A patient who was being treated at Queen Elizabeth Hospital Birmingham (QEHB), England, for novel coronavirus (NCoV) infection has died, the hospital has announced today.

The patient passed away in the hospital’s critical care unit on Sunday morning. The hospital says it “extends its sympathies to the family”. The patient was one of three family members who had been confirmed ill with NCoV over the last week – what health authorities describe as a “family cluster”.

According to QEHB, the patient who died had been undergoing treatment for a long-term, complex, unrelated health condition. The medical team said the patient was immune-compromised (had a weak immune system) and probably contracted the virus from a relative who is currently receiving treatment in a hospital in Manchester.

Both hospitals say they are working closely with the HPA (Health Protection Agency) which is following up other household members and friends the three infected people may have come into close contact with.

The World Health Organization (WHO) is urging all member states to monitor carefully for SARI (severe acute respiratory infections) as the number of novel coronavirus infections gradually increases.

WHO announced that it has been informed by the United Kingdom about another confirmed case of NCoV (novel coronavirus) infection in the country. This third case in the UK over the last week forms part of the same family cluster as the other two (at the time of this announcement, WHO had not been informed about the death of one from the family cluster).

The patient had no recent history of traveling abroad, which means the NCoV was probably transmitted from person-to-person.

In an online communiqué, WHO wrote:

“Although this new case offers further indications of person-to-person transmission, no sustained person-to-person transmission has been identified. “

So far, out of a total of 12 confirmed cases of human infection and illness with NCoV worldwide, six patients have died. This 50% death rate is much higher than the 9.5% rate during the 2002/2003 SARS (Severe Acute Respiratory Syndrome) pandemic which killed 774 out of 8,098 confirmed cases of human infection in 37 countries. The SARS virus (SARS-CoV) is also a type of coronavirus.

To date, four countries have registered confirmed cases of NCoV infection in humans:

  • 4 – UK. One death.

    1 Qatari and 3 British citizens (all members of the same family; a family cluster). One of the family members had no recent history of traveling abroad and had never been to the Middle East. The patient who died was already very ill before becoming infected, and was more susceptible to infection than most people. Therefore it is not possible, from this case, to determine how human transmissible the novel coronavirus is.

  • 5 – Saudi Arabia. Three deaths.
  • 2 – Jordan. Two deaths.
  • 1 – Germany. No deaths.

    The patient, a Qatari, recovered completely and is no longer in hospital.

Although many of the signs and symptoms of these latest infections are similar to those found in SARS, the HPA emphasized that the novel coronavirus is far less human transmissible.

Nobody yet knows how widespread this novel coronavirus is, how 11 out of the 12 confirmed human cases became infected (we know one of them caught the illness from another person in the same family). It is not known whether these infections occurred as a result of (close) contact with infected animals or infected people.

In all the cases, except for one, the patients had been in the Middle East.

WHO says it is encouraging “All Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns. Testing for the new coronavirus should be considered in patients with unexplained pneumonias, or in patients with unexplained severe, progressive or complicated respiratory illness not responding to treatment.”

No matter where in the world they occur, any cases of SARI in healthcare workers should be thoroughly investigated, as should clusters of SARI, WHO added, with new cases being reported immediately to both national health authorities and to WHO.

Health authorities have been asked by WHO to report cases as NCoV or the Novel Coronavirus, and not as SARS-like to avoid confusion.

Screening people at points of entry, travel or trade restrictions are not advised.

The novel coronavirus (NCoV) replicates faster than the SARS (SARS-CoV) and is able to penetrate the lining of passageways in the lungs and evade the immune system as easily as the common cold virus can. Scientists have expressed concern and say that the four British cases might be the tip of the iceberg.

The Daily Telegraph, a British national newspaper, quoted Volker Thiel, of The Institute of Immunobiology at Kantonal Hospital in St. Gallen, Switzerland, as saying “We don’t know whether the cases we observe are the tip of the iceberg. Or whether many more people are infected without showing severe symptoms.”

Thiel said that scientists worldwide need to cooperate rapidly to find out where this novel coronavirus came from, how widespread it is, and how contagious it might be.

Health Departments around the world are definitely starting to issue alerts, memos and bulletins regarding NCoV at a much higher rate now than a month ago.

The Department of Health in The Philippines has ordered all hospitals across the nation to report suspected cases of NCoV using a standard report form issued by the National Epidemiology Center “amid an increase in the number of incidents abroad”. Enrique Ona, Health Secretary, added that samples collected from patients with signs and symptoms of NCoV infection should be sent to the Research Institute for Tropical Medicine in Muntinlupa City for confirmation. Enrique Ona quoted the World Health Organization’s recommendation that member states be vigilant.

Written by Christian Nordqvist