Most of us feel at least a bit of anxiety over the latest ‘flu’ challenge – novel 2019 coronavirus (2019-nCoV). This stems primarily from the fact that we have a sense of helplessness about protecting ourselves and loved ones from this unknown. With the loss of trust in so many institutions, we’re also not certain that those charged with keeping us safe are actually doing what needs to be done.
So here’s the good, the bad and the ugly of 2019-nCoV:
So far there have been only eight cases of infection in the U.S. by this new bug It appears that all but one of those have occurred in people who had traveled to Wuhan, China before coming to the states and therefore contracted their illness outside of our borders. The spouse of one of these patients – who had not traveled to China – contracted the disease, which is evidence for the human to human transmission. This raises the greatest concern of all. However, it appears that close contact with an infected person is needed in order to become infected yourself.
It also appears that the mortality rate of this new infection is significantly less than other coronavirus epidemics (SARS and MERS) within the past 20 years. Around 10 percent of those contracting SARS died and 34 percent of those with MERS didn’t survive. Though it’s early with the Wuhan virus, it appears that the mortality rate is 2-3%. Should this hold, understanding that any virus can mutate at any time to become more virulent, it will be a blessing that we don’t see a higher death rate.
When a new coronavirus presents itself, it usually can be rapidly contained because its transmission most often is from animal to human. This allows for much easier isolation of people from the source of infection along with work to decrease the number of vector agents. This 2019-nCoV has demonstrated extremely rapid spread which made it apparent early on that human to human transmission was likely, if not proven quickly. As of this writing, there have been over 14,000 documented cases with the spread of infection including persons who had not traveled to or from China. This makes it much more difficult to isolate, predict and control.
In addition, because viruses are not able to be treated with antibiotics, the care available for those infected is primarily supportive. Treatment consists of mitigating the symptoms with fluids, anti-viral agents and medications for fever and aches. A vaccine is the best form of care to stop the spread and prevent greater numbers of infections from occurring or spreading. With a new virus, however, developing a vaccine that is safe and effective takes some time. The gene sequence of 2019-nCoV was determined very quickly and the CDC has made that information available to all so that manufacturers can work as rapidly as possible to develop that new vaccine. It is likely that we’ll not have this protection available until late summer or early fall at the very earliest.
The World Health Organization (WHO) has appropriately declared that this epidemic is a Public Health Emergency of International Concern (PHEIC). Dr. Tedros, the WHO Director-General, and his team are working overtime to try to contain this current challenge. This requires that all parties in the world share information and cooperate in order to solve this quickly.
China, however, is China. If the past is prologue, there is little confidence that China is sharing all the needed information, especially the number of cases and deaths. There are anecdotal reports that there are thousands of deaths in China that have yet to be reported to the international health community. Bugs are smart and have no respect for international or geographical boundaries. This is precisely why complete candor and sharing of information is vital to an appropriate response and conclusion of this epidemic.
One would think that the WHO would have the benefit of the world’s greatest knowledge and complete participation, especially at emergent times such as this. Sadly, due to politics, that is not the case. Taiwan has shown itself to be extremely responsible and transparent in its actions, especially in the area of medicine and science. Having had the privilege of visiting recently, the capacity of Taiwan to help formulate a vaccine or assist in other ways to help save lives and advance human engagement and intelligence at this time is remarkable.
However, China and other nations refuse to allow the full and equitable participation of Taiwan in the WHO. This increases the danger for all of us and makes global health security in times of crisis that much more difficult. The U.S. has appropriately and rightly supported Taiwan in its stated goal to participate in all international organizations. Ending Chinese political opposition to this is an important step in making the world safer.
Finally, and to put this in context, the average number of deaths from the annual flu in the U.S. is 12,000 – 60,000. This year's estimates are that it will kill 35,000. So, the best thing you and your family can do is to get a flu shot every year. That will be the most helpful for all.