Coronavirus in New York: What We Know So Far

Samples from all three patients have been sent to the Centers for Disease Control and Prevention laboratory in Atlanta for testing. The results from the first suspected case could come as early as Monday.

The city health commissioner recently called the virus’ eventual arrival here “inevitable,” but the health authorities say they are well prepared.

New York City health officials note that they have a long history of responding to contagious and frightening illnesses — going back to the days when outbreaks of cholera and smallpox threatened the city. In more recent years, they have contended with an Ebola case as well as a resurgence in measles.

But the new coronavirus — which is believed to have originated in Wuhan, China, late last year — presents significant challenges. It is spreading faster than either SARS or MERS, two other coronaviruses that jumped from animals to people, sparking outbreaks. And there are indications that some infected people might be contagious before they show symptoms.

Here is a rundown of the significant facts:

— What we know about the three patients

The first has been described as a woman under 40 years old who had been staying by herself in a hotel in New York City. She had recently traveled from China and began showing symptoms two days after arriving in the United States.

Late Friday night, following a 911 call, she was taken by ambulance to Bellevue Medical Center, the flagship of New York City’s public hospital system. Her symptoms, said Dr. Oxiris Barbot, the city’s health commissioner, were “fever, cough and a runny nose.”

Less information has been released about the other two patients, who are in separate hospitals in Flushing, Queens. Their genders are unknown; both are over 60 years old. Their symptoms include fever, cough and shortness of breath.

— Why does the city suspect the new coronavirus?

The three patients all had recently been to China, the source of the outbreak. And each one had tested negative for influenza and other common illnesses.

Still, the authorities have cautioned that the three may well turn out not to have the new virus. Most of the suspected cases around the country have not in the end been identified as the coronavirus.

— Health officials are telling New Yorkers not to be overly concerned

Public health officials note that the ordinary flu has proved to be far more dangerous so far. Across the country, the CDC says 68 children have died of the flu this year, and the agency estimates 10,000 adults have died. The coronavirus has not yet caused a single death in the United States, officials said.

Of course, that could change if the coronavirus begins spreading here. In China, there were 17,205 confirmed infections as of Sunday, and 361 people have died. Among laboratory-confirmed cases, the illness has a fatality rate of about 2%, although that’s expected to drop as more mild cases are discovered. For comparison: The 2009 H1N1 “swine flu” pandemic had a death rate estimated at 0.02%.

At times, city officials have given different guidance than scientists at the CDC. At a news conference, Mayor Bill de Blasio said transmission of the new coronavirus required “substantial contact with someone who already has it,” adding that “you don’t get it” from touching a surface.

The CDC, however, has more cautious advice: “It’s currently unclear if a person can get 2019-nCoV by touching a surface or object that has the virus on it and then touching their own mouth, nose or possibly their eyes.”

— For now, only the CDC can test for the new coronavirus

Local health departments around the country do not yet have that capability. “Since it’s a new test, there are set protocols in place where the CDC first has to standardize the way it runs the analysis,” Barbot explained. She said she hoped that within a week or two, New York City would be able to test for the coronavirus.

For now, all samples are being sent to the CDC laboratory in Atlanta. Results generally take a minimum of 36 to 48 hours — or longer.

— What happens if one of the patients is found to have it?

The public health authorities will start “contact tracing,” in which they try to determine each person whom the patient came into contact with and who might have been exposed. It’s tedious work, but crucial. It generally involves asking a patient to account their entire day “in excruciating detail,” Barbot explained.

Some sample questions interviewers might ask: Who did they greet with a hug? Who did they share utensils with during a meal?

If all goes well, contact tracing allows public health authorities to follow each chain of transmission and monitor potential patients for the onset of illness. This can play a key role in slowing and eventually stopping transmission.

But should the illness start spreading in New York City, further steps will be considered.

Suppose a father was found to have the new coronavirus and some time later other students in his child’s class were found to have the illness. “You would probably consider closing that school,” said Dr. Howard Markel, director of the University of Michigan’s Center for the History of Medicine.

Schools, it turns out, have been “real incubators” during some flu outbreaks, including the 2009 swine flu pandemic, as well as the Spanish flu pandemic a century ago, estimated to have killed more than 50 million people worldwide, said Markel.

And scientists are finding that the new coronavirus is spreading more like influenza, rather than at the slower rate of SARS and MERS.

Striking the right balance involves political instincts as well as medical knowledge. Isaac Weisfuse, a former deputy commissioner at the city’s Department of Health, said that if you close a school or another location prematurely “when there’s not evidence of transmission, not only do you inconvenience people, but they won’t trust the next thing you do.”

But, he added: “If you do it too late you have rapid infection.”

— What other measures could the Health Department take?

There are few limits to Barbot’s authority during a public health crisis. One of her 19th-century predecessors once remarked that he could seize City Hall and turn it into a hospital if he wanted.

But Barbot is likely to employ a measured approach for now. “One of the things we’ve learned is that actual risk doesn’t always match perceived risk,” she said.

As anxiety over the new illness swelled, she encouraged New Yorkers to go about their daily lives, including those who had recently returned from Wuhan or elsewhere in China — so long as they felt fine and symptom-free.

Barbot’s advice to New Yorkers: Wash your hands, cover your mouth when you sneeze and cough, and get the flu shot if you haven’t already.

This article originally appeared in The New York Times .