Some people look at the number, 43,138, of confirmed cases and then at the number, 1,018, who have died and say that the death rate for this disease is 1 in 40, or 2%. This doesn’t take into account that most of those 40K+ are seriously ill in hospital. Reportedly about 20-25%, require intensive care from suffering multiple organ failure, and are still in intensive care weeks later. Only 4,232 people have recovered from the disease. Which gives a 20% death to recovery rate. Obviously, as the situation evolves we will get a real death rate somewhere between 2% and 20%.
The real danger with this disease is that people who have caught it and are contagious initially show no symptoms. So someone can catch the disease from a symptomless friend, pass it on to another friend, who passes it on to another friend. And still none of them are showing any symptoms, yet they are all giving it to other people.
Scientists use the term R0 when describing epidemics. It is the number of new victims each infected person passes the disease on to. Just two weeks ago we were told that this Coronavirus had an R0 of 2. So one person infects 2, who infect 4, who infect 8 who infect 16 and so on. Now people are starting to think that the R0 for this Coronavirus is 5. So one person infects 5, who infect 25, who infect 125 who infect 625 and so on. It makes a huge difference. Certainly we know that one British victim (a schoolteacher!) who brought it back from China has infected 11 people (and counting).
Now for something amazing. The French flew several hundred people back from Wuhan. They took the ones showing symptoms of Coronavirus and put them in quarantine. Then they sent the rest home.
The next shock news is that incubation period of up to 14 days. It now appears that this was not derived from empirical evidence. They just took the number from the MERS Coronavirus epidemic and applied that. They were wrong, very wrong. Looking at real patients in the current epidemic has increased the number to 24 days (with a median of 3 days). So we are now well in the territory of Super Spreaders. In 2015 a single hospital patient with MERS Coronavirus led to 82 further victims catching the disease.
WHO Director General, Tedros Adhanom Ghebreyesus, is not mincing his words about events: “There have been some concerning instances of onward 2019nCoV spread from people with no travel history to [China], the detection of a small number of cases may indicate more widespread transmission in other countries; in short, we may only be seeing the tip of the iceberg.” Which pretty much ties in with the information above.
Prof Gabriel Leung, chair of public health medicine at Hong Kong University, has used an R0 of just 2.5 to predict that 60% of the world’s population will catch the disease. That’s 4.68 billion people. Just 2% of that total is 93,600,000 people, 5% is 234,000,000. And yet our politicians still let aeroplanes fly, spreading the disease around the world.
Now for some good news. It is vaccines that are going to save us. Once they are developed, found to work and found to be safe they can be mass produced, like the winter Flu vaccine is. I will quote from the Faculty of Pharmaceutical Medicine newsletter:
“In 2015 the World Health Organisation (WHO) published a list of high-risk infections. This accelerated R&D on dangerous pathogens that are the most prone to generate epidemics. The list included SARS and MERS and, as a result, a Target Product Profile for a MERS vaccines followed soon after.”
“Two years after the WHO published its list, the Coalition for Epidemic Preparedness Innovations (CEPI) was launched at Davos. This innovative private/public partnership has since raised over $700m to fund vaccines developments to prevent future epidemics.”
“Conventional vaccines stimulate the immune system with an infectious agent, or components of an infectious agent, modified to avoid harm but ensure that the immune system neutralizes the infectious agent. DNA vaccines are introduced into the patient as a plasmid containing the DNA sequence encoding the antigen(s) against which an immune response is sought. It relies on the in-situ human production of the target antigen which stimulate the production of the antibodies. One crucial advantage they have over conventional vaccines is that they can be manufactured quickly.”
“Whilst DNA vaccines for coronaviruses have not yet been approved for human use, the results of a first-in-humans study of a MERS coronavirus DNA vaccine were reported last year with convincing evidence of efficacy. It is now in phase II.”
So, basically, we are engaged in a race with millions of lives in the balance. The Coronavirus is advancing relentlessly, seemingly unstoppable by containment and quarantine. Meanwhile scientists and pharmaceutical companies rush to be able to stop it. Each day will make a difference for many. So by May there could be a ray of hope.