Coronavirus outbreak – update on UK preparations
The virus 2019-nCov was discovered to in the Wuhan province of China in December 2019. Having now infected thousands of people, it was declared a Public Health Emergency of International Concern (PHEIC) last month.
Amid rising fears, healthcare organisations like Public Health England are encouraging members of the public to stay calm and practice safe personal hygiene, by regularly washing their hands and carrying tissues to bin after sneezing or coughing. These measures are not the only safeguards at work, as laboratories around the world are working to develop a vaccine for this virus, with the UK donated £20 million to the Coalition for Epidemic Preparedness Innovations (CEPI) to produce a vaccine in the next few months.
Dr Sarah Pitt commented,
“The number of recorded cases of 2019-nCoV is increasing daily at the moment, with over 40,000 confirmed cases of the virus so far and now eight in the UK. Most cases have been reported from China. In other countries, all patients confirmed as being infected with this new coronavirus had either recently travelled from China or are very close contacts of someone who did.
The symptoms of the 2019-nCoV infection are a dry cough and pyrexia which may progress to serious respiratory problems such as difficulty in breathing and pneumonia. It is important to note that the majority of people do not develop the severe respiratory complications and it appears that a significant number of those infected do not experience any symptoms. Those who have sadly died had pre-existing health conditions which meant their bodies were less able to cope with the infection. The number of cases and the rate at which new cases are being recorded is of course a cause for concern for public health professionals.
Everyone should be aware of the problem and take medical advice if they become ill and think they may have been in contact with a person with 2019-nCoV. However, even from the incomplete figures that are currently, the case fatality rate (the percentage of people dying from the infection out of the total number of known cases) is around 2%. This is lower than for SARS (9.6%) and much lower than for MERS-CoV (34.4%).”
The symptoms
“Although coronaviruses do cause respiratory infections, they are not related to influenza viruses. They way that the mutation has occurred in the case of 2019-nCoV is completely different to the way the viral genetic material of Influenza A changed to produce Mexican swine flu. The symptoms which patients experience are not the same. Patients with influenza have whole body aching, sore throat, a chesty cough and sometimes diarrhoea and vomiting. The cough and feeling tired often last for a few weeks and people sometimes develop a chesty cough or even pneumonia. However, these complications are not usually caused by the influenza virus itself, but from a new infection by a bacterium taking advantage of the fact that the patient’s immune system is debilitated by fighting the influenza virus.
Based on observations and information gathered about known cases, the incubation time for 2019-nCov is considered to be between two and fourteen days. That is the length of time between being infected with the virus and developing symptoms. It is thought that people may be infectious during that time. It also appears that people who are asymptomatic and end up making a full recovery without experiencing any obvious coronavirus symptoms can still infect others. A key piece of information that scientists are trying to calculate is the ‘reproductive rate’ of the infection. This is the average number of new people who can be infected by one known case. Initial calculations put this as 2.2, meaning that each person with 2019-nCoV is likely to infect two other people if they come into contact with them while they have the virus. This compares slightly unfavourably to the estimated reproductive rate of 1.46 for the 2009 H1N1 influenza pandemic virus. However, it is worth bearing in mind that the equivalent figure for measles virus is 15. This is important because the aim of control measures is to reduce the reproductive rate to less than 1. When this happens, the number of new cases will start to fall.
While putting people in quarantine may seem harsh, the idea behind it is to prevent this spread from each one of those cases to two more people. This should speed up the time it takes to get the infection under control.”
IBMS members and their colleagues in laboratories throughout the world are working hard to process patient samples so that people’s test results can be made available in good time. This should help to contain the outbreak and while immediate control measures are being implemented, research scientists are working to develop a new vaccine
Treatment – the race for a vaccine
Sarah concludes,
“There are no antiviral drugs available to treat coronaviruses yet and resources are being put into trying to develop and trial a suitable vaccine. Attempts to make a vaccine against the SARS and MERS have so far been unsuccessful. However, with the knowledge from that work, more detailed information about this and advances in technology, more progress could be made this time.
Biomedical scientists in diagnostic virology laboratories across the world including the UK are testing throat swabs to look for the virus. They are using a routine technique to detect the viral genome. This is a standard method and it can easily distinguish between 2019-nCoV and other respiratory viruses, which means that the identification should be accurate. Some viruses will be fully sequenced and this information will be invaluable in tracing where the virus might have originally come from and if the virus is changing as it moves through humans.”
Although the number of confirmed cases seems set to continue to rise, it is essential that members of the public exercise caution and avoid overreacting to sensational news stories. It is important to stay calm, be aware of any advice from healthcare professionals and of course practise safe hygiene during this time.
IBMS members and their colleagues in laboratories throughout the world are working hard to process patient samples so that people’s test results can be made available in good time. This should help to contain the outbreak and while immediate control measures are being implemented, research scientists are working to develop a new vaccine”.
This article is a follow-up to our news story 'Coronavirus – prepared for any outbreak' which was published on 24th January