Health authorities have mobilized to stop the spread of a new illness, hoping to avoid a repeat of the SARS outbreak of 2003. Here’s what you need to know

Health authorities have mobilized to stop the spread of a new illness, hoping to avoid a repeat of the SARS outbreak of 2003. Here’s what you need to know

Banda Aceh, Indonesia, March 3: A group of women attend an information session on COVID-19. The world has entered uncharted territory in its battle against the deadly coronavirus, the UN health agency warned, as new infections dropped dramatically in China but surged abroad.
CHAIDEER MAHYUDDIN/AFP via Getty Images
The latest

  • Local transmission of COVID-19 in Canada is bound to happen sooner or later, infectious-disease experts say, urging national health officials to move faster to control the coronaviruss spread as infection and death tolls rise in Washington State. Canadas tally of coronavirus infections rose to 27 on Monday, with 18 cases in Ontario, eight in B.C. and one in Quebec.
  • With March Break coming up, Canadian families including health professionals face tough decisions about whether to keep or cancel their travel plans. Heres what some of those professionals recommend about how to weigh travel risks. (Some key questions: Are you prepared for possible flight cancellations or border closings? Do you have insurance in case youre hospitalized overseas, or to cover cancelled return flights?)
  • One Canadian tourist who regrets her travel plans is Julien Bergeron, who was stuck aboard the quarantined Diamond Princess cruise ship off the Japanese coast. He was infected and kept in isolation in hospital, where he spoke with The Globe and Mail on Monday about his ordeal. The boat was not a good place for quarantine, he said. When the virus began to spread on the ship, they should have checked us. And the people who were not sick, they should have taken us off the boat.
  • B.C. resident Yu Aijun wants Ottawas help to find out whether her husband, who died in Beijing in January, was killed by the coronavirus. David Zhaos cause of death was given as sudden, possibly a heart attack, but colleagues told Ms. Yu he was coughing, vomiting and exhibiting other COVID-19-like symptoms before he died.

What does this virus do?
The new virus that emerged last December in China officially called COVID-19, previously known as 2019-nCoV, and informally dubbed the Wuhan virus after the city where it was found is a coronavirus, a common type of infection among humans and animals. Corona means crown or halo in Latin, describing the viruses typical shape when seen under an electron microscope. The common cold is a type of coronavirus, but the Wuhan viruss symptoms (severe coughing, fever and muscle pain) resemble the more serious and dangerous types, such as SARS and MERS.
Much is still unknown about COVID-19. Check The Globe and Mails guide compiling health officials advice for people who are travelling, sick or have questions about the virus.
HOW DOES CORONAVIRUS
INFECT A PERSON?
Human coronaviruses most commonly spread from an infected person to others through:
The air by coughing and sneezing
Close personal contact, such as touching or shaking hands
Touching the eyes, nose or mouth after touching an infected surface
Rarely, fecal contamination
WHAT ARE THE SYMPTOMS OF THE VIRUS?
Headache
Runny nose
Sore throat
Cough
Fever
In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death
SOME FACTS ABOUT THE VIRUS
Belongs to large family of viruses that cause illnesses ranging from common cold to more severe diseases such as MERS and SARS
Coronaviruses are zoonotic, meaning they are transmitted between animals and people
There are no specific treatments for coronaviruses, but symptoms can be treated
MURAT YÜKSELIR / THE GLOBE AND MAIL, SOURCE: Centers for Disease Control and Prevention, Health Canada, WHO
HOW DOES CORONAVIRUS INFECT A PERSON?
Human coronaviruses most commonly spread from an infected person to others through:
The air by coughing and sneezing
Close personal contact, such as touching or shaking hands
Touching the eyes, nose or mouth after touching an infected surface
Rarely, fecal contamination
WHAT ARE THE SYMPTOMS OF THE VIRUS?
Headache
Runny nose
Sore throat
Cough
Fever
In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death
SOME FACTS ABOUT THE VIRUS
Belongs to large family of viruses that cause illnesses ranging from common cold to more severe diseases such as MERS and SARS
Coronaviruses are zoonotic, meaning they are transmitted between animals and people
There are no specific treatments for coronaviruses, but symptoms can be treated
MURAT YÜKSELIR / THE GLOBE AND MAIL, SOURCE: Centers for Disease Control and Prevention, Health Canada, WHO
HOW DOES CORONAVIRUS INFECT A PERSON?
Human coronaviruses most commonly spread from an infected person to others through:
The air by coughing and sneezing
Close personal contact, such as touching or shaking hands
Touching the eyes, nose or mouth after touching an infected surface
Rarely, fecal
contamination
COMMON SIGNS OF INFECTION
Headache
In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death
Runny nose
Sore throat
Cough
Fever
SOME FACTS ABOUT THE VIRUS
Belongs to large family of viruses that cause illnesses ranging from common cold to more severe diseases such as MERS and SARS
Coronaviruses are zoonotic, meaning they are transmitted between animals and people
There are no specific treatments for coronaviruses, but symptoms can be treated
MURAT YÜKSELIR / THE GLOBE AND MAIL, SOURCE: Centers for Disease Control and Prevention, Health Canada, WHO
Where has it spread?
1 to 910 to 99101 to 1000Over 1000 cases
What Canada has done
Ottawa, Jan. 26: Canadian Chief Public Health Officer Theresa Tam, right, speaks at a press conference as Health Minister Patty Hadju listens.
Justin Tang/The Canadian Press
So far, there are only 27 confirmed or presumptive cases of COVID-19 in Canada: 18 in Ontario, eight in British Columbia and one in Quebec. But dozens more Canadians and their families fell sick aboard the Diamond Princess cruise ship off the Japanese coast, which was put under a quarantine in February that only made the spread of the disease worse. Canadians infected aboard the ship remained in Japan for treatment, while those who were cleared were flown back to Canada and quarantined at the Nav Centre in Cornwall, Ont.
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Before the first cases appeared, Canadian health officials had put airports and hospitals on alert for possible cases, introducing screenings at airports in Vancouver, Montreal and Toronto. But by late February, once human-to-human transmission had been confirmed in the United States, authorities began warning of more pro-active measures, such as actively searching for new cases in Canadian communities. Health Minister Patty Hajdu said Canadians can prepare for a possible pandemic by making sure theyve stocked up on groceries and prescription drugs, and by following health officials recommendations about proper hygiene and when to stay home from work or school.
Coronavirus and Canadians: More reading
How the cruise ship coronavirus quarantine backfired
Canadian evacuees from Wuhan pass time in quarantine at CFB Trenton with video chats, parking lot walks
What China has done
Wuhan, March 1: Medical personnel in protective suits wave to a recovered coronavirus patient, newly discharged from the Leishenshan Hospital.
China Daily via REUTERS
Chinas response to the virus is one of the largest-scale public health mobilizations ever seen, with tens of millions affected by quarantine measures. Here are some of the steps officials have taken.

  • Cutting off Wuhan and environs: Chinas government suspended travel to and from Wuhan, a city of 11 million people, and more than a dozen nearby cities in Hubei province. Even local public transit was shut down to prevent the spread of the disease. Some local transit restrictions began to lift on Feb. 24, when China instituted a back to work tide to restart factories and businesses and reverse the economic slump caused by the outbreak.
  • Extending the holidays: The initial outbreak coincided with the Lunar New Year travel season, one of the largest annual migrations of people on Earth. To slow down post-holiday travel that could spread the virus, China extended the holiday, known locally as the Spring Festival, from Jan. 30 to Feb. 2.
  • Banning the animal trade: Given the viruss suspected connection to a wild game and seafood market in Wuhan, the Chinese government has outlawed the sale of all wild animals in China until more is known about how the coronavirus crossed the species barrier.

The Globe in China: Nathan VanderKlippe on the outbreak
Coronavirus outbreak thrusts China into a mass experiment in remote work
Fast, deadly spread of virus on cruise ship and in Hubei prompts questions about response
As the coronavirus spreads, China is losing its control online
In China, officials face conflicting demands: halt coronavirus and revive the economy
China using high-tech surveillance in battle against spread of coronavirus
At the epicentre of the coronavirus outbreak, Western medicine meets traditional Chinese remedies
SARS: Whats similar, whats different
Toronto, 2003: A man adjusts his protective mask as he leaves the SARS Clinic at the Women’s College Hospital.
Kevin Frayer/The Canadian Press
The COVID-19 outbreak has brought back unpleasant memories of SARS, a coronavirus that also originated in China and killed 44 people in Canada. But while the viruses may be similar, and while COVID-19 may have killed more people overall than SARS did, many of the conditions that made SARS such a threat in this country are less serious now.
The impact of SARS: After its emergence from Guangdong province, SARS spread to 8,098 people worldwide and killed 774 people worldwide, according to the U.S. CDCs estimates. Canada was the hardest-hit country outside of Asia: Over all, 44 people were killed in Canada, and 438 Canadians were diagnosed with probable and suspected SARS. It led to billions of dollars in economic losses as visitors avoided Toronto during what came to be known as the Spring of Fear.
Better preparedness: Canadian health officials learned a lot from SARS about early detection of infectious diseases, and many have expressed confidence that they are better prepared this time. B.C. Provincial Health Officer Bonnie Henry, for instance, noted before the first Canadian case appeared that officials already developed a test for the new coronavirus and had some idea of how it progressed, which they did not when SARS first arrived in 2003.
How the viruses differ:A study in the Lancet medical journal found some important differences in how the new coronavirus and SARS spread and cause symptoms. In one family in Shenzhen, the new virus produced symptoms within four days of exposure, whereas SARSs incubation period is as long as 10 days. A shorter incubation period means that new cases of infection can be identified and quarantined sooner, reducing the spread of infection.
Timeline of coronavirus onset
Median time from onset of symptoms*
Onset of symptoms
Hospital admission
Intensive care unit admission
0
1
2
3
4
5
6
7
8
9
10
11
Number of days
Shortness of breath
Acute respiratory distress syndrome
Shenzhen-based family visit infected relatives in Wuhan and return with illness
S
First sign of symptoms*
H
Attended hospital for investigation
Shenzhen
Wuhan
Shenzhen
Healthy family in Shenzhen
Visit infected family in Wuhan
Family return to Shenzhen infected
Dec. 26
Jan. 1
5
10
15
Patient 1: Mother
S
H
2: Father
S
H
3: Daughter
S
H
4: Son-in-law
S
H
5: Grandchild
H
6: Grandchild
H
Did not travel to Wuhan
7: Mother of patient 4
H
S
*Including fever (in 98% of patients), cough (75%), myalgia or fatigue (44%), and others.
THE GLOBE AND MAIL, SOURCE: THE LANCET
Timeline of coronavirus onset
Median time from onset of symptoms*
Hospital admission
Intensive care unit admission
Onset of symptoms
0
1
2
3
4
5
6
7
8
9
10
11
Number of days
Shortness of breath
Acute respiratory distress syndrome
Shenzhen-based family visit infected relatives in Wuhan and return with illness
S
First sign of symptoms*
H
Attended hospital for investigation
Shenzhen
Wuhan
Shenzhen
Healthy family in Shenzhen
Visit infected family in Wuhan
Family return to Shenzhen infected
Dec. 26
Jan. 1
5
10
15
Patient 1: Mother
S
H
2: Father
S
H
3: Daughter
S
H
4: Son-in-law
S
H
5: Grandchild
H
6: Grandchild
H
Did not travel to Wuhan
7: Mother of patient 4
H
S
*Including fever (in 98% of patients), cough (75%), myalgia or fatigue (44%), and others.
THE GLOBE AND MAIL, SOURCE: THE LANCET
Timeline of coronavirus onset
Median time from onset of symptoms*
Onset of symptoms
Hospital admission
Intensive care unit admission
0
1
2
3
4
5
6
7
8
9
10
11
Number of days
Shortness of breath
Acute respiratory distress syndrome
Shenzhen-based family visit infected relatives in Wuhan and return with illness
S
H
First sign of symptoms*
Attended hospital for investigation
Shenzhen
Wuhan
Shenzhen
Healthy family in Shenzhen
Visit infected family in Wuhan
Family return to Shenzhen infected
Dec. 26
Jan. 1
5
10
15
Patient 1: Mother
S
H
2: Father
S
H
3: Daughter
S
H
4: Son-in-law
S
H
5: Grandchild
H
H
6: Grandchild
Did not travel to Wuhan
7: Mother of patient 4
H
S
*Including fever (in 98% of patients), cough (75%), myalgia or fatigue (44%), and others.
THE GLOBE AND MAIL, SOURCE: THE LANCET
Further reading
On the science
Ivan Semeniuk explains: New coronavirus tests scientists ability to tangle with an evolutionary trickster
Race is on as coalition sets tight timeline for coronavirus vaccine
A brief history of plague panic, from the 1600s to todays coronavirus crisis
André Picard
This coronavirus threat isnt over. But the time to tackle the next threat is now
What Ontario didnt learn from SARS: During a public-health crisis, we need good information, clearly communicated
There is a new coronavirus on the loose, but we dont have to repeat the mistakes of SARS
Other commentary and analysis
Adrian Lee: For Chinese-Canadians like me, coronavirus is just the latest strain of infectious fear weve faced
Tony Clement: The coronavirus is now in Canada, but thanks to the lessons of SARS we are better prepared
David McKeown: Dont let the coronavirus mutate into an epidemic of fear and panic
Compiled by Globe staff
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With reports from Nathan VanderKlippe, Carly Weeks, Ivan Semeniuk, Kelly Grant, Andrea Woo, The Associated Press, Reuters and The Canadian Press

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