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Paradigm Shift Intervention Monitoring
Media Myth On
Coronavirus Transmission In HCWs
In Canada during the 2003 SARS outbreak, the virus was so readily transmitted that extra hospital staff were stationed outside SARS patients' rooms to make sure health care workers didn't enter without full protective gear.
"That has not happened with these patients yet," he said. "It indicates that this is not a virus that is readily transmitted person-to-person."
The above comments on an ABC News report on the two most recent nCoV deaths (the index case, 60M, from the UK cluster and the first confirmed case, 73M, from the UAE) are a step beyond media myth. The first two known nCoV cases were Jordan health care workers (HCWs) who died on April 19 and April 26, 2012. Although lab confirmation was made retroactively (November, 2012), the confirmation was well in advance of the above interview, and claims that nCoV hasn’t spread to health care workers are demonstrably false.
The Jordan outbreak was centered in an ICU. Local media reports described it as a SARS-like outbreak, and the similarities with SARS clusters involving HCWs in 2003 were clear.
Jordan initially sent out samples to labs in France and Egypt to identify the etiological agents, which failed because testing was limited to known human agents. However, after the novel coronavirus was identified in a fatal case hospitalized in Jeddah, and a Qatari who was transported to the UK by air ambulance, samples from Jordan were re-tested by NAMRU-3 (US Naval medical facility in Egypt), who confirmed nCoV in the two fatal cases, who were HCWs.
Although WHO failed to explain why nCoV was not confirmed in the surviving cluster members, an epidemiological team interview patients and family members and concluded that the symptomatic members of the cluster likely nCoV infected and were classified as probable case.
Confirmation of nCoV in milder cases has been problematic and a surviving member of a Riyadh cluster was also classified as a probable case after he tested negative. Three other family members tested positive, including the father (70M) and son (38M) who died. However, WHO also noted that family contacts of the HCWS who were also symptomatic were also classified as probable cases whose infection was due to human to human transmission.
Moreover, NAMRU-3 has released a full sequence from samples collected from the nurse (45F) who was hospitalized (April 9) and died (April 19), and that sequence was most closely related to the case who died in Jeddah. The clustered shared polymorphisms indicated that the two districts subclades arose via recombination. The two more recent sequences (from the Qatari nation hospitalized in the UK and the UK index case) formed a second subclade.
The presence of two human subclades, which are not closely related to any animal coronavirus, in cases with no animal contact, signal sustained nCoV transmission, WHO denials notwithstanding.