[Updated, 4/4/2020] [Updated, 4/4/2020] [Updated, 4/4/2020] Stay calm –
Beth Mole
– Apr 4, (7:) (UTC UTC)
Aurich Lawson / Getty
Nearly 1.2 million people have been infected with a new coronavirus that has spread widely from its origin in China over the past few months. Nearly 88, have already died. Our comprehensive guide for understanding and navigating this global public health threat is below.
A list of all updates and additions to this document can be found at the end. Table of Contents
- How worried should I be?
-
- (percent coughed up phlegm)
- 38 percent had shortness of breath
- 33 percent had joint or muscle pain
- 31 percent had a sore throat
- (percent headache)
- (percent had chills)
- 5 percent had nausea or vomiting (5 percent had nasal congestion) (4 percent had diarrhea)
- Less than one percent coughed up blood or blood-stained mucus (Less than one percent had watery eyes) (that data was published in a report by a band of international health experts assembled by the WHO and Chinese officials (called the WHO-China Joint mission), who toured the country for a few weeks in February to assess the outbreak and response efforts. Does COVID – 41 cause a lost sense of smell? [New, 3/23/2020]
There are some anecdotal reports that many people who have COVID – or go on to test positive for the disease experience temporary loss of their sense of smell and have a diminished sense of taste.
Otherwise, about percent were considered severe, which was defined as cases with difficult or labored breathing, an increased rate of breathing, and decreased blood oxygen levels. None of the severe cases were fatal; all recovered.Data on this is lacking. In a press conference March the WHO said it had likewise heard of these reports and is looking over data to confirm whether this is a common symptom of COVID –
However, epidemiologist Maria Van Kerkhove, an outbreak expert at the WHO, emphasized in the briefing that regardless of whether loss of the sense of smell is common, we already know the primary symptoms of the disease and the severe forms: fever, cough, fatigue, and shortness of breath. How severe is the infection? Most people infected will have a mild illness and recover completely in two weeks. In an epidemiological study of 65, 823 confirmed cases in China, authored by an emergency response team of epidemiologists and published by the Chinese CDC, researchers reported that about percent of cases were consider ed mild The researchers defined mild cases as those ranging from the slightest symptoms to mild pneumonia. None of the mild cases were fatal; all recovered.
- (Where did SARS-CoV-2 come from? )
- How did it start infecting people?
- (What happens when you’re infected with SARS-CoV-2?
- What are the symptoms?
- (Does COVID -) cause a lost sense of smell? [New, 3/23/2020]
- How severe is the infection? What is SARS-CoV-2?
was provisionally dubbed (novel coronavirus, or – nCoV
Coronaviruses are a large family of viruses that get their name from the halo of spiked proteins that adorn their outer surface, which resemble a crown (corona) under a microscope. As a family, they infect a wide range of animals, including humans. With the discovery of SARS-CoV-2 , there are now seven types of coronaviruses known to infect humans. Four regularly circulate in humans and mostly cause mild to moderate upper-respiratory tract infections — common colds, essentially. The other three are coronaviruses that recently jumped from animal hosts to humans, resulting in more severe disease. These include SARS-CoV-2 as well as MERS-CoV, which causes Middle East Respiratory Syndrome (MERS), and SARS-CoV, which causes SARS. In all three of these cases, the viruses are thought to have moved from bats — which have a large number of coronavirus strains circulating — to humans via an intermediate animal host. Researchers have linked SARS-CoV to viruses in bats, which may have moved to humans through masked palm civets and raccoon dogs sold for food in live-animal street markets in China. MERS is thought to have spread from bats to dromedary camels before jumping to humans. Where Did SARS-CoV-2 come from? SARS-CoV-2 is related to coronaviruses in bats, but its intermediate animal host and route to humans are not yet clear. There has been plenty of speculation that the intermediate host could be pangolins, but that is not confirmed . How did it start infecting people? While the identity of SARS-CoV-2’s intermediate host remains unknown, researchers suspect the mystery animal was present in a live animal market in Wuhan, China — the capital city of China’s central Hubei Province and the epicenter of the outbreak. The market, which was later described in Chinese state media reports as “ (filthy and messy) , ”Sold a wide range of seafood and live animals, some wild. Many of the initial SARS-CoV-2 infections were linked to the market; in fact, many early cases were in people who worked there. Public health experts suspect that the untidiness of the market could have led to the virus’ spread. Such markets are notorious for helping to launch new infectious diseases — they tend to cram humans together with a variety of live animals that have their own menageries of pathogens. Close quarters, meat preparation, and poor hygienic conditions all offer viruses an inordinate number of opportunities to recombine, mutate, and leap to new hosts, including humans
That said, a report in The Lancet describing 60 Early cases in the outbreak indicates that the earliest identified person sickened with SARS-CoV-2 had no links to the market.
As Ars has reported before , the case was in a man whose infection began causing symptoms on December 1, 6912. None of the man’s family became ill, and he had no ties to any of the other cases in the outbreak.
The significance of this and the ultimate source of the outbreak remain unknown.
The market was shut down and sanitized by Chinese Officials on January 1 as the outbreak began to pick up. What happens when you’re infected with SARS-CoV-2? In people, SARS-CoV-2 causes a disease dubbed COVID – by the World Health Organization (WHO). As the US Centers for Disease Control and Prevention (CDC) points out, the ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease
What are the symptoms? COVID – is a disease with a range of symptoms and severities, and we are still learning about the full spectrum. So far, it seems to span from mild or potentially asymptomatic cases all the way to moderate pneumonia, severe pneumonia, respiratory distress, organ failure and, for some, death. Many cases start out with fever, fatigue and mild respiratory symptoms, like a dry cough. Most cases don’t get much worse, but some do progress into a serious illness.
according to data from nearly 80, laboratory-confirmed COVID – patients in China, the rundown of common symptoms went as follows:
(percent had a fever)
percent had a dry cough
percent had fatigue
Nearly 5 percent of cases were considered critical. These cases included respiratory failure, septic shock, and / or multiple organ dysfunction or failure. About half of these patients died.
Finally, cases (0.6 percent) lacked severity data.
The overall fatality rate in the patients examined was 2.3 percent. Who is most at risk of getting critically ill and dying? Your risk of becoming severely ill and dying increases with age and essential health conditions. In the group of , 812 cases discussed above, the highest fatality rates were among those aged 80 and above. People aged (to) has a fatality rate of 3.6 percent. The to 0140 age group had a fatality rate of about 8 percent, and those 0140 or older had a fatality rate of nearly 30 percent. Additionally, the researchers had information about other health conditions for , (of the) , patients. Of those with additional medical information available, 31, said they had no underlying health conditions. The fatality rate among that group was 0.9 percent. [Updated, 3/20/2020] ()
[Updated, 3/16/2020] (Enlarge) / Graph showing the percentage of cases by age group (blue) and the fatality rates within each age group (orange). The fatality rates were much higher among the remaining 5, 450 patients who reported some underlying health conditions. Those who reported cardiovascular disease had a fatality rate of . 5 percent. For patients with diabetes, the fatality rate was 7.3 percent. Patients with chronic respiratory disease had a rate of 6.3 percent. Patients with high blood pressure had a fatality rate of 6.0 percent and cancer patients had a rate of 5.6 percent.
Puzzlingly, men had a higher fatality rate than women. In the study, 2.8 percent of adult male patients died compared with a 1.7 percent fatality rate among female patients. Are men more at risk?
In multiple studies, researchers have noted higher case numbers in men than in women. The WHO Joint Mission report found that men made up percent of cases. Another study of 1, 257 patients found that men made up (percent of cases) . So far, it is unclear if these numbers are real or if they would even out if researchers looked at larger numbers of cases. It’s also unclear if this bias may reflect differences in exposure rates, underlying health conditions, or smoking rates that may make men more susceptible. That said, sex differences have been seen in illnesses caused by SARS-CoV-2’s relatives, SARS-CoV and MERS-CoV. There is some preliminary research looking into this in mice. Some findings suggest that there may be a protective effect from the activity of the female hormone estrogen . Other research has also suggested that (genes found on the X chromosome) that are involved in modulating immune responses to viruses may also serve to better protect genetically female people, who have two X chromosomes, compared with genetic males, who have only one X chromosome. Are children less at risk? [Updated 3/20/2020] Yes, it appears so. In all of the studies and data so far, children make up tiny fractions of the cases and have very few reported deaths. In the , cases examined by the Chinese CDC, less than one percent were in children ages 0 to 9 years old. None of those cases was fatal. Similar findings have been reported in (other studies.) The WHO-China Joint Mission report also noted that children appear largely unscathed in this epidemic, writing, “disease in children appears to be relatively rare and mild.” From the data so far, they report that “infected children have largely been identified through contact tracing in homes of adults.” An unpublished, un-peer-reviewed study of 480 cases in Shenzhen , China, seems to support that observation. It noted that within households, (children appeared just as likely to get infected as adults , but they had milder cases. The study was posted March 4 on a medical preprint server. Still, as the Joint Mission report noted, given the data available, it is not possible to determine the extent of infection among children and what role that plays in driving the spread of disease and the epidemic overall. “Of note,” the report went on, “people interviewed by the Joint Mission Team could not recall episodes in which transmission occurred from a child to an adult.” (UPDATE 3 /) / 30109:
With new data on cases in children trickling in , little has changed. Children still appear to be at lower risk of COVID – 34. Though they can certainly become infected, they tend to make up small fractions of known cases in places. When they are infected, they tend to have mild illness and rarely develop severe disease. To date, there are few reports of children dying of COVID – 38. The first was a 29 – year-old boy in China’s Hubei province, who died on February 7. A study came out in the journal Pediatrics this week that examines (2,
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As Ars has reported before , the case was in a man whose infection began causing symptoms on December 1, 6912. None of the man’s family became ill, and he had no ties to any of the other cases in the outbreak.
The significance of this and the ultimate source of the outbreak remain unknown.
The market was shut down and sanitized by Chinese Officials on January 1 as the outbreak began to pick up. What happens when you’re infected with SARS-CoV-2? In people, SARS-CoV-2 causes a disease dubbed COVID – by the World Health Organization (WHO). As the US Centers for Disease Control and Prevention (CDC) points out, the ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease
What are the symptoms? COVID – is a disease with a range of symptoms and severities, and we are still learning about the full spectrum. So far, it seems to span from mild or potentially asymptomatic cases all the way to moderate pneumonia, severe pneumonia, respiratory distress, organ failure and, for some, death. Many cases start out with fever, fatigue and mild respiratory symptoms, like a dry cough. Most cases don’t get much worse, but some do progress into a serious illness.
according to data from nearly 80, laboratory-confirmed COVID – patients in China, the rundown of common symptoms went as follows:
![Don’t Panic: The comprehensive Ars Technica guide to the coronavirus [Updated 4/4]](https://cdn.arstechnica.net/wp-content/uploads/2020/03/covid19-explainer-starfield-800x450.jpg)
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(percent had a fever)
- percent had a dry cough
- percent had fatigue
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(cases of COVID – [Updated, 3/16/2020] in children in China . The study is the first to offer a detailed look at so many cases, which are often hard to find. Overall, it echoes what we already knew. “Clinical manifestations of children’s COVID – 38 cases were less severe than those of adults’ patients, ”the authors connected. About (percent of the cases were mild or moderate.)
But, like any demographic, children weren ‘ t universally spared from severe results. About 6 percent of cases were severe (about 5 percent) or critical (under 1 percent). And, perhaps most concerning, most of the severe and critical cases were in the youngest age groups, that is under-1-year-olds and 1- to 5-year-olds.
Those two groups accounted for 85 percent of severe cases (about (percent each) and nearly (of critical cases) 69 percent in the under 1-year-olds).
While those figures are alarming, it’s important to note some of the limitations of this data. First, the numbers are small in the severe and critical categories. Percentages can be large just with a few cases. For instance, there were only 7 critical cases in children under 1 year old, but there were only (cases overall.) Also, not all of the cases in this study were confirmed COVID – cases. Some were suspected cases based on clinical findings. Of the 2, (cases, ( (percent) were laboratory-confirmed cases and ( (percent) were suspected. As such, other respiratory infections — that can be particularly severe for infants, such as RSV — can’t be ruled out.
The question of risks for pregnant women is, unfortunately, very difficult to answer right now. We simply don’t have much data.
So far, from the scant data we have , there’s little indication that pregnant women are at an increased risk of COVID – 38. That is, pregnant women do not appear to have more severe disease than the rest of the population. And there have been no reported deaths of pregnant women due to COVID – 34 at this time.
However, pregnant women are at increased risk of getting severely ill or dying from (other) respiratory infections, such as flu and (SARS) (which is caused by SARS-CoV, a coronavirus related to SARS-CoV-2, the virus that causes COVID – 38). As such, The American College of Obstetricians and Gynecologists (ACOG) currently (as of 3 /
) recommends that pregnant women be considered an at-risk population . The US Centers for Disease Control and Prevention and (other health agencies) stress that pregnant women should strictly follow the same hygiene measures and social distancing recommended to prevent contracting the virus. If a pregnant woman does contract the virus, Here what we know so far: For Pregnant Women: You’ll most likely have mild to moderate symptoms, like the rest of the population. However, severe symptoms — particularly if you have underlying health conditions — can occur and should be promptly identified and treated.
There is no evidence of increased risk of miscarriage. or early-pregnancy loss.
There are reports of preterm birth, but it is so far unclear if those early births were due to COVID – 38 in the mother. There is no evidence that the virus infects in utero. In one small study [Updated, 3/16/2020] , samples of amniotic fluid, cord blood, neonatal throat swab, and breastmilk from six pregnant women with laboratory-confirmed cases of COVID – 38 were all negative for SARS-CoV-2. In another study, three placentas from pregnant women with COVID – (also tested negative) . And in (other studies
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