Wuhan Coronavirus

The current outbreak of novel coronavirus (2019-nCoV) was first reported from Wuhan, China, on December 31, 2019. The Huanan Seafood Wholesale Market that sells fish and meat from a variety of animals is believed to be the place of origination of the virus and has been shut down ever since. While the novel coronavirus is a member of the coronavirus family that has never been encountered before, like other coronaviruses, the first transmission has happened from an animal to a human after which human to human transmissions have been confirmed.

A coronavirus is a kind of common virus that causes an infection in your nose, sinuses, or upper throat resulting in cough, fever, and respiratory difficulties. These symptoms may appear 2 to 14 days after you’re exposed to the virus. In more severe cases, the infection can spread to the lower respiratory tract (the windpipe and lungs), and can cause pneumonia, severe acute respiratory issues and can even be fatal especially in older people, people with heart disease, or people with weakened immune systems. Most coronaviruses spread the same way, as other cold-causing viruses do- through infected people coughing and sneezing, by touching an infected person’s hands or face, or by touching things such as doorknobs, tissues, napkins, etc. that infected people have touched.

As of now, at least 425 people in China have died from the virus. Out of the total 20,704 confirmed cases around the world, 20,490 are from China. And the other 214 cases are from 27 other countries and territories outside China, with two deaths- one reported from the  Philippines, and the other from Hongkong. Most international cases are in people who had travelled to China. Concerned about a global outbreak similar to SARS (Severe Acute Respiratory Syndrome- a different coronavirus that spread from China to more than a dozen countries in the early 2000s and claimed 800 lives), many countries have increased screening measures, closed borders, suspended flights, evacuated their citizens and advised citizens against travel to China. And since the unprecedented outbreak of this virus, numerous companies including Google, Ikea, Starbucks, McDonald’s, Tesla, Microsoft have shut their shops or stopped operations temporarily in a bid to prevent the spread.

On the advice by the Emergency Committee, the new coronavirus 2019-nCoV, been declared as a “Public Health Emergency of International Concern” (PHEIC) by the World Health Organisation last week. In only a month since its emergence, more than 20,000 people in China alone have suffered this infection. 99% of the cases are in China. The Chinese government is beginning to pour out billions to provide liquidity as well as credit support and analysts believe that more support for the economy overall is likely to come. The country is known to get things moving fast, at monumental speed in its engineering. We can all see how Wuhan has completed building a 25,000 sq. metres, emergency 1000-bed hospital (Huoshenshan Hospital), in 10 days which is now fully functional and treating patients suspected of contracting the coronavirus. Another new emergency 1600-bed hospital (Leishenshan Hospital), is being built a little away from the earlier said hospital and is likely to be opened tomorrow. These hospitals are quarantined hospitals having all the safety and protective gear in place. There will be all the required medical supplies through other hospitals and factories. 1,400 medical personnel have been flown into Wuhan from the Chinese People’s Liberation Army. Over 20 million masks are being produced in China daily.

Quite naturally WHO is convinced that the unprecedented outbreak is being met with an unprecedented response in China and the country can control the outbreak there. But their concern is that it could spread uncontrollably to poorer countries with weaker health systems and may go unnoticed for some time. And if that happens these countries might lack the tools to spot or contain it and be overwhelmed by such outbreaks. WHO is working closely with global experts, governments, and partners to rapidly expand scientific knowledge on this new virus, to track the spread and virulence of the virus, and to advice countries as well as individuals on measures to protect health and prevent further spread of this outbreak.

WHO’s standard recommendations for the general public to reduce exposure to and transmission of such viral diseases are as follows:

• Wash your hands frequently and thoroughly by using soap and warm water or with an alcohol-based hand sanitizer.
• Avoid close contact with anyone who has fever, cough and flu-like symptoms.
• If you have fever, cough and difficulty breathing seek medical care early and share previous travel history with your health care provider. Avoid travel.
• When coughing or sneezing, cover mouth and nose with flexed elbow or tissue – throw the tissue away immediately and wash hands.
• When visiting live markets, avoid direct unprotected contact with live animals and surfaces in contact with animals.
• The consumption of raw or undercooked meat should be avoided. Milk or animal organs should be handled with care to avoid cross-contamination.

However the care and protection one needs to take in a case where one is diagnosed with this infection is the same when one suffers from cold and fever.

• Do not touch your face with unwashed hands.
• Get plenty of rest.
• Drink fluids.
• Take over-the-counter medicine for a sore throat and fever.
• A humidifier or steamy shower can also help ease a sore and scratchy throat.
• Wear a surgical mask, make sure you have the best fit possible around your mouth and nose.

The playbook for responding to this infectious disease outbreak is relatively simple. You identify cases. If they have symptoms, isolate, monitor and place them in quarantine. Diagnose and treat them. Track down all the contacts of the infected person, and do the same with those people and the same with contacts of contacts, if necessary so you prevent further spread thus limiting the R_0, pronounced “R naught”. R₀ is the basic reproduction number of infection. So it is the average expected number of cases coming from a single case over the course of its infectious period indicating how contagious the disease is. In general, you want to get the R₀ below 1; that’s how you get the disease under control. A new study coming from China reports the R₀ is 4.1, however more reviews on this number are awaited. But if this really is the number, it is a cause of great concern.

Since this infection is viral in nature, there is no specific treatment for the infection. Patients are generally given supportive care for their symptoms, such as fluids and pain relievers. Hospitalized patients may need respiratory support. There is no vaccine yet, but Health Institutes, Biopharmaceutical Companies and Researchers internationally have accelerated efforts on finding effective immunization methods after Chinese academics publicly posted the genetic sequence for the virus. Meanwhile, U.S.-based biotech ‘Gilead’ has struck a partnership with Beijing’s ‘China-Japan Friendship Hospital’ to test out an antiviral drug called ‘Remdesivir’ on actual humans in Wuhan.

The World Health Organization says it is critical to limit person-to-person transmission, spread more education about risk and symptoms, and ensure more rapid testing of possible cases. When such diseases outbreak, paranoia stems from misinformation and ingrained biases fans tension. Hence we should prevent the spread of unverified reports, false cure methods, confusions, claims or conspiracy theories and instead, preventive measures should continue to be taken, and support must be given to health professionals and others who are actively working to battle this epidemic!

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