Coronavirus

What is the coronavirus?

Ever since viruses were known to mankind, human coronaviruses (HCoVs) never garnered attention since they were only known to cause common cold like symptoms in otherwise healthy adults. This perception about HCoVs’ significantly changed during the 21^st century when 2 HCoVs’, SARS-CoV (severe acute respiratory syndrome coronavirus) and MERS – Cov (middle east respiratory syndrome coronavirus) emerged from the animal kingdom causing global epidemics with high mortality rates.

As 2019 came to an end another pathogenic HCoV, 2019 novel coronavirus (2019 – nCoV) was discovered in the city of Wuhan in China. As worldwide paranoia erupts about the deadliness of this pathogen, authorities are struggling to contain and understand it better.

Is an outbreak possible?

The possibility of an outbreak does not seem far fetched as research has just begun and is still nascent. The mobility and pervasiveness of the virus determines the enormity of an outbreak with initial figures estimating the new coronavirus having the capacity to infect anywhere between 1.5 and 3 people on contact with an infected person if stringent containment measures are not undertaken. Viruses like these are transmitted through air when a sick person coughs, sneezes or talks. They can travel only a few feet after being airborne suggesting that they are harder to catch than measles or tuberculosis. How long they can survive after hitting the ground is still being studied. If each infected person passes on the virus and infects two or three others, acceleration at this rate would suffice to cause an outbreak if effective measures are not taken for containment. Measures like identifying and isolating people affected and incorporating effective public health measures may by far be the best containment tactics, a paradigm that was implemented to contain the SARS pathogen in 2003.

Until recently, cases of people being infected outside China have been negligible but new reports suggest more and more people from other countries including the United States have tested positive despite them not having visited China. Cases of infection inside China have also accelerated alarmingly on a rate that far surpasses the SARS epidemic of 2003.

How fatal is the nCoV virus?

Determining the fatality of a new virus is often vigorous. Since the worst affected cases are the ones that are treated first there is no way in completely determining how likely a person would succumb to the virus. Coupled to this is the fact that people who have mild symptoms may never consult a doctor. This increases the possibility of more cases going unreported and skewing the death rate.

Researchers are of the opinion that the fatality of the new found nCoV virus is comparatively lesser than that of SARS and MERS which have a confirmed fatality rate of 1 in 10 and 1 in 3 people respectively. Confirmed reports suggest that less than 1 in 40 people who showed symptoms have actually died from the nCoV virus, majority of them being older men with other health related complications.

But it might not be necessarily true that pathogens having a low fatality rate may mean that they are not deadly. The influenza virus which has a fatality rate of less than 1 in 1000 is responsible for the hospitalization of 200,000 and the death of 35,000 people in the United States.

What are the symptoms?

The time taken for symptoms to develop after a person has been affected by a pathogen is known as the incubation period. Closely monitoring this period is crucial in mitigation and containment of the pathogen. Some pathogens like influenza have a low incubation period of 2 to 5 days causing the person infected to transmit the virus before flu symptoms fully develop. This makes it virtually impossible to detect and isolate people who might have become contaminated. The SARS virus had an incubation period of 5 days and in addition to that a sick person could transmit the virus only after symptoms developed completely. This made it easier for the authorities to identify and contain the virus.

It has been estimated that the new nCoV virus has an incubation period of 2 to 14 days but researchers still do not know if a sick person would transmit the virus before symptoms develop completely. This has become a reason of concern since the virus could elude detection.

How much damage has been done?

Authorities are finding it increasingly difficult to contain an outbreak in a city like Wuhan having a population more than New York City. Wuhan has daily flights to major cities of the world and also has an elaborate high speed railway and domestic airline that connects it to major Chinese cities like Shanghai and Beijing. The situation has dramatically changed from time the SARS virus hit China in 2003. Transportation infrastructure has quadrupled and there is heavy migration of Chinese workers to other Asian and African countries risking them with infection.

Travel restrictions have been imposed and Wuhan is on temporary lockdown but authorities believe it is too late now since almost 5 million people had travelled out of the city owing to the Lunar New Year,   before restrictions were imposed.

The response scene so far

Chinese authorities have responded to the outbreak by completely cutting off transportation in the city. The poultry market which is believed to be the epicenter of the outbreak has also been shut down. Even though WHO officials have lauded the aggressiveness with which Chinese authorities are carrying out response procedures, it has also brought with it its own set of impediments.

For instance the case of 51 year old Wuhan resident, Xiao Shibing sheds much light into the situation that has unfolded because of the lockdown. After suffering from symptoms that resembled a fever, when he finally decided to go visit a doctor he was told that he was suffering from a lung infection and not the coronavirus. When his condition got worse he was not admitted into the local hospital with authorities shunning him away citing an acute shortage of beds and hospital staff.

In the rural areas of Wuhan the condition is even worse with patients lining up on the hospital corridors for days together. Faced with tremendous work pressure doctors are finding it incredibly difficult to cater to the needs of the influx of people pouring into hospitals and local clinics.

Vaccine development

Considerable virus containment can be achieved by the vaccine development. It took researchers approximately 20 months to develop vaccination during the SARS outbreak in 2003 but it was never used since the virus was eventually contained. Researchers hope to learn from past outbreaks and cut the vaccine development timeline further by studying the genome of the new coronavirus.