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Paradigm Shift Intervention Monitoring
Coronavirus Alerts Issued
The above comments are from a novel betacoronavirus alert by Public Health Agency of Canada which was similar to alerts issued by agencies in multiple countries including Hong Kong and Brunei.
These alerts followed the November 23 WHO update which increased the number of confirmed cases to six and cited two additional probable cases. The two probable cases and two of the confirmed cases were from the same family from Riyadh, Saudi Arabia. Two of the family members died including a father (70M) and son. Both died after developing renal failure and the son was hospitalized after his father died suggesting he was infected by his father. However, the disease onset dates for the family members has not been released, but confirmation of the two probable cases is expected this week. One of the survivors initially tested negative, but the negative was likely false. All four family members had similar symptoms, but the two fatal cases were more severe and developed renal failure or multi-organ failure.
The first two cases also developed renal failure. The first case (60M) died, while the second case (49M) has been hospitalized for almost 3 months. The three deaths and prolonged hospitalization for the four cases with renal failure is similar to SARS CoV cases in 2003, where about 5% of lab confirmed cases developed renal failure and the vast majority died. However, about 90% of the confirmed SARS CoV cases survived, suggesting that milder cases due to the current novel coronavirus have not been reported.
The milder cases may be widespread. The initial cases had visited Mecca and one had done so during Umrah week, raising concerns that pilgrims from the Hajj have spread the virus well beyond Saudi Arabia and Qatar, where all eight confirmed or probable cases were identified.
WHO has recommended wider testing and expects additional positives. As noted above, the novel coronavirus has not been detected in any animal species in spite of aggressive testing of multiple species, especially bats, following the 2003 SARS CoV outbreak.