By Joseph DeFranco
On 29 January 2020, Dr. Anthony Fauci, the Director of the National Institute of Allergy and Infectious Disease (NIAID), spoke at the ASM Biothreats meeting about the advent of the 2019 novel coronavirus (2019-nCoV).
Although scientists first characterized the human coronaviruses (CoV) in the 1960s, CoVs rarely received international attention. Then, in 2002, severe acute respiratory syndrome (SARS), a new disease, caused worldwide panic and consternation as the virus spread quickly from China to the rest of the world. Of the 8,098 SARS-infected patients, there were 774 fatalities (9.5% Case Fatality Rate [CFR]), and the pandemic cost the global economy an estimated US$30-100 billion. In the wake of SARS, the World Health Organization (WHO) would implement new International Health Regulations (IHR) to address some of the weaknesses exposed during the 2002 pandemic.
In 2012, another highly pathogenic CoV zoonosis, Middle East respiratory syndrome (MERS), was discovered after a Saudi Arabian man died from respiratory failure. Although the international health community feared the worst, MERS-CoV had limited human-to-human spread, lowering the risk of a pandemic. Today, MERS-CoVhas a much higher chance of causing severe disease than its phylogenetic neighbor SARS given that it has already caused 858 deaths from a total of 2,494 cases (36% CFR). In 2017, the WHO placed both SARS-CoV and MERS-CoV on its Priority Pathogen list, hoping that the international community would prioritize them for scientific research and development.
The current situation involving 2019-nCoV is ongoing and escalating quickly. On 31 December 2019, China reported 27 cases of pneumonia of unknown cause. The claim at that time was that all of the individuals were exposed to the same animal at a fish market; however, Dr. Fauci and other US officials now believe that the first 2019-nCov infection presented in early December, and sustained human-to-human transmission is occurring. At the time of Fauci’s discussion, there were 6,000 cases and a mortality rate of about 3-4%. Dr. Fauci stated that this is a disease of the elderly, because only 2% of the cases occurred in younger people. Moreover, to the best of our knowledge, only 25% of recognized cases developed a severe disease, which is slightly lower than SARS.
Due to the experiences with CoV outbreaks, the global health community initiated appropriate preparedness and response activities. Since Dr. Fauci’s lecture, the WHO declared the 2019-nCoV outbreak a public health emergency of international concern (PHEIC), and the US is denying entry to any foreign national who has traveled to China in the last two weeks. Additionally, Dr. Fauci discussed that the WHO and possibly the US Centers for Disease Control and Prevention (CDC) might soon get access to “ground zero” in Wuhan, China to help evaluate and contain the disease. He also discussed the current phylogenetic analysis, asserting that officials do not know whether it will mutate, and, if it does, whether those mutations be more infectious and/or lethal. Yet, he did express optimism, stating that an accepted diagnostic test should be distributed to US hospitals and clinics within the next few weeks. This is a significant step to containing the spread of the outbreak to specific areas or regions.
Toward the conclusion of his discussion, he added that this is the third outbreak of human CoV in 18 years. For decades, scientists have discussed a universal flu vaccine, but Dr. Fauci believes that we should start considering a universal coronavirus vaccine. As of 2 February 2020, there are 17,373 cases of 2019-nCoV worldwide, more than double the count of total SARS cases. The 2019-nCoV outbreak can be tracked here.