San Francisco Chronicle

Coronaviru­s risk low, but Bay Area is wary

Far from any cases, residents still snap up face masks

- By Erin Allday

The new coronaviru­s that has sickened more than 6,000 people worldwide and killed more than 130 is causing major upheaval across China, the epicenter of the illness. It’s also alarming Bay Area residents who — at least for now — are at very low risk of illness, but are stocking up on face masks and asking health care providers for advice on protecting themselves and loved ones. At least two Bay Area counties have opened public health emergency centers this week to disseminat­e accurate and uptodate informatio­n about the outbreak. Several stores reported running low on masks, which are being sold to customers concerned for their own safety or who plan to send them to people in China.

The outbreak of the respirator­y illness has the potential to become a major global health threat, and people in the U.S. should pay attention to updates about how to protect themselves, by avoiding travel to China, for example.

But public health and infectious disease experts said for now, people in the Bay Area and other parts of the U.S. should be far more concerned about influenza than the new coronaviru­s. That means they should wash their hands regularly

and stay home from work or school if they’re sick.

“There are a lot of people who are quite concerned (about the new virus),” said Sara Cody, Santa Clara County health officer. “But with just a few cases in the United States and none in the Bay Area, we have no evidence there’s humantohum­an transmissi­on here. We don’t have recommenda­tions that people take any particular action.

“It is important to remember that we’re having a very busy flu season,” she added. “So we are really emphasizin­g that if you’re sick, stay home. And if you’re not, wash your hands a lot and make sure you’ve had your flu shot. As much as we can prevent what’s preventabl­e, that’s great, particular­ly when everyone’s concerned about this new virus.”

As of early Wednesday, the new coronaviru­s had infected 5,974 people in China and dozens more elsewhere, though some infectious disease experts say that number is probably far higher with many cases not being reported or tested. The virus has been confirmed in at least 18 countries and four U.S. states.

Two cases of coronaviru­s have been reported in California, in Los Angeles and Orange counties; the three others are in Washington state, Illinois and Arizona. Nationwide, 73 possible cases are under investigat­ion. The five confirmed domestic cases are people who recently were in China and almost certainly were infected there before flying to the United States.

Experts in global health threats said they were keeping a close eye on the outbreak because of the potential for a major epidemic. Coronaviru­ses are a common cause of mild illness, but three types have been responsibl­e for large, serious outbreaks of respirator­y illness: the current one, and the viruses that cause SARS and MERS.

SARS (severe acute respirator­y syndrome) infected about 8,000 people and killed nearly 800, about 10%, before largely disappeari­ng in 2003. MERS (Middle East respirator­y syndrome) has infected about 2,500 people and killed nearly 900, or about 36%. The coronaviru­ses that cause those illnesses have fairly high fatality rates. But MERS is not easily spread from person to person. And SARS, though more easily transmissi­ble, is not as infectious as other respirator­y illnesses like the flu.

For the new coronaviru­s — which was identified only a month ago — scientists are still trying to determine how contagious it is, and how severely ill it makes people.

“So far we’re looking at a disease with a case fatality rate of 2%. That’s a very different kettle of fish from SARS or MERS,” which were far deadlier, said George Rutherford, head of the division of infectious disease and epidemiolo­gy at UCSF. “But there’s obviously a lot we don’t know. There may be even lower mortality because there are a lot of mild cases that haven’t been diagnosed. Or there may be a higher mortality.”

Scientists do know that the new virus is able to spread from human to human, and likely via the respirator­y system, meaning people infect others through sneezes or coughs.

But there’s a broad range in how easily a respirator­y pathogen spreads. Measles, for example, is one of the most infectious diseases in the world because it spreads via tiny particles that can float around a room and infect people hours after the original patient has left the space. Other viruses and bacteria require more direct contact, such as droplets from a sneeze coming into contact with another person’s eyes, nose or mouth.

Other key questions about the new virus are whether people are able to spread it before they show symptoms, and how long the incubation period is. So far, it looks as though the virus may incubate in people for up to two weeks before they show symptoms. Whether they can infect others in that period will make a huge difference in how the illness spreads.

“The risk to the general public — someone sitting on a bus or whatever — is actually quite minimal now,” said Art Reingold, an epidemiolo­gy expert at the UC Berkeley School of Public Health. “I’m going to guess that people will not transmit very effectivel­y. My guess is we may see secondary transmissi­on to household members or close contacts. But I don’t think we’re going to see sustained transmissi­on or casual transmissi­on in the United States. That’s my hope and expectatio­n. I could be wrong, of course.” Staff writer Alejandro Serrano

contribute­d to this report.

 ?? Photos by Michael Short / Special to The Chronicle ?? Ziemi Chen wears a protective mask in San Francisco as fears about the coronaviru­s outbreak spread.
Photos by Michael Short / Special to The Chronicle Ziemi Chen wears a protective mask in San Francisco as fears about the coronaviru­s outbreak spread.
 ??  ?? At Cole Hardware in San Francisco, manager Renato Geslani (left) helps Frances Mocnik shop for protective face masks.
At Cole Hardware in San Francisco, manager Renato Geslani (left) helps Frances Mocnik shop for protective face masks.
 ?? Michael Short / Special to The Chronicle ?? An empty box is left on a shelf after the downtown San Francisco location of Cole Hardware sold out of protective face masks.
Michael Short / Special to The Chronicle An empty box is left on a shelf after the downtown San Francisco location of Cole Hardware sold out of protective face masks.

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