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Updated Feb 14, 2020
What do you need to know about coronavirus transmission? A new respiratory virus, now named COVID-19, is demonstrating pandemic spread far beyond that of past related viruses. As a scientist, pathologist and traveler, I want people to have access to straight forward, accurate information about COVID-19, the new respiratory coronavirus, originating in Wuhan, China and now spreading to other regions of the world.
The first thing to understand is that Coronaviruses have caused disease outbreaks in people before. MERS and SARS are two related viruses you have probably heard of that also caused respiratory disease outbreaks in recent years.
All of these viruses have one thing in common: they originated in animals and then evolved to infect humans. While scientists don’t know for sure yet what animal was the source for COVID-19, the initial people affected all spent time at an open market selling live animals.
Update: Nature has now reported evidence that the likely source of coronavirus transmission to humans was a protected mammal, the pangolin
|Animal Source of |
* as of Feb 14, 2020
In 2002, SARS was the first human coronavirus to cause severe respiratory disease. It also originated in China, and 20-30% of those infected required mechanical ventilation; 10% died. Of interest, people infected with SARS did not typically have upper respiratory symptoms but developed lower respiratory disease or pneumonia. Scientists believe this occurred because SARS used a particular receptor on cells to infect them, and this receptor (ACE2) is only present in the lung, not in the upper airway.
Fortunately, while SARS hit hard, spread rapidly and widely, due to good public health practices is no longer a concern.
In 2012 another severe Coronavirus infection, MERS, caused an outbreak originating in the Middle East. As of 2019, WHO reports fewer infections with MERS, but more deaths. Most of the cases remain in Saudi Arabia. In short, MERS has occasional smaller outbreaks but has not caused extensive outbreaks like SARS.
COVID-19 (formerly 2019-nCoV)
Now we have COVID-19, first identified on December 31 of 2019. Much is unknown about the virus, other than it is new and probably originated from an animal source. So far, it has spread to at least 19 countries, including most in East and Southeast Asia, Australia, the United States, Canada, and France and Germany in Europe. In the US, there are, for the moment, 15 confirmed cases from Washington, California, Arizona, Illinois and more. Samples from 36 states are pending confirmation.
The spread of COVID-19
We are at the very early stages of this new outbreak. Unfortunately what is concerning can be seen in this graph created by Johns Hopkins CSSE. It shows the exponential growth of cases, particularly in Mainland China since January 19. At that time there were well under 500 cases, but in approximately 10 days that has grown to almost 8000. The increase in case numbers does not seem to be abating, thus setting this outbreak to be much larger and more significant compared to SARS and MERS.
Update February 14: Due to complications in testing the reported confirmed cased jumped on February 13 and it now looks like the number of cases is still growing rapidly.
Johns Hopkins also provides an interactive map that presents a real-time visualization of the case numbers across the globe.
So how can a person be best informed regarding the facts of this brewing pandemic? In my opinion, the best place to go for reliable information is the Center for Disease Control’s (CDC’s) Website. They update their information every Monday, Wednesday, and Friday and present it in a clear and readable format.
To fly or not to fly
Airlines are heading the concern and canceling more and more flights. Likewise, countries with inbound flights from CHina are upping their screening or even quarantining passengers.
Update January 31, 2020 – WHO is now calling this outbreak a world health emergency and the CDC has elevated it to a Level 4 situation and is recommending NO travel at all to China.
If you have a ticket to China and your flight has not been canceled what should you do? The CDC says don’t go for any reason. Take this advice seriously. To put it in perspective, last summer, when the Ebola virus crossed from the Democratic Republic of the Congo (DRC) into Uganda, the CDC and WHO did not make a comparable travel recommendation.
But this disease is different. Unlike Ebola that spreads from person to person via bodily fluids/blood, COVID-19 is a respiratory virus and likely spread by air or touch. Ultimately, it is probably safest to avoid planes as much as possible for the next few weeks. Fortunately, coronaviruses do not survive well on surfaces; therefore, hand-washing can be pretty useful. But there isn’t much that can protect a person from the aerosol coronavirus transmission, or breathing in the virus if it is present in the air.
Masks won’t help
Don’t rely on a mask. Please. Most masks won’t protect you from coronavirus transmission. The only kind that will block out airborne viruses is an N95 respirator mask. These need to be correctly fitted and are very uncomfortable to wear for a long time. The N95 respirators are not practical. The typical surgical masks you often see people wearing won’t work because they are too loose-fitting. If you want more details on masks, NPR did a very thorough story on the usefulness – or uselessness of masks to prevent 2019-nCoV infection.
The bottom line
- Do not travel to China.
- Keep up to date by going to the CDC website.
- If you think you may be infected, call your ER before you go in so they can protect other patients from possible infection.
- Don’t panic., just be smart.
- Go to the CDC website for up-to-date and accurate information
Images from Shutterstock