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Coronavirus from the public health perspective: facts and fake-news

Coronavirus from the public health perspective: facts and fake-news

The Wuhan coronavirus epidemic (2019-nCoV) has dominated the headlines during the recent weeks. What is the real extent of the danger? Maciej Furman and Edyta Piętak from the Institute of Public Health of the Jagiellonian University Medical College shed some light on this issue.

 

 

2019-nCoV, vaguely referred to as coronavirus in mass-media, is a new type of virus spread via respiratory droplets. Its outbreak began in the Chinese city of Wuhan, as a result of the consumption of dubious quality meat from such animals as foxes or koalas [1].

The urban centre inhabited by about 11 million people is currently cut off from the rest of the world. The footage from the city has shown scenes of chaos and panic, whereas people throughout China have been queuing to buy surgical masks.

Priceless facts

Sensational news should always be taken with a pinch of salt. The scale of disinformation on the situation in Wuhan, both in and outside China is best illustrated by the amount of fake news related to this issue, such as the picture of people lying in the street, allegedly infected with the virus, which turned out to be a 2014 photo of an art installation from Frankfurt.  

Fortunately there has also been lots of honest reporting on the epidemics, including a map showing the spread of the disease in the People’s Republic of China and the entire world (created by the Johns Hopkins University’s Center for Systems Science and Engineering). The public opinion is constantly updated about new cases. The situation is also monitored by the World Health Organisation (WHO), which declared the outbreak of coronavirus a global health emergency.

A global threat?

China is often the place of origin of new diseases. This was, for instance, the case of SARS or swine influenza. According to the WHO data, the SARS outbreak in China in 2002-2003 resulted in 5,327 cases of the disease and 349 deaths [2]. Altogether, the epidemics killed 774 people in 17 countries. There have already been more confirmed cases of coronavirus than of SARS in China. The number of infected is predicted to rise. Will this growth be limited to China or will the epidemics spread throughout the world? At the moment, the risk of mass infections and deaths from coronavirus outside China is considered to be very low.

Phylogenetic studies have revealed that 2019-nCoV belongs to the Sarbecovirus subgenus of the Betacoronavirus genus. It should be noted that 2019-nCoV is closely related (with 88 percent identity) to two bat-derived viruses: bat-SL-CoVZC45 and bat-SL-CoVZXC21, which cause severe acute respiratory syndrome (SARS). The phylogenetic analysis suggests that bats could be the original hosts of the virus, whereas the animals sold at the market in Wuhan may represent an intermediate host, facilitating the transfer of the virus to humans. What’s important, the structural analysis shows that in humans 2019-nCoV might be capable of binding with the angiotensin-converting enzyme 2 receptor – a hormone which is, most importantly, responsible for causing contractions in blood vessels, the rise in aldosterone and, consequently, the regulation of arterial blood pressure.

Keep calm, it’s only a coronavirus

Coronaviruses are an extremely common cause of cold and other upper respiratory tract infections. The infections are zoonotic diseases, which means that humans can get infected as a result of contact with animals.

The symptoms of 2019-nCoV include dry cough, fever, and shortness of breath. There have also been some reports of symptoms unrelated to respiration, such as nausea, vomiting or diarrhoea [3]. Many of the affected people recover in several days, but in some, especially the very young, the elderly, or those with a weakened immune system, a more serious infection can develop, leading to a respiratory and kidney failure. Scientists are working very hard to understand the aetiology of the virus, and the Chinese health authorities have published its full genome in international databases. At the moment, there are no effective antiviral drugs against this particular coronavirus, so it’s necessary to focus on symptomatic treatment. A specialist aggressive treatment at an intensive care ward can also be applied as a life-saving option for those most severely affected.

A bad time for fruitful discussion

Europe also fears the epidemics. New cases have been reported in Germany and France. The fear of a global pandemics is typical of a globalised world, where not only goods and information can travel at lightning speed. The global public opinion is concerned about the possible spread of the virus with the parcels or packages from China. Yet, the Polish State Sanitary Inspectorate has stated that the danger of contracting the virus from parcels is close to zero.

A time of epidemics does not provide favourable conditions for a fruitful discussion. From the public health perspective, the threat should always be assessed based on hard data. The number people infected with the “common” flu needs to be compared to the number of those suffering from the coronavirus infection, taking into account the mortality in both groups and evaluate the possible spread of the virus. As of 6 February 2020, there have been about 28 thousand reported cases of 2019-nCoV infection, 565 of which have led to the patient’s death.

Infected economy

The spread of the dangerous virus has alarmed the markets and threatened economic growth. There are rising fears that coronavirus will harm the global economy, nullifying the benefits from the economic truce and easing of the geopolitical tensions between the US and China. As China accounts for about one third of the global economic growth, the slowdown caused by the quarantines in large cities and production reductions in most factories will be felt around the globe. The situation may be further worsened by the transportation restrictions which may disrupt the supply chains. The lower production rates in China may deal a blow to iron ore mines in Australia and India, which supply Chinese steel plants with raw materials. The possible economic consequences include the decline in sales of microchips and screens produced in Korea and Malesia, factory machines produced in Germany, as well as car parts manufactured in the Czech Republic, Hungary and Poland. This means that the 2019-nCoV epidemics can have a serious global impact, even if it doesn’t turn into pandemics.

Original text by M. Furman and E. Piętak: JU Institute of Public Health Blog

 

Sources:
1.    2019 Novel Coronavirus (2019-nCoV) Situation Summary. https://www.cdc.gov/coronavirus/2019-ncov/summary.html. Data dostępu: 31.10.2020.
2.    Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003.https://www.who.int/csr/sars/country/table2004_04_21. Data dostępu: 31.01.2020.
3.    Nanshan Ch., Min Z., Xuan D.Jieming Q. Fengyun G. Yang H. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study.The Lancet. https://doi.org/10.1016/S0140-673620.

 

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