In the Spring of 2009, a new virus emerged, species-jumping from pigs to humans in Mexico. The H1N1 swine flu, as it came to be known, began to spread around the world, and black-and-white images of the 1918 Spanish-flu pandemic, which killed close to 50 million people worldwide, soon appeared in news reports. In the absence of any foolproof way to guess the damage it might do, doomsayers speculated that this H1N1 could be a repeat of that terrible scourge.
As a doctor, I urged parents at a camp my son was attending in Maine to give all their children Tamiflu, in order to slow the spread of the new virus. It worked, and the flu was stopped in its tracks, at this camp and elsewhere. A vaccine was hastily prepared, which also worked. In the end, the swine flu killed 200,000 people worldwide that first year, far short of the 500,000 deaths that can result from a normal yearly flu season, and nowhere close to the damage done by the 1918 pandemic.
If a pandemic is a virus taking hold in different countries at the same time with sustained spread in each, then the Chinese coronavirus emerging today doesn’t quite yet qualify, but it seems clear that it will before long. The virus is spreading throughout central China. It has passed the 25,000-case mark as of this writing, and killed more than 500 people. The chances are that the true numbers are far greater, as many thousands of illnesses with upper-respiratory symptoms or even pneumonia may be misdiagnosed and not automatically tied to the virus. This problem is only getting worse as the few hospitals equipped to deal with the virus are overwhelmed and supply lines are cut off by quarantines. Desperate times call for desperate measures, and China has gone from underreacting and suppressing information to quarantining an entire region of close to 60 million people. Thankfully, Beijing is finally reaching out to the international medical community for help.
Placing a chokehold on travel both to and from China may help to slow the spread of the coronavirus, but it has also created panic, and people who are afraid to take fewer precautions to prevent the virus’s transmission. The virus currently appears too contagious to be completely confined. Sporadic cases in the U.S. are likely to lead to more-sustained spread over time as the virus becomes more accustomed to passing between humans. Unfortunately, we don’t yet have a vaccine or anti-viral treatments. Both will be tested, and we are likely to have an effective vaccine within the year, based on our prior knowledge and use of coronavirus vaccines in animals, as well as the vaccine created to stop the 2003 SARS outbreak, which has potential to combat the virus. Two anti-viral drugs, Remdesivir, which was developed to combat Ebola and Marburg virus, and Kaletra, an HIV treatment, show some promise against coronavirus as well.
In the meantime, HHS has declared the coronavirus outbreak a national public-health emergency, following the World Health Organization’s declaration of an international public-health emergency a few days earlier. CDC is correctly taking “aggressive actions” to try to control the spread of the virus in the U.S., expanding testing, working closely with state and local health authorities, releasing strong advisories against travel to China, and mandating two-week quarantines for those returning from affected regions.
Will these actions be enough? I spoke to Dr. Anthony Fauci, longtime director of the National Institute of Allergy and Infectious Diseases, who said he thinks these actions will help to slow the virus’s spread, if not completely stop it, while work is accelerated on a vaccine. He also pointed out that as the late spring and more-humid summer months arrive, all respiratory viruses, including this one, tend to stop spreading. He is, however, concerned about the possibility that there could be a second wave of the virus next fall.
Will the coronavirus be another Swine Flu, which scared us silly but ended up being less deadly than the yearly flu, or will it be like SARS, which had an almost 10 percent death rate before petering out far short of the coronavirus’s case numbers? The answer is that this pathogen will chart its own unique course, and we should monitor it closely for further mutations or changes in its effect on victims.
Our public-health leaders should be lauded for their efforts so far, but now is not the time to let down our guard. We must remain vigilant in slowing the virus’s spread, and cannot afford to stop pursuing a vaccine even for a moment.