Coronavirus outbreak, N95 masks, traditional medicine and other burning questions — answered

The coronavirus outbreak originating in China has made its way across the globe, with nearly 12,000 confirmed cases. There are three confirmed cases in India as of 5 February 2020. There is considerable panic as countries race to contain its spread through screening and quarantine measures. Companies and universities have pressed into action; trying to figure out better diagnostics and possible treatment for the new virus.

The ambiguity to the virus’ origin and fear created by its rapid spread and lack of cure has incited a deluge of misinformation. So here are four questions you really need to know about this outbreak.

How deadly is the viral outbreak?

The virus is the latest member of the coronavirus family to jump from other animals to infecting humans. The scientific community has already determined the genetic sequence of the virus. We now understand that every infected person can infect up to 4 people. The virus spreads through the air, enveloped in tiny droplets released as a person sneezes, coughs or talks. Spitting in public places or coughing without covering one’s mouth are basic hygiene fails that needs to be avoided.

Image credit: AP

The mortality rate of this viral outbreak is less than 3 percent. This mortality rate is comparable to influenza outbreaks which kill approximately 3 percent of those infected. The SARS outbreak of 2003 had a mortality rate of 10 percent, while the Nipah viral outbreak of 2018 resulted in mortality of more than 88 percent. The coronavirus infection is more severe in the elderly and those with compromised immune systems. These target populations need to be identified and equipped with protective measures.

Where has the virus come from aka is it a bioweapon?

The exact origins of the virus are still unknown. The epicentre of the virus has been traced to a seafood market in China’s Wuhan. Scientists have found similarities in the gene sequence of this particular virus to those infecting bats and snakes. The virus has likely jumped from one of these species to humans. Jumping technically means a change in the spike proteins of the virus – those that give the virus its characteristic corona appearance and also specify which host cells it can infect. Think of this as a lock and key – the structure of the virus spikes is key to determining which host cell it can enter. The bat virus would have been unable to infect a human cell, until this structure changed.

If each person infected with the new coronavirus infects two to three others, that may be enough to sustain and accelerate an outbreak, assuming nothing major is done to bring down the numbers. Image: Getty

There is much speculation of whether this virus is a bio-engineered weapon. This speculation has part arisen because the Wuhan National Biosafety Laboratory housed in the Wuhan Institute of Virology in Wuhan is authorised to host dangerous pathogens. Conspiracy theories have been widely peddled, but bottom line is we have no evidence to demonstrate that the virus has been intentionally meddled with.

Either way the crucial thing now is to concentrate on containing the spread of the disease and not creating speculation. Blaming countries can only incentivise them to obfuscating data instead of transparently sharing disease burden and their response.

How useful are N95 masks in keeping safe from infection?

Fundamental to containing the disease is the utility of the N95 masks. India already has a shortage of masks in India, driving manufacturers to raise costs by up to 10 times normal costs. The export of masks from India has been banned as their demand has skyrocketed over the past few weeks. The effectiveness of the masks in stopping viruses is questionable – viruses are after all extremely tiny particles. But the mask does two things – first, it acts as a barrier to respiratory droplets which would otherwise act as a reservoir of viruses in the environment. Second, it reduces unnecessary touching of mouth and nose and by itself can reduce viral residues been left on objects. Thus though the exact effectiveness of masks is unknown, there is some practical utility to them.

Masks are selling out in Singapore amid concerns about the Wuhan virus. Singapore confirmed on 23 January the first case of the Wuhan coronavirus, detected in a Chinese national from Wuhan who arrived in Singapore on 20 January 2020. Image: Ng Sor Luan/EPA

As India prepares for a possible outbreak within her boundaries, it will be important to maintain stockpiles that are easily accessible. Priority areas for mask distribution would be enclosed spaces such as airplanes, theatres; places housing immunocompromised people such as old-age homes, schools and hospitals and to all healthcare workers.

But thought has to be also given to the disposal of these masks after use. If these masks end up in landfill, they could act as a crucible for the resurgence of the disease. A pipeline for collection and incineration of the masks needs to be set up to ensure their safe disposal.

Will traditional medicine work?

Both Chinese and Indian sources have put out information suggesting there is a role for traditional medicine in preventing or treating the disease. This variant of coronavirus is a novel variant and therefore, no traditional medicine has been formally tested against it. The available information is thus only a speculative advisory and not a fool-proof prescription. There is moral hazard associated with such an advisory – for example, there may be no harm in taking steam inhalation every day, but there is no guarantee that this will protect from the disease. Advisories should make this clear.

India's third case of coronavirus was confirmed in kerala by the Health Min on Monday, 2 February 2020. Image: PTI

The absence of acceptable scientific proof and presence of quacks has made scientists abhor traditional medicine practices. However, Indian citizens do consult traditional healers and therefore, it is essential to include them in any coordinated effort to contain the disease. A consultative approach to figure out the best way to get suspect cases identified and quarantined is of utmost importance.

Where to next?

The coronavirus outbreak has reached India’s shores and India has set up diagnostic and quarantine facilities to stop its spread. It is important now to remain calm and self-report any symptoms to a doctor. Take basic precautionary measures – wash hands regularly, do not spit in public paces, and cover your mouth while coughing or sneezing. Scientists are finding ways to create a vaccine for the coronavirus, but this will likely take a few months. But if this virus makes you apprehensive, remember this may not be very different from a flu outbreak. Normal hygiene measures and vaccinations can prevent from a number of respiratory diseases, so please do not shun away from them.

The author is a research fellow with Takshashila’s Technology and Policy programme. She tweets at @TheNaikMic

Also read: Coronavirus is sparing children and largely affecting the ill and aged — infection experts explain why



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