COVID-19: what happens next with the coronavirus outbreak?

In early December 2019, a virus emerged in Wuhan, China, which had never been seen previously. It was found to be part of the coronavirus family which also includes the virus that causes the common cold.

As of 10^th February 2020, the number of confirmed cases of novel coronavirus has reached more than 40,000 worldwide. More than 1000 people have died, including one death outside of China. So far there have been eight cases in the UK, with the UK government now introducing strengthened legal powers to impose restrictions on people considered by health professionals to be at risk of spreading the virus. The World Health Organization (WHO) categorises the global risk from the virus as high and the risk within China to be very high. The UK government has raised the risk to the UK from low to moderate.

And with the number of diagnoses rapidly increasing, what needs to happen to stop the situation getting worse?

A new name

The virus will soon be renamed by the International Committee on Taxonomy of Viruses (ICTV) which is charged with coming up with an appropriate and accurate name to make identifying and communicating about the virus easier. The new name of the virus must follow WHO guidelines to avoid previous harm caused by the misnaming of diseases such as swine flu, which led to unnecessary harm to pig populations and pork industries. The guidelines state that the name:

• Must not include geographic locations, people's names, types of animal or food, or cultural, population or industry related terms.

• Should not include terms which may incite unnecessary fear (such as unknown, death, fatal or epidemic).

• May include generic or specific descriptive terms of various aspects of the disease or other identifiers.

We should know the new name of novel coronavirus in the next few days. The name is important to how we communicate about, and how the public will respond to, the disease. There have already been reports of discrimination against Chinese and Asian communities and individuals in the wake of the virus as it has been so heavily linked, including in name, to China and Wuhan.

Update: the disease caused by the virus was officially named Covid-19 on 11th February. The virus itself has been designated SARS-CoV-2 to reflect its close connection to the SARS virus.

Getting prepared

The international community has created a Strategic Preparedness and Response Plan to protect states with weaker health systems in an attempt to curb the spread of novel coronavirus. Between February and April 2020, the WHO has called for US$675 million to be spent to support health organisations and public health activities to prepare for and respond to infections. The plan aims to:

• Limit human-to-human transmission.

• Identify, isolate and care for patients early.

• Communicate information between and within countries.

• Minimise the social and economic impact.

• Reduce the spread of the virus from animal sources (where the virus originated).

• Address unknown factors and needs.

The money will be spent on establishing international coordination and operational support, improving and building preparedness and response operations and fast-tracking important research and innovation.

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Potential spread

Whilst the official numbers of diagnosed are now over 40,000, the real number of infections is undoubtedly higher. In some people, the virus will be extremely mild and unnoticeable, whereas in others it can lead to serious and life-threatening complications such as breathing difficulties and pneumonia. Naturally, the more serious cases, particularly where people require hospitalisation, are more likely to be picked up and recorded. Early detection of the virus is improving day-by-day and effective testing techniques can rapidly confirm new infections.

For each person infected with the virus, one study modelling the potential number of infections suggested there were nearly 76,000 infections before 25^thJanuary. At that point, a total of 1,320 cases had been confirmed, as reported by the WHO.

Novel coronavirus isn't yet considered pandemic, but the researchers suggest that, without the right measures coming into place, it could. If community-level outbreaks are sustained in areas around the world, a pandemic may be declared. The 2009 swine flu is a recent example of a pandemic which resulted in the deaths of hundreds of thousands of people. However, fewer than 200 cases of coronavirus infection have been seen outside of China.

"If we invest in fighting at the epicentre, at the source, then the spread to other countries is minimal and also slow," said WHO's Director-General Dr Tedros Adhanom Ghebreyesus. "If it's minimal and slow, what is outside can be controlled easily."

SARS (Severe Acute Respiratory Syndrome) is a coronavirus with similar symptoms to this new coronavirus and has been closely linked to the new infection. The SARS outbreak in 2003 was considered an epidemic rather than a pandemic, with 8,000 cases across 26 countries. The new virus appears to be more infectious but less deadly than SARS.

Developing treatments and vaccines

There isn't currently a vaccine for novel coronavirus, but scientists are looking to develop one. Various companies are racing to develop a safe vaccine which could prevent the spread of the virus and protect those most vulnerable, including older people, those with long-term conditions and those with weakened immune systems.

The UK government has contributed £20 million to fast-tracking the development of a vaccine, although it will likely still be at least several months before one becomes available. Vaccines have to go through various trials before they can be given to the public. However, as the novel coronavirus is so similar to other diseases such as SARS and MERS, scientists can use data from those outbreaks to give themselves a head start on creating a vaccine.

At the moment, the best protection we have is to practise good personal hygiene, including plenty of handwashing, covering your mouth and nose when you cough or sneeze and avoiding people who may be infected.

Currently there isn't any specific treatment for coronavirus. Antibiotics do not work on viruses and, although various antiviral treatments are being trialled on patients, no single antiviral has been found to treat the infection. People infected with novel coronavirus are being treated by managing their symptoms, rather than aiming to cure the infection. However, as more people are treated and more treatments are tested, we should come closer to an effective treatment.

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