Coronavirus Q&A

1. What is coronavirus?

Coronavirus is not a single virus, but a family of viruses (virii?). There are over 20 different coronaviruses. The most famous of which are the coronavirus that caused SARS and the coronavirus that caused MERS. This new strain of the coronavirus comes from Wuhan, China. It's currently labeled 2019-nCoV which simply means novel coronavirus in 2019. Let's hope there's a better name in the future.

2. Where did the nCoV come from?

Past coronaviruses came from animals to humans. For example, SARS likely came from bats, while MERS likely came from camels. We're not entirely sure about where the nCoV came from. One possibility is that it came from a seafood market in Wuhan, China. This seafood market sold live animals to eat. So it's possible the nCoV came from one of these animals at the seafood market. However, the Lancet published a paper showing how some Wuhan patients infected with nCoV were not present at the seafood market, which casts doubt on this theory. Based on genetic analysis, though, the nCoV seems to have come from bats (like SARS). So that's the best guess for now.

3. How many cases of nCoV are there?

You can check Johns Hopkins for the most up-to-date information. As I write this, there are 17,489 cases with 362 deaths in the entire world. However, 17,306 of these cases are in China and 361 of these deaths are in China. So outside of China there are 183 cases and 1 death (Philippines) from nCoV. In short, the coronavirus is at present still an epidemic (i.e. predominantly afflicting one region - China) rather than a pandemic (i.e. worldwide). To be fair, the Lancet recently published a paper arguing that there's possibly a severe underreporting problem and that there might be as many as 75,000 cases most of which again would be in China.

4. How deadly is nCoV?

Based on current available data, it looks like nCoV has a 2%+ fatality rate (362 deaths in 17,489 cases). Contrast this with SARS (10% fatality rate) and MERS (35% fatality rate). The seasonal flu has a 0.1% fatality rate. However the problem is that we're still in the midst of the epidemic so it's very likely the fatality rate is inaccurate. In short, the jury's still out on how deadly nCoV is.

5. How do you get nCoV?

It looks like nCoV is primarily transmitted via droplets. Think someone coughing or sneezing on another person. (Note this is different from airborne transmission, which the media often mistakes for the same as droplets.) Secondarily nCoV may be transmitted via fomites, i.e., inanimate objects that can be contaminated by a disease. Think of someone coughing into their hand, then touching a table or door, then another person touching the same table or door, then rubbing their nose or eyes, and getting sick from it. Currently it's thought nCoV doesn't transmit via airborne transmission or at worst it's far less likely than droplets and fomites.

6. How do you treat nCoV?

Currently there is no treatment available for nCoV other than general supportive care (e.g. oxygen, mechanical ventilation, hydration). There are antivirals under trial now (e.g. oseltamivir, lopinavir, ritonavir), and the media is presently reporting these antivirals worked in a patient in Thailand, but the truth is it's really still too early to tell whether antivirals will be effective for a larger population. Antivirals were tried during the SARS epidemic, but in the end the antivirals weren't all that helpful. There are public and private organizations including the NIH and J&J attempting to develop vaccines, but this is likely to take many months at least.

7. What can you do to protect yourself?

If you're in the US or another developed nation, then taking the precautions you'd normally take during flu season is sufficient. Regularly washing your hands, covering your nose or mouth when you cough or sneeze, routinely cleaning surfaces that might carry fomites (e.g. table surfaces, door handles), keeping your distance from those who are infected, etc. Surgical masks won't hurt, but they're really unnecessary unless you're a health care worker in a hospital (and even that's more to protect from pathogens other than coronavirus).