A worrying never-before-seen coronavirus (CoV) has emerged into the human population in the Chinese city of Wuhan, with a number of people killed and hundreds infected. The virus – known tentatively as novel CoV 2019 (nCoV-2019) - has spread to Thailand, Japan and South Korea with some human-to human transmission detected.
The beginning of the Lunar New Year celebrations may allow for the virus to move even further and with nCOV-2019's relation to Severe Acute Respiratory Syndrome (Sars) - which also began in China nearly 20 years ago - are we in a better place to stop it?
In early 2003, China alerted the world to Sars. This alert came after three months of fighting the infection. By this stage, 806 people were known to be infected and 34 of those dead. Over the course of the following year, Sars would go on to infect nearly 8,000 people, killing 10 per cent of infected and spreading to 17 countries across the globe before it was stopped.
Significant human-to-human transmission was noted and many healthcare workers treating the ill became infected. The cause of the outbreak was found to be a coronavirus, previously known only to cause the common cold in humans. The infection was traced to live animals, such as civet cats, in markets whose closure and culling of animals alongside a massive local and global health response quelled the outbreak. It has been calculated that the Sars outbreak cost East Asia $54 million.
The nCoV-2019 outbreak bears striking similarities to the Sars crisis, but closer inspection of the details suggests that some critical differences can leave us more optimistic. While rapid virus gene sequencing from scientists in China shows that this strain of coronavirus is closely related to Sars-CoV and that human-to-human transmission is happening, nCOV-19 is a cousin sharing only 80 per cent of its identity and those differences may add up to huge biological changes.
NCoV-19 appears to be not as deadly as Sars-CoV by an order of magnitude (1 per cent versus 10 per cent). But It may still be early days regarding how transmittable nCoV-2019 is as the apparent lower case-fatality rate may make it harder to identify cases without robust screening of populations. Recent modelling suggests upwards of 1,700 cases may be out there, pushing it to be more similar to Sars-CoV. Similarly unknown is whether civet cats play a role in passing nCoV-2019 to people as it did with like with Sars-CoV. This needs to be assessed such knowledge might help stop the source of the outbreak.
Critically, the situation surrounding the outbreak today is not as it was in the early 2000s. Like during the Sars outbreak, the Chinese authorities will be working tirelessly to contain this virus and treat those affected. But with nCoV-2019, China have been more open in quickly reporting developments and sharing critical data, such as viral genome sequences that have allowed the development of rapid diagnostic tests in Europe for example. Having gone through Sars, China now has unparalleled experience in tackling emerging infections at home.
Furthermore, the global research environment has also drastically changed over the last twenty years. But only continued investment in this work will mean that outbreaks of new viruses like nCoV-2019 will no longer be a threat. The Coalition for Epidemic Preparedness Innovations (CEPI), a public-private coalition founded in 2016 is one such organisation, that aims to “derail epidemics by speeding up the development of vaccines”. It includes getting financial support for preparedness against the unknown "disease X", a category which surely nCoV-2019 fits.
No longer considered only agents of the common cold, coronaviruses have garnered in-depth investigation into their basic biology, how they cause disease, and how we can stop them by vaccines and antivirals. Many of these approaches and pipelines supported in the recent past post-SARS can be being directly translated to the nCoV-2019 virus.
We should be optimistic that nCoV-2019 outbreak will be overcome soon but only support of more research into emerging infections will mean that outbreaks like these are no longer threats to humanity.
Connor Bamford is a virology research fellow investigating antiviral immunity in the lung at the Wellcome-Wolfson Institute for Experimental Medicine at Queen’s University Belfast