Gone viral
How serious is coronavirus?
It started in a live seafood market in Wuhan, a city of more than 11 million people in the central Chinese province of Hubei.
Since the latest coronavirus strain was discovered in December, at least 440 have been detected in China, mostly in Hubei. Nine people are known to have died in Hubei, and others, including a health worker, are critically ill.
The virus has spread to South Korea, Japan, Thailand, Taiwan and the United States, where the first case was confirmed yesterday.
Health authorities in Brisbane are monitoring a recent arrival from Wuhan who is suspected to have the virus. No cases have yet been detected in New Zealand.
So far, the World Health Organisation has not recommended trade or travel restrictions, but its officials were meeting last night to discuss the outbreak, and whether to declare a public health emergency.
What is coronavirus?
Coronaviruses are a broad family of viruses that cause respiratory illness.
They are mostly found in animals – only six have previously been identified in humans, including Sars-CoV, which led to the deadly Sars (Severe Acute Respiratory Syndrome) outbreak in 2003, and Mers (Middle East Respiratory Syndrome) in 2012. This new virus, known as 2019-nCov, brings that tally to seven.
What are the symptoms?
Common signs of infection include fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe respiratory illness, kidney failure and death.
Why is it called a coronavirus?
Corona comes from the Latin for crown or halo. Under a microscope, the virus has spikes that protrude from its membranes, resembling the Sun’s corona.
How serious is it?
Scientists have unlocked the genetic code of the virus in ‘‘record time’’, with co-operation from China, according to Robert Booy from the National Centre for Immunisation Research and Surveillance at the University of Sydney.
But it is still unclear how easily and rapidly the illness will spread. So far, the outbreak has been milder and slower than was the case with Sars.
Almost 800 people died from Sars, out of about 8000 cases. Mers has been even more deadly, with about 35 per cent of cases resulting in death.
However, viruses can mutate into more dangerous and contagious forms, and it’s too early to say what will happen with this one.
What do we know about the spread of the virus?
One challenge in investigating – and stopping – the virus is how much information Chinese authorities share about its spread. To control the outbreak, it’s critical to know whether cases being found in other cities are all related to Wuhan. If the disease has been circulating independently in other parts of China, that information will not only affect how China acts to contain it, but how other public health agencies in the world seek to prevent its spread.
What’s being done to stop it?
‘‘With global travel, the spread of any infectious disease is literally a plane ride away,’’ says Robert Glatter, an emergency physician at New York’s Lenox Hill Hospital.
However, he says we should not lose perspective. ‘‘It’s more likely that you would encounter the flu compared to the coronavirus. It’s the flu and measles which pose a greater threat to the global community at this time.’’
Airports around the world have stepped up screening procedures in an effort to detect travellers carrying the virus. Those procedures will include
taking temperatures; those with high temperatures could be set aside for additional tests.
Part of the difficulty in screening, however, is that symptoms are similar to flu, which will be found among many travellers during the northern hemisphere winter.
How can it be treated?
There is no specific treatment for coronavirus. Because it is a virus, antibiotics are not effective. Recommended measures are similar to those for colds or flu, such as rest and drinking a lot of fluid.
There is no vaccine yet. Nine studies are examining coronavirus vaccine development.
What is New Zealand doing?
No screening precautions had been put in place in New Zealand, the Ministry of Health said earlier this week.
Director of Public Health Caroline McElnay said the ministry was keeping a close watch on developments ‘‘and has been in frequent communication with the health and border sector to give advice’’. ‘‘As recommended by the World Health Organisation, there are currently no travel or border restrictions to countries to date.’’
She told RNZ yesterday she was in talks with the Institute of Environmental Science and Research and laboratories to get tests for the virus up and running, but was unsure when that would happen. ‘‘Australia has now been able to get that test up and running there, so at the moment we would have to send samples to Australia.’’
Should we be doing more?
Chinese new year begins on Saturday, which is likely to lead to a peak in Chinese visitors to New Zealand over the next two weeks. Almost 51,000 visitors arrived from China in February last year, and in 2018 the figure was almost 70,000.
Professor Michael Baker, a medical epidemiologist at the University of Otago, told RNZ: ‘‘I think we should be very worried . . . the whole world is in the same situation, in that we are short of information and that’s typical of what happens in the early days of an outbreak that looks like it could become a pandemic – in fact, technically, it’s close to being a pandemic now.
Biologist Siouxsie Wiles, of the University of Auckland, has written on her blog: ‘‘One interesting feature of the Sars and Mers outbreaks is that, while most infected people didn’t infect many other people, some became what are known as ‘super-shedders’ – infecting huge numbers of other people.
‘‘So, should we be worried? The World Health Organisation is saying there’s no need for alarm just yet, but there is still so much not known about this virus that things could change very quickly.
‘‘As of Monday, it looked like the virus wasn’t transmitting very well between people, but there are now reports that 14 healthcare workers have been infected from one patient. This could mean super-shedders are starting to emerge.
‘‘If that’s the case, we may well start to see big jumps in the number of cases. But it could also just be a failure in the systems that should be in place to protect healthcare workers from infection. Let’s hope it’s the latter.’’
What happened with Sars and Mers?
In November 2002, the Sars epidemic began spreading through China: over eight months it moved to more than two dozen countries, killed 774 people, and infected more than 8000 people. Health authorities say that ‘‘Patient Zero’’ came in contact with an animal in China’s Guangdong province, which borders Hong Kong.
The virus was finally contained in mid-2003. Healthcare workers made up about 20 per cent of victims in areas heavily hit by the disease, according to the WHO. There’s still no cure for Sars, but the initial outbreak was contained by isolating suspected patients and screening passengers travelling from infected areas, or those suspected of having symptoms.
Mers started spreading in the Middle East in 2012. Scientists say the first infection moved from a camel to a human in Saudi Arabia. The disease is associated with the deaths of 790 people since 2012, the US Centers for Disease Control and Prevention (CDC) reported in 2018. The outbreak was similarly contained by isolating patients.
What precautions should travellers take?
Travellers to China are advised to avoid contact with animal markets, all animals (dead or alive), and animal products, such as uncooked meat.
The WHO has issued recommendations to limit the spread of the virus, which include avoiding close contact with infected people, frequently washing hands, avoiding close contact with sick farm animals, and encouraging people with symptoms to practise ‘‘cough etiquette’’, such as covering the nose and mouth when coughing or sneezing.
Washing hands for at least 20 seconds with soap and water is advised, and the CDC recommends also using an alcohol-based hand sanitiser, containing at least 60 per cent alcohol.
The Ministry of Health advises all travellers who become sick within a month of their arrival in New Zealand to seek medical advice and contact Healthline at 0800 611 116 or a doctor.