No Proof China Coronavirus Contagious Before Symptoms Show, Malaysian Expert Says

By CodeBlue | 28 January 2020

Wearing a face mask is only necessary when there’s evidence of sustained human-to-human transmission of 2019-nCoV in Malaysia, says a Sungai Buloh Hospital physician.

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KUALA LUMPUR, Jan 28 — A Sungai Buloh Hospital official today disputed the Chinese government’s assertions that a new coronavirus from China could spread during its incubation period.

Dr Suresh Kumar Chidambaram, head of the medical department at Sungai Buloh Hospital and a consultant infectious disease physician, told radio station BFM that there was no supporting evidence for the statement by China’s health ministry.

China’s health minister Ma Xiaowei said last Sunday that the novel coronavirus, currently known as 2019-nCoV, could be infectious before symptoms show, BBC reported, unlike other viruses like SARS and Ebola that become contagious only when symptoms appear.

“What we know is coronaviruses spread after patient gets symptoms. Whether it spreads before, we don’t know yet. So we want to start our action based on what we know,” Dr Suresh said this morning.

“As we get more definite information whether there’s asymptomatic spread, we can’t act on those just based on one report. We are asking for more information, is it true, is that contributing to the spread? We don’t know what’s contributing to the spread.”

Dr Suresh also told BFM that it was not unusual to transport coronavirus patients, in response to criticism about the transportation of three 2019-nCoV patients from Johor to Sungai Buloh Hospital in Selangor.

“We’ve done it before for MERS coronavirus,” he said, pointing out that patients with coronaviruses like MERS and SARS only become extremely infectious at the peak of their disease.

“Early in the disease, infectiousness is low — that is what we know from SARS, from MERS coronavirus,” Dr Suresh said.

“So that’s the reason why initial step was to take them over here while they’re still very stable, they had no symptoms. And they’re transported not in a public transport system; transported on our own.”

He explained that the general understanding of coronaviruses is that transmission happens later in the disease, unlike influenza, because they bind near the lungs, not high up near the nose like the flu. The new strain of coronavirus from China comes from the same family of viruses that produce deadly infections like SARS and MERS, or mild conditions like the common cold.

CNN reported United States’ Center for Disease Control and Prevention’s (CDC) National Center for Immunisation and Respiratory Diseases director Dr Nancy Messonnier as saying that there wasn’t “any clear evidence” yet that people could transmit 2019-nCoV before they start showing symptoms.

Dr Suresh pointed out that 2019-nCoV has not shown sustained human-to-human transmission yet outside Hubei province, the epicentre of the pneumonia-like outbreak in China, nor in Malaysia that confirmed four cases — all Chinese nationals from Wuhan, the provincial capital of Hubei.

“Every time we get a single patient that is positive, we test everybody that is around them. then we test if positive or not. As of now, we can’t find anybody positive. So if that is positive, and subsequently, that person gave it to another person, then there’s sustained human-to-human transmission in that country. Then that country also becomes a hotspot,” the physician told BFM.

Japan reported today its first human-to-human transmission of 2019-nCoV involving a Japanese male bus driver who did not travel to Wuhan, but drove buses with tour groups from the central Chinese city twice this month, according to The Japan Times.

AFP reported this evening that a German man with the coronavirus, who hadn’t visited China, was infected by a Chinese work colleague, believed to be the first human transmission in Europe.

The World Health Organization’s (WHO) situation report yesterday said among the 37 cases identified outside China, only one was the result of human-to-human transmission among close family contacts in Vietnam.

Over 100 people have died from the novel coronavirus as of today, all in China, while the number of confirmed infections jumped by almost 60 per cent overnight to 4,515. The WHO said 13 countries outside China have reported 45 cases, with no deaths, according to the Guardian.

When asked if wearing a face mask was a necessary preventive measure against the coronavirus, Dr Suresh said it was not wrong to wear it in public since it prevents other diseases like the flu.

“But it becomes necessary when we have evidence there’s sustained human-to-human transmission within Malaysia. We don’t have that,” Dr Suresh told BFM.

“All of our cases so far have been people who visited Hubei province and we’ve not got anybody else without that link. So we’re not showing that. When we show that, then of course we encourage everyone to wear a mask.”

Dr Suresh Kumar Chidambaram, head of the medical department at Sungai Buloh Hospital

The physician said, however, that people should wear a mask for 14 days upon their return from China, even if they test negative for 2019-nCoV, and stay indoors.

Face masks have sold out in cities like Johor Baru and Kota Kinabalu, The Star reported.

Dr Suresh expressed hope that Malaysia would be able to contain 2019-nCoV before the coronavirus of unknown origins is transmitted between people.

“We did that for SARS, we’re doing for MERS coronavirus, we stop the virus before it can have sustained human-to-human transmission.”

The Guardian reported China’s National Health Commission as saying yesterday that the incubation period for 2019-nCoV was generally three to seven days, with the longest no more than 14 days. Respiratory droplet transmission is the main route of transmission, according to China, but the virus can also be transmitted through contact.

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