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Possible Scenarios: Coronavirus

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Dr KK Aggarwal    12 February 2020

  1. Hit and run virus and will disappear in six months
  2. Join the flu on the listing of the world’s winter illnesses —that will be routinely vaccinated against.
  3. Might take the form of a global pandemic, killing millions of people.

Hit and run virus

Travel restrictions and quarantine imposed in Hubei province and elsewhere over millions of people began two weeks ago. Coronavirus is believed to have an incubation period of up to 14 days.

As per WHO, cases continue to be reported in Hubei province but the same acceleration is not seen in provinces outside Hubei or in Hong Kong, Macau and Taiwan.

Deadly outbreak is tamped down by quarantines and hospitalization.

It appears that asymptomatic infections do not drive the outbreak, based on other coronaviruses. Four common coronaviruses are already endemic in people which seem to cause about 10% to 30% of colds, and pneumonia, as well as the more dangerous MERS and SARS, with SARS being the closest genetic match to 2019-nCoV.

Will become endemic like another seasonal flu

It may go on to have seasonal behavior, with flare-up in winter like the flu. This pattern has been seen in at least two of the common coronaviruses.

This would mean that it would reappear next winter. Such a thing happened with the 1918 Spanish flu pandemic that hit the world in two seasonal waves.

However, this will give us time for clinical trials to test the effectiveness of antiviral drugs including remdesevir and development of a new vaccine.

 Deadly global pandemic: Unlikely

The relatively few cases appearing in several countries may flare up worldwide in the coming months with deadly consequences. This was seen in 1957, when a flu pandemic killed 1.1 million people worldwide, and again in 1968, when another flu strain killed about 1 million people.

As per WHO, it has not seen an outbreak in doctors and nurses outside of Wuhan.

The Spanish flu outbreak of 1918 had a death rate of 2.5% and affected the young.

The new coronavirus mortality rate is lower than 2%, owing to unreported milder cases. A Chinese National Health Commission official said on Monday that the death rate in provinces except Hubei was 0.16%. That’s still higher than influenza, which has about a 0.03% death rate.

Nearly 82% of 2019-nCoV cases are mild, 15% are severe, and 3% are critical.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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