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Everything You Wanted to Know About the Novel Coronavirus but Were Afraid to Ask


René F. Najera, DrPH

January 25, 2020

What Is a Coronavirus?

Coronaviruses are nothing new to humans. Back in 2003, a coronavirus (CoV) jumped from animals to humans and . That virus came to be known as SARS (Sever Acute Respiratory Syndrome), and it caused about 8,000 confirmed cases and about 800 confirmed deaths. (Note the word “confirmed.” There may have been many more cases that were not detected because they were not tested or not sick enough to be detected.) Coronaviruses are named as such because they look like little crowns under the electron scanning microscope: [caption id="attachment_2151" align="alignnone" width="1920"]
Latin: corona[/caption] These viruses . They have been known for over 50 years, and there are so many strains that it is hard to design a vaccine that will target all of them in enough proportion that it would prevent a significant number of cases. We'll talk more about vaccines against them later on.

Why the Big Deal?

The reason why “novel” coronaviruses are a big deal is because they are viruses that were not previously found in the human population. As a result, we don't have any immunity against them. This allows them to infect large numbers of people very quickly and to cause a syndrome that is more serious than the syndrome caused by viruses that humans are accustomed to. In 2003, it was SARS. In 2012, it was MERS (Middle Eastern Respiratory Syndrome). Now, in 2020, the problem is a novel coronavirus initially reported in the city of Wuhan in the Chinese province of Hubei. It's the very dark red province in the following map I prepared: [caption id="attachment_2147" align="aligncenter" width="605"]
The blue dots represent cities under quarantine by the Chinese government.[/caption] These viruses were new to humans and have caused a stronger than normal syndrome. There is also little we know about the natural host of the viruses. In 2003, the suspects were civets and bats. In 2012, the suspects were camels. Now, the suspects are anything from snakes to rodents. The Chinese government , but that is still yet to be fully confirmed.

What Are the Symptoms?

The have been described by those who've lived through them as a “cold on steroids,” with strong head and body aches, fever, and upper respiratory symptoms. Those who get very sick develop lower respiratory symptoms like pneumonia and difficulty breathing. In most cases of death, there was some comorbidity to contribute to the victim's demise like diabetes, cancer or a compromised immune system due to age or disease. People who are otherwise healthy and catch a coronavirus infection are very likely to survive.

Should You Worry?

One of the questions that those of us who work in public health are always asked is about the risk of disease and death from any particular disease. Should you worry? Well, it depends. If you are in Wuhan, China, right now, the answer is that you should worry and listen to the authorities on what to do. If you are in the United States, your risk from this disease is minimal. You have a higher risk of contracting other serious infections like influenza or an antibiotic-resistant bacterial infection. For influenza, .

What About a Vaccine?

As stated above, it is difficult to make a vaccine that will cover all the different coronaviruses out there. For those like SARS or MERS, the difficulty has been finding a proper medium in which to grow the viruses in the laboratory. This is necessary to create either attenuated (alive, but not dangerous) viruses or to harvest virus segments to use as vaccines. . This has not stopped public and private agencies from working on a vaccine. Anthony Fauci, MD, who is the Director of the National Institutes of Health, . Nevertheless, it will be months before one even clears Phase 1 trials. As is the case when new viruses begin to cause disease in humans, most of the response will be about stopping the epidemic with social distancing and information rather than a vaccine.

Remain Vigilant

This situation in China is developing and there is going to be a deluge of news coming your way in the next few days and weeks. You need to be aware of what is going on but try not to obsess about it. There are thousands of dedicated public health workers who have been called into action and will be working 24/7 to keep an eye on the spread of the virus. If there is something that needs to be done, you will be informed by the Centers for Disease Control and Prevention (CDC), the National Institutes of Health, and your state and local health departments. Meanwhile, wash your hands as often as you can, especially after touching public surfaces or being in contact with other people. Eat a balanced diet that is nutritious so you remain healthy. Get plenty of rest but also get some exercise once in a while. Like in 2003 and 2012, we will get through this.


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