From Coronavirus to coronacrisis, and back

Rolling media coverage and fake news are fueling widespread panic about COVID-19. A sense of perspective might help to allay concerns.

In December 2019, a new illness began making news around the world. Traced to Wuhan, China, scientists quickly discovered that this was a novel coronavirus for which no decisive treatment currently exists. Since then, public fears have grown in line with media coverage and the spread of the virus to different parts of the world.

But are we right to be so worried about the virus now known as coronavirus?

By the numbers

Respiratory infections are caused by bacterial, parasitic and viral agents, with the latter accounting for almost 50 percent of all cases. Their symptoms range from mild to severe and include pneumonia, chronic obstructive pulmonary disease and bronchiectasis.

Excluding tuberculosis, lower respiratory tract infections are the third biggest global killers, resulting in about 3.2 million fatalities per year. Their global disease burden accounts for approximately 95 million Disability Adjusted Life Years.

In addition to influenza, other viruses capable of causing respiratory infection include coronaviruses (CoV). These fall into two categories: seasonal viruses that continuously circulate within the human population; and novel viruses that are primarily zoonotic, meaning they can jump from animals to humans.

It is thought that CoVs account for about 10 percent of total viral respiratory infections worldwide. Infection with seasonal CoV results in flu-like symptoms including fever, muscle aches, cough, sore throat, and tiredness. The illness associated with novel/zoonotic CoV is more severe, primarily due to the lack of herd immunity to these new viruses.

There have been at least two major outbreaks CoVs in recent years. The Severe Acute Respiratory Syndrome(SARS) CoV that first appeared in 2002 resulted in 8,098 confirmed cases and 774 deaths worldwide. Traced to China’s Guangdong Province and attributed to civet cats, most cases of human-to-human transmission occurred in healthcare settings and were due to inadequate infection control. Strict infection practices brought the global outbreak to an end in less than two years.

As with SARS, most cases of the Middle East Respiratory Syndrome (MERS) CoV were hospital-acquired. First identified in 2012, the virus resulted in approximately 2,500 cases and caused 858 deaths worldwide. Originally a novel virus with zoonotic qualities, MERS continues to circulate primarily among the Middle East’s camels. Fortunately, the virus has not spread among human populations with the same ease as SARS.

And then there’s the latest COVID-19 which, at face value, is outstripping SARS and MERS at an alarming rate. At the time of writing, this outbreak had over 50,500 confirmed cases in 26 countries and was responsible for at least 1450 deaths.

Worse still, the attack rate (or transmissibility) of this virus as indicated by its reproductive number (Ro) is worryingly high.

In layman’s terms, this equation is concerned with how rapidly the disease spreads and the average number of people infected by a single person. A recent study suggests that COVID-19 has a Ro of 4.08. By comparison, SARS had a (pre-intervention) Ro of 2.0, while MERS reached 0.7. Outbreaks with a reproductive number below 1.0 gradually disappear.

Fighting back

The bad news doesn’t end there. As things stand, there is no specific treatment available for the new virus despite a combination of anti-viral drugs and supportive care showing promising signs. And while developing a vaccine is an important component of global efforts, gaining international approval typically takes years, as does the production of sufficient quantities to meet demand.

As a daily slew of global media reports suggests, a mixture of containment and strict hygiene remains the frontline measure for COVID-19.

Undeterred, academic institutions, health organisations and pharmaceutical companies around the world are working to develop effective treatment options. To this end, the medical community has high hopes for recent studies showing a combination of interferon-beta and Remdesivir (a broad-spectrum antiviral drug) as effective in treating MERS and other CoVs. There’s understandably less enthusiasm for the growing number of ‘natural’ remedies touted as an effective treatment.

With their large migrant populations and emerging status as global transport hubs, the Gulf States have more than a passing interest in combatting COVID-19. For instance, Qatar’s Ministry of Public Health has joined forces with Hamad Medical Corporation, Qatar University and Hamad Bin Khalifa University to study the evolution of CoV – specifically MERS – in animals and humans. The partnership hopes to identify genetic signatures to better understand the pathogenicity and transmission of these viruses.

To assist, Qatar University has recently acquired the country’s first Biosafety Level 3 Lab for research purposes. This state-of-art facility will be a valuable asset should COVID-19 reach Qatar.

Applying the brakes

With every passing day and casualty, a fearful global public worries that the worst is yet to come. Concerns are fueled by a constant stream of media coverage, some of which includes dire warnings that over 50 percent of the world’s population is at risk of being infected by COVID-19.

Conspiracy theories claiming the virus is a lab-made bioweapon and other examples of fake news are more than unhelpful. It’s time to put things into perspective.

Excessive worrying over COVID-19 draws attention away from a virus that should at least have an equally fearsome reputation.

Each year, influenza – an infection often confused with the common cold – kills between 250,000 to 500,000 people. In the United States alone, influenza accounts for 10-45 million cases per year resulting in 140,000–810,000 hospitalisations and between 12,000 and 61,000 deaths.

When going up against ‘the flu’, COVID-19 looks like a work-in-progress rather than the next big thing.

That said, a sense of perspective should not give way to complacency regarding a virus that World Health Organization Director-General Tedros Adhanom Ghebreyesus recently mentioned in a speech which also covered the recent Ebola outbreak. As he sees it, both underscore the need for countries to invest in preparedness rather than panic.

To date, only three people have succumbed to COVID-19 outside China, a statistic that arguably justifies ‘common sense’ approaches to containment. Time will tell whether ‘more of the same’ benefits healthcare professionals working on treatment options.