On the 8th of December 2019, Chinese authorities reported an instance of pneumonia of unknown origin. The World Health Organisation (WHO) confirmed the presence of a novel coronavirus in the lungs of a hospitalised individual on the 9th of January 2020, and indicated it as the causative agent of disease. The origin of the virus, presently called 2019-nCoV, is thought to be wild animals sold at a seafood market in the city of Wuhan, Hubei province, although there is some suggestion that an individual was infected earlier, despite no contact with the seafood market.

On the 22nd of January, the Chinese government announced a complete quarantine of the city of Wuhan. With a population in excess of 11 million, larger than both London and New York, this was a significant development in the attempt to contain the outbreak. Police have barricaded roads, the international airport is closed, and most of the city’s infrastructure is suspended. This has wide-ranging implications for the residents of Wuhan, and frustrations are growing as hospitals become overcrowded and supermarkets are left unstocked. The quarantine of Wuhan has recently been expanded to 15 cities throughout the Hubei province, affecting nearly 60 million people. The Chinese government is acting on lessons learned during the SARS outbreak of 2002-03 and in reaction to a perceived slow initial response in Wuhan. However, it is unclear if this extreme reaction will be effective in limiting the spread of the virus as cases have already been confirmed in all provinces of China and in over 20 countries around the world.

As of the first of February, over 10,000 individuals have been confirmed to be infected, with over 200 deaths recorded in mainland China. The number of cases in China have already surpassed the total number of cases of SARS worldwide, though the number of fatalities remains lower than with SARS. Isolated cases have also been seen across eastern Asia, with 14 cases reported in Thailand, and incidences in Australia, the US, the UK, Canada, France and Germany. 

Little is known about transmissibility of 2019-nCoV, though transmission through respiratory droplets is likely, as has been seen for the related SARS and MERS coronaviruses. The incubation period is also not known at present and is anywhere from 2-14 days, with most cases causing moderate and broadly flu-like lower respiratory track illness lasting at least 10 days. However, estimates are that 25% of cases can be categorised as ‘serious’, with some requiring admission to intensive care wards for breathing assistance. Mortality figures remain difficult to determine, as many early cases were likely unconfirmed and the extent of reporting is not currently known.

Preventing the spread of an aerosol-transmissible virus in a large, well-connected country such as China, poses startling new challenges. Whilst the 2019-nCoV outbreak is different from diseases such as Ebola that require direct contact for transmission and typically occur in areas with low population density, some similarities can be drawn, especially the importance of community engagement. Ultimately, regardless of the type of outbreak, people require good and credible information from those managing the outbreak. It is important that credible experts and proper evidence is shown to affected communities in order for them to respond adequately, and more importantly so that their trust in the external response is gained.

Whilst the Chinese government has launched a media campaign to inform their citizens about the outbreak, the strict regulation of what information is conveyed in-country could have significant impacts on community trust. In addition, it is unclear what effects the broad-reaching quarantine is having on community trust. There are clear signs of government action and investment, such as the rapid building of a new isolation hospital; however, there does not seem to be the same support for existing medical facilities or for the affected communities directly.  

In an outbreak of a highly-transmissible, novel infectious disease there is a pressing need for rapid containment. However, containment over a longer period of time will require community support and engagement. It is hoped that these containment efforts will be balanced with effective community engagement and a reinforcing of the local health infrastructure, together this could enhance disease containment while facilitating long-term community recovery.