I will be doing a series of chapters on the Novel Coronavirus (nCoV), AKA the Wuhan Acute Respiratory Syndrome (WARS) virus due to the recent outbreak. Edit: since publishing this chapter, WHO has labelled this virus COVID-19. I will still be referring to this virus as nCoV for clarity's sake during the initial period these chapters were posted but the chapter names will be changed to "The COVID Series".

I am currently a physician in Hong Kong (HK) and, as such, a frontline staff in this epidemic.

nCoV is a virus first noted at the end of 2019 breaking out in Wuhan, a city in China of 11 million people. It presents with typically upper respiratory tract symptoms (cough, phlegm, runny nose) with an incubation period of 7-14 days (that is, people that are infected do not show symptoms until 7-14 days and during that period are able to spread the virus without knowing it). At first, it seems like the people who present with this virus had been to a Wuhan wild game market, but recently there have been observations of human-to-human spread. Allegedly, the virus was first caught as a result of people consuming wild animals.

I say allegedly because it's not yet confirmed and there are still some theories out there, some of them a bit more conspiratorial.

The fear with this nCoV in HK is the history of the SARS (severe acute respiratory syndrome) virus outbreak in China and HK in 2003. Due to a combination of factors, including the dense population of HK and the delayed reporting of information from China to WHO about the disease, hundreds of people died. The virus has a fatality of almost 10%, some of them young and healthy people. Some of them frontline medical staff who had no idea just how lethal this virus is. One of the most prominent deaths was Dr TSE Yuen-man, an internal physician who was only 35 years old. The scars from the impact of SARS ran deep in HK, especially in the healthcare world.

Having learnt from SARS, HK people were understably on edge about this outbreak. We thought CCP (Chinese Communist Party, AKA the political party of China) would act quicker, quarantine sooner, be more cautious. And the same for the HK government.

It turned out not be the case.

It started as the reporting of statistics. By early January, the media claims there were 59 suspected nCOV cases in Wuhan and 30 suspected cases. There were no suspected cases anywhere else in China at the time.

Sounds bizarre, right? If the outbreak happened in end of December 2019 and the media reports are to be believed, then do those folks who get infected at the Wuhan market either stay in Wuhan or go to Hong Kong? And literally nowhere else in China (or the rest of the world)?

The under-reporting has a lot of us anxious and understandably so. We don't know how many there are. The numbers are unreliable. There could be hundreds or thousands of cases, some of them diagnosed but hidden under propaganda, some of them deliberately not seeking medical attention (for fear of isolation), some of them not showing symptoms.

Another problem was the severe shortage of resources. Winter surge is a phenomenon across the world, where the cold weather triggers a whole host of issues such as pneumonia, flu, falls, heart attacks. More people get admitted. People recover slower, get more complications. Bed occupancies are at an all-time high. Since October, the ward occupancies have persistently been at above 100%, up to 150%. Extra beds are laid out in the corridors. People wait for hours in A+E just to get a bed on the ward.

The department of health head gave a public announcement, promising 1400 more beds to tackle the winter surge and the nCoV outbreak, including more isolation beds. We frontline staff see that and only feel dread. They might be able to provide 1400 more physical beds, but what about the staff? Where are the extra nurses to give out medications when the most thinly-stretched areas have forty patients to one nurse? Where are the extra healthcare assistants to take blood pressure and temperatures and help people to and from bathrooms? The extra doctors to round those cases? The extra physiotherapists and occupational therapists to rehab cases? The extra radiology and lab technicians to run the additional tests?