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Sunday, February 2, 2020

Amgen Analysts Paused After Q4 Report, Say Valuation Reflects Growth Potential

Amgen, Inc.’s AMGN 4.47% disappointing 2020 EPS guidance issued Thursday spooked investors, leading to a pullback in the stock.

The Amgen Analysts

Wells Fargo analyst Jim Birchenough maintained an Equal-Weight rating on Amgen with a $220 price target.
Mizuho Securities analyst Salim Sayed maintained a Neutral rating and $215 price target.
Baird analyst Brian Skorney downgraded Amgen from Neutral to Underperform and lifted the price target from $173 to $185.
Wells Fargo: Amgen Shares Fully Valued Relative To Growth
Amgen’s fourth-quarter results came in ahead of expectations, although product sales continued to remain sluggish, Birchenough said in a Thursday note.
The analyst said he continues to see headwinds for legacy products on competition and price erosion.
While commending the company on its focus on new products and pipeline, Birchenough expressed skepticism regarding the prospects for a durable response with the KRAS G12C inhibitor AMG510 and competitive positioning of bispecific T-cell engagers in cancer.
“Overall we continue to view Amgen shares as fully valued relative to growth,” the analyst said.

Mizuho Eyes Reasons For Amgen’s Disappointing Guidance

Amgen’s 2020 EPS guidance of $14.85-$15.60 is significantly lighter than the consensus estimate of $16.19 despite revenue guidance of $25 billion-$25.6 billion surrounding the consensus estimate of $25.4 billion, Sayed said in a Thursday note.
Exploring the reasons for the underwhelming guidance, the analyst said Amgen typically guides conservatively at the beginning of the year. Conservatism is the key, especially with a new CFO at the helm, he said.
Amgen said it is reshaping its product portfolio with a focus on driving volume growth, according to Mizuho.
The company may have to spend incrementally on SG&A, Sayed said.
Finally, Mizuho said it sees a disconnect between how the Street and Amgen are modeling share buybacks, especially following the Otezla purchase and the elevated stock price.

Baird: Premium Reflects Unwarranted Enthusiasm

Amgen’s strong execution even in the face of some serious headwinds has been more than reflected in the stock, Baird’s Skorney said in a Friday note.
The company’s market share for Neulasta slipped from 80% in the third quarter to 74% in the fourth quarter, reflecting the entry of several biosimilars, the analyst said.
Neulasta revenues could suffer further as additional biosimilars launch, he said.
Skorney sees AMG 510 and tezeplumab as the backbone of Amgen’s late-stage pipeline, with both programs generating readouts this year.
“While we do not deny there is potential for both of these medications to rapidly grow into multibillion-dollar products, we believe that at the current price AMGN shares reflect this expectation.”
The analyst estimates peak sales of about $2.8 billion for tezepelumab and $2.7 billion for AMG 510.
“The current premium reflects a level of enthusiasm that just isn’t warranted, in our opinion, given the company’s stage of maturity,” Skorney said.
Baird attributed the upwardly adjusted price target to the prospects for AMG 510 and tezepelumab.
https://www.benzinga.com/analyst-ratings/analyst-color/20/01/15227358/amgen-analysts-sidelined-after-q4-report-say-valuation-reflects-growth-potential

Saturday, February 1, 2020

Emerging understandings of 2019-nCoV

“There is an emergency in China, but it has not yet become a global health emergency…WHO is following this outbreak every minute of every day”, said Dr Tedros Ghebreyesus, Director-General of WHO, on Jan 23. A novel coronavirus (2019-nCoV) outbreak is emerging, but it is not yet a Public Health Emergency of International Concern (PHEIC). As we went to press, more than 500 cases have been confirmed in China, as well as in Japan, South Korea, Thailand, and the US. The virus can cause a severe respiratory illness, like SARS and MERS, and human-to-human transmission has been confirmed. These characteristics are driving China’s urgent public health actions, as well as international concern. But much remains unknown. The pieces of the puzzle that is 2019-nCoV are only now beginning to come together.

Today, we publish the first clinical data from individuals confirmed to be infected with 2019-nCoV from Wuhan, China. Chaolin Huang and colleagues provide comprehensive findings for the first 41 laboratory-confirmed cases. 27 of these 41 cases had direct exposure to the Wuhan seafood market that is thought to be the initial site of infection from an animal source. All had viral pneumonia. The severity of illness is concerning: almost a third of patients developed acute respiratory distress syndrome requiring intensive care; six patients died; five had acute cardiac injury; and four required ventilation.

Separately, Jasper Fuk-Woo Chan and colleagues report clinical and microbiological data from a family of six people who had travelled to Wuhan and later presented with pneumonia to Shenzhen Hospital in Guangdong province. Five were identified as infected with 2019-nCoV. Notably, none had been to the Wuhan market, but two had visited a Wuhan hospital. The authors suggest these findings confirm human-to-human transmission. Together, these Articles provide an important initial picture of the clinical spectrum and transmission of this new disease.

In an accompanying Comment, Chen Wang, George Gao, and colleagues describe the early sharing of clinical data from the outbreak and emphasise the urgent need for more information about pathogenesis and viral transmission, as well as the pressing need to develop best supportive care and a vaccine. They also caution against overstating the mortality risk, as early reported case-fatality rates may be high due to bias towards detecting severe cases. As David Heymann reflects in another accompanying Comment, publication of these Articles provides peer-reviewed information urgently needed to refine the risk assessment and response, which are happening in real time.

China has quickly isolated and sequenced the virus and shared these data internationally. The lessons from the SARS epidemic—where China was insufficiently prepared to implement infection control practices—have been successfully learned. By most accounts, Chinese authorities are meeting international standards and isolating suspected cases and contacts, developing diagnostic and treatment procedures, and implementing public education campaigns. Dr Tedros has praised China for its transparency, data sharing, and quick response. Likewise, WHO has reacted fast and diligently. Despite massive attention and conjecture about the level of threat posed by 2019-nCoV, and whether WHO should declare a PHEIC, the agency’s emergency committee has not bowed to pressure to take such a decision until necessary. We commend WHO for its resilience.

There are still many gaps in our understanding. The early experiences of these patients and the response to their symptoms before cases were reported remain undocumented. The exposure and possible infection of health workers remain extremely worrying. We will not know for some time the consequences of the quarantine imposed in Wuhan on Jan 23, 2020. Chinese public health authorities are under enormous pressure to make difficult decisions with an incomplete, and rapidly changing, understanding of the epidemic. The shutdowns may seem a drastic step—whether they represent an effective control measure deserves careful investigation and much will likely depend on maintaining trust between authorities and the local population. News media that worsen fears by reporting a “killer virus“ only harm efforts to implement a succesful and safe infection control strategy.

Openness and sharing of data are paramount. There are enormous demands for rapid access to information about this new virus, the patients and communities affected, and the response. But equally crucial is the need to ensure that those data are reliable, accurate, and independently scrutinised. As for all public health emergencies, we will be making all related Lancet content fully and freely available.

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Published: January 24, 2020

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DOI: https://doi.org/10.1016/S0140-6736(20)30186-0

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https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30186-0/fulltext

Avian Flu in China Adds to Economic Concerns Amid Coronavirus Spread

Chinese authorities announced Saturday a recurrence of avian influenza in chickens in central China, adding fresh economic concerns for a country reeling from an outbreak of coronavirus that has sickened nearly 12,000 people since it emerged in December.
In a sign of the pressure already on China, Australia and Vietnam joined the U.S. and others in distancing their citizens from the country over the coronavirus, while Apple Inc. shut its stores on the Chinese mainland and Beijing pledged more support for embattled businesses.
The avian influenza is likely to add to the economic damage rather than pose a major immediate health risk. China’s Ministry of Agriculture and Rural Affairs said that a case of H5N1 avian influenza, last identified in China in April last year , had killed 4,500 chickens in central Hunan province, prompting authorities to cull another nearly 18,000 birds. But while avian influenza can be fatal in humans, with a mortality rate of 60%, according to the World Health Organization, it doesn’t spread easily to humans.
In addition to the coronavirus, China has been grappling with an outbreak of African swine fever that has decimated the country’s pig population over the past two years. Pork is China’s main source of protein, and swine fever last year pushed overall consumer inflation to the highest level in eight years.
Hunan province, where the avian influenza outbreak announced on Saturday took place, neighbors Hubei province, the epicenter of the coronavirus outbreak.
Australia said that it would impose new entry restrictions in an effort to contain the spread of coronavirus, banning foreign nationals who have been in mainland China in the past 14 days from entering Australia, while Qantas Airways Ltd., the country’s national carrier, said it would suspend flights to the mainland starting Feb. 9.
Vietnam’s civil aviation authority said it would halt all flights to and from Taiwan and China, including the special Chinese territories of Macau and Hong Kong, starting Saturday.
Several countries and airlines have suspended flights to China, including Pakistan, Italy and the U.S.’s American Airlines Group Inc., Delta Air Lines Inc. and United Airlines Holdings Inc.
The move by Australia, which also ordered its citizens returning from China to self-quarantine for 14 days, to tighten entry restrictions followed a U.S. tightening. A day earlier, the U.S. said it would deny entry to foreign nationals who had traveled anywhere in China within the past 14 days and imposed quarantines on Americans returning from Hubei province, whose capital is Wuhan.
The coronavirus has killed 259 people and infected nearly 12,000 in China as of late Friday, according to the official National Health Commission in Beijing. The number of infected patients in China alone now exceeds the global total for severe acute respiratory syndrome, or SARS, which killed nearly 800 people after emerging from southern China in 2002 and 2003.
Authorities in Beijing pledged more support for the economy in a bid to reassure investors before markets reopen on Monday.
Companies and industries in regions hit particularly hard by the outbreak, including those that provide medical supplies, could get reduced lending rates, the central bank said in a joint statement with other government agencies, including the Finance Ministry and the banking regulator.
China’s cabinet said separately that products imported from the U.S. to control the outbreak will be exempt from punitive tariffs through March 31. Authorities also exempted tariffs and other taxes on products donated by overseas entities, according to a joint statement by the Finance Ministry and the customs agency.
Resources are strained in Hubei province, and medical staff have been forced to turn away patients because of a lack of beds and basic medical supplies.
Local authorities in Huanggang, a city about 35 miles east of Wuhan, imposed new restrictions on residents’ movements, saying only one person per household in the city center would be allowed to go out every two days to purchase basic necessities.
Apple is closing all of its retail stores and corporate offices in mainland China until Feb. 9 “out of an abundance of caution and based on the latest advice from leading health experts,” it said. The company operates more than 40 stores in China.
North Korea said through its state media that it would send an aid fund to Chinese authorities, a rare extension of aid from Pyongyang.
North Korean leader Kim Jong Un, in a letter to Chinese President Xi Jinping, “expressed deep consolation for the families who lost their blood relatives due to the infectious disease,” according to a report in Pyongyang’s official Korean Central News Agency.
North Korea — a close ally of China that has long been dependent on China’s largess — was among the first countries to adopt stringent measures to keep the coronavirus outside its borders, and vowed to redouble its efforts.
“The novel coronavirus throws the world into uneasiness and horror, but the advantages and might of our state system…will be fully demonstrated to the whole world once again, when we ensure that the virus does not reach our country and that no one suffers from the infections,” it read.

https://www.marketscreener.com/APPLE-INC-4849/news/Avian-Influenza-in-China-Adds-to-Economic-Concerns-Amid-Coronavirus-Spread-29928965/

China central bank sees temp economic impact from virus, pledges support

China’s central bank said it will use various monetary policy tools to ensure liquidity remains reasonably ample, and added that the broader economic impact from a fast-spreading coronavirus outbreak in the country should be temporary.

In multiple statements issued on Saturday afternoon, the People’s Bank of China (PBOC) said that it will appropriately lower lending rates to support firms affected by virus outbreak.
It added that the impact from the epidemic on the broad economy should be temporary. So far, the virus has claimed the lives of nearly 260 people.
Investors are bracing for a volatile session in Chinese markets when onshore trades resume on Monday after a break for the Lunar New Year which was extended by the government due to the virus outbreak.
The statements from the PBOC were jointly issued with banking and insurance, securities, foreign exchange regulators and the finance ministry.
The virus outbreak will have a short-term and temporary impact on the country’s financial markets, said Cao Yu, vice chairman of the China Banking and Insurance Regulatory Commission (CBIRC), in a separate statement made on Saturday.
He also called on banking sector to offer comprehensive credit support to listed companies that might have reasonable funding needs in the wake of disruptions caused by the epidemic.
The efforts to contain the virus have caused major disruptions and threaten to knock growth in China and globally, just when it looked like some relief was in store following the recent preliminary Sino-U.S. trade deal to defuse their protracted tariff war.
Authorities in China had already stepped up support measures last year when growth in the world’s second-biggest economy slumped to a near three-decade low, as demand at home and abroad shriveled.

https://www.marketscreener.com/BANK-OF-CHINA-LIMITED-1412661/news/China-central-bank-sees-temporary-economic-impact-from-virus-pledges-support-measures-29928455/?countview=0

Companies feel impact of coronavirus outbreak in China

Some companies have warned that a coronavirus outbreak in China could disrupt supply chains or hurt bottom lines as factories and shops shut and airlines suspend flights.

FINANCIAL IMPACT:
* Electrolux said the epidemic could have a material impact if its Chinese suppliers were further affected and that it was implementing contingency plans.
* H&M said store closures in China – about 45 – hurt sales in January. The company said it sources “a lot” from China but its flexible supply chain had contained disruptions so far.
* China’s Baidu Inc said it was delaying the announcement of its fourth-quarter results and advised its employees to work from home.
* Hyundai Motor said it planned to halt South Korean production of a sport utility vehicle this weekend to cope with a supply disruption caused by the virus outbreak.
* Jaguar and Land Rover parent Tata Motors expects the outbreak to hamper production in China and hit profits.
*Japan Airlines Co said a quarter of reservations for China flights were cancelled in the past 10 days.
* Levi Strauss shut about half its stores in China and said it will take a near-term hit.
* LG Display said it had not yet closed any of factories in China but warned the outbreak increased uncertainty for suppliers.
* McDonald’s, which closed several hundred of its roughly 3,300 stores in China, said overall impact on profits would be “fairly small” if the virus stayed contained in China.
* Remy Cointreau warned that a potential impact from the outbreak would be significant because of its big exposure to China.
* Royal Caribbean Cruises, which cancelled three trips of its China-based cruise liner, trimmed its 2020 earnings forecast by about 10 cents per share, and said it would take a further 10-cent hit if travel restrictions continued until the end of February.
* Sangyong Motor said it would idle its plant in the South Korean city of Pyeongtaek from Feb. 4 to Feb. 12 for the same reason.
* Samsung Electronics said it had extended a holiday closure for some factories in line with Chinese government guidance but declined to comment on the impact.
* Samsung affiliate and battery maker Samsung SDI, which counts Volvo among its customers, warned of a hit to its March-quarter earnings.
* SK Hynix, which has a chip plant in the eastern Chinese city of Wuxi, said the outbreak had not yet disrupted production but that could change if the situation was prolonged.
* Starbucks, which closed more than half its roughly 4,300 stores in China, delayed a planned update to its 2020 forecast and said it expects a material but temporary hit.
* Tesla warned a 1-1.5 week delay in the ramp of Shanghai-built Model 3 cars could slightly hurt March-quarter profit after China ordered a shutdown of the factory. Tesla is also evaluating whether the supply chain for cars built in its California plant will be affected.
STORE/FACTORY CLOSURES:
* Apple Inc said it would shut all official stores and corporate offices in mainland China until Feb 9.
* Alphabet’s Google temporarily shut all offices in China, Hong Kong and Taiwan.
* Deere & Co said it has temporarily closed its facilities in China until the company determines it appropriate to reopen.
* U.S. makers of surgical masks including 3M, Owens & Minor and Alpha Pro Tech are ramping up manufacturing because of surging demand in China and around the world in response to the outbreak.
* Toyota Motor shut factories in China through Feb. 9.
* Walt Disney shut its resorts and theme parks in Shanghai and Hong Kong.
* Fast Retailing closed about 100 Uniqlo stores in Hubei.
* IKEA closed all 30 stores in China.
* Swatch closed five stores in Wuhan, Yum China closed some KFC and Pizza Hut stores in the city, Luckin Coffee closed its cafes and AB Inbev suspended production at its brewery.
* Imax delayed film releases in China.
AIRLINE CANCELLATIONS:
For airlines suspending flights to China, please click on https://www.reuters.com/article/us-china-health-airlines-factbox/factbox-airlines-suspend-china-flights-because-of-coronavirus-outbreak-idUSKBN1ZU131
HOTELS, BOOKING PLATFORMS, AGENCIES:
* Hyatt said it was extending its cancellation policy for Chinese travellers and hotels by nearly three weeks to Feb. 29.
* InterContinental Hotels and Hyatt Hotels said they would allow customers to cancel for free reservations booked for China for specific dates..
* Ctrip, China’s largest online booking platform, said more than 300,000 hotels on its platform had agreed to refunds on bookings between Jan. 22 and Feb. 8.
* Fliggy, Alibaba’s booking site, offered similar refunds, as did several Chinese and European tour operators.
LIMITING TRAVEL TO CHINA:
* Walmart Inc said it is temporarily limiting “non-business critical travel” to, from, and within mainland China amid the outbreak, while Chevron Corp asked its staff to postpone all non-essential travel to China.
https://www.marketscreener.com/news/Companies-feel-impact-of-coronavirus-outbreak-in-China–29920501/?countview=0

U.S. to quarantine all American Wuhan evacuees as CDC eyes pandemic risk

U.S. health officials said Friday they would quarantine 195 U.S. citizens who were evacuated from Wuhan, China, amid an outbreak of a novel coronavirus — the first time in 50 years the Centers for Disease Control and Prevention has taken such action.
The order will be effective for 14 days from the date of evacuation.
Dr. Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, told reporters health officials were prepared for the possibility that the outbreak of the coronavirus could become a pandemic — the worldwide spread of a disease. “We are preparing as if this is the next pandemic,” she said, stressing that the agency hoped it would not become one.

“If we take strong measures now, we may be able to blunt the impact of the virus on the United States,” Messonnier said.
She added: “Please do not let fear or panic guide your actions.”
The passengers arrived at March Air Reserve Base in Southern California Wednesday after being flown from Wuhan, with a stop in Anchorage. The passengers had been monitored for symptoms — including cough and fever — before, during, and after the flight.
U.S. officials said Wednesday that all passengers had volunteered to stay at the base in isolation for a few days while they could be assessed, but one person tried to leave the base that night and was placed under a 14-day quarantine by local authorities.
The federal quarantine issue was ordered for a number of reasons, CDC officials said. Among them: the number of confirmed cases and deaths in China has jumped every day this week; more countries are reporting infections, including incidents of human-to-human transmission of the virus; and evidence documented this week by German researchers that showed a person with no symptoms of the virus passing it on to others.
The virus, known provisionally as 2019-nCoV, has caused nearly 9,700 confirmed infections and killed 213 people in China. About 100 additional infections have been reported in 18 other countries, and no deaths. The large majority of cases outside China came from people who picked up the virus in China and then traveled to the other countries.
CDC officials framed the quarantine decision as the best way to preclude the potential spread of the virus to the people’s families and communities. They said that monitoring the people for 14 days also meant that should any of them become sick, they can be quickly identified.
CDC scientists have developed a test for the coronavirus, but Messonnier said it might not be advanced enough to detect the virus if people are not showing symptoms yet. The quarantine is set for 14 days because that is the longest amount of time the virus is thought to be able to “incubate” in a person before creating symptoms.
Quarantining people involves restricting the movements of people who may have been exposed to a pathogen but are not yet sick; it is different than isolation, which refers to containing people who are sick. The last time a federal quarantine order was issued for potential cases was in the 1960s for smallpox evaluation, CDC officials said.
The CDC also confirmed Friday that China had agreed to allow some of its experts into the country “to support” the Chinese response and help study the transmission of the virus and the range of severity seen with infections, a spokesperson said. The World Health Organization is sending another mission to China to collaborate on the response and investigation.
The repatriated passengers had been evacuated from Wuhan, the central Chinese city of 11 million people where cases of the virus were first documented last month and where the outbreak is centered. U.S. officials arranged the flight as the virus spread and China imposed lockdowns on Wuhan and other cities, shutting down travel to and from the areas and essentially quarantining tens of millions of people.
One person with a fever was not allowed to board the flight in Wuhan, U.S. officials said Wednesday.
Messonnier called the quarantine “an unprecedented action.” But, she said, “we are facing an unprecedented public health threat.”
CDC officials acknowledged that a quarantine came with downsides, including the potential for fear and for the stigmatization of people under quarantine. “We’re taking every measure to make sure people are treated with dignity and respect,” said Dr. Martin Cetron, CDC’s director of global migration and quarantine.
There have been six confirmed U.S. cases of the coronavirus infection. Five were travel-related. The sixth, announced Thursday, marked the first U.S. case of human-to-human transmission; one of the travel-related cases, a woman in Illinois, transmitted the virus to her husband before she was isolated.
U.S. health officials have said since the outbreak started that they expected travel-related cases and for some of those patients to pass the virus on to their close contacts. If they can restrict the virus to cases of limited spread among contacts and prevent the virus from circulating more broadly, it is much easier to snuff out the virus.
On Thursday, the State Department increased its travel warning to Americans, urging them to avoid travel to China. Secretary of State Mike Pompeo cited the WHO’s declaration of the outbreak as a global health emergency as part of the rationale for the warning. But WHO officials have stressed the declaration was being made to encourage countries not to impose travel and trade restrictions on China.
Several airlines have halted flights to and from the Chinese mainland, including, as of Friday, American, Delta, and United.

U.S. to quarantine all American citizens evacuated from Wuhan, as CDC raises pandemic possibility

Top WHO official says it’s not too late to stop the new coronavirus outbreak

Mike Ryan, head of the World Health Organization Emergencies Program WHO

There is still reason to believe the growing coronavirus outbreak in China can be contained, a top World Health Organization official said Saturday, pointing to some evidence that the disease may not be spreading as rapidly as is feared. He also downplayed reports that people infected with the virus may be contagious before they show symptoms — a feature that, if true, would make it much harder to control. “Until [containment] is impossible, we should keep trying,” Dr. Mike Ryan, head of the WHO’s Emergencies Program, said in an interview with STAT. The WHO declared the outbreak a global health emergency on Thursday.
The gargantuan efforts China is making to try to halt the spread of the virus is buying the rest of the world “precious lead time” to prepare for the possibility they might have to cope with it as well, he said: “We need to thank China for that opportunity.”

“That is not to say that the disease won’t get ahead of the Chinese authorities completely or get ahead of the other countries that are containing it,” Ryan said. “But there’s enough evidence to suggest that this virus can still be contained.”
For instance, data from some studies in China looking at how much transmission occurs when the virus gets introduced into a household suggests the secondary attack rate — the number of people the first case infects — isn’t that high. “But that’s obviously a few studies across a very large event,” Ryan cautioned.
There haven’t been many reports of health worker infections, a feature that fueled the earlier outbreaks of SARS and MERS, coronaviruses that are related to this new pathogen, provisionally called 2019-nCoV. Likewise, there has not been a lot of spread from cases discovered in other countries in tourists from China or people returning from China.
Still, numbers of cases are growing in big leaps — China reported 2,102 new cases and 46 additional deaths on Saturday. And those numbers might be higher still but for the fact that China has a backlog of tests to be processed. Ryan said the problem isn’t testing reagents — the country has indicated it has adequate supplies — but the sheer number of tests that need to be run.
“So there are clear indications obviously that the disease numbers are growing. But there is also some contradictory evidence as well that doesn’t completely align with the kinds of R0s that are being estimated,” Ryan said.
R0 — pronounced R-naught — is the reproductive number of a disease, the number of people, on average, each infected person goes on to infect. Most studies so far have estimated the R0 in this outbreak to be between 2 and 2.5, which is higher than seasonal flu — about 1.3 — but lower than SARS, which had an R0 of between 2 and 5.
Ryan would not say what circumstances would lead the WHO to declare this event a pandemic — an outbreak that might be expected to spread around the globe. That kind of discussion, he said, would be a distraction.
“If that becomes the discussion, then we’re all going to lose focus,” Ryan insisted. “We have to remain laser-focused on containment and slowing down the spread of disease.”
As of Saturday, he said, the world has seen nearly 12,000 confirmed cases, all but 133 of them in China. Nearly two dozen countries outside of China have diagnosed cases. The United States has reported eight cases, one of which contracted the virus in this country from a relative who had traveled to China. The latest U.S. case, confirmed on Saturday, is a University of Massachusetts Boston student in his 20s who returned from a visit to China on Tuesday.

The Trump administration declared the outbreak a public health emergency on Friday, saying it would temporarily bar entry to Chinese nationals who had been in China in the past 14 days and would quarantine Americans returning from China. On Thursday, the State Department told Americans not to travel to China.
There have been a total of 259 deaths reported so far, all in China. “Almost all of the mortality is in the over 40s,” Ryan said “and a strong preponderance of males.” About a third of the cases have pre-existing health problems.
One of the concerns about this outbreak has been reports that people may be able to transmit the virus before they develop symptoms — which, if true, would make containment tools like quarantine less effective than they were during the 2003 SARS outbreak.
A report published Thursday in the New England Journal of Medicine pointed to this type of transmission, sometimes called asymptomatic spread, in a cluster of cases in Germany.
But Ryan said the data the WHO are seeing suggests some people who have been publicly labeled “asymptomatic” were actually already experiencing some symptoms.
“We still believe, looking at the data, that the force of infection here, the major driver, is people who are symptomatic, unwell, and transmitting to others along the human-to-human route,” he said. “That is the pressure wave.”
Ryan admitted he was surprised by the speed with which the outbreak has taken off. China alerted the WHO to the fact that it believed a new virus was causing pneumonia in the central Chinese city of Wuhan on Dec. 31. On Jan. 7 it announced it had isolated a new virus.
The total number of confirmed cases in this outbreak — just a month old — has already surpassed the SARS outbreak, which played out over a period of at least eight months in 2002-2003.
“For me it’s been unusual to see a new disease emerge and, on the face of it, move so quickly,” he said. If the scientists studying the genetic sequences of the viruses are right and the outbreak began sometime in late November or early December, “then this is a very rapid emergence and very rapid infection of a lot of people.”