A federal health official on Wednesday announced the U.S. should prepare for the new coronavirus to “take a foothold” in the country. That comes as 15 cases of the virus have been confirmed in the U.S., the latest one in Texas on Thursday.
In late January, the World Health Organization declared the outbreak a global emergency. More than 60,000 cases have been reported around the world and more than 1,300 people have died.
WHO has formally named the disease that coronavirus causes: COVID-19.
The outbreak started in Wuhan, China, a city of 11 million, which has been put under quarantine by authorities. In North Texas and around the world, airports and universities have suspended travel to China.
But as countries take precautions against the virus, fear and misinformation about the threat grows.
Yasmin is the director of Stanford Health Communication, clinical assistant professor in the Stanford Department of Medicine and a former officer in the Epidemic Intelligence Service at the U.S. Centers for Disease Control and Prevention, where she investigated disease outbreaks.
We do know at the moment there is human-to-human transmission of the virus. What do we know about how that happens?
Right now, what we’re understanding is that this virus is spread from person to person through droplet transmission. That means when someone coughs, sneezes or maybe even talks and they are infectious -- they are sick and have the disease inside them -- those virus particles end up in droplets and they can spray about one to two meters away. They can also fall onto surfaces. Somebody can go touch that surface, touch their mouth. You need that virus to go towards a mucus membrane towards your respiratory tract.
That’s why even though it sounds basic, we’re always on people about 'wash your hands.' Wash your hands with soap and water, especially during this time of year, since it’s flu season. Also, if you have a cough or you’re sneezing, please don’t cough into your hand and walk around. Cough into a tissue and then throw that tissue away.
So why is it so important what they’re named? (The official name for the disease is COVID-19 and the virus that causes it is called Severe Acute Respiratory Syndrome Coronavirus 2).
Names of viruses and diseases are so important and there are real guidelines, best practices as to what to name a virus or disease and what not to name them. There can be repercussions.
For example, in 2009, when H1N1 was spreading, it was given the name Swine Flu because it originally came from a strain of flu in pigs ... except by that point, there was already transmission occurring between people. The infection was spreading from person to person, but giving it the name Swine Flu led to the unnecessary slaughtering of hundreds of thousands of pigs. These are the reactions we can see. Words are so powerful. We have to be really careful what we call things.
So what does this virus actually do inside the body?
It replicates inside specific cells. With this new coronavirus, we think it latches onto receptors called ACE2 and those are found deep inside our lungs so that makes sense why the symptoms are then coughing and fever and pneumonia.
Really what viruses are doing is hijacking our own cellular machinery for their own gain. They are so amazingly interesting, I think, for this reason. They’re just churning out loads and loads and loads of copies of themselves and trying to do what we do, which is survive and continue their legacy and spread from one person to another.
Lots of reports say this virus causes pneumonia. Smething that seems to be getting lost in the reporting is that there is a range in the severity of symptoms from patient to patient.
Absolutely. That’s why even though I think SARS is a good name, it still has the severe in it and that’s not truly descriptive of the whole range of manifestations of disease that this virus causes. So even with this being called SARS Cough 2, you would think it must cause severe disease in everyone? It does not. It’s even in a smaller minority of patients that we’re seeing that really serious disease -- that pneumonia. For others, it’s a mild illness -- it’s a fever and cough, feeling really fatigued and we also think there might be many, many more people who have such mild symptoms from this infection that they’re not even registering it thinking they’re sick.
For people who get really sick, what kind of treatments are being offered to them?
There’s nothing specific for this virus. There’s no specific anti-viral treatment -- and that’s true for a lot of viruses. What you do is provide supportive treatment. That means if someone’s kidneys are failing, you put them on dialysis. If they can’t breathe properly, you putting them on a ventilator and you’re just trying to support each organ system in turn.
Do we know who’s most at risk for being infected?
That data is still coming out. I think with SARS, it looked like everybody was susceptible to having potentially severe disease. What I’m seeing from the data so far with this new coronavirus is it looks like it’s older people -- people in their 60s, even late 70s who are having the more severe manifestations of the disease. We’re keeping an eye on that as more data comes out.
Of the people who have become critically ill or died, do they have things in common besides age? Are there other health problems that make it harder for them to fight off the infection?
It looks like you’re more susceptible to severe disease if you’re older, but also if you have existing health conditions -- things like diabetes or heart disease. That’s not unusual in the realm of virology and infectious disease for those individuals to be more vulnerable to severe illness.
Why is it hard to know how lethal it is?
One of the other lessons we learned from the SARS epidemic is that you would think that 21st century technology is what saved us during that pandemic. You would think it was really high tech stuff that helped us get it under control. Actually, in retrospect, all the analyses show that it was classic 19th century field epidemiology skills that helped us get that outbreak under control and it’s going to be the same here.
That sounds basic. But what that involves doing is what I was trained to do -- the art and science of going door to door, building trust with people, getting really detailed histories. Finding out: Did you have symptoms? What were you feeling? Who did you talk to? Where did you go?
[It] sounds so not tech and I’m speaking to you from Silicon Valley where we’ll all about that, but that stuff is so crucial early on in helping you understand the incubation period, how severe this is, who it’s going to spread to and just where the outbreak is headed.
This conversation has been edited for clarity.
This story was updated at 11:38 a.m. on Feb. 13.