For five days, Arizona State University freshman Ziwen Zhang was quarantined in isolation.

Zhang went home to Wuhan, China, for winter break and returned to ASU on Jan. 9. Before she came back, she developed a fever.

"I went to the ASU health center just because I had a fever…and my friends worried about it," she said. "So I just checked in case."

She wanted to know if she had the new strain of coronavirus that has rapidly spread from the Wuhan region of China since it was first detected in December.

There have been nearly 12,000 confirmed cases of the new virus worldwide, a number that keeps rising, along with 259 deaths in China resulting from the virus. Eight of the confirmed cases worldwide have been in the United States; one of them is a member of the ASU community in Tempe.

Since that case of coronavirus was confirmed on Sunday, students at the Tempe campus have been on edge. Some Chinese international students complain that the university isn't doing enough.

On Thursday, the World Health Organization decided the new coronavirus was a global health emergency. ASU researchers and health officials caution against panic and say that the general risk to the public remains low. But the lack of testing opportunities and a dearth of reliable information have made students nervous, and some students want to see the school expand testing for the virus and take more preventative measures.

Some students from China want to be tested

After health center doctors took a sample of Zhang's blood, she said, they told her she needed to stay in a single room until she got her results: no going in or out. She couldn't leave for any reason, not for class or to get food. She had to rely on a university staffer to deliver her meals from the dining hall.

On Sunday, she was given a clean bill of health and was free to go.

But Zhang said one of her friends, who also traveled to Wuhan over winter break and returned with a cough but no fever, had a different experience with the health center.

"She went to the health center in Tempe campus and they just told her, 'You have just the normal cold, if your cold is getting more serious, then come back and check-in,'" she said. "So she just went back home."

This concerned Zhang, because she said she thinks the university isn't taking the new coronavirus and its potential to spread seriously enough.

Currently, monitoring for the new strain of coronavirus at ASU is being overseen by state and county health officials, as well as the Centers for Disease Control and Prevention, which needs to approve all testing.

There are about 3,500 international Chinese students who attend ASU, according to Daniel Zheng, the president of an ASU international Chinese student organization called Fun-Fun. Many traveled home over winter break, he said, but haven't been able to be tested for the new coronavirus, even if they show respiratory infection symptoms.

Expanded testing is one request that Zheng and other Chinese international students who are part of Fun-Fun urged university officials to consider at a meeting on Monday. The meeting included Fun-Fun, the ASU Chinese Students and Scholar Association, and university officials, such as the Tempe dean of students and the university's chief of medical staff.

"At the meeting, we learned that the school would only take tests for students who have been to Wuhan and who have a fever," Zheng said. "Maybe we should expand the search because there are some students, as far as I know, who came back from Wuhan and do not show any symptoms but maybe they are just in their incubation period.”

ASU officials have declined to comment on the specifics of Monday's meetings, but say that they are working closely with the Maricopa County Department of Public Health and the Arizona Department of Health Services to monitor the situation.

The incubation period for this new coronavirus remains unclear, but according to ASU coronavirus researcher Brenda Hogue, the new virus is genetically similar to other known strains.

"In general for these viruses there’s about a 14-day window where one could potentially still be infectious," Hogue said.

What researchers know about new coronavirus

Hogue has been studying coronaviruses for nearly her whole professionallife — over 25 years. The viruses are common throughout the animal kingdom and when she first startedher research, there were only two strains that affected humans.

Now there are seven. Three of these strains are severe: severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) — viruses that have spread in the past — and this new strain.

The other four strains are common, less severe and are thought to cause about 30% of common colds.

Looking at the genetics of the new coronavirus can give researchers important insights into how the virus is spreading and how they might be able to stop it.

"This is a brand-new virus and we're just starting to learn about its genomic makeup," said David Engelthaler, the co-director and associate professor of the Pathogen and Microbiome Division at the Translational Genomics Research Institute (TGen) in Flagstaff.

The virus is thought to be about 90% similar to another coronavirus strain found in bats, according to Hogue and about 80% similar to SARS.

There are some key areas in which the new strain of coronavirus differs from all the other human strains. When testing for the new coronavirus, Engelthaler says the CDC-developed test looks at these genome areas to determine whether a patient has the new coronavirus.

“It is probably a really good test and is very specific, it’s just limited in the overall information it can give you. It can say yes or no, is the virus present," he said.

Using rapid genome sequencing technology, where researchers can use a machine to quickly spit out the entire genome of a sample organism, TGen is developing its own test to use for the new coronavirus that can quickly display all the information about the specific virus that the patient is infected with.

"We want to make sure we can pick up any new mutations that may be occurring," he said. "These mutations, or evolutions, in the virus may change the way the viruses behave and are transmitted, or may allow the virus to infect new and different species."

Like most viruses, Engenthaler said this one has and will continue to evolve. So far, the genome and structure of the new coronavirus have changed very little.

"Our goal is to make sure there are additional tests so that not everything has to be run through the state public health lab or CDC lab, to try to make sure as many people can be tested as possible," Engenthaler said.

Getting a new diagnostic test on the commercial market can take months, if not years. The test could be expedited for emergency use if the situation worsens and the country declares a public health emergency, according to Engenthaler.

That remains unlikely for now, according to Matthew Scotch, an ASU researcher who uses data science to track viruses. According to the current genetic data, all the current cases of the new coronavirus stem from one source: China.

“We don’t see a lot of localized human-to-human transmission, a lot of these people infected in the United States have direct travel ties to China," he said. "Where we’re going to go into that large-scale problem is where you have more of these locally transmitted infections. That’s certainly possible but we’re not there yet."

On Thursday, the CDC confirmed the first human-to-human transmission of the virus in the United States. The case occurred in Illinois, in a man who contracted the virus from his wife, who had been previously infected. In a release, the CDC said there are likely to be more confirmed cases of the virus in the U.S. in the days ahead.

Understanding the spread of the virus

Because the new coronavirus is so genetically similar to SARS, it is thought to be similar tothat virus in terms of how it spreads, though researchers say they need to take a closer look.

"We don’t have a full understanding of how the virus is spreading," Hogue said. "There’s still a lot to learn."

SARS first emerged in Asia in 2003 and the outbreak quickly spread to over two dozen countries. The virus is thought to have infected over 8,000 people and caused over 700 deaths during the first year of the outbreak.

Symptoms of the new coronavirus include cough, cold, fever, and lower respiratory infection or inflammation of the lung. This separates it from a common cold, which typically only affects the upper respiratory system and isn't as severe.

“We do know based on SARS, there were experiments done to see how long that virus would survive on a hard surface, and some reports indicated about 96 hours and some other reports indicated that it could remain infectious over a period of 3-5 days," Hogue said.

Because of the similarities between SARS and the new coronavirus, Hogue and other researchers are hoping to use their existing knowledge about SARS to help develop therapies to combat the new virus.

Hogue previously worked on developing a SARS vaccine that showed success in mice trials but that never made it to human trials or approvals. Currently, there are no vaccines on the market for SARS or MERS, a virus that spread in 2012, but Hogue and other researchers will be revisiting their old research on both diseases.

"The expectation is that a lot of that information can be used to help expedite…producing a vaccine against this new virus," Hogue said.

Hogue highlighted three important areas of the virus's genetic code to look at when developing a treatment. Two of these areas are similar to SARS, Hogue said. One is the part of the genome that is responsible for how much inflammation the virus causes in the lungs, and the other area is responsible for virus replication.

One key area where the new coronavirus differs from SARS is a part of the virus's genetic RNA that is responsible for creating spike-like structures on the outside of the virus to attach to host cells and infect the host.

"This is a region that you need to understand in order to be able to generate a vaccine that will be effective to prevent infection," Hogue said.

Infected people may not show symptoms

Another key difference for this new virus is that unlike SARS, most of the person-to-person spread of the virus did not occur in health care settings.

"In this case, it appears that ... the virus is out in the community and that it’s not just restricted to very sickened individuals that are in the hospitals," Hogue said. "Some of the individuals that have tested positive for the virus, they’re asymptomatic, which actually raises concerns about patients that could be infected but not exhibiting symptoms." Those patients could then spread the virus, Hogue said.

Like SARS, the new coronavirus is also thought to spread through particles traveling in the air. This has prompted many people who are fearful of the new disease to buy face masks.

"Certainly the masks can help if one is in proximity of an infected individual," Hogue said.

At any given spot on ASU's Tempe campus, a smattering of students can be seen walking to class, riding skateboards or talking with friends at lunch, all while wearing masks.

Zheng said that he received a free mask from ASU's health center, which has been providing masks to students who request them, but that ASU is limiting each student to only one mask.

"Many doctors are recommending people to wear masks but school officials told us it was only necessary for people who are sick to wear a mask," Zheng said. "I think the school is wrong because it doesn’t know who on earth is carrying the virus and who is sick. Some people who are infected don’t actually know that they are sick.”

A university spokesperson said the university has no official stance on whether or not students should wear masks, but issued a statement saying the best way to prevent the spread of disease is through good hygiene practices. ASU is also giving free hand sanitizer to students who want it.

When Zheng went to the nearby pharmacy to buy more masks, he said the stores were all sold out. So he decided to take matters into his own hands; using Fun-Fun club funds, Zheng ordered more masks.

"We have already ordered 300 masks," he said. "After we receive the masks, we will hand out masks to students on campus.”

In addition to buying the masks, the Fun-Fun organization and the Chinese Students and Scholar Association collected over 1,000 survey responses from Chinese parents and students that listed concerns over the new coronavirus and requests that students had for the university.

Students want more precautions taken

Many of these requests echo sentiments in other student petitions to cancel classes or switch to online classes and cancel large events for a few weeks until the university can be sure that the threat of the virus spreading has passed.

Despite requests from Chinese students to cancel the Chinese Spring Festival event on campus on Tuesday, Zheng said the university went ahead with plans.

At the festival, ASU student Oliver Shao, 20, could be seen wearing a large white face mask while chatting with his friend.

Shao is originally from Wuhan and has been talking with his family back home about the virus. Though he didn't travel home for winter break, he said he is concerned because the death toll from the virus keeps rising.

"It's better to have a mask on to protect each other," he said.

He criticized the university for its limited communication with students about the new coronavirus case and said the mask makes him feel safer.

"The university should give students enough information to prepare for the virus, but they don't," he said.

Tensions are high around campus, and the slightest cough can make someone recoil.

"I just took an astronomy class and five or six people were coughing and it made me really scared," said Yue Huang, 20, a third-year ASU student who sported a black mask during her lunch outing with a friend.

Risk of virus spreading in U.S. remains low

University officials and researchers maintain that the general risk to the public remains low, and have stressed that people should not panic about the new coronavirus case, nor should they freak out if they see someone else coughing.

"People need to realize it’s also the peak of the flu season," Scotch said. "It more likely is, at the worse case, that they have the flu, not some strange new virus they’ve never heard of.”

Scotch said that to learn more about the virus, people should go to reputable sources for information such as the CDC, the World Health Organization and other health officials.

To reduce risk, ASU is continuing to work with state health officials to monitor the situation and has suspended all university-related travel to China. The university is urging students to minimize the spread of all diseases through practicing good hygiene such as washing hands often, staying home when sick, cleaning frequently touched objects or surfaces and avoiding close contact with sick people.

“This virus really does seem to spread pretty well between people but it does not spread as fast as fear and that’s one thing we can all control," Engenthaler said.

Despite these reassurances, students remain concerned about the disease. Even though the current risk is low, Zheng doesn't want to risk the situation getting worse.

"We cannot wait to pay attention to the situation until the epidemic has become very serious, so I think the school should take it seriously," he said.

Arizona Republic journalist Alex Li contributed to this story.

Amanda Morris covers all things bioscience, which includes health care, technology, new research and the environment. Send her tips, story ideas, or dog memes at amorris@gannett.com and follow her on Twitter @amandamomorris for the latest bioscience updates.

Independent coverage of bioscience in Arizona is supported by a grant from the Flinn Foundation.

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