PART I: The new Coronavirus
By Heidi Dunn and Bree Xiong
Chinese Medicine Practitioners at ben&biao
Last weekend Heidi collected her parents from Sydney International Airport. They were flying in from the UK and arrived like the majority of the other passengers (with facemasks on), just as our PM – Scott Morrison announced that Australia would no longer be receiving any international visitors flying direct from China, effectively closing our borders to mainland China. With all the public announcements, media attention, and concern around this ‘coronavirus’ making the round, so….
“How concerned should I be of the Coronavirus?” has become a frequent question asked by many of our patients over the recent weeks but at the same time the answer is often more nuanced with the simplest answer being “it depends”.
There are many different factors relating to concern of new Coronavirus, some of which we touch upon later on, however one key aspect is geography and the spread of the illness, which why there is a higher concern around China with the majority of cases centralised and concentrated there.
Many of you may well aware of reports of the 2019 Novel Coronavirus spreading in December 2019 and first originating in Wuhan, China. Currently, the medical community, expert boards, universities and hospitals are working hard on a vaccine as well as novel approaches to treat the virus.
So, what is exactly is the Coronavirus?
Coronavirus is simply a type of virus and there a many different version of Coronaviruses with varying severity such as the typical ones we see during our cold and flu seasons versus SARS or MERS. The one that is garnering all this media attention at the moment is called 2019 Novel Coronavirus (2019-nCoV) and it is a type of Coronavirus which was only seen in animals before and has now made it to us (similar to SARS and MERS).
While all the numbers of cases and deaths being constantly published within the media, it can be daunting and concerning, however it is worth putting this into perspective
How this novel Coronavirus compared
Common Cold and Flus:
We have all heard the statistics each year during the cold and flu seasons with figures sitting in the millions of cases globally. The standard Coronavirus is responsible for up to 25% of common colds each year with many other virus (rhinovirus, influenza strains) also contributing to these annual statistics.
The WHO reports between 3 million and 5 million hospitalisations from severe influenza each year with an estimated 650,000 deaths.
SARS and MERS:
- Severe Acute Respiratory Syndrome (SARS-CoV) resulted in a total of 8098 global cases with 774 deaths and a fatality percentage of (~10%) in 2003.
- Middle East Respiratory Syndrome (MERS-CoV) resulted in a total of 2494 global cases with 858 (~34%) deaths in 2012.
2019 Novel Coronavirus (2019-nCoV):
- The 2019 novel Coronavirus fatality percentage currently sits at ~2-4% (as of 4 Feb 2020).
Although there are less total cases of SARS and MERS in comparison the 2019 novel Coronavirus, the SARS and MERS Coronavirus strains are actually much more deadly based on what we have seen so far.
The difference is that the infection rates are much lower in SARS and MERS compared to 2019 Novel Coronavirus and because this novel Coronavirus is also new to humans (like in SARS and MERS), our immune system is having a difficult time recognising and dealing with it.
This has allow it to spread quickly, particularly in affected and densely populated areas such as China.
- As of 4 Feb 2020, there has been a total of 20,630 confirmed global cases according to the World Health Organisation (WHO).
- Of that total, 20,471 are confirmed within China with further breakdown into 13,522 cases within the Hubei province (Wuhan) itself.
- While outside of China, Japan has the most number of confirmed cases being 20, with Australia confirming 12 cases. There have been 425 deaths in China and 2 deaths, one in Hong Kong and one in the Philippines (3 Feb 2020) which mark the first time deaths have occurred outside of China.
For more official information, please see the WHO website (https://www.who.int/)
For more information about 2019-nCoV (https://www.who.int/emergencies/diseases/novel-coronavirus-2019)
And situation report updates (https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/)
As such, much of the concern is around the spread and how new 2019-nCoV is, therefore in order to limit the spread of the 2019 Coronavirus, Governments have to be cautious and implement isolation periods, vaccine development (Phase 3 clinical trials are currently underway) and travel restrictions in order to contain it.
With vaccines and treatments for 2019-nCoV in the works (and with quite a lot of progress since Dec), the more we can reduce the spread and transmission, the better.
What are the signs?
The Coronavirus, presents similarly to a common cold (in the early stages) or seasonal influenza and could also have the same complications such as more severe secondary respiratory issues.
You should visit a general medical practice or Emergency Department immediately if you suspect this after travelling to/from China (not just Wuhan, Hubei Province), after which measures will be put in place for isolation. This is important so limit the spread of the infection further.
The first signs and symptoms (Day 5-7) may not be a fever or just a low fever (<38.5 C) but may present with:
- Digestive issues;
- Shortness of breath;
- Slight cough.
Complications become more common, if after the first 2-3 days of infection, temperature shoots up to >39 C, with presentations of:
- Increased breathing difficulties;
- Oxygenation to different areas of the body becomes poor;
- Large scale Lung effusion/Pneumonia (fluid in the lungs- causing further breathing difficulties)
Who is at Risk? – (Risk of Contraction)
Everyone has the potential of catching this viral infection, in the same way everyone is at risk of catching the cold or flu.
Improved hygiene behaviours such as good hand-washing, wearing masks, and minimising face touching can all help to reduce the risk of contraction a virus.
Who is at Risk? – (Risk of Complications)
The 2019 Novel Coronavirus is particularly concerning for individuals whom have a higher risk of experiencing complications with the common influenza.
These populations include the elderly, young children, along with the immune compromised such as those with those with chronic systemic diseases such as diabetes, cancer, SLE etc.
For more on the Coronavirus, the TCM perspective and treatment, please continue reading by clicking the associated links below for Part 2 and 3.