Title Photo: 3D rendition of a SARS-CoV-2 virion (virus particle). Picture source: Wikipedia.
News about the novel coronavirus are stressing the world. Just yesterday, the WHO declared a pandemic after all. While numbers of newly confirmed cases in mainland China are gradually decreasing, many countries are announcing more and more cases in their territories.
Spreading quickly, the virus had already caused more casualties within only a few days after the outbreak was made public than SARS did in 2002/2003. As SARS-CoV-2 is a new virus, it is hard to predict the course it is going to take.
We are even more connected than we were seventeen years ago, both through social media as well as international travel. You might have heard about infections not too far away from where you live. Yet, what does this mean? Will this affect you and your beloved ones? How should we react?
I’m not sure how you are doing, but living in Japan made me experience the spreading of a virus much closer than SARS, H1N1, or Ebola ever did. Navigating through the situation, I collected a bunch of information. Naturally, I’m neither a health professional nor do I work in crisis management. Yet, as all the knowledge helped me to keep my cool, I hope you’ll find this article series useful as well.
First of all, I’m offering explanations on the virus itself, the symptoms of the disease, as well as the pandemic in a global context. In the next piece, you’ll get six tips summarizing what you can and should do to face the novel coronavirus. I’ve got other articles in planing, following up on other aspects of the situation.
Let’s tackle this as a community—cautiously, but calmly!
Where did the virus come from?
So far, it is not for certain what the exact origin of this novel coronavirus is, though the spillover (the incident of a virus jumping from animals to humans) probably happened at a wet market called Wuhan Huanan Seafood Wholesale Market [武汉华南海鲜批发市场]. Like other Chinese wet markets, it sold fresh fish and meat, thus the name ›wet‹, but also live animals and exotic wild game, before it was closed on January 1st.
Coronaviruses are quite common in animals and occasionally mutate into a strain that affects humans as well, which is called zoonosis. These viruses often originate in wild animals—typically bats or birds—and can transfer to life stock, that is then eaten and in close contact with farmers.
For both SARS as well as MERS, for example, bats have been the virus reservoir (or ›natural reservoir‹), the origin of the virus. SARS was traced back to a population of horseshoe bats in the Chinese Yunnan province, who have transmitted the virus to masked palm civets, weasel-like mammals. These civet cats were sold alive at a wet market in Guangdong, the Chinese province bordering Hong Kong. MERS had dromedaries as intermediate hosts, who carried the virus for at least two decades before it affected humans.
Bats are the most likely candidate for being the natural reservoir for SARS-CoV-2 as well. Rumors it could have come out of the National Biosafety Laboratory in Wuhan, which is part of the Wuhan Institute of Virology, have been condemned by the scientific community. Multiple scientists from several countries have proven that SARS-CoV-2 originates from wildlife. This also debunks rumors circulating in China, the virus could be an attack against the People’s Republic by the US.
As for the intermediary species, pangolins (endangered scaly anteaters, who are still sold illegally in China despite a ban from 2017), civet cats again, or pigs could be possible. Snakes were discussed as well, but it is highly unlikely that a virus is transmitted from cold-blooded to warm-blooded hosts.
What are ›SARS-CoV-2‹ and ›COVID-19‹?
›Novel Coronavirus‹ means that it is a newly identified type of coronaviruses, a virus family that causes diseases in animals and that can mutate to affect humans as well, as I have just explained. ›Corona‹ is Latin for ›crown, halo‹ and refers to the shape of little ›nobs‹ on the surface of the virus particles (virions). The virus strain itself is now known as ›SARS-CoV-2‹ (Severe Acute Respiratory Syndrome Coronavirus 2), the disease it causes ›COVID-19‹ (Corona Virus Disease [from] 2019).
These terms were determined by the WHO (World Health Organization) and replaced initial names such as ›Wuhan-SARS‹ or ›WARS‹, ›Wuhan Virus / Coronavirus‹ or ›Wuhan Seafood Market Pneumonia Virus‹, as well as ›nCov‹ or ›2019-nCov‹. The outbreak started at the beginning of December 2019, in Wuhan City, the capital of the Eastern Central Chinese province Hubei.
From Wuhan, the virus spread quickly to Hubei and every province in the People’s Republic of China. First international cases were singular, swiftly contained, and connected to people who had been in affected areas. However, we’ve got many so-called community outbreaks by now, which means that patient zero—the first person of an infection chain—can not be linked directly to the epicenter of the outbreak.
What does it mean that it is a Pandemic?
Neither SARS, MERS, or Ebola have been pandemics. (Most sources I’ve checked, at least. Some consider SARS to have been one.) The last pandemic we have overcome was the one with H1N1, commonly known as the ›swine flu‹, in 2009/2010. An estimated 700 to 1400 million people were infected worldwide. Ongoing pandemics are the common cold, the seasonal flu (influenza), and HIV/AIDS.
The difference between an epidemic and a pandemic lies not only in the number of cases but in the ways a virus is spreading as well. ›Epidemic‹ means ›effecting the whole people‹ (of a nation), from Greek ›epi‹ (among, upon) and ›dēmos‹ (people, district). An epidemic still suggests a limitation to certain areas, though, whereas a pandemic, with ›pan‹ meaning ›everywhere‹, reaches deep into societies worldwide.
Even when countries such as South Korea, Italy, and Iran had entered an epidemic phase, it hasn’t been a pandemic at first. Cases were singular or cluster cases, which could be traced back to Chinese tourists, for example, and were relatively contained. We could overlook these cases clearly, even when the numbers were high such as among believers of the religious sect Shincheonji [신천지] Church of Jesus in Daegu, South Korea or on the Princess Diamond cruise ship at anchor in Yokohama harbor, Japan.
But when confirmed cases appeared on every continent of the world but Antarctica and community outbreaks became a common thing, some officials started to speak of the early stages of a pandemic. Frankly, I’ve been struggling with why it took the WHO that long to announce the pandemic status. The word itself changes nothing for the given situation in each effected country, but it allows us to face the truth: The virus is here and it is now not a question of if but how we all deal with it.
It is not like nothing can be done anymore. On the contrary, the way we are treating this crisis and how much each and every one of us is willing to contribute can very much shape the course the pandemic is taking from now. We have to work together to slow down the virus in the speed it would naturally take.
This is called ›flattening the curve‹: When the same amount of infections occur over a longer period of time, our health systems can cope with the pressure. But when there are too many patients at once, a health system is reaching a critical point and not everyone can receive the help they need. That’s what happened in Wuhan and it is happening in some parts of Italy right now. Be aware that this has nothing to do with China or Italy, it is simply how viruses work.
What we need to do lies right between panicking and not giving a shit at all. The impact on the human body is pretty measurable by now and it is not a killer virus that is wiping us off the earth, so let’s keep it together, folks. But if we do nothing, we would be putting more vulnerable people at risk and our health systems would crack.
How SARS-CoV-2 can be contracted?
SARS-CoV-2 can be transmitted through contact and droplet infection. It is not airborne, meaning that the virus particles are not staying in the air after someone has breathed them out. Your pets won’t be carriers either, despite rumors they could be. (Please cuddle them dearly!) Neither will imports from China.
The virus attacks the airways (respiratory tract) and spreads by coughing, sneezing, speaking, kissing and so on, as well as by shaking hands and touching each other. Virions are also transmitted from our hands to surfaces we touch, where others can pick them up.
But don’t be anxious about your surroundings suddenly being all contagious. If you have seen images of public areas being widely disinfected, be aware of where these pictures come from. The actions that were necessary in Wuhan, for example, are not needed in your hometown, even if there are some confirmed cases.
Personal hygiene is a key measure to minimize the risk of infections—not just of the novel coronavirus. Wash your hands regularly and thoroughly or sanitize them when you can’t wash them. Also, avoid touching your face as much as possible. Like many others, this virus is a bit ›lazy‹. It needs you to carry it to your nose and mouth.
It seems like infections through the eyes are also possible, so avoid touching them as well. And don’t forget to clean objects that are in contact with your face, such as your cellphone and your glasses. But more on these measures in the next part of this mini-series.
The incubation period, the time between contracting a virus until symptoms appear, lies between 2 to 14 days. However, a few exceptional cases had a longer incubation period of up to 27 days. Unfortunately, though less likely, SARS-CoV-2 can be transmitted even before someone is showing symptoms.
But please don’t panic. The likelihood of contracting this novel coronavirus is still relatively slim. Especially, if you haven’t been in affected areas such as Hubei (China), Daegu (South Korea), Lombardy (Italy), or Heinsberg (Germany), etc. yourself or if you haven’t been in direct contact with someone who has.
Car crashes, diabetes, HIV, or the seasonal flu, for example, are so much more likely to affect you. We have learned to integrate these threats into our daily lives by acting appropriately and not to worry too much. That’s how we can deal with COVID-19 as well. Let’s learn what to do while not forgetting to enjoy the upbeat parts of our lives.
What are the symptoms of COVID-19?
With mild symptoms, you probably have a sore throat and an elevated temperature, which can fade after two or three days. For moderate or more serious cases, significant signs for COVID-19 are a dry cough, shortness of breath or difficulties breathing, as well as a fever and overall fatigue. Less common are chills, limb pain, headaches, a blocked or running nose, and diarrhea.
If you are suspecting you could have contracted the novel coronavirus, please call your doctor or your national emergency hotline for COVID-19. They will tell you what to do. Don’t go straight to a medical practice or hospital. They can get overcrowded with people who don’t need care or you could infect others.
As the name ›SARS-CoV-2‹ or ›Severe Acute Respiratory Syndrome Coronavirus 2‹ states, this coronavirus affects the respiratory tract (airways) severely (people can die) and acutely (directly as in not with a delay such as HIV, for example). The virions (virus particles) travel into the lungs, where they can cause pneumonia (inflammation of the lungs).
This inflammation leads to a swelling in the lung membrane, caused by the immune system fighting the infection. Unfortunately, this can limit or even shut down the transmission of oxygen into the bloodstream. Modern healthcare can deal with these conditions in intensive care. Yet in severe cases, patients can succumb to COVID-19 or a secondary viral or bacterial infection, that attacks the weakened body.
As mentioned before, this affects mostly people in an elderly age or with previous health issues such as heart problems, high blood pressure, diabetes, or cancer. Due to limited defense mechanisms in a body, diseases can’t be fought off as successful as usual. (This, by the way, is why you should never visit someone in a hospital when you are not feeling well.)
The majority of people contracting the novel coronavirus, though, only experience mild to moderate symptoms. There are also asymptomatic infections, where people carry SARS-CoV-2 but don’t have symptoms, meaning they don’t develop the disease COVID-19.
Less than 20% of the confirmed cases become severe or critical. But taking mild, undiagnosed cases into account, the percentage is likely to be even smaller.
What is the course of this coronavirus?
There is so much not for certain about SARS-CoV-2 and COVID-19 yet. Take the mortality rate, for example, the percentage of how many people die from an infection. We know that it is higher than the one of the seasonal flu but much smaller than the one of the other coronaviruses SARS (10%) and MERS (34%).
We will have to wait for definite numbers. Recent analyses show an average 2.3% death rate in the People’s Republic of China with a higher number in Wuhan and smaller rates outside of Hubei province. Outside of China, the mortality rate should be significantly under two percent as there are fewer cases to manage and we are better prepared.
Scientists are working on vaccines, which won’t be available earlier than a year from now, and on therapeutic agents (medications), which optimistically could be available rather soon. Antibiotics won’t help, by the way, because they are only effective against bacterial infections. All doctors can do for now is treating the symptoms until a patient has recovered.
It is impossible to predict the exact future of SARS-CoV-2 as is a new virus we have only seen for a couple of months. There are two major questions: Whether or not infection rates will go down with warmer temperatures. And how the virus will mutate over time.
Many viruses slow naturally down when temperatures go up as people are less cramped up at home. Yet, like the seasonal flu, they can return in a second wave when the months get colder again. Another scenario is that the virus does not lose speed and ›rolls through‹ the year.
Viruses change over time and as a matter of fact, the SARS-CoV-2 strain already has slight mutations. It could get more contagious or severe like the ›Spanish flu‹ did hundred years ago—it was even more deathly in the second year. But it seems more likely that it could become weaker as a virus’s main goal is to spread and survive, not to kill as many hosts as possible.
Whatever the future may bring, please stay healthy, be safe, and be considerate towards others!