tube passengers

People in London are concerned the coronavirus will reach the city

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THE new coronavirus is now spreading in several countries. As New Scientist went to press, eight cases of infection had been confirmed in the UK, including a man who went home to Brighton from a conference in Singapore via a ski resort in France.

Four other people on the ski trip were diagnosed as infected after returning to the UK, including a doctor. The medical centre where the doctor works has now been shut. A further five people at the ski resort were diagnosed while still in France, and one other case was confirmed on return to Spain.

So is the rest of the world ready for the coronavirus? The short answer is no. “I am utterly convinced that no country is fully prepared,” says Jennifer Nuzzo at the Johns Hopkins Bloomberg School of Public Health in Maryland.

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Serious disease outbreaks pose three threats. There is the direct impact in terms of illness and deaths. Then there are people with other illnesses who are disadvantaged because health services are overwhelmed. For instance, regular vaccinations ceased during recent Ebola outbreaks in West Africa, leading to children dying of other diseases. Finally, there is the economic impact of travel bans and people not working.

Nuzzo is one of the authors of the Global Health Security Index, which scores countries out of 100 based on their ability to cope with these threats.

The average score in 2019 was just 40. China scored 48. The US, UK, the Netherlands, Australia and Canada top the ranking, with scores ranging from 84 to 75, but they too will struggle if the coronavirus becomes a pandemic and spreads globally, even if it isn’t especially deadly, says Nuzzo.

For now, the aim is to stop the coronavirus from spreading. The strategy is to identify people who are infected, quarantine them and trace their contacts in case any are infected too.

Imminent threat

As long as the number of cases spreading beyond China remains a trickle, rich countries are well placed to do this. But many poorer countries don’t yet have the capacity to test for the virus.

Hospitals in the US and the UK are preparing isolation facilities, and on Monday, the UK declared the virus an imminent threat, allowing the country to forcibly quarantine people.

There are concerns that some countries aren’t providing sufficient funding and training. “Bottom line: they aren’t taking this seriously enough,” US senator Chris Murphy tweeted last week after attending a briefing on the US government’s preparations.

Isolating all infected people in hospitals and tracing their contacts also works only if case numbers remain low. If case numbers rise, it doesn’t make sense to fill hospitals with people with mild infections who don’t need treatment.

At this point, the strategy would have to switch to asking people with mild cases to isolate themselves at home, and treating people who are seriously ill in communal wards.

“If coronavirus is worse than swine flu, it will be horrendously difficult to handle”

“In that case, we are in an epidemic situation,” says Mark Woolhouse at the University of Edinburgh, UK. “We won’t be able to control it, and it will have to run its course.”

Paul Hunter at the University of East Anglia, UK, thinks a coronavirus pandemic would be no worse than the 2009 H1N1 swine flu pandemic. Efforts to contain this outbreak after it began in Mexico failed and it spread globally, infecting up to a quarter of the population and killing up to 500,000 – a death rate of approximately 0.02 per cent.

Nuzzo agrees it is plausible a coronavirus pandemic could be similar to swine flu, but says the US would be hard-pressed to manage even in this scenario.

However, there are reasons to think a coronavirus pandemic could be worse than the 2009 pandemic was. Infected people seem to pass the virus on to between two and four others on average, compared with about 1.5 for flu, says Woolhouse. There is also no pre-existing immunity against coronavirus, whereas older people had some against H1N1.

Woolhouse stresses that he isn’t predicting that a coronavirus pandemic will be worse than H1N1 was. “But we should at least think about what we would do in those circumstances,” he says.

The UK authorities have planned only for a pandemic similar to 2009. They are currently discussing whether a more severe outbreak is a reasonable concern, says Woolhouse.

“If it is worse than H1N1, then it would be horrendously difficult to handle,” says Hunter.

No one can say for sure what will happen. But Nuzzo thinks it is already too late to stop the virus going pandemic, and that China’s drastic measures to contain it will cause a lot of harm. “I’m really worried about the potential disruption that their measures will cause,” she says.

Nuzzo thinks efforts should focus on preparing communities to cope with the virus rather than trying to halt its spread.

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source: newscientist.com

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