On December 31, 2019, the first cases of a novel coronavirus were identified in Wuhan City, Hubei Province, China. Since then, the disease, now officially known as COVID-19, has spread to several countries and claimed the lives of over 47,000* people.
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How far has the virus spread?
The total number of confirmed cases of COVID-19, total number of related deaths and total number of those who have recovered. Information correct as of 2nd April 2020, 06:52 (BST). *
As of March 11, 2020, cases of the virus had been confirmed in over 100 countries. You can keep up to date with the spread of the virus with this outbreak tracker from researchers at John Hopkins University.
Following a number of discussions, the outbreak was declared a PHEIC (Public Health Emergency of International Concern) by the WHO on January 30, 2020, signifying the global public health risk of the disease and the need for a coordinated international response. By this time, preventative measures such as travel restrictions had already begun to be put in place. A recent study has suggested that quarantine on a cruise ship has resulted in more coronavirus patients. However, were infected passengers to have left the ship, new epicenters of disease may well have been established. This reiterates the importance of effective quarantine measures. Many people are using face masks in a bid to protect themselves, however the effectiveness of this is questionable.
The outbreak was declared a pandemic on March 11, 2020, in response to the number of cases outside China increasing 13-fold, and the number of affected countries tripling over the past two weeks.
In response, Italy imposed a lock down on the whole country, and movement restrictions are being implemented elsewhere in an effort to halt the virus's spreads. As more and more countries impose varying degrees of restrictions, one group have surveyed the British public to see what they think about the measures being taken by the government.
A new modelling study has estimated that a combined approach of physical distancing interventions, comprising quarantine, school closure, and workplace distancing, is most effective at reducing the number of SARS-CoV-2 cases. Emphasis has also been placed on good hand hygiene to reduce spread of the virus.
What you need to know about coronavirus
What is a coronavirus?
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). Other coronaviruses circulate among animals including camels, cats and bats. Occasionally, animal coronaviruses may acquire mutations that enable them to infect people and then spread between people. In 2002-2003, an outbreak of SARS originating in southern China eventually caused 8,098 cases across 37 countries, resulting in 774 deaths. Consequently, in the light of the recent outbreak, there is understandable fear of another such epidemic.
What are the symptoms of infection with this novel coronavirus?
Primary clinical signs include fever and breathing difficulties, associated with the development of pneumonia, however chills, sore throat and headache have also been described by those affected. Person-to-person spread is thought to occur via respiratory droplets, in a similar way to the spread of influenza. Whilst some individuals may experience only mild clinical signs, there have already been over 2,500 fatalities associated with the infection, mostly in the elderly or those with underlying medical conditions.
Studies of the cases so far have indicated a median incubation period of 5.1 days, and that 97.5% of people who develop symptoms will do so within 11.5 days of exposure, suggesting the 14 day isolation period recommended is appropriate.
It is however important to bear in mind that individuals with coronavirus may be infectious prior to showing any symptoms. Such cases along with those who only experience mild clinical signs are thought to have fueled rapid "stealth transmission" through the population.
There have also been some suggestions that loss of smell and taste could also be linked to coronavirus infection.
A recent study from the National Institutes of Health also demonstrates that SARS-CoV-2 is stable for several hours to days in aerosols and on surfaces, suggesting individuals could acquire the virus after touching contaminated objects. Soap appears to kill coronavirus successfully so thorough hand washing is recommended.
How is the infection diagnosed?
Currently, testing is done is specialized laboratories. The first diagnostic assay to be published by the WHO as a guideline for diagnostic detection, was developed at the German Center for Infection Research in January. Several other tests are currently in development, including a lateral flow test and a gene sequencer.
A recent study has demonstrated that chest CT outperformed lab testing, suggesting it should be used as the primary screening tool for COVID-19. Novel coronavirus imaging has also shown “significant overlap” with SARS and MERS. A potential role for lung ultrasound in has also been suggested in COVID-19 diagnosis.
On February 28, the FDA issued a new policy for certain laboratories seeking to develop diagnostic tests for coronavirus to help expedite the availability of coronavirus diagnostics. As of March 18, 2020, six tests had been granted Emergency Use Authorization.
Researchers have now detected COVID-19 viral RNA and live virus in specimens other than nose-throat swabs and sputum samples, raising the possibility that the disease may spread through additional routes, thus testing should be changed accordingly.
The lab of Dr Changchun Liu at the University of Connecticut Health Center has recently developed a simple, low-cost, CRISPR-based method which can detect infectious diseases such as COVID-19.
What treatments are available?
COVID-19 is a viral infection, meaning antibiotics are not a viable treatment option. There are currently no anti-viral treatments available. Most patients will make a full recovery without treatment. Those with severe infections will be given supportive treatment such as oxygen or artificial ventilation to keep them alive until they start to recover themselves.
A recent study has suggested the use of steroids should be avoided. In addition, over-the-counter anti-inflammatory drugs, such as ibuprofen, should be avoided if you have coronavirus symptoms because they could worsen the condition, French authorities have warned.
Developing new drugs and vaccines can take years. Existing drugs may offer a possible "quick response" to the pandemic. Improving understanding of the virus, including it's structure, may also help to expedite the vaccine development process. This video explores the use of chloroquine and zinc as a treatment combinations.
An overview of published scientific information on potential therapeutic agents and vaccines for the new coronavirus, highlighted that to date, more than 500 patents have been issued for vaccines and therapeutic agents that could help prevent or treat coronavirus infections. A phase 1 clinical trial of a coronavirus vaccine has now commenced, and a phase II trial of SNG001, an interferon beta-based therapeutic, is set to start in coronavirus patients.
A study was recently published in the Journal of Biological Chemistry outlining how an antiviral drug that is currently being tested in patients with the novel coronavirus (COVID-19), remdesivir, works.
Furthermore, a preprint of a study conducted by researchers from Utrecht University, in collaboration with Erasmus MC and Harbor BioMed, outlines the first report of a human monoclonal antibody that can block SARS-CoV-2.
To assist scientists in expediting therapeutic and preventaitve development, a portal for sharing data from coronavirus trials is set to launch.
Researchers from Queen’s University Belfast are currently screening approximately 1,000 drugs, which have already received regulatory approval for other indications, to ascertain if they can reduce virus infection or replication and virus-induced inflammatory responses in airway epithelial cell models and to determine if they can therefore be repurposed to treat COVID-19 patients.
How are scientists responding?
The complete genome of COVID-19 was recently posted on the UC Santa Cruz Genome Browser, an interactive web-based tool used by researchers all over the world to study genetic data. This enables scientists to look at the virus’ structure and research potential ways to attack it. Analyzing this genetic data, scientists have recently concluded that SARS-CoV-2 is a product of natural selection.
Scientists from Australia and France have also successfully cultured the virus from patient samples, enabling research to begin on potential treatments and vaccines.
Researchers from The University of Texas (UT) at Austin and the National Institutes of Health recently created the first 3D atomic scale map of the 2019-nCov spike protein using cryogenic electron microscopy (cryo-EM).
The World Bank Group has also announced up to $12 Billion to support the COVID-19 response efforts. In another recent announcement, six research projects are to share a £20 Million fund.
The Internet of Things (IoT) is an automated solution that can scale quickly to match the speed of a growing epidemic. In the wake of the current coronavirus outbreak being declared a pandemic, we take a look at how the IoT is being employed here.
*Data retrieved from the Johns Hopkins University Coronavirus Resource Centre.