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Coronavirus. Is it time to panic?
Downtown Sydney today felt like a hospital with the number of people wearing face masks. Fear seems to be gripping the world over the new coronavirus outbreak. This environment allows misinformation to spread just like the virus itself and it’s hard for us to know what is credible. The World Health Organisation has now declared the virus a global health emergency, so should we all panic? Start buying masks from Amazon?
This week I asked some top infectious disease experts about where this virus came from, its danger relative to other outbreaks and how best to lower our risk of infection. Here is what I learned.
The virus likely came from bats. How?
Coronaviruses are a large family of viruses. Human coronaviruses can cause mild illnesses like the common cold. However, most coronaviruses infect animals, not people. Nasty versions can evolve and sometimes spread from animals to humans. This new virus (nCoV-2019) is linked to a wild animal market in Wuhan, China in Dec 2019. It has infected 9,800 so far, causing 213 deaths in China and spread to 18 other countries (98 cases and no reported deaths outside China).
Just published research suggests a close relative to SARs (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) which have their origins in bats. What’s up with bats? I asked bat-virus expert Professor Vikram Misra, from the University of Saskatchewan. His answer was fascinating, suggesting a link to stressful conditions at wild animal markets.
Why are bats, good virus hosts?
Our work and that of others suggests that bats have evolved to have a benign relationship with their viruses. The viruses don’t cause obvious disease and the bats retain at least some of the viruses for extended periods of time. The natural resistance of bats to viral disease may be a by-product of the evolution of flight and the high metabolic activity needed to stay in the air. However, this is difficult to prove.
Professor Vikram Misra
How does a virus jump from bats to humans?
Stress upsets the delicate bat-virus relationship causing the viruses to multiply. The viruses are shed in large amounts and have the potential of infecting animals/people with whom they come in contact. The spillover of SARS-CoV and, quite possibly, nCoV-2019, may be examples of this.
In both cases it seems that various animals were captured in the wild and kept in small cages for sale. The animals were adjacent to others that would not be near in the wild. Under these stressful situations if the bats shed large amounts of virus there would be good chance for other animals, or the people attending the animals, to become infected.
Professor Vikram Misra
Is the new Coronavirus more dangerous than SARs or MERs?
Seems to be a milder version, but spreads quicker
Fear gets clicks on the internet - so there’s alot of fearmongering being spread about coronavirus. So the first thing I asked experts was whether this new coronavirus was more dangerous than previous outbreaks (SARs in 2003 and MERS in 2012). A key thing you will hear is something called ‘Case Fatality Rate (CFR)’ which is the proportion of people who die when getting a disease. Although the new coronavirus is spreading faster, the good news is that the CFR has been falling over the past few days with milder symptoms beyond the first cases.
[The new coronavirus] is likely to be more transmissible but it is also likely less severe [than SARs]. As more milder cases are diagnosed, the Case Fatality Rate (CFR) has been falling over the last few days. CFR is based on lab confirmed cases and naturally hospitalised and severe cases are tested first.
Professor Dale Fisher writes, Chair of the Global Outbreak Alert and Response Network at the World Health Organisation.
Other experts confirmed the milder mortality rate when asked if it was more dangerous than SARs:
No. The mortality rate for the novel coronavirus has been between 2 - 3 percent compared with a 9.6% mortality rate from SARS. However, the novel coronavirus does appear to be more transmissible than SARS. (Full answer here)
Professor Julian Leibowitz, expert on coronaviruses from Texas A&M Univeristy
It seems far less fatal than MERs too.
The new 2019-nCoV conronavirus (Wuhan) is more contagious than MERS… However, the case fatality rate for MERS is 35% while for 2019-nCoV is less than 3%. (Full answer here).
Dr Ghazi Kayali, an expert on MERs from Lebanon
Having a lower mortality rate is encouraging but being more contagious is not good and could still result in many more fatalities than previous outbreaks if not stopped.
Older people more at risk
Some media reports suggest that the virus is more likely to impact healthier immune systems via a ‘cytokine storm’, making it more dangerous than SARS. Is that true? I asked Professor Eleanor Fish, a cytokine expert and immunologist from the University of Toronto who responded:
No. It is the elderly who are at greater risk
What precautions can we take?
Let’s get some perspective. Since October 1 in the US alone, at least 15 million people have gotten the flu and 8,200 people have died from it. The techniques to lower your risk of getting influenza are similar to the coronavirus.
Professor Fisher says face masks are important to stop the spread of coronavirus, particularly for health workers, but he gives us 3 pieces of general advice for us to lower the risk of infection:
Social distancing…..the virus travels on droplets therefore can only go 1-2 metres from a cough.
Cough etiquette means covering up coughs ideally with a tissue.
Hand hygiene with soap and water or an alcohol based hand rub is also very important and some would say more important than a mask as people can touch something with the virus and then they touch there mouth or eyes and infect themselves.
Stop touching your face..
I remember a number of years ago having lunch with Nobel Prize-winning immunologist Professor Peter Doherty. We were talking about getting the flu and he gave me a bit of advice that stuck with me “just don’t touch your face”. Why?
Viruses can’t get through our skin - they need to be exposed to mucous membranes (eyes, nose, mouth or cuts). Some objects can carry the virus - like a doorknob, handrail, elevator button or phone. These infected objects are called ‘fomites’. Touching the surface of a fomite acquires the virus on the surface of your skin and when you touch or rub your eye, nose or mouth - exposes your mucous membrane and you acquire the virus.
This is why it's important to wash your hands prior to eating or touching any membranes (e.g. putting on eye contacts). Washing your hands is one of your best protections and one that you have full control over. (Full answer here)
Dr John Brooks an expert on fomites from USDA
So although viruses can spread through the air (droplets can reach up to 2m), it’s more likely you will touch an infected surface in high-traffic public areas. But you only get infected if you then touch your eyes, nose or mouth. So stop touching your face and wash your hands and/or use alcohol sanitizers when you travel..
Will a vaccine be discovered?
Consensus: 100% Affirmative from 6 experts
A vaccine for the new coronavirus will be rapidly discovered for several reasons:
1) the viral sequence is known and the virus will soon be isolated in culture in different labs,
2) technologies exist that allow a rapid vaccine development,
3) the protective antigen of similar SARS coronavirus is known
4) several companies and government organizations have already started to develop such a vaccine in China, Russia, Europe and USA
5) CEPI (Coalition for Epidemic Preparedness Innovations) is committed to fund a part of these projects
6) previous positive experience exists with vaccine candidates already developed against the close SARS virus that were protective in animal models. (Full Answer here)
Professor Frédéric Tangy, a vaccine expert from the Pasteur Institute in France
It seems all experts agree that a vaccine is near certain to be developed but given the safety and testing provisions, it will likely take months to years. Other experts say ‘it may also turn out that we won't need one’ based on the SARs and MERs examples.
Ban the sale of bats in wild-animal markets?
China announced a temporary ban on wild-animal markets in an attempt to stop the spread of the new coronavirus. There have been calls to make this ban permanent. Given that bats have now played a role in multiple virus outbreaks (and looks like this one too), maybe at the very least it’s time for governments everywhere to ban their sale in wild-animal markets. Leave them in their natural habitat - happy, stress-free and avoiding causing global virus outbreaks maybe?
In the meantime, may the facts be with you!
Ben McNeil, Founder of Metafact
January Metafact Review
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Each month we investigate a topic voted by members by asking the world's top experts to review the evidence. Reviews are what you need to know. Read all the reviews here.
We gathered more than 50 of the world’s top researchers in neuroscience and sleep research to share the facts about sleep and health. How much sleep does science recommend? What can a lack of sleep cause? Can you die from a lack of sleep? Can you get too much sleep? This review gives you the latest science-backed intelligence you need to know on sleep and health.
Our January poll results have finished and there was a virtual dead-heat between “Vitamin-C” and “Regenerative Farming”. We will put them on the lists for us to review in the coming months.
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