The 2019 Novel Coronavirus (SARS-CoV-2) is a new virus that emerged in China in late 2019 and quickly jumped into scientific and mainstream news. When facing a potential pandemic, it can be difficult to share information without inducing panic. There’s no doubt that SARS-CoV-2 presents a significant threat to public health, but as with all viruses in their emerging stages, we often find ourselves with more questions than answers. However, through the work of the World Health Organization (WHO), government officials and hardworking scientists worldwide, we can begin to understand some of the details about SARS-CoV-2.
What is SARS-CoV-2?
On December 31, 2019, Chinese health authorities reported an outbreak of lower respiratory infections in Wuhan City, China. All confirmed cases at that point indicated that the outbreak originated at a market selling live poultry and seafood. Those infected first experience fever and severe cough, along with pneumonia and lung lesions. The virus was quickly identified as a novel coronavirus of unknown zoonotic origin.
Coronaviruses are notable for infecting animals such as cows, chickens and pigs, in addition to humans. Disease-causing coronaviruses often originate in non-human animals and later leap human populations. SARS-CoV, for example, was eventually traced to civets, which were an intermediate step for the virus originating in a species of bats. At this time, the animal origins of SARS-CoV-2 have not been determined.
Coronaviruses get their name from the halo of fringe surrounding their virions, which resemble the solar corona. Notable examples include Severe Acute Respiratory Syndrome (SARS-CoV), which infected over 8,000 individuals and caused 774 deaths in 2003, and Middle East Respiratory Syndrome (MERS-CoV), which has infected almost 2,500 and caused 858 deaths since 2012.
Previous reports referred to the virus as “Wuhan Coronavirus,” “Novel Coronavirus” and “2019-nCoV.” The virus was officially named “SARS-CoV-2” by the International Committee on Taxonomy of Viruses on February 11. The disease caused by SARS-CoV-2 is called “COVID-19.”
How bad is it?
The World Health Organization declared a Public Health Emergency of International Concern on January 30. As of February 20 at 2:00PM CST, WHO reported 75,204 confirmed cases of COVID-19 worldwide. The vast majority of cases been in China. 2,009 deaths have been confirmed, with 3 outside of China. 25 countries have confirmed cases of the virus.
According to CDC, the illness caused by SARS-CoV-2 produces mild to sever symptoms such as fever, cough, and shortness of breath. COVID-19 appears to often be relatively minor for patients without other serious health concerns, especially compared to other coronavirus outbreaks. The fatality rate has fluctuated between 2-4%, though the short period of available data and an unknown number of asymptomatic infections put that number in question. Even so, there is no reason to take the disease less seriously. Any illness affecting the lower respiratory system has the potential to cause damage to the lungs, including acute respiratory distress syndrome (ARDS). A January 29 article in The Lancet found that in a cohort of 99 hospitalized patients, 17 developed ARDS and 11 of those subsequently died. While overall the virus produces relatively low fatality rates, infection can have serious consequences.
The biggest concern at this point is the probability for widespread infection. Estimated R0 values (a measure of the average number of people who will be come infected by a single infected individual) currently range between 2 and 3, which is in the same range as diseases such as SARS and HIV. As Ed Yong explains in The Atlantic, diseases with an R0 value below 1 will likely decline, while those with values greater than 1 will continue spreading. While not necessarily a cause for panic, these early estimates do indicate that SARS-CoV-2 is a serious threat with a high potential for transmission.
There are several factors that give SARS-CoV-2 greater potential for widespread infection. First, it’s a very new disease that only appears to have jumped to humans in the past few months. This means that the whole global population is likely vulnerable, since no one would have the benefit of previous exposure. Second, the relatively low rates of severe illness mean that fewer infected individuals will independently seek medical attention. Many infected people will continue with life as usual, spreading respiratory droplets to everyone they come in contact with.
In an article published on January 24 in the New England Journal of Medicine, researchers from the National Institute of Health in the U.S. and Erasmus Medical Center in the Netherlands explain that low pathogenicity paired with efficient transmission creates prime conditions for an epidemic. They write, “A virus that poses a low health threat on the individual level can pose a high risk on the population level, with the potential to cause disruptions of global public health systems and economic losses.”
What are scientists and health care workers doing about it?
Several countries have instituted travel restrictions and mandatory quarantines upon entry, including the United States, Australia, Indonesia, India, and several others. The United States State Department declared a “Level 4: Do Not Travel” travel advisory for China, the highest level on the scale. Many commercial airlines have canceled flights to China, including US-based Delta Air Lines, American Airlines and United Airlines.
Notable research developments related to SARS-CoV-2 include:
- January 24 – Viral sequence published in the New England Journal of Medicine
- January 29 – Virus successfully cultured from patient samples
- February 5 – CDC releases protocols for qPCR-based detection
- February 19 – Structure of viral spike published in Science
On January 31, a group of 94 journals signed an open-access pledge for all research related to SARS-CoV-2. The pledge also states that all relevant research will be made available on preprint sites and shared with the WHO. The executive editor of NEJM stated on February 13 that they were receiving up to 20 submissions a day related to SARS-CoV-2.
At this time, there are no drugs approved for use against SARS-CoV-2, but several trials are underway. A team based at Emory University announced plans to test a molecule previously shown to inhibit two other coronaviruses against SARS-CoV-2. Another team used Remdesivir, an adenine analog, in the first successful treatment of SARS-CoV-2 in the United States. A team in Singapore is using serum from recovered patients to treat patients in the early stages of the illness, and a patient in Thailand was successfully treated using a combination of HIV and flu drugs. The National Institute of Health has previously stated in a report that they believed a vaccine against SARS-CoV-2 could be available for early human testing within three months.
The best way to protect yourself from infection is always to practice good hygiene, especially washing your hands with soap and water. Cover your mouth and nose while coughing or sneezing, and maintain a safe social distance. If you show symptoms and have traveled to China or might have contacted someone who has recently traveled to China, seek medical attention quickly. As the WHO states in every situation report, the most important objective is to slow human-to-human transmission rates, and keeping yourself safe is a crucial part of that.
Promega is prepared to support scientists in their work towards understanding SARS-CoV-2 and developing drugs to treat the infection. Click here for more information.
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