a rare move the government has closed the forbidden city here in beijing over health concerns related to the coronavirus something they didn't do some 17 years ago during the sars crisis. the chinese government was criticized for the way it handled the sars virus back in 2003 mainly for its lack of transparency the world health organization has decided not to declare the current outbreak a global health emergency but there's growing concern over the coming week when the millions of people who have traveled for the holiday return again raising the risk the virus may be spread further by people who are contaminated but have yet to show symptoms scott hodler al-jazeera beijing. in a moment we'll bring in our panel but 1st let's speak to tarik your star of it's from the world health organization in geneva tarik the w.h.o. said it was too early to consider this outbreak a public health emergency of international concern why one of the reasons for that decision and what would have to happen for it to become a global health emergency well as we have said yesterday in a press conference following the meeting there were different opinions that have been expressed at the immediate emergency committee and director general of the show was very clear what he said to this is clearly an emergency in china and there is a higher risk of further spread he may reconvene a. meeting of emergency committee at the very short notice as the as the situation develops further china has locked down numerous cities in their response so far to this outbreak what is the w.h.o. stance on that and does the w.h.o. believe that that is an appropriate or effective containment measure. well the role of w. it sure is to provide science based recommendations and opinion to our countries every country obviously has the right to introduce measures that they think are necessary on their territory we hope that these measures will be effective and that it will not last very long and it is really important to say that. what is important when you have an outbreak of a new virus you have to have containment measures and mitigation measures meaning providing help to those who fall sick and contain and basically trying to reduce the risk of a spread so different measures can be introduced to do dat to try to at least slow down the disease what is really important is that health systems are on alert around the world as china has already put in place monitoring for sick people being able to test them and diagnose them and being able to treat them it is also important to provide a writer information to the population so when it comes to the measure measures it's really difficult sometimes to strike the balance between the benefits for the population of some containment measures and some social disruption so i think or each country based on their context will decide what measures are needed since you're speaking about measures the w.h.o. warn the public not to underestimate the severity of this epidemic could you speak to specific measures that people can take to try to protect themselves going forward. exactly so i mentioned what health systems should do what health officials should do day should be on a on alert today should raise preparedness levels in different health facilities being equipped and be able to provide assistance to those who are sick now for the general public for the time being there are still much of an unknown about the virus itself but we know it is a corona virus so it is cozy respiratory illness so we are commanded measures that are all as recommended for respiratory illnesses that is hand hygiene that is basically a covering of mouth when when sneezing and coughing avoiding contact. person who is sick read a flu like symptoms avoiding contact live animals to market and really for people before they travel if they are sick if they should really 1st go and see their doctors so they can be diagnosed so really everyone should try really to help . the health system because what may happen as well that a lot of people because of this outbreak will rush to the hospitals even though they day day may not have symptoms that are that are consistent with respiratory illness symptoms tar do we know yet the actual extent of human to human transmission rate but we know that there is a human to human transmission and this is consistent with that coronaviruses in general as we have seen with sauce with the murderous and me that occurred arse's this means that there is a human to human transmission among close contacts so we have no really clear of this of sustained human to human transmission although there are some indications that that's various the virus has infected from the infected person to another one so 2nd generation but again so far we see clusters but we really have to look at it we have to look at the data we asked. at that early stage so we know about coronaviruses in general but we have to get into the data and try really to understand that it's done better and same goes really for the severity of the virus some people have mild symptoms some people have severe symptoms we still don't know if there are symptomatic cases we have noticed that the majority of people who get sick are older people and those who eventually died most of them had underlying health conditions but again it's really too early to draw conclusions because we need to really to to look to look more we need to do more testing and more studies to be able to understand but as we do these studies to understand a virus we need to be ready to help those who fall sick and make sure that the all measures are being put in place to reduce the risk all right thank you so much for your time tariq we can now speak to our other guests in hong kong we have nicholas thomas he's an associate professor at city university of hong kong and specializes in asian health security and in london we have natalie mcdermott she is a clinical lecturer at king's college london who researches disease outbreak control nicholas let me start with you the chinese government was criticized for how it handled its reaction to the sars virus in 2003 especially for its lack of transparency how is china dealing with this outbreak and do you believe that they have learned the lessons from the sars outbreak. i think thank you i think that we need to sort of break this down a little bit i think on the technical side with the medical people this was a very fast response we found out about the market on the 31st of december in line with the w.h.o. chinese authorities shut down the market on the 1st on the 7th the genome was sequenced on the 8th it was confirmed as a coronavirus that's fairly quickly however i think that when we look at maybe at the local level measures could have been implemented a lot faster. but at the central level at least there's been significant concern and pressure from the chinese leadership that the policies to address these issues lessons that china has learnt sent sars be taken forward natalie right now in china there is an unprecedented lockdown of cities going on do you believe that this will actually minimize the risk of the virus spreading. so i think that's a difficult question because essentially we've never locked down an entire city before to see how well we can contain an outbreak it depends on the population that you are dealing with often because the primary understanding is that if you lock down a city you prevent people migration and so you prevent the disease spreading further afield now we already know that with this corona virus outbreak we have cases in what is 29 different provinces in china already and we've had cases going overseas so whether quarantine an entire city or several cities is going to achieve much now i'm not sure it also depends on how compliant the population are willing to be with that in this context we do seem to have a population who are being very compliant with what they've been asked to do but in some circumstances if you quarantine an entire city you introduce fear and panic and sometimes you have people who take things into their own hands and you might end up creating a situation where you have defiance and rioting and people trying to escape the city and that ultimately makes the situation worse so it really depends on the population or to your addressing in that context nicholas is the region capable of handling this effectively well i think the other groups natalie i think china is trying to deal with this is best it can but to a certain extent it's winter in china they're already different viruses different flus in circulation and so people's immune systems are already going to be challenged now as we have seen we are getting 2nd and their reports from the w.h.o. of 3rd generation transmission which means we're no longer thinking just about the people who are initially exposed to the infected wildlife we're thinking about the people that have infected and then the people next to the people that they're infected as well this is going to make the job of the authorities to actually bring this to a halt that much more difficult especially because it is coming up to chinese. new year as well and we are looking at hundreds of millions of people about to be going on the move so beyond beyond the 10 shutdown cities we are going to have a lot of people who do carry the virus who move into other parts of china and also beyond china as well at the moment we're talking about quarantines on flights out of han in particular but we're already finding cases in shanghai for example or in guangdong where there are major international transit hubs and that's going to challenge not just the chinese authorities to contain it but also the regional and international ports as world to deal with this badly how much does the concern grow if the virus spreads to a poor country let's take me in more as an example of a country whose health sector is not as developed may not be able to respond as quickly. yes so i think that that's probably where the major concerns are because we are aware that countries that have a very developed a robust health infrastructure probably able to contain any cases that arrive in that country and identify them very quickly and trace any contacts and so the likelihood of of a disease spreading in a country like that is much more limited but if you take a country that doesn't have ready access to testing facilities that perhaps doesn't have the personality infrastructure to implement any kind of screening or monitoring of people who've arrived in the country and also that may have a health infrastructure that's quite limited with a limited number of health of professionals perhaps not even appropriate isolation facilities or equipment things start to become much more complicated and it's likely that in that situation while this virus may cause disease and may cause problems and spread in a country like that it's likely actually that it's the overwhelming of the health infrastructure in that country that's going to cause secondary effects such as people who have other diseases or of the illnesses not being able to access treatment because the facilities are overwhelmed by trying to deal with viral disease outbreak nicklas hospitals and medical workers and on are making urgent appeals for supplies the central government has acknowledged this severe strain on resources but just how bad is the situation right now we're seeing videos being uploaded through various chinese social media sites showing very crowded hospitals where people are going along to them still wearing face masks of course but going along complaining of high fevers and other flu like symptoms now in some cases on the social media sites these have been corridos have been jam packed with people and simply not enough health care frontline health care help is around doctors and nurses now the danger with this of course is that most of those people will not have. actually have the corona virus they may have the flu which makes them more susceptible but then in being in tight confined spaces with someone who would have the corona virus there's a much greater risk of it spreading into the general population and as you said at the same time the hospitals in in the corn 1000 cities simply don't have the resources to deal with this massive influx and so here's another question for china how do they get this all the equipment they need from the rest of the country and indeed from overseas into these affected cities this is very much a supply and logistics question which i think the learning curve on this is very steep and i think what we're seeing here is china really trying to sort of play catch up to all the technical infrastructure type issues such as down's mosques and so on that the people coming into the hospitals need natalie i just want to take a step back for a moment for our viewers so we can help them better understand this topic could you tell us more about coronaviruses how rare is it that they transmit from animals to humans how rare is it they transmit from human to human so we don't now that there's about 7 corona viruses that cause disease in humans this the most recent one from will happen is the 7th so we've known that there are coronaviruses for quite a long time that can infect humans and the vast majority of them cause some form of disparate tree illness so we've known all say that they can usually spread from human to human by droplet infection so when people sneeze and cough and if they're infected and somebody is nearby they might become infected now that really varies though depending on the virus you're talking about so we know that solace which which is also a corona virus was quite infectious so if people sneezed and coughed other people became infected as well whereas we don't see that as much with the mers virus which is occurring a virus that we see set collecting in the middle east for the most part at. and while that sometimes can spread to humans particularly in hospital settings we don't see it so much in immediate family members although it has been reported that that can occur so they these coronaviruses can vary and how infectious they are and they can vary a little bit in the type of disease that they cause as well how often a virus essentially does a species hop so from an animal host into a human is is a good question we know that there's a number of coronaviruses as well that infect animals that don't at the moment infect humans. the last couple of decades we've seen 3 coronaviruses essentially do a species hop so solace in 20022003 that was found in bats but originated the species hop from a civic animal in sioux humans and then with that was around 2012 so that again was found in bats but it infected camels and and then did the species hop from camels into humans and obviously in this current outbreak we're still waiting to identify what the animal reservoir is. in the past 2 decades several fast spreading diseases have caused global alarm between 20022003 the highly contagious severe acute respiratory syndrome or sars outbreak in china led to nearly 800 deaths in 17 countries according to the w.h.o. that's almost 10 percent of those who became infected it's thought to have spread from the civet cat to humans swine flu also known as h one n one quickly spread around the world in 2009 categorized as a pandemic it's estimated to have killed between 100000 half a 1000000 people the middle east respiratory syndrome or mers was identified in saudi arabia in 2012 it killed more than 850 people and it's thought to have come from a camel nicolas let me ask you are the chinese authorities do providing enough information about how this disease is spreading i think what we've seen in the past 2 weeks in particular the chinese c.d.c. has been very proactive in releasing patient data as fast as i can on a daily basis the question though is to what extent the frontline doctors actually have the diagnostic testing facilities to correctly identify people who are suffering from the new novel coronavirus this is the issue that goes along with many more mosques and more gams needing more diagnostic facilities and also more technicians who can run the tests we're seeing very quickly the local infrastructure in will hon although it has some very good hospitals being overwhelmed with the demand being placed on them and the amount of tests that she then subsequently having to do so i think on the one hand there is a clear line of reporting coming out of the chinese c.d.c. but the information coming into that at the grassroots level is very much still being will it is being overwhelmed and the need to be more streamlining of the procedures but then this we're dealing with populations were never dealt with before and the quarantine situations. and so i think this is very much a case of learning as best as you can as you go not only china's government cabinet has now been appointed control over this crisis how significant is that what message does that send to the international community as far as how china is dealing with this versus how they dealt with with other outbreaks in the past yes so i think it sends the message that they're taking it very seriously i think all of their actions so far have demonstrated how seriously they're taking this and as nicholas said we. have seen them act far more promptly this time than with the sars outbreak in 2002 in 2003 such that we actually had the sequence of this virus very promptly and that sequence was released to health care professionals and research is around the world very promptly so that they could start developing diagnostic tests in their own countries and they could start looking at the nature of the virus and how it might behave so this has been very prominent i think that the. nature of quarantining to communities and cities well that's something that hasn't really been done before and i think as nicholas said time will tell as to how effective that is in in this context but i don't think that even if it is effective in this context i don't think we can necessarily extrapolate that to other coaches in other countries necessarily i think each country needs to make that own decisions about how best to address that understanding that population and ensuring that they have circulated appropriate disease messaging as well nicholas i saw you nodding along toward natalie was saying did you want to jump in no i just think that we are very much in a new situation i think. over looks at saaz as the touchstone it's a krone virus emerge from china but i think when you look at for example the hate 7 and 9 outbreak which took place roughly 8 years ago 7 years ago in china there you have an example of when the chinese authorities were very proactive engage you know in engaging the international community and i think that lesson is perhaps more relevant to what we're seeing today with external experts come in the central level government and the c.d.c. have been quite proactive in sharing the scientific information i think the question is very much now getting local authorities at the municipal at the provincial level and perhaps even lower down at county levels within china to be more responsive to whenever a novel threat is identified to meet lee putting in place measures to contain it as well as get information out to the local population but the same time i think that also implies that local populations i'm so are in a bit of a learning curve as to how to deal with these issues because undoubtedly they're going to rewrite given what we've seen in china for the last 2 decades certainly here in hong kong i mean i was here in 2003 when saas broke out the was considerable fear we had streets being very empty now today what we're seeing are people taking those lessons forward and saying right there's an outbreak we need to wear masks we need to observe better personal hygiene and even if they're not sick themselves they're already wearing masks as a preventative measure and so i think that a social level you can see how here in hong kong people have actually taken those lessons on board and are applying them in a way which helps to limit the possible transmission of the disease all right we've run out of times we're going to have to leave it there thanks so much to our guests nicholas thomas and natalie mcdermott and thank you too for watching you can see the program again any time by visiting our website al-jazeera dot com and for further discussion go to our facebook page at. facebook dot com forward slash a.j. inside story you can also join the conversation on twitter our handle is at a.j. inside story for me mohammed to me and the whole team here bye for now. still navigating dangerous rapids from the time we departed through the time we finished our scares to the fisherman dicing with death. i'm afraid of falling i'm afraid of dying but if i don't go i can feel my family meet the man who go to the extreme just to make a living i'm not your have to be a strong swimmer otherwise the surf i'm risking it all vietnam on al-jazeera. al jazeera explores prominent figures of the 20th century and how rivalries influenced the course of history steve jobs a much better market share than bill gates. is going to prevent the fall bill made software what it is today will change the world to high tech visionaries whose breakthroughs inspired a digital revolution jobs and gates face to face on al-jazeera. a journey of personal discovery. which is the call of a letter to germany addressed to my ground. 0. traces of family links to the regime of benito mussolini and. his fascism return to italian politics pressures in the family it makes me sick this letter. found. on al-jazeera we understand the differences in the semantics of cultures across the world so no matter what we do to the news and current affairs that matter to you. this is al-jazeera. hello and welcome to the sound is there a news hour live from. scene that is coming up in the next 60 minutes is day 3 of the impeachment trial of president trump it's about to get under way and will be live in washington. trying to contain the spread of a new virus china restricts the movement of 40000000 people and orders a new hospital to be built in a way.
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