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A quickly spreading coronavirus outbreak in China could upend the country’s healthcare priorities as the health regulators and reimbursement agency officials gear up to “control and prevent” the worst public health emergency since the deadly SARS outbreak in 2003.

 

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CHINA RESPIRATORY VIRUS SPREADING TO OUTSIDE ASIA Source: Shutterstock


It started from a usual busy shopping season at a local foodstuff market, and quickly spread to the whole city and many cities beyond.

January is usually a busy shopping time for people in China as they get ready for a week-long Spring Festival celebration, and in the central city of Wuhan, a flu-like symptom quietly went rounds in a crowded Seafood market.

First, one patron at Southern China Seafood Market fell ill, and soon more people started coughing and developed pneumonia-like symptoms. Patients were sent to local hospitals for care.

Since the first reported case discovered on 31 December, the virus, identified as novel coronavirus (nCoV), has spread from the city of Wuhan with 11 million people to megacities of Beijing, Shanghai, and Shenzhen, and even made its way to the non-bordering countries of Japan, South Korea, and Thailand.

Cases have also piled up. Local health authority Wuhan Health Commission initially reported 40 confirmed cases and no fatalities; by 12 January, over 100 cases were reported and one patient death. As of 5 pm on 21 January, the figure has nearly tripled to 291 cases, according to the China National Health Commission.  And a separate report shows that as many as 14 medical workers have been affected, suggesting human-to-human transmission.

“Coronavirus is an RNA virus that has no therapeutic agent available. RNA viruses are very challenging to develop a drug, compared to DNA viruses (such as HIV, HBV and some herpes viruses),” Jim Wu, CEO and founder of Ark Biosciences Inc., a Shanghai based antiviral therapy developer told Pink Sheet.

Transparency
China’s initial response to the outbreak has been criticized as a lack of transparency, and a secrecy surrounding the outbreak could complicate the efforts to “control and prevent” the outbreak despite the government vowed to do so.

Despite the first confirmed case on 31 December, China waited until 12 January to share with the World Health Organization the genetic sequence of the novel coronavirus, which is to be used by other countries in developing specific diagnostic kits, said the organization.

On 20 January, the Chinese government officially designated the Wuhan pneumonia a Category 2 infectious disease, the second-most serious level. Category 1 would allow mandatory quarantines by the government, and the outbreak's current designation seems designed to allow the government maximum flexibility while reassuring the public. Some wonder if the interpersonal transmission of the virus had been identified earlier, there wouldn’t have been as many medical workers affected by the virus.

During a same-day Cabinet meeting, Chinese Premier Li Keqiang required all levers of government to be open and transparent, emphasizing coordinated information dispatchment.

Different China, Same Approach?
Fear of the further spread of the Wuhan virus is evident. The timing of the outbreak makes such worries acute, since the end of January is essentially the busiest travel season in China, with 300 million people estimated hit the road to join families in Chinese New Year celebration, the biggest festival for the whole year.

And, the fear is particularly pronounced in a country where the memory of severe avian respiratory syndrome (SARS) outbreak still vividly remembered. In early 2003, an outbreak of flu- and pneumonia-like virus infections killed 800 people, thousands of cases reported worldwide.

Compared to 17 years ago, China has grown by leaps and bounds, evolving from an economy with less than $2 trillion in annual GDP to become the second largest economy in the world.

So far, the responses from health companies have largely focused on diagnosis of the novel viral infections. Several companies, including genome sequencing firm BGI Genomics Co. Ltd., have rushed to develop a testing kit for medical facilities to detect the viral infection.

Meanwhile, Chinese medical experts suggest early detection, early diagnosis, and quarantine. The massive movement of travelers during the Chinese New Year adds another complexity, but people should take precautions and avoid large crowds, they added.

Zhong Nanshan, a physician from Guangzhou Hospital and well-known for his expertise in respiratory diseases, said the Wuhan and Guangdong cases show increasing human-to-human transmission.

First Confirmed Cases Outside Asia
On 21 January, the US Center for Disease Control and Prevention (CDC) announced the first confirmed case with Wuhan pneumonia discovered in Washington State. A traveler from China has been diagnosed to have the virus. 

So far, As many as 24 public traded health companies have seen their shares up by 9%. Many of the drug makers are makers of ingredients for antiviral and antibiotics, such as Dongbei Pharma, Lukang Pharma, New China Pharma, and Lianhuan Pharma.

Traditional Chinese Medicines makers also see large 10% gains. One of them, Xiangxue Life Sciences, manufactures oral liquid for flu, while Yilin Pharma markets TCMs for avian flu.

Among diagnostics companies, large players such as BGI and Dian Diagnostics are rushing to have their testing kits ready for hospital lab use, although none seem to have been granted formal approvals from the National Medical Products Administration.

Large companies aside, smaller players are emerging to seize the opportunity. Shenxiang Bio for one announced a rapid diagnostic kit that can detect the nCov virus in as little as 30 minutes.

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