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WHO declares Coronavirus a Global Health Emergency on Jan 31 2020
Coronavirus has become potentially a pandemic. In matter of just days infections climbed to more than 10,000 cases, more than 200 deaths in China. Outside of China, there are more than 100 cases in 22 countries. Ominously the first local transmission is reported in the USA, as well as in Germany, Japan, Taiwan, Thailand and South Korea. Malaysia has 8 cases, Singapore confirmed 16 and Thailand 15.
In an emergency meeting last night WHO convened a meeting and declared a Global Health Emergency. “The main reason for this declaration is not what is happening in China but what is happening in other countries,” said WHO chief Tedros Adhanom Ghebreyesus. The main concern is the spread to countries which are not well prepared to handle the crisis.
Experts expect the epidemic to rise peaking in 10-14 days. Many nations have evacuated their citizens from Wuhan China. China has mobilised more than 6000 medical personnel to Hubei, building 2 quarantine hospitals in 6 days to tackle the illness. The hospitals are scheduled to open on Feb 5. WHO United Nations agency is not only working with China but also is working with countries everywhere in partnership to activate response readiness.
Researchers are racing to develop a vaccine which could be available 6 months away. They are also find answers to some lingering questions to this rapidly evolving health challenge to contain an epidemic. When are people contagious? How long is the incubation period? How big is the infection spread considering that some cases may be mild or symptomless?
Public Health Concern, Will it be Endemic?
Although more tests are needed, researchers say the new viral strain, is likely a RNA virus targeting a protein ACE2. However, the binding power is less than the SARS virus. Nevertheless the RNA virus has a mutation speed 100x faster than DNA virus eg smallpox. The implication for speed of spread is very significant.
As the official confirmed cases went up 10 fold in a week, will the coronavirus continue to circulate among the population? If containment efforts fail, there is a risk of the virus becoming endemic. Presently, there are many case of infected people with no symptoms, making it extremely difficult to control. If containment fails and it becomes endemic, like influenza, that means a virus outbreak and deaths may occur every year. If the virus mutates, vaccines may not keep up as it would always be steps behind.
According to the World Health Organisation (WHO), symptoms of the pneumonia are mainly fever, with a number of patients having difficulty breathing, and chest radiographs showing invasive lesions of both lungs.
People to People Transmission
What is ominous is that the virus is capable of spreading from person to person as confirmed by the China National Health Commission. The virus spreads through droplets when an infected person sneezes or coughs or direct contact. These droplets could land on surfaces passing on the virus through contact mode as well. As of today, 20 places in all the provinces of China have reported incidence of the virus.
This poses great risk of a pandemic outbreak due the massive people movement before and after the Lunar New Year. Health authorities in several countries have responded by barring, screening movement of people from China as well as imposing a 14 day quarantine on identified contacts with exposure to the virus.
Coronavirus is transmitted through the air and by touch. Initially primarily, it infects mammals and birds. Most coronavirus only cause mild flu-like symptoms like the common cold, but SARS-CoV and MERS-CoV can cause severe life threatening respiratory illness in people. This new 2019-nCoV causes severe inflammatory response similar to SARS-CoV and MERS-CoV.
So far, the fatalities involve immunocompromised patients who have other health problems. The virus can spread by touch, incubation period is usually 3-7 days. Four new test kits are available allowing rapid diagnosis within a day, compared to several days before.
There is no vaccine and effective antiviral treatment for coronavirus infections
China Medical Workers are infected too
The Wuhan Coronavirus (2019-nCoV)
The new coronavirus — a mysterious, pneumonia-like illness, first appeared last month. It has since aroused fear around the region, where memories of the SARS epidemic 17 years ago are still linger. The SARS viral epidemic was a deadly health threat. It began in China too, killing more than 800 people worldwide. Scientists identified the new virus as 2019-nCoV.
This novel 2019-nCoV appears to spread much faster than SARS but it is less lethal. The mortality rate is 2-4% whereas it’s 11% in SARS. Experts believe that the number of cases could be far more than reported. Some cases as symptomless and some are not diagnosed. Researchers at Lancaster University estimate that only 5.1% of infections in Wuhan have been identified.
Chinese krait & Chinese cobra-may be the source of new virus
The virus is likely to originate from wild animals sold at a seafood market. From the genetic code sequence of the virus, it is possible that snakes—the Chinese krait and the Chinese cobra—may be the source of the this new virus, perhaps passed on by fruit bats.
New strain Coronavirus also linked to Fruit bat
Line of Defence
The first line of defence is vigilance. To prevent spread, China has moved to lock down Wuhan and other cities in Hubei. All countries should move to quarantine people who have exposure to the virus for 14 days. Members of the public should practise basic health hygiene such as washing hands frequently. Wear a mask only if you are sick, particularly when you visit the doctor and hospital
Experts have asked the public to wear a mask if unwell, avoid crowded places. Consult a doctor and provide recent travel history openly.
by Yashwini Ravindranath
Born & raised in Malaysia, Yashwini earned her M.D. studying in Moscow's Russian National Research Medical University. With an affiliation towards research, all things coffee and the startup ecosystem, she now contributes articles to GetDocSays View all articles by Yashwini Ravindranath.
