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Paradigm Shift Intervention Monitoring
Coronavirus Case In Mecca for Umrah Week
The above translation of comments by the brother of the first novel beta coronavirus case (49M) in Qatar indicates the brother traveled to Saudi Arabia for Umrah week. Media reports cited his visit to Mecca prior to more severe symptoms that developed in Doha, Qatar prior to air ambulance transfer to London, where the novel coronavirus was detected by the Health Protection Agency using a pancornavirus PCR test developed after the SARS CoV outbreak in 2003.
The above case developed renal failure and was hospitalized for several months, but survived. Symptoms, including renal failure matched SARS CoV from 2003 as well as the first confirmed case fatally infected with the recent novel coronavirus. Renal failure was also reported for the two members of the Riyadh cluster, who died. The son was nCoV confirmed, while tests on his father (70M) are pending. The gap in dates of death suggest human to human transmission.
The similarities of these severe cases with the 2003 SARS CoV outbreak raise concerns that the cases with renal failure represent the severe cases in the spectrum of presentations. For the 2003 SARS CoV outbreak, about 5% developed renal failure and most with renal failure died. These similarities raise concerns that most infections with the novel coronavirus are milder than the fatal cases or those with renal failure, and the milder cases are largely untested.
WHO has recommended wider testing, but the linkage of the initial cases to Mecca, including a trip during Umrah week, raises concerns that the novel coronavirus has spread well beyond Saudi Arabia and Qatar. Large numbers of pilgrims from Indonesia, India, and Pakistan visited Saudi Arabia for the Hajj, and the return of those pilgrims to their counties or origin has increased concerns.