On December 12, 2019, a series of mysterious cases were admitted into hospitals in Wuhan, Hubei Province of China¹, leaving Chinese doctors completely baffled. Little did they know, this was the dangerous onset of a new 21st century viral epidemic-turning pandemic, soon to wreak havoc as it suddenly and dangerously emerged from the shadows. An epidemic is an outbreak of a disease; rapidly disseminating among particular individuals of a particular region. Once that outbreak goes global; affecting multiple countries and continents on a large-scale, it is then termed a pandemic, and this is the case of the 2019 coronavirus, termed (2019-nCoV) by WHO¹ and the second 21st century pandemic to emerge. In fact, major catastrophic viral pandemics have occurred in the last century, gaining notoriety for their tragic impacts on human lives; from causing severe implications, to hospitalization, detrimental disease, economic burden, and tragically, millions of deaths all around the world. First up, known as the largest and most detrimental influenza pandemic in history, the 1918 ‘Spanish influenza’ atrociously took the lives of 50 million innocent civilians across the globe. Roughly four decades later, the 1957 ‘Asian influenza’ and 1968 ‘Hong Kong influenza’ were responsible for an estimated 1.1 million deaths each. The first viral pandemic of the 21st century occurred in 2009, quickly spreading across Mexico and the United States. The 2009 H1N1 Swine flu killed up to 600,000 people in the first year it spread.² The widespread transmission of these deadly viruses could be due to the inadequate preparedness and implementation of infection control practices.³ However, combining the plethora of knowledge gained from these previous pandemics and significant advancements in medicine and technology; leaders, scientists, and physicians nowadays have attributed an amalgam of ideas and active measures that need to be immediately employed in order to efficiently prepare for future pandemics and control their widespread dissemination, which are not a matter of if, but when, as seen in the case of this most recent Coronavirus outbreak. In this context, several questions arise: what information have we obtained from previous outbreaks? Can this information, along with the advancements in medicine, be used to prevent them?
Advancements in medicine and technology: A blessing
First and foremost, two previous precursor Coronavirus outbreaks have occurred before 2019-nCoV (novel Coronavirus); severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002 and Middle East respiratory syndrome corona virus (MERS-CoV) in 2012.⁴ The significant advancements, major evolution, and new research tools seen in medicine and technologies today have given scientists increased leverage and great opportunities to thoroughly tackle modern-day problems and employ early interventions in controlling outbreaks and attaining molecular epidemiological data with quick agility and rapid assessment. For example, evolution in genomic sequencing allowed the rapid characterization of the 2019-nCoV. Within a few weeks, scientists were able to rapidly sequence the whole viral genome, analyze it and publish its full genome in genome data banks using the Oxford Nanopore MinION device.¹ If this were a century ago, such rapid characterization could not be employed. Second, these genetic sequences provide crucial information on the evolution, origin, virulence, pathogenic potential, transmission mechanisms, and antigenic properties of the virus.⁵ Based on the genomic data, scientists were able to construct real-time RT-PCR diagnostic tests specific for 2019-nCoV immediately and compare the new genetic sequence with the previous coronavirus outbreaks.⁶ As it turns out, the amino acid sequences that were used for CoV (Coronavirus) species classification were 94.4%⁷ identical between 2019-nCoV and SARS-CoV.
Effective measures: What exactly needs to be done?
According to the (COVID-19) Situation Report by WHO, over 100 countries have now reported laboratory-confirmed cases of COVID19.⁸ As a young scientist and researcher in the molecular microbiology field, I found it crucial to suggest these 10 measures that need to be employed to reduce transmission of the 2019 corona virus today and preventing future epidemics tomorrow.
1. Immediate actions to close off public transportation on a wide scale, including railway and train stations, city highways, and airports. Traveling needs to be ceased for the time being.
2. Instructing civilians to avoid public/ crowded areas to minimize transmission.
3. Wearing masks and gloves at all times in public.
4. Education campaigns and surveillance systems in order to assess the ongoing situation, alerting civilians of the severity of the disease, transmission methods of the virus, and other protective measures (frequent handwashing, sanitization, clean hygiene)
5. Patients with chronic diseases (cardiovascular and diabetes) and (old age, obesity, immunocompromised) are first to contract the virus; they need to be quarantined.
6. Worldwide governments need to come together to plan effective campaigns to fund medical facilities and associations to obtain every medical supply necessary for infected patients. Priority for low-income countries as they’re also subject to numerous other challenges including poverty, hygienic problems, and lack of financial status. Developed countries need to help developing countries.
7. Publicly asking celebrities to launch education campaigns to inform the public, and to donate graciously to medical facilities.
8. Worldwide government funding for developing a rapid vaccine and making them both cheap and accessible for ALL PEOPLE, consequently, the Coalition for Epidemic Preparedness Innovations have already started work on 8 promising vaccine candidates.⁹
9. Isolating infected patients in secluded, newly made medical facilities to prevent transmission whilst quarantining suspected patients.
10. Banning public occasions, outdoor activities, parties, festivals, schools, universities, work, and such for the time being to prevent further transmission allowing scientists to rapidly develop vaccines while minimizing infected cases. The public need to understand the severity of the situation, and that their health should be prioritized first.
1. Chan, Jasper Fuk-Woo, et al. “A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster.” The Lancet 395.10223 (2020): 514-523.
2. Kain, Taylor, and Robert Fowler. “Preparing intensive care for the next pandemic influenza.” Critical Care 23.1 (2019): 337.
3. Wang, Chen, et al. “A novel coronavirus outbreak of global health concern.” The Lancet 395.10223 (2020): 470-473.
4. Song, Fengxiang, et al. “Emerging coronavirus 2019-nCoV pneumonia.” Radiology (2020): 200274.
5. Medina, R. 1918 influenza virus: 100 years on, are we prepared against the next influenza pandemic? Nature Reviews Microbiology 16, 61–62 (2018).
6. Wang, Chen, et al. “A novel coronavirus outbreak of global health concern.” The Lancet 395.10223 (2020): 470-473.
7. Zhou, Peng, et al. “A pneumonia outbreak associated with a new coronavirus of probable bat origin.” Nature (2020): 1-4.
9. Gates, Bill. “Responding to Covid-19—A Once-in-a-Century Pandemic?.” New England Journal of Medicine (2020).