The latest on the coronavirus

In the wake of an outbreak of coronavirus that began in China in late December 2019, Harvard T.H. Chan School of Public Health experts have been speaking to a variety of media outlets. We’ll be updating this article on a regular basis. Here’s a selection of stories in which they offer comments and context:

February 18, 2020: S’pore is gold standard for case detection: Harvard study (The Strait Times)

In an analysis to estimate the underdetection of COVID-19 cases, Marc Lipsitch, professor of epidemiology and director of the Center for Communicable Disease Dynamics, and colleagues at Harvard Chan School said that Singapore’s approach for detecting the disease as “a gold standard of near-perfect detection”.

February 18, 2020: The Coronavirus Outbreak Could Bring Out the Worst in Trump (The Atlantic)

President Trump stated that the coronavirus outbreak was “totally under control” and that “it’s going to be just fine” in an interview at the World Economic Forum in Davos, Switzerland. However, politicians, infectious disease experts and epidemiologists remained concerned. “Everyone is using caution in how we’re framing what the risk is, primarily because we don’t understand what the risk is at this moment,” said Michael Mina, assistant professor of epidemiology.  “The last thing anyone would say is, ‘We’re not concerned.’ Everyone is concerned.”

February 16, 2020: Fact-Checking ‘Contagion’ — In Wake Of Coronavirus, The 2011 Movie Is Trending (NPR)

The 2011 movie Contagion, starring Gwyneth Paltrow, has experienced renewed interest since news of the novel coronavirus broke. The movie’s plot does have some similarities to the current outbreak, although the imaginary Contagion disease kills 20% of those infected, which is 10 times more than the estimated 2% death rate from COVID-19. Some experts say that the movie has some realistic aspects. “”What is accurate is the professionalism and devotion of staff in the EIS at CDC,” said William Hanage, associate professor of epidemiology. “These people are tireless, and I’m truly honored that several of my former students went on to serve in EIS. It’s also not an especially glamorous job, for all its importance, and Kate Winslet’s portrayal [of an EIS epidemiologist] captures that.”

February 16, 2020: How Many People Might One Person With Coronavirus Infect? (Wall Street Journal)

Researchers are still attempting to define how many people have already been infected–and how many will become infected–with the novel coronavirus that causes COVID-19. Based on the currently available data, Marc Lipsitch says a global pandemic is likely, but the number of people who will have symptoms is still unknown.

February 15, 2020: Boston foodies, officials fight coronavirus fears with ‘Dine Chinatown’ initiative (WHDH News)

As the number of coronavirus cases rise worldwide, local officials and diners specifically patronized businesses in Boston’s Chinatown that have seen fewer visitors due to fears of the virus. “At this point, there’s no reason to avoid Chinatown. I’m here today, I was at a Chinese restaurant last week, I love Chinese food,” Marc Lipsitch said.

February 15, 2020: ‘It’s meant to help’: Harvard professor responds after government dismisses study on undetected coronavirus cases (The Jakarta Post)

Nadhira Afifa, an Indonesian student in the Department of Global Health and Population, filmed an interview with Marc Lipstich about a recent study that he and other researchers at Harvard Chan School wrote. Among other topics in the study, the authors questioned the lack of reported COVID-1 cases in Indonesia. The Indonesian government downplayed the concerns raised in the paper. In the interview with Afifa, Lipsitch said that the study “is meant to be a helpful signaling of something that needs to be looked at.”

February 13: ‘Tip of the iceberg:’ Why Covid-19 deaths will keep rising even as the coronavirus outbreak wanes (Fortune)

Even though it appears that the coronavirus outbreak may be slowing in China, the number of deaths there are rising. But that doesn’t mean the virus is getting more deadly, say experts. “Deaths are a lagging indicator,” said Marc Lipsitch, who has been modeling the outbreak. He said that once people are infected, “it takes around three weeks on average for someone to die.”

February 13: Scientists fear coronavirus spread in countries least able to contain it (Nature)

Experts say that coronavirus may be going undetected in some countries with weaker health care systems, such as those in southeast Asia and Africa, putting them at risk for outbreaks. Marc Lipsitch, said that Africa is not as exposed to risk as some southeast Asian nations where there are direct flights from Wuhan, the epicenter of the virus. But the travel of Chinese laborers to Africa could be a route for transmission, he said.

February 12: Cases Of COVID-19 Soar On Quarantined Coronavirus Cruise Ship. 218 Now Affected. (Forbes)

Experts have been criticizing Japanese authorities’ decision to quarantine a cruise ship docked in Yokahama port as cases of coronavirus—dubbed ‘COVID-19’ by the World Health Organization—have mounted on the ship. “The government must become creative and figure out some way to safely remove the passengers and crew from the ship while maintaining a quarantine away from the city,” said Michael Mina.

February 12: Understanding pandemics: What they mean, don’t mean, and what comes next with the coronavirus (STAT)

A number of experts, including Marc Lipsitch, think that the novel coronavirus will soon become a pandemic—meaning that it will spread across regions. But it’s still unclear how severe such a pandemic would be.

February 12, 2020: Worker on board Diamond Princess says crew are at greater risk of coronavirus (CNN)

The Diamond Princess cruise ship docked outside of Yokohama, Japan, contains more than 3,700 passengers and crew who have been quarantined on the boat since February 4, 2020. Although passengers have been mostly confined to their quarters, many crew continue to work and live in close quarters, which may allow the virus to spread from one crewmember to another. “I think a lot of thought went into what to do with the passengers, but it puts the crew at increased risk. It’s a closed environment, a ship. It’s the perfect place for an infectious disease to spread,” said Eric Rubin, Irene Heinz Given Professor of Immunology and Infectious Diseases.

February 11: Coronavirus Likely Now ‘Gathering Steam’ (Harvard Gazette)

In a Q&A, Marc Lipsitch said he thinks it’s just a matter of time before the novel coronavirus spreads widely internationally. “I think we should be prepared for the equivalent of a very, very bad flu season, or maybe the worst-ever flu season in modern times,” he said.

February 11: The Coronavirus Appears to be Sparing One Group of People: Kids (CNBC)

Most people who have died from the novel coronavirus were over age 60 or had pre-existing conditions such as heart disease or diabetes, while infections in children appear rare. It could be that children are getting infected with mild cases of the virus and therefore their cases aren’t being reported to authorities, said Marc Lipsitch. But he added that scientists still need to figure out whether children with mild cases can infect others at high rates.

February 11: ‘It’s only a model’: Health Ministry dismisses Harvard study on potential coronavirus spread in Indonesia (The Jakarta Post)

A Harvard Chan School study co-authored by Marc Lipsitch has suggested that Indonesia—which has not reported any patients testing positive for coronavirus—should have at least some confirmed cases given the high number of passengers who routinely fly to the country from Wuhan, the Chinese city at the epicenter of the outbreak. But a health official in Indonesia questioned the study, calling it “only a prediction.” The Harvard Chan study was also mentioned in a Reuters article about the lack of coronavirus cases in Indonesia, and in a Jakarta Post article about 68 people in North Sumatra who are in self-quarantine after returning from China.

February 10: Coronavirus Cases Double on Quarantined Cruise Ship. Is It Time To Evacuate Passengers? (Forbes)

Michael Mina and Eric Feigl-Ding, visiting scientist, both questioned the wisdom of keeping people quarantined on a cruise ship docked in Yokahama, Japan, as cases of coronavirus climbed among the passengers—including 10 crew members. Said Mina, “By enforcing that the crew and passengers remain onboard while crew members are known to be infected necessarily places the crew (as well as the passengers) in what I would consider to be an absolutely unacceptable amount of risk.” Said Feigl-Ding, “I predict if they stay on the ship, the number of cases will keep rising for a while.” Commenting on the cruise ship situation in a Washington Post article, Mina said, “If they can reasonably and carefully manage to deboard the ship and get them into hotel rooms, I think that would be optimal. The question is, what’s it going to take to do that?” Also, a Vox article quoted a tweet from Mina about the quarantine being “no longer ethical.”

February 7: Experts Warn Coronavirus May Be Spreading Undetected in Indonesia, Thailand (Voice of America)

Experts say that the number of coronavirus cases reported in Indonesia and Thailand is lower than they would expect, given their proximity to Wuhan in China, where the outbreak originated. A non-peer-reviewed study by Marc Lipsitch and Harvard Chan colleagues analyzed the number of passengers taking flights from Wuhan to destinations around the world to determine locations where coronavirus cases may be going undetected. “Undetected cases in any country will potentially seed epidemics in those countries” and could then spread to other countries, said Lipsitch. The Harvard Chan study was also cited in articles in the Guardian, the Jakarta Post, the Phnom Penh Post, and the New York Times.

February 7: Coronavirus Outbreak On Quarantined Japan Cruise Ship Spreads. 61 Passengers Now Affected (Forbes)

Some experts, like Michael Mina, are questioning whether quarantining  passengers is the best way to minimize the outbreak of the new coronavirus on a cruise ship at Yokohama port. “This seems to me to be more a decision made with a focus on preventing spread from the ship to Japan, rather than having the focus be on the passengers,” Mina said. “I would not advocate for an evacuation and just let everyone go out into the city, but I think getting people on land and out of the ship is the right thing to do. I think it would reduce risk of disease among those who have not yet been exposed — particularly if the departure of the ship is done methodically and appropriately, with proper safeguards.”

February 6: What we know about the new, novel coronavirus: A timeline (PRI’s The World)

As the number of cases and deaths from the novel coronavirus mount, Michael Mina cautions that these numbers don’t necessarily relate to how contagious the disease is, how fast it’s spreading, or how many people are actually have it. “There has been a lot of fearmongering in this outbreak, mostly because of social media and the rapid dissemination of both good and false information,” he said. “I think one of the important things is to find reliable sources.”

February 6: Coronavirus: Wuhan Communist Party official apologises for failure to provide patients treatment (South China Morning Post)

Wuhan, where the new coronavirus outbreak originated, had 8,300 confirmed cases of infection as of February 4. The city has been racing to add hospital beds to care for patients, including building two new hospitals in less than two weeks and converting a sports stadium and two convention halls into “modular hospitals.” Winnie Yip, professor of the practice of international health policy and economics, said the Wuhan strategy was sensible, but added, “Building new hospitals or shelters alone is not adequate, it will also need to be complemented by community strategies, such as limiting group activities, and personal hygiene practices.”

February 6: Opinion: Can China Prevent Its Next Epidemic? (Undark)

China has taken some drastic measures to contain the new coronavirus outbreak, such as locking down multiple cities—effectively quarantining 45 million people. But it’s unclear if this move will help, and it may actually hurt by cutting off people’s access to health care and support. “It seems likely that it will reduce people’s access to medicine and food because it’s harder to get things into the city,” said Marc Lipsitch.

February 5: Report that said Wuhan coronavirus can spread before symptoms was flawed (CNN)

Marc Lipsitch commented on a New England Journal of Medicine report that suggested that the novel coronavirus could spread asymptomatically—a report that was later found to be flawed. “This was likely an error of being inadequately careful by the authors, an error that is understandable in a crisis situation, but is still problematic,” he said.

February 5: ‘This beast is moving very fast.’ Will the new coronavirus be contained—or go pandemic?

Lipsitch said that he expects to see sustained transmission of the novel coronavirus (2019-nCoV) outside China. “I would be really shocked if in 2 or 3 weeks there wasn’t ongoing transmission with hundreds of cases in several countries on several continents,” he said. But even if the virus does spread around the world, it’s not clear what percentage of the population will get very sick and die. It’s possible that there are tens of thousands of people with mild disease who never seek medical care and may not even know they were infected with 2019-nCoV. “So what looks like a horrific disease may be the horrible tip of a very large iceberg,” Marc Lipsitch said.

February 5: Coronavirus Outbreak May Already Be a Pandemic (Elemental)

The coronavirus outbreak that originated in China is very likely to be declared a pandemic, according to several health officials. But that doesn’t necessarily mean its effects will be catastrophic. The word “pandemic” is “just a word for ‘widespread transmission,’ and there are varying degrees of that…” said Marc Lipsitch. “It doesn’t say anything about the severity of the illness.”

February 4: Even Without Symptoms, Wuhan Coronavirus May Spread, Experts Fear (New York Times)

There were inaccuracies in a New England Journal of Medicine report suggesting that the Wuhan coronavirus can be spread by people who aren’t showing any disease symptoms. But experts still think such asymptomatic spread may be happening, based on anecdotal information. If early symptoms include common complaints such as back pain or headache, doctors may not consider the possibility that a patient is infected with the coronavirus. In cases like this, “the public health challenge of figuring out who’s infectious is about as great as if it was truly asymptomatic,” said Marc Lipsitch.

February 4: Researchers say the coronavirus may be more contagious than current data shows (CNBC)

Marc Lipsitch said that it may take weeks before scientists have a firm grasp on just how contagious the novel coronavirus is.

February 4: Officials question report of virus spreading before symptoms (AP)

It’s still unclear whether the new coronavirus can be spread by people with no symptoms. That’s in spite of the fact that there were flaws in a report from the New England Journal of Medicine report suggesting the existence of asymptomatic transmission. “This is still a point of great uncertainty and it’s an important uncertainty,” said Marc Lipsitch.

February 4: Key evidence for coronavirus spread is flawed as public health decisions loom (Washington Post)

Even though a recent report in the New England Journal of Medicine suggesting that new coronavirus can be spread by people who are asymptomatic was based on incorrect information, experts say it’s still possible that people can spread the disease before showing symptoms. The public health situation surrounding the coronavirus is challenging as news about its spread and effects continue to emerge, they say. Marc Lipsitch said that public policy regarding coronavirus should be flexible, to take into account information that may change or evolve.

February 4: WHO says countries must act to stop coronavirus outbreak (BBC Newshour, at 7:50)

In the midst of a crisis like the new coronavirus epidemic, it’s very hard to gather high-quality data to help define the extent of disease transmission and the severity of illness, said Marc Lipsitch. “The next step really needs to be a concerted effort to characterize the epidemiology of this virus and not just the severe cases, who understandably get the medical attention but may not be the only stories from the public health perspective,” he said.

February 3: Study claiming new coronavirus can be transmitted by people without symptoms was flawed (Science)

A January 30 paper in the New England Journal of Medicine suggested that even people without any symptoms could spread the novel coronavirus to others—but the paper was based on incorrect information. Given how fast data are coming out amid the growing global crisis, even peer-reviewed papers should be read with extra caution, said Marc Lipsitch. “I think peer review is lighter in the middle of an epidemic than it is at normal speed, and also the quality of the data going into the papers is necessarily more uncertain,” he said.

February 3: Coronavirus cases hit 17,400 and are likely to surge (Harvard Gazette)

Michael Mina said he expects the official tally of coronavirus cases to climb steeply. “We can assume that this is growing at somewhat of an exponential rate, and it will continue increasing in scale,” he said.

February 3: To fight coronavirus spread, the U.S. may expand ‘social distancing’ measures. But it comes at a cost (STAT)

In response to the new coronavirus outbreak, many places around the world have implemented “social distancing” steps such as canceling large public gatherings, asking students to stay home from school, or closing down borders. Ashish Jha, K.T. Li Professor of Global Health and director of the Harvard Global Health Institute (HGHI), told STAT that officials consider such measures when the rate of new infections exceeds what any hospital or town can handle. But he noted that large-scale public health interventions like shutting down schools can come at a cost: a sense of panic.

February 2: New China virus details show challenge for outbreak control (Washington Post)

Officials are concerned about certain aspects of the new coronavirus, such as asymptomatic transmission. If the virus can spread from person to person without causing symptoms, “it will spread further and perhaps for longer than we initially hoped,” Jha told the Post. Another concern is the lack of an accurate test for the virus. “Any factor that makes it harder to be sure if someone is a case or not makes control harder,” said Marc Lipsitch.

January 31: Declaring coronavirus emergency alone is not enough, experts say (Devex)

The World Health Organization’s declaration that the novel coronavirus outbreak is a public health emergency will help unlock financial and personnel resources to help stem the virus’ spread and help boost cooperation among countries, say experts. HGHI senior fellow Olga Jonas said she hopes that the outbreak brings more attention to the importance of strengthening countries’ capacities to handle emergencies, not just in the present but in the future as well.

January 31: Medical professionals battle virus misinformation online (AP)

Misinformation that has spread online about the novel coronavirus—such as false claims about how to prevent it, or videos that purport to show people experiencing terrible side effects—has fueled fear and caused confusion, say experts. One example of the dangers of false information propagated online is the recent uptick in measles cases in the U.S., fueled by anti-vaccine groups. “It’s one of the clearest consequences of this kind of misinformation,” said Kasisomayajula “Vish” Viswanath, Lee Kum Kee Professor of Health Communication.

January 31: Don’t Listen To Sen. Tom Cotton About Coronavirus (Huffington Post)

Experts say that Sen. Tom Cotton (R-Ark.) has been spreading misinformation and fear about the new coronavirus, such as urging all Americans in China to “get out now” and even suggesting that the coronavirus could have come from a “Chinese super laboratory.” Michael Mina called the latter claim “ridiculous,” noting that “all signs point to a pathogen that has been circulating in animals and jumped to humans. It’s pretty common for these viruses and there’s no good reason for him to be saying something like that.” Mina added, “Panic is never a useful thing to elicit in a population … and anyone who’s doing that probably shouldn’t be in a public policy office.”

January 31: What we know about the new coronavirus outbreak and how to respond (PRI’s The World)

Michael Mina discussed the novel coronavirus in a Facebook Live Q&A cosponsored by PRI’s The World and the Forum at Harvard Chan School.

January 29: Wuhan Building Two Hospitals in Just Days (VOA)

Winnie Yip said that the two coronavirus treatment centers being constructed in Wuhan are badly needed, because “most large tertiary hospitals in China are very crowded and overstretched.” She added, “In the long run, China should build a stronger primary health care and public health system that would actually prevent something like this [the coronavirus outbreak] happening at large scale.”

January 29: Worried About Catching The New Coronavirus? In The U.S., Flu Is A Bigger Threat (NPR)

So far, only a few people in the U.S. have been infected with the new strain of coronavirus identified in China, while millions have gotten sick with flu and more than 8,000 have died from their infection. With any respiratory illness—whether flu or coronavirus—people are vulnerable to secondary bacterial infections. To ward off these infections (such as pneumonia), experts recommend a pneumococcal vaccine for young children, older people, and those with certain medical conditions. “We don’t know whether this new coronavirus tends to predispose people toward pneumococcal infection, but many respiratory viruses do,” said Marc Lipsitch.

January 29: Scientists warn nCoV more infectious than SARS, but experts have doubts (Center for Infectious Diseases Research and Policy, University of Minnesota)

Marc Lipsitch and Caroline Buckee, associate professor of epidemiology, comment on how how infectious the new coronavirus may be.

January 29: Three of the most Viral Claims About the Coronavirus Are Fake (Mother Jones)

Inaccurate information about the new coronavirus has been reported in the media—such as the claim that there’s a cure. Michael Mina said, “There’s lots of fearmongering going on about global pandemic, a catastrophe happening or about to happen.”

January 28: Center for Communicable Disease Dynamics offers ‘tweetorial’ on coronavirus

Marc Lipsitch offers a “tweetorial” to help make sense of current information about the virus.

January 28: Up All Night (BBC) (listen at minute 8:28)

Asked if the media is overblowing the risk from the new coronavirus, Marc Lipsitch said that while the scale of coronavirus-related illness and death is far less than that of the flu, “It’s novel, we don’t understand how it works….Until we understand it, caution is appropriate.” He said one of the most important things that scientists have to find out about the virus is whether it can spread when people are asymptomatic, because if that can happen, it will make it harder to control transmission.

January 27: What we know about novel coronavirus so far (PBS)

Vish Viswanath told PBS that public experts are debating the wisdom of China’s decision to shut down transportation for 17 cities in the wake of the outbreak—effectively placing 50 million people under quarantine. He called the scale of quarantine “unprecedented.”

January 26: Coronavirus spreads to Los Angeles, Orange County: How concerned should we be about spread? (Los Angeles Times)

Michael Mina said, “We don’t have evidence yet to suggest this is any more virulent than the flu you see in the U.S. each year.”

January 24: Should you panic about the coronavirus from China? Here’s what the experts say (Los Angeles Times)

Michael Mina said that even if the new coronavirus is not especially lethal, other characteristics of the virus—such as how easily it spreads—are unknown, fueling fear and even panic. “As humans, we are always fearful of the [un]known,” he said.

January 22: Mystery Coronavirus from China: What to Know (WebMD)

Michael Mina said the development of a rapid test for the new coronavirus makes him hopeful that the outbreak can be contained. “This has probably been the fastest response to date of any epidemic,” he said.