Wuhan Coronavirus: Akin to normal flu, it can spread during the incubation period and before the onset of symptoms.

Reproduced from: https://www.hindustantimes.com/more-lifestyle/decoding-coronavirus-awareness-and-precautions-are-key/story-doEVbJGzXahp6s1zwTJ6hM.html published Jan 28, 2020

Even as the death toll from the new coronavirus detected in Wuhan China crosses 100, the number of cases with infection has almost doubled. The virus apparently emerged from illegally traded wildlife (bats and snakes) at a seafood market in Wuhan and is known to spread through human-to-human contact.

Akin to normal flu, it can spread during the incubation period and before the onset of symptoms. This is also what sets it apart from other viruses like SARS and MERS and makes it harder to contain. Amidst all the chaos, there is a need to debunk some of the misconceptions around the disease and raise awareness to avoid panic.

Good News

It is not new: Every decade, a zoonotic coronavirus crosses species and infects humans. In this decade, this virus is the 2019-nCoV. The name is derived from its shape, resembling a crown or solar corona when seen under an electron microscope. The three deadly human respiratory coronaviruses that have been identified so far include:

- Severe acute respiratory syndrome coronavirus [SARS-CoV]

- Middle East respiratory syndrome coronavirus [MERS-CoV])

- 2019-nCoV: 75% to 80% identical to the SARS-CoV.

People infected with these coronaviruses have a severe inflammatory response. In the current situation, the mortality rate is 3% as against 10% in SARS and 33% in MERS.

It is unlikely to spread through seafood in India: The virus has been traced to snakes in China, so, it is unlikely to spread in India through sea food. Snakes hunt for bats and reports suggest that snakes were being sold in the local seafood market in Wuhan. This increases the likelihood that the 2019-nCoV might have moved from bats to snakes and then to humans at the outset of the outbreak. It is still unclear though how the virus could adapt to both the cold-blooded and warm-blooded hosts.

It spreads only through lower respiratory infections: Such cases are likely not to travel. That is one reason human-to-human transmission has not been reported outside China.

Not a public health emergency yet: Although an emergency has been declared in China, it is not the case in other parts of the world.

Bad News

• The virus is unpredictable.
• There is no specific treatment or vaccine for the virus.
• All countries are susceptible to new strains because their populations do not have immunity against them.
• The diagnosis of the condition is also a challenge given that the initial symptoms can resemble common cold or other respiratory conditions.
• The need of the hour is to diagnose the first case and quarantine, which will require multiple ministry coordination.
• However, the severity of illness is concerning with almost a third of patients who developed acute respiratory distress syndrome requiring intensive care.

The way forward

Panicking and spreading misinformation must be avoided. We need to adopt universal precautions like against any flu, i.e., regular washing of hands, covering the mouth and nose while sneezing and staying away from a person who is coughing or sneezing by three feet.

At a larger level, all stakeholders including the National Health Authority, the Ministry of Health and Family Welfare and the National Health Portal must join hands and act in unison to spread public awareness about the virus and symptoms. This will help in early identification and prevent it from spreading further.

Stringent quarantine measures (14 days) and accurate diagnostic techniques must also be employed for appropriate diagnosis, contact tracing, isolation and treatment of patients and to prevent mortality.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA