The official death toll has surpassed 1,000, according to official figures. The actual toll may be far higher in China. Bodies may be cremated without a diagnosis, and Chinese authorities are ruthlessly censoring nonofficial reports. A whistleblower, Fang Bin, who shot videos of corpses in Wuhan, has reportedly been arrested.
Some may downplay the severity of the problem, noting that seasonal influenza kills tens of thousands every year. But these are some ways in which 2019-nCoV is different:
- Influenza has been everywhere for a long time, so most people have some degree of immunity. The “n” in 2019-nCoV stands for “novel.” The whole world is a “virgin population” for this newly emerged virus.
- The incubation period for influenza is up to 4 days. While 2019-nCoV may cause symptoms relatively soon, infected but apparently healthy people may be contagious for 14 days or even 24 days.
- Influenza infects the upper respiratory tract. If a patient gets pneumonia, it is likely a bacterial superinfection curable with antibiotics. The 2019-nCoV targets the lower respiratory tract, causing severe viral pneumonia, which may not manifest until a week into the illness.
- Older patients with pre-existing illnesses are the most likely to die of influenza. Young, healthy persons may also succumb to 2019-nCoV. The Chinese eye doctor who first sounded the alarm is dead at age 34.
- Influenza survivors are expected to recover completely. The coronavirus may cause scarring in the lungs. The receptor targeted by 2019-nCoV in lung cells is also in the kidneys, so severely affected patients may have renal failure or multiorgan failure.
Unless the disease can be contained, The coronavirus epidemic could spread to about two-thirds of the world’s population, according to Hong Kong’s leading public health epidemiologist, Prof Gabriel Leung.
The importance of effective quarantine is shown by the history of American Samoa and Western Samoa in the 1918 influenza pandemic. American Samoa, which enforced rigid quarantine, had no fatalities. Western Samoa permitted commerce to continue, lost 24% of its population, including half of the most productive age group, and collapsed.
Africa is especially vulnerable. About 1,500 passengers from China arrive in Ethiopia every day. Africa is only now receiving 2019-nCoV test kits.
For more about pandemic preparedness and links to information on protecting yourself and your family, see Doctors for Disaster Preparedness Newsletter, September 2019.