New Coronavirus News from 15 Feb 2020b

The world's biggest work-from-home experiment has been triggered by coronavirus [CNN Business, 15 Feb 2020]

By Jessie Yeung

Hong Kong (CNN Business)In offices across Asia, desks are empty and the phones are quiet, as the region grapples with a deadly virus.

In major hubs like Hong Kong and Singapore, shops are shuttered, public facilities are closed, and there are few people wandering the usually-bustling financial districts.

Instead, millions of people are holed up in their apartments, in what may be the world's biggest work-from-home experiment.

The novel coronavirus outbreak, which began in Wuhan, China, in December, has now infected more than 67,000 people and killed over 1,500, the vast majority in mainland China.

Around 60 million people in China were put under full or partial lockdown in January as the government tried to contain the virus. Restrictions have been implemented in many other places too -- but there is also pressure for companies to get back to work, with Chinese President Xi Jinping warning this week that the country needed to stabilize its economy.

In an attempt to limit social contact to slow the spread of the virus, known officially as Covid-19, millions of employees in China and other affected areas are currently working from home.

For some employees, like teachers who have conducted classes digitally for weeks, working from home can be a nightmare.

But in other sectors, this unexpected experiment has been so well received that employers are considering adopting it as a more permanent measure. For those who advocate more flexible working options, the past few weeks mark a possible step toward widespread -- and long-awaited -- reform.

Frustrations and unexpected benefits

In China, the outbreak has taken a toll on the world's second biggest economy, which had already been struggling due to the US trade war and a slump in domestic demand. Now, businesses have been closed for weeks, raising fears of mass lay-offs, unemployment, and housing foreclosures.

One estimate warned that the outbreak could cost China $62 billion in lost growth.

With authorities urging businesses to reopen, employees across China are beginning to work from home. More than half of workers in the capital Beijing plan to do so instead of going into the office, according to state-run newspaper China Daily.

Tech companies including Tencent, Alibaba and Microsoft have told CNN their staff will work from home for the next one to two weeks, citing health and safety concerns.

The governments of Singapore, Hong Kong, and Macao have ordered civil servants to work from home and asked private employers to do so where possible, with only essential staff or emergency service providers still at the office.

Civil servants in Hong Kong have been working from home for weeks, since the Lunar New Year holiday ended in late January. A Hong Kong government statement said it "appealed to other employers to make flexible work arrangements for employees in order to reduce contacts among people."

Schools in many of these places have been suspended -- so teachers are instead conducting classes through digital learning tools, such as Google Hangouts and other video conferencing software. One Hong Kong school requires students to "check in" digitally and do lesson tasks online with hourly deadlines, so if students skip a class, it leaves a digital record.

But bringing the classroom online has proved frustrating for some educators -- especially those who work with children who have special learning needs or disabilities.

"We use a lot of hands-on learning, so it's been really challenging trying to make our online learning meaningful for the kids when we're not in a classroom environment," said Karen, a special education teacher in Hong Kong, who requested a pseudonym to avoid identifying the school.

Like other schools, Karen and her colleagues have relied on digital tools such as video calls and Google Docs -- but challenges are made harder because her students need a lot of adult support.

"The parents are also working from home, and are having to also be teachers -- it's almost an impossible situation," she said.

Special needs students also often rely on the structure, routine, and human interaction provided by school -- which means remote learning can be unsettling or frustrating.

But for other digital-based sectors, working from home has instead been surprisingly effective, say employers in the field.

"It's a test run that we didn't really choose to implement, but we're quite happy with it," said Brice Lamarque, sales and accounts director at a web and branding agency in Hong Kong.
Nearly all the agency's employees have been working from home this month -- and will continue for as long as the Hong Kong government advises, he said.

"Before (the epidemic) happened, we were not really keen on letting our team work from home because we value collaboration," said Lamarque. "But this experience actually showed us that the whole team collaborates quite well even if they're not in the same room, so we're looking at adding that into our employee benefits ... maybe two to three weeks a year."

However, he admitted that a big part of the work-from-home success owed to the digital nature of their company and industry -- employees only require a computer and internet connection, meaning they can work from anywhere.

Joe Hasberry, a Hong Kong employee at an asset management firm, has also been working from home -- but unlike Lamarque, he and other coworkers will be returning to the office next week. The company needs to meet with clients and visitors, meaning it's hard to keep working from home beyond a few weeks.

"Some guys at my office are more (in) investor relations -- it's much more people-centric, so that part of the job wouldn't be able to be done from home," he said.

Meanwhile, some people face social pressure from employers to go into the office despite government guidance to work from home. Employees in customer service industries or front-of-house roles often don't have the option to work remotely.

In China, factory workers also don't have this choice -- instead, those able to return will face stringent health and safety measures each day, like having their body temperatures checked and hands disinfected before entering the workplace, according to state-run media Xinhua.

Some employees in Hong Kong told CNN that they were frustrated that the arrangement could put them at a higher risk of infection, heightened by memories of the 2003 severe acute respiratory syndrome (SARS) outbreak that devastated the city.

Is this the future of work?

Although digitally-based industries may be better suited to work from home, advocates have been pushing for years to make work more flexible, arguing that it can be done with the right infrastructure, to the benefit of both employees and employers.

The past decade has seen expanding opportunities for remote working and increasing remote job listings -- and this shift is largely due to new technologies and changing family demographics.

The movement has been embraced by many parents who say the ability to work from home makes it easier to juggle childcare and a career. Many families who can't afford nannies or day care face a difficult decision when they have a baby, with one of the parents -- often the woman -- having to sacrifice career advancement to care for their child.

The option to work from home doesn't just empower women -- it makes it easier for working fathers to step into that role too, in a step toward gender equality that benefits all parties.

Technological advancements have also made working from home more accessible across all sectors.

"Nowadays, compared to 10 years ago, it is a lot easier to access emails remotely, cloud-based filing, dial-in to calls and video conferencing remotely," said Marie Swarbreck, founder of FLEXImums, a company in Hong Kong that connects job applicants to remote or flexible work opportunities. "The technology and software is available for people to work remotely."

She acknowledged that the current work-from-home situation in Hong Kong has produced "extra challenges which are out of our control" -- for instance, working parents have to care for children whose classes have been suspended. Homes that are empty, quiet, and perfect for remote working on a typical day are now filled with people and distractions.

But these are extraordinary circumstances -- not the norm, she said. Current challenges don't mean that working from home is ineffective, or that it shouldn't be implemented more widely beyond the outbreak.

"Being able to create a workplace that welcomes and encourages working from home, remotely, flexibly, is certainly, in my opinion, the way regular daily life will become more and more."

First case of coronavirus confirmed in Egypt [Arabnews, 15 Feb 2020]

• Health ministry did not give nationality of the affected person
• Egypt immediately informed World Health Organization

CAIRO: Egypt's Health Ministry has confirmed the first case of the new virus in the North African country.

In a statement Friday, Health Ministry spokesman Khaled Mugahed said the person was a “foreigner" who is carrying the virus but not showing any serious symptoms.

Officials were able to confirm the case through a follow-up program the government implemented for travelers arriving from countries where the virus has spread. The ministry statement said the person was hospitalized and in isolation.

The statement did not specify the person's nationality or what port of entry he or she arrived at in Egypt.

A viral outbreak that began in China has infected more than 64,000 people globally. The World Health Organization has named the illness COVID-19, referring to its origin late last year and the coronavirus that causes it.

The Egypt case would be the first in the African continent. Experts and African leaders have expressed concern that should the virus spread there, it might wreak havoc among less developed countries with fewer health resources.

Egypt confirms coronavirus case, the first in Africa [Al Jazeera English, 15 Feb 2020]

The country's health ministry says the affected person is a 'foreigner' who is hospitalised and in isolation.

Egypt has confirmed its first case of a deadly coronavirus that emerged in central China at the end of last year and has since spread to more than two dozen countries around the world.

Health Ministry spokesman Khaled Mugahed said in a statement on Friday that the affected person was a "foreigner" who did not show any serious symptoms.

Officials were able to confirm the case through a follow-up programme implemented by the government for travellers arriving from countries where the virus has spread.

The ministry statement said the person was hospitalised and in isolation. It did not specify the person's nationality or their point of entry.

The development made Egypt the first country in the African continent to report a confirmed case, and the second in the Middle East region, after the United Arab Emirates late last month diagnosed its first cases.

'Grave threat'

Officially known as COVID-19, the virus was first detected in Wuhan, the capital of Hubei Province in central China, in December last year.

It has so far killed almost 1,400 people and infected nearly 65,000 others globally.

Three deaths have been recorded outside mainland China - one in Hong Kong, one in the Philippines and the most recent in Japan.

More than two dozen countries have confirmed cases and several nations have evacuated their citizens from Hubei.

The World Health Organization (WHO) has warned the virus poses a "grave threat" to the world.

Here’s what coronavirus does to the body [National Geographic, 15 Feb 2020]

BY AMY MCKEEVER

From blood storms to honeycomb lungs, here’s an organ-by-organ look at how COVID-19 harms humans.

MUCH REMAINS UNKNOWN about the novel coronavirus ripping through China, but one thing is certain. The disease can cast a storm over the whole human body.

Such has been the nature of past zoonotic coronaviruses, ones that hopped from animals to humans like SARS and MERS. Unlike their common-cold-causing cousins, these emergent coronaviruses can spark a viral-induced fire throughout many of a person’s organs, and the new disease—dubbed "COVID-19" by the World Health Organization on Tuesday—is no exception when it is severe.

That helps explain why the COVID-19 epidemic has killed more than 1,500 people, surpassing the SARS death toll in a matter of weeks. While the death rate for COVID-19 appears to be a tenth of SARS, the novel coronavirus has spread faster.

Confirmed cases rose to more than 60,000 on Thursday, nearly a 50 percent jump relative to the prior day, and the tally has risen by another 7,200 since then. This leap reflects a change in the way Chinese authorities are diagnosing infections instead of a massive shift in the scope of the outbreak. Rather than wait for patients to test positive for the virus, diagnoses now include anyone whose chest scan reveals COVID-19’s distinctive pattern of pneumonia. This method will hopefully allow authorities to isolate and treat patients more quickly.

If this outbreak continues to spread, there’s no telling how harmful it could become. A leading epidemiologist at the University of Hong Kong warned this week that COVID-19 could infect 60 percent of the globe if left unchecked. On Thursday, China’s National Health Commission said more than 1,700 health care workers are ill with the new virus, and the announcement came just a day after the WHO wrapped a summit on the best protocols for hospital care and the development of therapeutics, like vaccines.

But what actually happens to your body when it is infected by the coronavirus? The new strain is so genetically similar to SARS that it has inherited the title SARS-CoV-2. So combining early research on the new outbreak with past lessons from SARS and MERS can provide an answer.

The Lungs: Ground zero

For most patients, COVID-19 begins and ends in their lungs, because like the flu, coronaviruses are respiratory diseases.

They spread typically when an infected person coughs or sneezes, spraying droplets that can transmit the virus to anyone in close contact. Coronaviruses also cause flu-like symptoms:
Patients might start out with a fever and cough that progresses to pneumonia or worse. (Find out how coronavirus spreads on a plane—and the safest place to sit).

After the SARS outbreak, the World Health Organization reported that the disease typically attacked the lungs in three phases: viral replication, immune hyper-reactivity, and pulmonary destruction.

Not all patients went through all three phases—in fact only 25 percent of SARS patients suffered respiratory failure, the defining signature of severe cases. Likewise, COVID-19, according to early data, causes milder symptoms in about 82 percent of cases, while the remainder are severe or critical.

Look deeper, and the novel coronavirus appears to follow other patterns of SARS, says University of Maryland School of Medicine associate professor Matthew B. Frieman, who studies highly pathogenic coronaviruses.

In the early days of an infection, the novel coronavirus rapidly invades human lung cells. Those lung cells come in two classes: ones that make mucus and ones with hair-like batons called cilia.

Mucus, though gross when outside the body, helps protect lung tissue from pathogens and make sure your breathing organ doesn’t dry out. The cilia cells beat around the mucus, clearing out debris like pollen or viruses.

Frieman explains that SARS loved to infect and kill cilia cells, which then sloughed off and filled patients’ airways with debris and fluids, and he hypothesizes that the same is happening with the novel coronavirus. That’s because the earliest studies on COVID-19 have shown that many patients develop pneumonia in both lungs, accompanied by symptoms like shortness of breath.

That’s when phase two and the immune system kicks in. Aroused by the presence of a viral invader, our bodies step up to fight the disease by flooding the lungs with immune cells to clear away the damage and repair the lung tissue.

When working properly, this inflammatory process is tightly regulated and confined only to infected areas. But sometimes your immune system goes haywire and those cells kill anything in their way, including your healthy tissue.

“So you get more damage instead of less from the immune response,” Frieman says. Even more debris clogs up the lungs, and pneumonia worsens. (Find out how the novel coronavirus compares to flu, Ebola, and other major outbreaks).

During the third phase, lung damage continues to build—which can result in respiratory failure.
Even if death doesn’t occur, some patients survive with permanent lung damage. According to the WHO, SARS punched holes in the lungs, giving them “a honeycomb-like appearance”—and these lesions are present in those afflicted by novel coronavirus, too.

These holes are likely created by the immune system’s hyperactive response, which creates scars that both protect and stiffen the lungs.

When that occurs, patients often have to be put on ventilators to assist their breathing. Meanwhile, inflammation also makes the membranes between the air sacs and blood vessels more permeable, which can fill the lungs with fluid and affect their ability to oxygenate blood.

“In severe cases, you basically flood your lungs and you can’t breathe,” Frieman says. “That’s how people are dying.”

The Stomach: A shared gateway

During the SARS and MERS outbreaks, nearly a quarter of patients had diarrhea—a much more significant feature of those zoonotic coronaviruses. But Frieman says it’s still not clear whether gastrointestinal symptoms play a major part in the latest outbreak, given cases diarrhea and abdominal pain have been rare. But why does a respiratory virus bother the gut at all?

When any virus enters your body, it looks for human cells with its favorite doorways—proteins on the outside of the cells called receptors. If the virus finds a compatible receptor on a cell, it can invade.

Some viruses are picky about which door they choose, but others are a little more promiscuous. “They can very easily penetrate into all types of cells,” says Anna Suk-Fong Lok, assistant dean for clinical research at the University of Michigan Medical School and former president of the American Association for the Study of Liver Diseases.

Both SARS and MERS viruses can access the cells that line your intestines and large and small colon, and those infections appear to flourish in the gut, potentially causing the damage or the leakage of fluid that becomes diarrhea.

But Frieman says we don’t know yet if the novel coronavirus does the same. Researchers believe COVID-19 uses the same receptor as SARS, and this doorway can be found in your lungs and small intestines.

Two studies—one in the New England Journal of Medicine and one preprint in medRxiv involving 1,099 cases—have also detected the virus in stool samples, which might indicate the virus could spread via feces. But this is far from conclusive.

“Whether that kind of fecal transmission is occuring for this Wuhan virus, we don’t know at all,” Frieman says. “But it definitely looks like it’s there in the stool and it looks like people do have GI symptoms associated with this.”

Blood storm

Coronaviruses can also cause problems in other systems of the body, due to the hyperactive immune response we mentioned earlier.

A 2014 study showed that 92 percent of patients with MERS had at least one manifestation of the coronavirus outside of the lungs. In fact, signs of a full body blitz have been witnessed with all three of the zoonotic coronaviruses: elevated liver enzymes, lower white blood cell and platelet count, and low blood pressure. In rare cases, patients have suffered from acute kidney injury and cardiac arrest.

But this isn’t necessarily a sign that the virus itself is spreading throughout the body, says Angela Rasmussen, a virologist and associate research scientist at Columbia University Mailman School of Public Health. It might be a cytokine storm.

Cytokines are proteins used by the immune system as alarm beacons—they recruit immune cells to the site of infection. The immune cells then kill off the infected tissue in a bid to save the rest of the body.

Humans rely on our immune systems to keep their cool when facing a threat. But during a runaway coronavirus infection, when the immune system dumps cytokines into the lungs without any regulation, this culling becomes a free-for-all, Rasmussen says “Instead of shooting at a target with a gun, you’re using a missile launcher,” she says. That’s where the problem arises: Your body is not just targeting the infected cells. It is attacking healthy tissue too.

The implications extend outside the lungs. Cytokine storms create inflammation that weakens blood vessels in the lungs and causes fluid to seep through to the air sacs. “Basically you’re bleeding out of your blood vessels,” Rasmussen says. The storm spills into your circulatory system and creates systemic issues across multiple organs.

From there, things can take a sharp turn for the worse. In some of the most severe COVID-19 cases, the cytokine response—combined with a diminished capacity to pump oxygen to the rest of the body—can result in multi-organ failure. Scientists don’t know exactly why some patients experience complications outside of the lung, but it might be linked to underlying conditions like heart disease or diabetes.

“Even if the virus doesn’t get to kidneys and liver and spleen and other things, it can have clear downstream effects on all of those processes,” Frieman says. And that’s when things can get serious.

Liver: Collateral damage

When a zoonotic coronavirus spreads from the respiratory system, your liver is often one downstream organ that suffers. Doctors have seen indications of liver injury with SARS, MERS, and COVID-19—often mild, though more severe cases have led to severe liver damage and even liver failure. So what’s happening?

“Once a virus gets into your bloodstream, they can swim to any part of your body,” Lok says.

“The liver is a very vascular organ so [a coronavirus] can very easily get into your liver.”

Your liver works pretty hard to make sure your body can function properly. Its main job is to process your blood after it leaves the stomach, filtering out the toxins and creating nutrients your body can use. It also makes the bile that helps your small intestine break down fats. Your liver also contains enzymes, which speed up chemical reactions in the body.

In a normal body, Lok explains, liver cells are constantly dying off and releasing enzymes into your bloodstream. This resourceful organ then quickly regenerates new cells and carries on with its day. Because of that regeneration process, the liver can withstand a lot of injury.

When you have abnormally high levels of enzymes in your blood, though—as has been a common characteristic of patients suffering from SARS and MERS—it’s a warning sign. It might be a mild injury that the liver will quickly bounce back from or it could be something more severe—even liver failure.

Lok says scientists don’t completely understand how these respiratory viruses behave in the liver. The virus might be directly infecting the liver, replicating and killing off the cells itself. Or those cells might be collateral damage as your body’s immune response to the virus sets off a severe inflammatory reaction in the liver.

Either way, she notes that liver failure was never the sole cause of death for SARS patients.

“By the time the liver fails,” she says, “oftentimes you’ll find that the patient not only has lung problems and liver problems but they may also have kidney problems. By then it becomes a systemic infection.”

Kidney: It’s all connected

Yes, your kidneys are caught up in this mess, too. Six percent of SARS patients—and a full quarter of MERS patients—suffered acute renal injury. Studies have shown the novel coronavirus can do the same. It may be a relatively uncommon feature of the disease, but it is a fatal one. Ultimately 91.7 percent of SARS patients with acute renal impairment died, according to a 2005 study in Kidney International.

Like the liver, your kidneys act as a filter your blood. Each kidney is filled with about 800,000 of microscopic distilling units called nephrons. These nephrons have two main components: a filter to clean the blood and a little tubes that return the good stuff back to your body or send the waste down to your bladder as urine.

It’s the kidney tubules that seem to be most affected by these zoonotic coronaviruses. After the SARS outbreak, the WHO reported that the virus was found in kidney tubules, which can become inflamed.

It’s not uncommon to detect a virus in the tubules if it’s in your bloodstream, says Kar Neng Lai, a professor emeritus at the University of Hong Kong and consultant nephrologist at Hong Kong Sanatorium and Hospital. As your kidneys are continuously filtering blood, sometimes the tubular cells can trap the virus and cause a transient, or milder, injury.

That injury could become lethal if the virus penetrates the cells and begins to replicate. But Lai—who was also a member of the first group of researchers reporting on SARS and contributed to the Kidney International study—says there was no evidence that the SARS virus was replicating in the kidney.

That finding, Lai says, suggests acute kidney injury in SARS patients might be due to a diverse set of causes, including low blood pressure, sepsis, drugs, or a metabolic disturbance.
Meanwhile, the more severe cases that led to acute renal failure showed signs of—you guessed it—a cytokine storm.

Acute renal failure can also sometimes be brought on by antibiotics, multi-organ failure, or being connected to a ventilator for too long. Everything is connected.

Pregnancy and coronavirus?

It’s the great irony of the Twitter age that we know too little about the novel coronavirus as we drown in information updates about it. Medical journals have published several studies about this outbreak—some more vetted than others as researchers rush to feed the maw. Meanwhile, news outlets are reporting every development. All this information whirls around the internet where discerning fact from fiction is a notorious challenge.

“This is really unprecedented in terms of the up-to-the-minute reporting on what’s going on in these studies,” Rasmussen says. “It’s really tricky trying to sort through all of the information and figure out what’s really supported, what’s speculative, and what’s plain wrong.”

For example last week, doctors at a hospital in Wuhan reported that two infants tested positive for the novel coronavirus, one just 30 hours after birth. Naturally, this troubling headline spread across news organizations, given it raised questions of whether pregnant women can infect their unborn children in utero or whether the disease can be transmitted during birth or through breast milk.

But let’s pump the breaks. Mother-to-infant transmission wasn’t observed with SARSnor MERS despite numerous cases involving pregnant women. Plus, there are other ways a newborn could catch the coronavirus, Rasmussen says, such as by being born at hospital overrun with infected patients during a hectic emergency.

In fact, a new study published Thursday in The Lancet offers preliminary evidence that the coronavirus cannot be passed from mother to child.

In the report, researchers observed nine women in Wuhan who had COVID-19 pneumonia. Some of the women had pregnancy complications, but all cases resulted in live births without evidence of transmitting the infection. While this study doesn’t completely rule out the possibility of transmission during pregnancy, it underscores the need to exercise caution in speculating about this disease.

“There needs to be a high standard of evidence before you can say that’s happening definitively—and certainly before you start making changes to how cases are managed clinically or in terms of public policy,” Rasmussen says.

Frieman agrees. He hopes this epidemic will prompt more funding for coronavirus research like the recent pledges from the European Union and the Bill & Melinda Gates Foundation. But Frieman wants the support and interest to last even if this outbreak eventually fizzles out, unlike what happened with SARS research.

“Right after the SARS outbreak, there was a big bunch of money and then it went away,” Frieman says. “Why don’t we have these answers? Nobody funded these things.”

Coronavirus and protests are a double whammy for Hong Kong [CAPA - Centre for Aviation, 15 Feb 2020]

The novel coronavirus outbreak (2019-nCoV, now Covid-19) is forcing major schedule changes for airlines across the Asia-Pacific region, with the Chinese mainland carriers and air services most affected.

Outside the mainland markets, Hong Kong has been hardest hit by the industry’s latest crisis and both Cathay Pacific and Hong Kong Airlines have borne the brunt of the downturn.

A rebound is likely, if the post-SARS experience is a predictor. But conditions have changed 17 years later and the outcome could be different, particularly if the virus continues to spread.

China’s Leader, Under Fire, Says He Led Coronavirus Fight Early On [The New York Times, 15 Feb 2020]

By Amy Qin

Xi Jinping was aware of the outbreak nearly two weeks before he first spoke publicly about it. It could draw him directly into questions about whether officials did too little, too late.

Under fire for its response to the coronavirus epidemic, China’s authoritarian government appears to be pushing a new account of events that presents President Xi Jinping as taking early action to fight the outbreak that has convulsed the country.

But in doing so, the authorities have acknowledged for the first time that Mr. Xi was aware of the epidemic and involved in the response nearly two weeks before he first spoke publicly about it — and while officials at its epicenter in the city of Wuhan were still playing down its dangers.

That new account risks drawing the president, China’s most powerful leader in decades, directly into questions about whether top officials did too little, too late.

In an internal speech published on Saturday, Mr. Xi said he had “issued demands about the efforts to prevent and control” the coronavirus on Jan. 7, during a meeting of the Politburo Standing Committee, the highest council of the Communist Party, whose sessions are typically cloaked in secrecy.

In the speech, he also said he had authorized the unprecedented lockdown of Wuhan and other cities beginning on Jan. 23.

“I have at every moment monitored the spread of the epidemic and progress in efforts to curtail it, constantly issuing oral orders and also instructions,” Mr. Xi said of his more recent involvement.

Mr. Xi’s advisers may have hoped that publishing the speech, delivered on Feb. 3. would dispel speculation about his recent retreat from public view and reassure his people that he can be trusted to lead them out of the epidemic. The virus so far has officially infected more than 68,000 people and killed more than 1,650 worldwide, the vast majority in mainland China.

“The overall tone of the speech appears to be defensive,” said Minxin Pei, a professor of government at Claremont McKenna College in California. “He wants to change the narrative, which until this point has been very unfavorable to the top leadership.”

Delivered at a meeting with top party officials, when the epidemic had already spiraled into a national crisis, the speech could expose Mr. Xi to criticism that he didn’t treat the initial threat urgently enough, and make it difficult for him to shift blame onto local officials for what many see as the government’s early mishandling of the epidemic.

The remarks also raise questions about what top leaders knew at the time and what instructions they issued based on that knowledge.

That Mr. Xi convened a meeting of China’s highest political body in early January indicates that the coronavirus was already being seen as a matter of high-level concern — making his subsequent silence even more conspicuous, experts say. An official account of the Jan. 7 Standing Committee meeting issued at the time by Xinhua, the state news agency, made no mention of a discussion of the coronavirus.

“It seems like he’s trying to indicate that ‘we weren’t asleep at the wheel,’” said Jude Blanchette, the Freeman Chair in China Studies at the Center for Strategic and International Studies. “But it comes off like ‘we knew this was a problem, but we weren’t sounding the alarm.’”

In the speech this month, Mr. Xi signaled his displeasure with lower-level bureaucrats for their “shortcomings” in implementing the party’s top-level directives.

In early January, officials in Wuhan were giving open assurances that human-to-human transmission of the virus was unlikely. Some government experts agreed.

“For now, it seems there is no clear evidence of human-to-human transmission,” Xu Jianguo, a senior expert on communicable diseases at the Chinese Center for Disease Control and Prevention, said in an interview in early January with Ta Kung Pao, a Hong Kong newspaper.

“This shows that the threat level from this virus is limited.”

The new information places Mr. Xi’s involvement in fighting the epidemic much earlier than was previously known. His earliest public comment on the epidemic came on Jan. 20, when he gave brief instructions that were published in state media.

In the days after Mr. Xi’s Jan. 7 orders were issued, politicians in Wuhan met for the annual meeting of the city’s People’s Congress, its party-controlled legislature. Over that time, the Wuhan health commission’s daily bulletins on the outbreak said repeatedly that there were no new cases of infection, no firm evidence of human-to-human transmission and no infection of medical workers.

But signs were growing that politicians and government experts underestimated the potency of the new coronavirus. On Jan. 9, a 61-year-old man surnamed Zeng died — the earliest confirmed fatality from the virus. Already, some doctors in Wuhan hospitals were worried enough to warn friends and propose special wards for patients showing symptoms of infection.

Even after Mr. Xi made his first public remarks about the epidemic on Jan. 20, he mostly kept it at the bottom of his public agenda. On the day before the Lunar New Year holiday began in late January, he took the stage at the Great Hall of the People in Beijing and declared his success in guiding China through a difficult year — making no mention of the virus that was already spreading fear throughout the country.

As he spoke, Wuhan, a city of 11 million, was going into lockdown mode, in a desperate attempt to stop the virus from spreading.

Mr. Xi’s first public appearance after the lockdown of Wuhan on Jan. 23 came two days later, when he presided over a meeting of the Politburo Standing Committee.

“We’re sure to be able to win in this battle,” he proclaimed.

But in the days after, he all but disappeared from public view, emerging only a handful of times to preside over Communist Party meetings and to meet foreign visitors, including the director-general of the World Health Organization and Cambodia’s autocratic leader Hun Sen. In the meantime, he directed the country’s No. 2 leader, Li Keqiang, to lead the group handling the emergency, effectively turning him into the public face of the response.

For days, Mr. Xi’s absence from public view fueled speculation that he was trying to shield his own reputation by taking a back seat in the fast-unfolding crisis. In the past week, he has returned to center stage in an apparent effort to swat away such talk.

This past week, Mr. Xi went to a neighborhood center in Beijing, a hospital and a center for disease control in what state media billed as a visit to the “front line” of China’s efforts to combat the epidemic. He has yet to visit Hubei, the province at the center of the epidemic.

A few days later, Mr. Xi fired two top Communist Party officials in Hubei, a move intended to calm simmering public anger and contain the political fallout.

By publishing the Feb. 3 speech now, experts say, Mr. Xi appears to be staking his reputation on the outcome of the epidemic fight.

“What’s really interesting in the speech is there’s a lot of the word ‘I’ in it,” said Mr. Blanchette, of Center for Strategic and International Studies. “This is clearly putting himself at the center of Beijing’s response to this while also falling back on the old excuse of blaming cadres for longstanding pathologies of China’s political system.”

The Feb. 3 speech was published by Qiushi, or Seeking Truth, the Communist Party’s top doctrinal journal. It is rare for such an internal speech to be published in full so quickly.

In the speech, Mr. Xi described the efforts to end the epidemic as a “people’s war” and he singled out two key battlegrounds: Hubei Province, where the infections and deaths have been concentrated, and Beijing, the capital.

He also acknowledged that the epidemic and the fight to curtail it were likely to hurt the economy, slowing production and cooling trade.

In response, Mr. Xi said the government would provide financial support for businesses, help migrant workers return to their jobs and step up support for construction projects. He said the blow to consumer spending could be offset by encouraging spending in new areas, such as 5G phone networks, as well as online entertainment and education.

He also emphasized the importance of taking control of the narrative and winning over public opinion at home and abroad.

“There must be closer monitoring and assessment of opinion, proactively speaking out and giving positive guidance,” Mr. Xi said of Chinese public sentiment.

“Seize the initiative and effectively shape international opinion,” he added.