Coronavirus — eight of the biggest questions
Here’s one: Has a vaccine been developed yet?
There are lots of things we still don’t know about the new coronavirus, COVID-19, which has claimed 1,000 lives in China and sickened 13 people in the U.S. — including seven in California, with a new case reported Monday in a person evacuated by plane from Wuhan and quarantined in San Diego at the Marine Corps Air Station Miramar.
But we’re learning fast. Emerging research is bringing us closer to answering these key questions:
Where did the virus come from?
A new genetic analysis from South China Agricultural University suggests that the virus jumped to humans from pangolins — long-snouted mammals often used in food and traditional Chinese medicine.
If verified, the pangolins may just be an intermediate host. The virus probably originated from bats. But bats hibernate in winter, so it’s unlikely that they directly infected people.
It’s possible that a bat virus and pangolin virus combined during viral reproduction, then infected people. It’s also possible that pangolins are just one of multiple intermediate hosts, and other animals are also to blame.
How fast does the virus spread?
Currently between 1.4 and 2.5 people, on average, catch a disease from one contagious person.
Transmission is influenced by how much a person coughs and sneezes — and how much virus is in the secretion. If you cough and sneeze a lot, you’ll expel more virus and infect more people. But if you’re so sick that
you can’t leave your bed, you’ll be more isolated and will spread less disease.
Source: Dr. Amesh Adalja, infectious disease specialist, Johns Hopkins Center for Health Security
What makes you sick?
The virus may trigger a severe immune overreaction, called a “cytokine storm.” A cytokine storm is an overproduction of immune cells and their activating compounds, or cytokines, which triggers a surge of immune cells into the lungs, where they cause inflammation.
Viruses that have coevolved with humans over a long time typically trigger less inflammation. But this virus is new. Source: Jan Carette, associate professor of microbiology and immunology, Stanford University
Why do you die?
The respiratory tract — from the nose and tonsil crypts all the way down to the lungs — is an excellent portal of entry for a virus.
The resulting lung inflammation and fluid buildup can lead to breathing distress. It also sets the stage for a secondary bacterial pneumonia. And if the lungs are already damaged from smoking, age or other infections, then they’re much more susceptible to a harmful pathogen.
When combined with chronic lung disease, the two problems cause more rapid decline in lung function and are more likely to cause rapid, permanent injury. Source: Dr. Jack Coleman Jr., senior medical director
of the Lung Health Institute
Why doesn’t everyone die?
Deaths so far suggest that the new coronavirus has a fatality rate around 2%. That’s more than seasonal flu, which kills fewer than 0.1% of those it infects. But it’s less than SARS’ 10% — and not nearly as fatal as MERS (Middle East respiratory syndrome coronavirus), with a 37% death rate.
But it’s likely an overestimate, since mild cases aren’t being counted. People who feel minor aches and pains don’t go to doctors. So we really don’t know the full spectrum of illness.
We need to start detecting the mild cases, so we learn the true burden of disease. But we also need to understand the risk factors
for severe disease, so we can focus our efforts on protecting and caring for those patients.
Source: Dr. Amesh Adalja, infectious disease specialist, Johns Hopkins Center for Health Security
If you survive, are you immune?
People who are infected and then recover will likely show some immunity to the virus.
But it’s not lifelong. It wanes over time. If it’s seasonal, it may ebb and flow.
Source: Dr. Amesh Adalja, infectious disease specialist, Johns Hopkins Center for Health Security
What drugs are being tested?
The world of antiviral drug research is growing quickly. The drug now being tested in China for effectiveness
against the new coronavirus, called remdesivir, comes the Foster City-based pharmaceutical company Gilead Sciences. It’s an antiviral medication that was developed to treat Ebola.
Modern medicine has made huge inroads against once-fatal and chronic infections like HIV. With successful medications, coronavirus could be eradicated.
Source: Fred Cohan, professor of biology, Wesleyan University
Can a vaccine save us?
The first vaccine targeting the virus could be available in 18 months, World Health Organization chief Tedros Adhanom Ghebreyesus said in Geneva on Tuesday. In Washington, D.C., Dr. Anthony Fauci, director of the National
Institute of Allergy and Infectious Diseases, estimated it would take at least a year.
On Tuesday, the U.S. Department of Health and Human Services announced that it is partnering with New Jersey-based Janssen Research & Development to share research, development costs and expertise to accelerate Janssen’s investigational vaccine into clinical evaluation.
Janssen also will work on the scale-up of production and manufacturing facilities needed to make a vaccine in bulk.
Companies lost a lot of money trying to produce a vaccine during the Ebola outbreak. Once a crisis fades, they are left with the enormous costs — and no market.
Source: Reuters and Department of Health and Human Services