Coronovirus - Should we panic?
The health authorities in China, by the end of 2019 alerted the world about a potentially new virus that had caused pneumonia in a handful of people in Wuhan since mid-December. The number of cases has since exploded, with more than 600 cases confirmed till this weekend. The virus has been confirmed to be a new coronavirus, in the same family as SARS ( Severe Acute Respiratory Syndrome coronavirus) and MERS( Middle East Respiratory Syndrome coronavirus )
Though the World Health Organization (WHO) has not yet classified the virus as an international emergency considering the low number of overseas cases, however, WHO director-general Tedros Adhanom Ghebreyesus has called it 'an emergency in China'.
The newly identified coronavirus has been spreading in China, and has now reached several other countries. As the number of confirmed cases and deaths continue to rise, health officials are working on all fronts to learn more about the virus and put appropriate measures into place to curtail its spread. Here's a look at what needs to be understood about the virus, now called 2019-nCoV.
What is the present situation ?
Fifteen additional deaths have been reported in Wuhan, where the virus originated, raising the death toll alarmingly, according to the Health Commission of Hubei Province. This news brings the total number of deaths linked to 2019-nCoV in China up to 42, with only three of these outside of Wuhan, The New York Times reported. Nearly 1,300 individuals in China have been infected with the virus to date, BBC reported. In addition to the cases reported in China, reports of the infection have been confirmed in Australia, France, the U.S. and seven countries in Asia.
Should India worry ?
As fear looms over the coronavirus outbreak, the Health Ministry has taken effective steps to discuss the deadly infection and its preventive management in India as 18 people are currently being held under observation. The Ministry also said that it has operationalised a 24X7 call centre to monitor and answer queries regarding novel coronavirus.
The suspected cases in four cities of India have been kept under observation to check for possible exposure to the deadly coronavirus following their return from China. Reportedly, they showed mild symptoms of coronavirus infection, fever, cough and sore throat. As per reports, the Union Health Ministry had informed that the ones in Mumbai, Hyderabad, Bengaluru have tested negative while those in Kerala are still being observed.
India has intensified measures to check passengers for coronavirus. Directions have been issued for multidisciplinary central teams to be sent to the seven states where thermal screening is being done at seven designated airports -- New Delhi, Kolkata, Mumbai, Chennai, Bengaluru, Hyderabad and Kochi.
What is a coronavirus?
Coronaviruses are a large family of viruses that can cause respiratory illnesses such as the common cold, according to the Centers for Disease Control and Prevention (CDC). Most people get infected with coronaviruses at one point in their lives, but symptoms are typically mild to moderate. In some cases, the viruses can cause lower-respiratory tract illnesses such as pneumonia and bronchitis.
These viruses are common amongst animals worldwide, but only a handful of them are known to affect humans. Rarely, coronaviruses can evolve and spread from animals to humans. This is what had happened with the coronaviruses known as the Middle East respiratory syndrome coronavirus (MERS-CoV) and the severe acute respiratory syndrome coronavirus (SARS-Cov), which are known to cause more severe symptoms.
How many people are affected ?
As of now, there are nearly 1,300 cases confirmed and 42 deaths linked to the 2019-nCoV virus in China, according to The New York Times. A second person in the United States -a woman in Chicago is confirmed to have the virus; the first case was confirmed in a man in Washington state. Both individuals had recently returned from Wuhan.
It is being reported that there are now 1,400 confirmed cases of Wuhan coronavirus around the world. There is one new case in Hubei and two new cases in Hainan, according to Chinese authorities,that might push the total in mainland China to 1,362.
How far has the virus spread?
The first cases of the pneumonia-like virus were reported in Wuhan, China on Dec. 31, 2019. Since then, the virus has spread to various other countries, including Thailand, Japan, the Republic of Korea, the United States, Australia, France, among others.
The CDC is also investigating more than 60 people in 22 states of the U.S for a possible infection with the new virus, officials said. Eleven of those people have so far tested negative for the virus. But hundreds of suspected cases are being investigated in countries across Asia, as well as the UK and Mexico.
How contagious is the virus?
It is too soon to know how easily the virus will spread. It is airborne and can be transmitted between people. Chinese authorities have presented evidence of fourth-generation cases in Wuhan and second-generation infections outside of the city.
The World Health Organization heard the preliminary calculations for the average number of infections that each infected person may go on to cause, known as R0. This is estimated to be 1.4 to 2.5 people per infected person. In comparison, seasonal flu usually has an R0 of around 1.3.
How deadly is it?
So far, 42 deaths have been linked to the virus, which suggests a comparatively low fatality rate. “Most people feel this is somewhere on a spectrum between a relatively mild infection and SARS, which had a very high case-fatality rate,” says Mark Woolhouse, University of Edinburgh, UK. Again, it is too soon to be sure. There are concerns that the virus could mutate and become more dangerous.
The origin of the virus ?
Since the virus first popped up in Wuhan in people who had visited a local seafood and animal market, officials could only say it likely hopped from an animal to humans. A recent genetic analysis suggests that the virus resembles viruses that infect bats and snakes. Researchers believe that it may have resulted from separate viruses in bats and snakes recombining. This could have happened in the wild, but may also have occurred in the market, where the animals have been kept in close proximity to each other.
In a new study, however, researchers sequenced the genes of 2019-nCoV (as the virus is now called), and then they compared it with the genetic sequences of more than 200 coronaviruses that infect various animals around the world. Their results, detailed in the Journal of Medical Virology, suggested that 2019-nCoV likely originated in snakes.
The scientists noted there are two snakes that are common to southeastern China where the outbreak originated: the many-banded krait (Bungarus multicinctus) and the Chinese cobra (Naja atra). However, some experts have criticized the study, saying it's unclear if coronaviruses can indeed infect snakes.
How did the virus transmit from animals to humans ?
Some viruses are known to become capable of transmitting to humans, and this coronavirus is one of those. The study published in the Journal of Medical Virology, revealing the likely snake host, also found that a change to one of the viral proteins in 2019-nCoV allows the virus to recognize and bind to receptors on certain host cells. This ability is a critical step to entering cells, and the researchers said that the change in this particular protein may have helped the virus pass on to humans. This occurs due to a mutation in a gene for a protein. If the virus was secreted in the animals’ faeces, this could have become aerosolised and breathed in, some researchers speculate.
Can the virus spread between humans?
Yes, in limited cases, according to the CDC, but the primary mode of transmission seems to be from animal to human. In terms of how one would catch the virus, the CDC says that human coronaviruses are most commonly spread between an infected person and others via:
—the air (from viral particles from a cough or sneeze);
—close personal contact (touching or shaking hands);
—an object or surface with viral particles on it (then touching your mouth, nose or eyes before washing your hands);
—and rarely from fecal contamination.
Can the virus cause a pandemic ?
In order for this virus, or any, to lead to a pandemic in humans, it needs to:
efficiently infect humans, replicate in humans and then spread easily among humans. Right now, the CDC is saying this virus passes between humans in a limited manner, but they are still investigating.
Should it be compared to SARS and MERS?
MERS and SARS have both been known to cause severe symptoms in people. It's unclear how the new coronavirus will compare in severity, as it has caused severe symptoms and death in some patients while causing only mild illness in others, according to the CDC. All three of the coronaviruses can be transmitted between humans through close contact.
MERS, which was transmitted from touching infected camels or consuming their meat or milk, was first reported in 2012 in Saudi Arabia and has mostly been contained in the Arabian Peninsula, according to NPR. SARS was first reported in 2002 in southern China with no new cases have been reported since 2004 and is thought to have spread from bats that infected civets. The new coronavirus was likely transmitted from touching or eating an infected animal in Wuhan.
During the SARS outbreak, the virus killed about 1 in 10 people who were infected. The death rate from 2019-nCoV isn't yet known, although most of the patients who have died from the infection have been older than 60 and have had preexisting conditions. However, more recently, a young healthy man died in Wuhan, raising concern that the virus might be more dangerous than thought, according to The Washington Post.
What are the symptoms of the new coronavirus ?
Symptoms of the new coronavirus include fever, cough and difficulty in breathing. These symptoms are similar to those caused by SARS, according to a recent study published in the journal - ‘The Lancet’.
Despite sharing some symptoms that were similar to SARS, there are some important differences, such as the absence of upper respiratory tract symptoms like runny nose, sneezing, sore throat and intestinal symptoms like diarrhea, which affected 20% to 25% of SARS patients, lead author Bin Cao, from the China-Japan Friendship Hospital and the Capital Medical University Beijing, said in a statement.
How is it diagnosed ?
Health authorities in China have sequenced the genome of the virus and have shared this information, allowing groups around the world to be able to test for the virus. Since there are no specific antiviral treatments for the infection, those affected with the virus are treated for their symptoms.
The healthcare provider may order laboratory tests on respiratory specimens and serum to detect human coronaviruses. Laboratory testing is more likely to be used when there is severe illness or a suspected infection.
How to treat it?
There are no specific treatments for coronavirus infections and most people will recover on their own, according to the CDC. So treatment involves rest and medication to relieve symptoms. When mildly sick, taking plenty of fluids and rest may help but consulting a healthcare provider at the earliest is essential.
There is no vaccine for the new coronavirus but researchers at the U.S. National Institutes of Health confirmed they were in the preliminary stages of developing one. In addition, the drug company Regeneron announced that it is in the early stages of developing a treatment for this virus, according to NBC News.
What is being done to stop the spread ?
The Chinese government has suspended most of the travel to and from Wuhan as well as 12 other nearby cities, according to The New York Times. This "lockdown" affects about 35 million people, the Times reported.
Major airports in countries including the U.S, Turkey, Africa , South Africa, Kenya, Nigeria and India are conducting screenings to make sure incoming passengers aren't infected. However, latest information from the U.S. officials is that they are currently reevaluating the effectiveness of this screening.
The CDC also recommends avoiding nonessential travel to Wuhan. Most countries have directed all non-emergency personnels and families to leave Wuhan, as per the reports.
What to expect in the coming days?
Looking at what happened with MERS and SARS, it's likely that some spread of the virus from close contact between humans will continue to occur, according to CDC. More cases in different countries will likely be identified in the coming days.
How can people take precautions ?
If travelling to Wuhan, one should avoid contact with sick people, avoid dead or alive animals, animal markets or products that come from animals such as uncooked meat, according to the CDC. One should often wash hands with soap and water for at least 20 seconds, they cautioned. If a person is infected by the virus, he can take steps to help avoid transmitting it to others such as isolation at home, separating oneself from other people in the house, wearing a face mask, covering coughs and sneezes and washing your hands as per the guidelines.
People who travelled to Wuhan and became sick with fever, cough or difficulty in breathing within the following two weeks should seek medical care right away, and inform medical staff about their recent travel.
(Chairperson CSA, Sr Dir FWO, Editor- The Intl Journal, Director- TGL)