Virus could be changing in unknown ways, making it difficult to stamp out

Chinese doctors are seeing the coronavirus manifests differently among patients in its new cluster of cases in the northeast region compared to the original outbreak in Wuhan, suggesting that the pathogen may be changing in unknown ways and complicating efforts to stamp it out.

Patients found in the northern provinces of Jilin and Heilongjiang appear to carry the virus for a longer period of time and take

longer to test negative, Qiu Haibo, one of China’s top critical care doctors, told state television on Tuesday.

Patients in the northeast also appear to be taking longer than the one to two weeks observed in Wuhan to develop symptoms after infection, and this delayed onset is making it harder for authorities to catch cases before they spread, said Qiu, who is now in the northern region treating patients.

Second waves hard to trace “The longer period during which infected patients show no symptoms has created clusters of family infections,” said Qiu, who was earlier sent to Wuhan to help in the original outbreak. Some 46 cases have been reported over the past two weeks spread across three cities – Shulan, Jilin city and Shengyang – in two provinces, a resurgence of infection that sparked renewed lockdown measures over a region of 100 million people.

Scientists still do not fully understand if the virus is changing in significant ways and the differences Chinese doctors are seeing could be due to the fact that they’re able to observe patients more thoroughly and from an earlier stage than in Wuhan. When the outbreak first exploded in the central Chinese city, the local health-care system was so overwhelmed that only the most serious cases were being treated. The northeast cluster is also far smaller than Hubei’s outbreak, which ultimately sickened over 68,000 people.

The mutation question

Still, the findings suggest that the remaining uncertainty over how the virus manifests will hinder governments’ efforts to curb its spread and re-open their battered economies. China has one of the most comprehensive virus detection and testing regimes globally and yet is still struggling to contain its new cluster.

Researchers worldwide are trying to ascertain if the virus is mutating in a significant way to become more contagious as it races through the human population, but early research suggesting this possibility has been criticized for being overblown.

“In theory, some changes in the genetic structure can lead to changes in the virus structure or how the virus behaves,” said Keiji Fukuda, director and clinical professor at the University of Hong Kong’s School of Public Health. “However, many mutations lead to no discernible changes at all.”

It’s likely that the observations in China don’t have a simple correlation with a mutation and “very clear evidence” is needed before concluding that the virus is mutating, he said.

Northeast differences

Qiu said that doctors have also noticed patients in the northeast cluster seem to have damage mostly in their lungs, whereas patients in Wuhan suffered multiorgan damage across the heart, kidney, and gut.

Officials now believe that the new cluster stemmed from contact with infected arrivals from Russia, which has one of the worst outbreaks in Europe. Genetic sequencing has showed a match between the northeast cases and Russian-linked ones, said Qiu.

Among the northeast cluster, only 10% have turned critical and 26 are hospitalized.