The coronavirus (COVID-19) that originated in Wuhan, China, is affecting the lives of literally billions of people around the world. Speculation about its origins and its potential to sicken and kill people has been rampant. Some of this has been fueled by China’s lack of transparency about how bad it was/is in China. And there still exists a credibility problem with stats coming out of China.
China seems to be an incubator for these types of epidemics. From the Spanish Flu of 1918-19 to the SARS outbreak some years back, the last hundred years has seen a series of viruses originate in China with the potential to be pandemics.
Just how bad is this particular outbreak? Where did it actually originate? What are the mortality rates? Just as smallpox decimated the Native American population because of a lack of resistance to it, does this virus have a similar potential with different genetic populations around the world? Once a person recovers, is re-infection possible?
To even begin to approach answering these questions, much data is needed. And therein lies the problem.
The virus was first noticed in November. This appears to be accurate although the Chinese doctor who first identified COVID-19 has now died from the illness. His revelations about the virus were, at first, suppressed by the Chinese government. It is unclear why they did this. Most likely, they were concerned about the potential economic effects.
At this point less than four months worth of data exist. This is not a lot to build a treatment regimen on or to be able to forecast long-term effects and scenarios. However, data does exist. And this provides a ground floor from which to begin creating strategies for containing the epidemic. Will it become a pandemic? Only time will tell.
According to bnonews.com, there are currently 79,756 confirmed cases worldwide, including 2,628 fatalities. The vast majority are located in the province where Wuhan is.
Outside of China and the Diamond Princess cruise ship, the next country with the largest number of cases is South Korea with over 800. The huge majority of these have been traced to one woman, who appears to have been asymptomatic while she was attending church services in a very crowded venue. More than 1,000+ people routinely attend services there. Worshippers in the church are encouraged to be full-throated in their singing of hymns. Most of the 800+ cases appear to have originated with this woman.
This leads to one of the conclusions reached by those studying the outbreak. Crowded areas with relatively poor air circulation seem to be breeding grounds for new sources of the infection. Originally the virus was thought to have originated in a Wuhan seafood market. However, more careful research now indicates that most likely someone who was a carrier of the virus attended the market and infected one or more people there. After this the crowded conditions of the market allowed for a quick and exponential spread of the illness.
Asymptomatic spread of the infection is another problem. More than one instance of this has been identified. Reuters reports on one such case,
This is scary. How many “Typhoid Mary’s” are there? It seems (from various reports) that people can be carriers, yet show no symptoms for weeks. They can pass it on without showing signs of illness themselves.
This makes a 14-day quarantine period seem arbitrary. Another issue is the number of false negatives that are being returned from tests for the virus. Some people have 3, 4, 5 negative tests before a positive test occurs. Apparently the viral load can remain low enough to be undetectable for extended periods.
As reported by the Taiwan News,
The incubation period for the Wuhan coronavirus (2019-nCoV) can last up to 24 days, according to a study by renowned Chinese pulmonologist Zhong Nanshan.
The study finds that the average incubation period of the virus is 3 days but that it can take as little as one day and as long as 24 days for a patient to develop symptoms.
Again the 14-day quarantine period seems not to be grounded in the reality of this illness. One can expect that treatment regimens will be updated again soon. There have already been 6 updates to these regimens.
Another conclusion recently reached is the fact that it does not appear that body contact is needed to spread the infection. It appears at this point that airborne infection can be a method of transmission. As reported by Kyodo News last week,
This conclusion makes the decision of the US State Department to fly 14 infected patients back on the same airplane as healthy passengers problematic. Even though the patients were separated from the rest of the passengers by a sheet, the plane’s air circulation system could be the mechanism for further infections.
Can this be contained? The parameters of this particular infection will make it very difficult to do so. This is considered a “virgin fields” epidemic. That is, if exposed, unless you have genetic protection, you will contract the illness. How severe will depend on your individual immune system and how compromised it may be.
The virus can “hide” inside people, that is, be undetectable for extended periods of time. Asymptomatic people can travel long distances and begin new sources of the infection. We are liable to see “pulses” or “waves” of infection in different areas. Italy seems to be experiencing a bit of this right now with ten towns currently under some kind of quarantine.
Italy has spawned further spread into Spain, its Canary Islands possession, Austria and Germany. Brazil in South America and Algeria reporting cases signals two new regions added to the infection list. The virus has spread from Asia to Europe, North America, Australia and Africa.
Then there is Iran. Who knows just how bad it is there? Rumors abound about the number of cases and the number of deaths. If Iran is not able to contain the infection, it will spread all over the Middle East. At least one case in Canada has been traced back to Iran. Obviously that person returned to Canada via air travel. How many others were exposed within that plane? Where are they now?
This appears to be a possible Spanish Flu level event, in other words, a pandemic. Are we there yet? The answer is an unequivocal “No.” Keep in mind such an event would overwhelm medical systems worldwide. The death rate could approach 5%.
Aggressive and transparent reporting of this by all governments (including the US) is vital. This event will be with us for an extended period of time.