A novel strain of a coronavirus (2019-nCoV) was first detected in the city of Wuhan, China on December 31, 2019 and, by the middle of January, thousands of Chinese citizens were sick. According to Johns Hopkins University Center for Science and Engineering, as of Jan. 30, 2020 there were 217 deaths among 9,776 confirmed coronavirus cases, with 92 of the cases identified in 20 countries other than China, including six cases in the U.S.1 On Jan. 30, the World Health Organization (WHO) declared the novel coronavirus outbreak that began in Wuhan and spread to many cities in China to be a “Public Health Emergency of International Concern.”2 By Feb. 6, there had been 28,353 cases confirmed worldwide, including 12 in the U.S., and 565 deaths had been reported with all but two occurring in China.
Public health officials believe the origin of the outbreak can be traced to an unsanitary food market in Wuhan where live seafood, reptiles, animals and birds were sold for human consumption.3 The market was shut down the next day by health authorities.3 The WHO says the evidence suggests people consumed infected bats and snakes from the Wuhan market,4 but exactly which animal is the primary source of the outbreak is still not known.5 6
What is Coronavirus?
The WHO describes coronaviruses (CoV) as a large family of viruses that cause illness ranging from the common cold to more severe infectious diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV)7 The new coronavirus (2019-nCoV) strain identified by health authorities has not been previously identified in humans.
Coronaviruses are zoonotic, which means they infect and can be transmitted between animals and humans.7 Investigations have found that SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans. There are several known coronaviruses circulating in animals that have not yet infected humans.7 Since health officials have not identified this latest strain in humans before, they have given it generic name of “a novel coronavirus” while investigations continue.3
The China coronavirus infection resembles viral pneumonia or influenza and common signs include fever, chills, sore throat, headache, muscle aches and respiratory symptoms such as cough and breathing difficulties. According to the CDC, “The complete clinical picture with regard to 2019-nCoV is still not fully clear. Reported illnesses have ranged from infected people with little to no symptoms to people being severely ill and dying.”8 Individuals can be incubating the infection for 10 to 14 days before symptoms begin, although it is unclear whether they are infectious during this time period.9 CDC reports that, “Typically, with most respiratory viruses, people are thought to be most contagious when they are most symptomatic (the sickest). With 2019-nCoV, however, there have been reports of spread from an infected patient with no symptoms to a close contact.”10
Like with influenza, the majority of are recovering but in some cases, the new coronavirus infection can cause complications like pneumonia, severe acute respiratory syndrome, kidney failure and death.7 Reportedly, the preliminary fatality rate associated with 2019-nCoV is about three percent but it appears to be higher in those over age 50, who have accounted for the majority of deaths in China.11 Older age groups are also at risk for complications of SARS and MERS, as well as influenza.
China Confirms Virus Can Spread From Human to Human
Initial reports out of China that the virus was unlikely to spread between humans were proven to be inaccurate as more and more cases were confirmed by Chinese and international health authorities.12 Early news reports, such as one where a patient was suspected as having infected as many as 14 medical staff in one hospital, gave evidence for the infection being spread more easily than initially thought.13
The U.S Centers for Disease and Prevention (CDC) states that much is unknown about how the novel 2019-nCoV spreads.14 Current knowledge is primarily based on what is known about similar coronaviruses. Most often transmission from person-to-person happens among close contacts (about 6 feet).
Person-to-person transmission is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory infections spread.12 These droplets can potentially land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. It is currently unclear if a person can get 2019-nCoV by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes.12
Wearing masks to prevent transmission of 2019-nCoV may or may not work, depending upon the type of mask and how it is handled or if the virus can be contracted through eye exposure with infected droplets.15 The CDC is recommending frequent hand washing with soap and water for at least 20 seconds to help prevent transmission of this and most other infections.
High Level Biohazard Lab Opened in Wuhan in 2018
There have been several media reports stating that the outbreak may have originated from a laboratory that is part of China’s covert biological weapons program. The laboratory known as Wuhan National Biosafety Laboratory is the only declared site in China that permits working with deadly viruses.16
Dr. Dany Shoham, a senior analyst with Israeli military intelligence for biological and chemical warfare in the Middle East and worldwide from 1970 to 1991 said that, “Certain laboratories in the institute have probably been engaged, in terms of research and development, in Chinese [biological weapons], at least collaterally, yet not as a principal facility of the Chinese BW alignment.”13 China has denied having or developing any dangerous biological weapons.
All researchers in the Wuhan high containment laboratory must change their clothing upon entering the facility, shower upon exiting and decontaminate all of the materials used during experimentation. Laboratory members wear full-body, pressurized suits to isolate themselves from the surrounding environment. The laboratory itself must be held in a separate building or an isolated wing within the surrounding university and must be supplied with its own air filtration and decontamination systems.17
Over the past decade, there have been a number of reported security breaches in high containment biohazard labs around the world, including in the U.S., where bioterrorism and vaccine researchers are experimenting with lethal microbes and developing genetically engineered viruses and new vaccines.18 19 In 2014, the U.S. issued a temporary moratorium on U.S. funded research conducted in labs where scientists create more dangerous mutated forms of the SARS, MERS and influenza viruses that have the potential to start global pandemics in human populations if they escape from the labs.20 21 In 2017, that moratorium was lifted and the U.S. Department of Health and Human Services resumed funding researchers creating lab altered viruses that could spread quickly through human populations.22
Simulated Coronavirus Pandemic Exercise Held in October 2019
The Center for Health Security at John Hopkins University has a fictional pandemic simulation program to prepare communities for biological threats, pandemics and other disasters.23
On October 18, 2019, the Johns Hopkins Center for Health Security in partnership with the World Economic Forum and the Bill and Melinda Gates Foundation hosted Event 201, a high-level simulated coronavirus pandemic exercise in New York City.15 The exercise pointed out areas where international public/private financial partnerships will be required to respond to a pandemic in order to diminish large-scale economic and societal impact on countries around the world.15
Participants in Event 201 were dropped in the middle of an uncontrolled novel coronavirus outbreak that was spreading like wildfire in South America and causing worldwide havoc.15 As fictional newscasters from “GNN” narrated simulated events, the immune-resistant virus (nicknamed CAPS) was crippling trade and travel, sending the global economy into free-fall. Social media was rampant with rumors and misinformation, governments were collapsing and citizens were revolting.15
Those participating in the New York City pandemic simulation included a large group of public policymakers, pharmaceutical companies such as Johnson & Johnson; mainstream media outlets like NBC/Universal, business leaders and government health officials. Event 201 provided them with an opportunity to evaluate disaster response systems and whether current systems are strong enough or need to be expanded.15
Dr. Eric Toner, senior scholar with the Center for Health Security said, “Once you’re in the midst of a severe pandemic, your options are very limited. The greatest good can happen with pre-planning.”15
Coronavirus Vaccines Are Being Fast Tracked
In response to the coronavirus outbreak in Asia, drug companies and the National Institutes of Health (NIH) have begun working on a 2019-nCoV vaccine that will be fast tracked to licensure.24 Anthony Fauci, MD, director of the National Institutes of Allergy and Infectious Diseases has said that it would take a few months until the first phase of the clinical trials begins and more than a year until a vaccine might be available.16
Dr. Fauci stated that, “When we were dealing with SARS, we developed monoclonal antibodies as potential therapeutics.”25 He added that, “Given the somewhat close homology between SARS and the new novel coronavirus, there could be some cross-reactivity there that could be utilized.”17
1 Johns Hopkins University Center for Science and Engineering. 2019 n-CoV Global Cases. Feb. 6, 2020.
2 World Health Organization. WHO declares the new coronavirus outbreak a Public Health Emergency of International Concern. Jan. 30, 2020.
3 Sun L, Berger M. What we know about the mysterious, pneumonia-like coronavirus spreading in China and elsewhere. The Washington Post Jan. 22, 2020.
4 Woodward A. Experts think that Wuhan coronavirus jumped from bats to snakes to people. Bats have been the source of at least 4 pandemics. Business Insider Jan. 28, 2020.
5 World Health Organization. Novel Coronavirus – China. Jan. 12, 2020.
6 Zraick K. What We Know About the Wuhan Coronavirus. The New York Times Jan. 21, 2020.
7 World Health Organization. Coronavirus.
8 Centers for Disease Control and Prevention. 2019 Novel Coronavirus (2019-nCoV) Situation Summary. Feb. 1, 2020.
9 Miller K. A person may be able to spread novel coronavirus before they have any symptoms. Prevention Jan. 31, 2020.
10 Centers for Disease Control and Prevention. How 2019-nCoV Spreads. Jan. 31, 2020.
11 Foley KE. Seniors seem to have the highest risk of dying from coronavirus. Quartz Jan. 31, 2020.
12 Griffiths J, Gan N. China confirms Wuhan virus can be spread by humans. CNN Jan. 22, 2020.
14 See Footnote 10.
15 Godoy M. What Doctors Say About Their Role in Containing Coronavirus. NPR Jan. 29, 2020.
16 Gertz B. Coronavirus may have originated in lab linked to China’s biowarfare program. The Washington Times Jan. 26, 2020.
17 Lanese N. Only one lab in China can safely handle the new coronavirus. Live Science Jan. 2020.
18 CIDRAP. CDC Details problems at Texas A&M Biodefense Lab. Sept. 5, 2007.
19 CIDRAP. CDC Monitoring More Staff After Anthrax Lab Breach. June 20, 2014.
20 Bryce NG. How A Tilt Toward Safety Stopped A Scientists Virus Research NPR Nov. 7, 2014.
21 Boyce NG. Debate Over Bird Flu Research Moratorium Flares Up Again. NPR Jan. 7, 2016.
22 Boyce NG. NIH Lifts ban on Research That Could Make Deadly Viruses Stronger. NPR Dec. 19, 2017.
23 Pearce K. Pandemic simulation exercise spotlights massive preparedness gap. Hub.Jhu.edu Nov. 6, 2019.
24 Cohen E. Vaccine for new Chinese coronavirus in the works. CNN Jan. 20, 2020.
25 Lovelace B. US health officials fast-track coronavirus vaccine, hope to start clinical trial in three months. CNB Jan. 28, 2020.