NOVEL CORONAVIRUS: AN EMERGING NEW PANDEMIC?

“While the trajectory of this (novel coronavirus) outbreak is impossible to predict, effective response requires prompt action from the standpoint of classic public health strategies to the timely development and implementation of effective countermeasures.” – From a Viewpoint feature

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Forewarned is forearmed, so goes a popular saying.  That was what American billionaire Bill Gates seemed to be telling his audience when he talked about epidemics in a discussion that was hosted by the Massachusetts Medical Society and the New England Journal of Medicine in 2018.

While the world was busy lifting children out of poverty and the getting better at eliminating infectious diseases, but “there’s one area though where the world isn’t making much progress,” Gates pointed out, “and that’s pandemic preparedness.”

Business Insider’s Kevin Loria, who covered the discussion, reported: “The likelihood that such a disease will appear continues to rise.  New pathogens emerge all the time as the world population increases and humanity encroaches on wild environments. It’s becoming easier and easier for individual or small groups to create weaponized diseases that could spread like wildlife around the globe.”

Such fierce observation may create some anxiety if not panic to some people.  But the reality is, the world should not be complacent or else it will not be prepared for whatever outcomes the disease may bring.

As Gates points out: “In the case of biological threats, that sense of urgency is lacking.  The world needs to prepare for pandemic in the same serious way it prepares for war.”

If the world will continue the “business as usual” thinking, then history might repeat itself.  Remember the Great Plague of Marseille in 1720?  This last significant European bubonic plague – caused by bacterium Yersinia pestis – killed a total of 100,000 people in the France city.

One hundred years later, in 1820, a cholera had spread to Thailand, Indonesia and the Philippines.  On the island of Java alone, in Indonesia, the outbreak caused the death of 100,000 people.

It was worst in the Philippines.  “The cholera epidemic was spreading like wildfire in towns and villages along both banks of the Pasig River,” said one historical account.  “Eyewitness claimed the cemeteries were overflowing with bodies and dead bodies were being left on the streets.  A rumor went around claiming a person that will bury someone who died in the morning would in turn be buried in the afternoon.”

One hundred years thereafter, the Spanish Flu took over.   Actually, it started in January 1918 and ended on December 1920.  “Probably 50 million, and possibly as high as 100 million (three of five percent of Earth’s population at that time) died, making it one of the deadliest epidemics in human history,” Wikipedia reports.

It’s 100 years since the Spanish Flu happened.  Now, comes the novel coronavirus (2019-nCoV), which was identified by Chinese authorities.  The virus is associated with an outbreak of pneumonia in Wuhan City, Hubei Province.

“Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats,” the US Centers for Disease Control and Prevention (CDC).  “Rarely, animal coronaviruses can evolve and infect people and then spread between people.”

Such as has been seen with SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome).  “When person-to-person spread has occurred with MERS and SARS, it is thought to have happened via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread,” the CDC explains.

Coronaviruses are named for the crown-like spikes on their surface.  There are four main sub-groupings of coronaviruses, known as alpha, beta, gamma and delta.  Human coronaviruses were first identified in the mid-1960s.  So far, seven coronaviruses can infect people, including 2019-nCoV.

“Early on, many of the patients in the outbreak in Wuhan, China reportedly had some link to a large seafood and animal market, suggesting animal-to-person spread,” the CDC reports.  “However, a growing number of patients reportedly have not had exposure to animal markets, suggesting person-to-person spread is occurring.”

In a report carried by Channel News Asia (CNA), President Xi Jinping admitted that China was facing a “grave situation” as death toll from the coronavirus outbreak kept growing.  State-run China Global Television Network also reported that a doctor who had been treating patients in Wuhan had died from the virus.

The 2019-nCov is deadlier than SARS.  “This time I’m scared,” admitted Dr. Yi Guan, who played an important role in tracing the development of SARS and is the director of the State Key Laboratory of Emerging Infectious Diseases at the University of Hong Kong

“Conservative estimates suggest that the scale of infection may eventually be 10 times higher than SARS,” Dr. Yi pointed out.

Unfortunately, the virus is spreading in other parts of the world: Australia, Canada, France, Hong Kong, Japan, Macau, Malaysia, Nepal, Singapore, South Korea, Taiwan, Thailand, the United States, and Vietnam.  

Hours after the United States confirmed its second case, American President Donald Trump tweeted: “China has been working very hard to contain the coronavirus.  The United States greatly appreciates their efforts and transparency.”

But the good thing is: everyone is trying to cooperate.  “Just 10 days after the pneumonia-like illness was first reported among people who visited a seafood market in Wuhan, China, scientists released the genetic sequence of the coronavirus that sickened them,” wrote Carolyn Y. Johnson of The Washington Post.  “That precious bit of data, freely available to any researcher who wanted to study it, unleashed a massive collaborative effort to understand the mysterious new pathogen that has been rapidly spreading in China and beyond.”

That’s a good news, indeed. “The pace is unmatched,” Dr. Karla Satchell, a professor of microbiology-immunology at Northwestern University Feinberg School of Medicine, was quoted as saying.  “This is really new.  Lots of people (in science) still try to hide what they’re doing, don’t want to talk about what they’re doing, and everybody out there is like: This is the case where we don’t worry about egos, we don’t worry about who’s first, we just care about solving the problem.”

Dr. Ivan Hung, chief of infectious diseases division at the University of Hong Kong, sees the brighter side in all of these.  He said the ability to rapidly identify the virus in patients should help authorities to counteract its spread.  “So far, the virus is behaving in a less lethal manner than SARS,” he was quoted as saying by a daily.

The Geneva-based World Health Organization (WHO) says the common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties.  In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.

There is still no specific cure or vaccine available against 2019-nCoV.  Right now, what can people do is to prevent it from spreading and getting the virus.  WHO’s standard recommendations for the general public to reduce exposure to and transmission of a range of illnesses are as follows:

· Frequently clean hands by using alcohol-based hand rub or soap and water for at least 20 seconds;

· Avoid touching eyes, nose or mouth.  When coughing and sneezing, cover mouth and nose with flexed elbow or tissue; throw tissue away immediately and wash hands;

· Avoid close contact with anyone who has fever and cough;

· If you have fever, cough and difficulty breathing, seek medical care early and share previous travel history with your health care provider;

· When visiting live markets in areas currently experiencing cases of novel coronavirus, avoid direct contact with live animals and surfaces in contact with animals;

· The consumption of raw or undercooked animal products should be avoided.  Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices.

· While traveling, if you choose to wear a face mask, be sure to cover mouth and nose; avoid touching mask once it’s on.  Immediately discard single-use mask after each use and wash hands after removing masks.

· If you in an unfamiliar place, eat only well-cooked food.  Avoid spitting in public.

(Photos taken from the net)