Yesterday, I provided information from The New York Times on six key factors about the Wuhan coronavirus/2019-nCoV. Today, I share with you an informative article from Vox, which explains in detail two key concepts that researchers are still trying to nail down in these earliest days of the virus outbreak: the basic reproduction number (R0 or R-naught), and the case fatality rate (CFR).
The Jan. 28th Vox article, titled The 2 key questions that will determine if the coronavirus outbreak becomes a pandemic, states:
Less than four weeks into the outbreak, fear about how bad this could get is spreading faster than the virus. And with good reason.
While the vast majority of cases and deaths are occurring on mainland China, 2019-nCoV has already made its way to at least a dozen other countries, including the US, Germany, and Canada. People are buying face masks. Markets are on edge. Cities and countries are responding with mass quarantines and travel bans. The whole thing feels a lot like the 2011 pandemic film, Contagion.
So how big could the outbreak get? Is this the next pandemic — a disease that spreads globally?
An answer to this question requires knowing the answers to two other questions: How easily does the 2019-nCoV spread from person to person, and how deadly is the virus? At the moment, scientists only have informed guesses, which are likely to solidify in the coming weeks and months. But what we know so far is instructive.
I urge you to click over and read the entire article. Between yesterday’s New York Times article and this one, you will be comfortably up-to-speed on 2019-nCoV.
How Do We Deal With Infectious Diseases?
A 2016 article appearing in the scientific journal Physics Reports, titled Statistical physics of vaccination, provides a handy reference chart outlining all the various ways that humanity has responded to limit the spread of infectious diseases throughout history (this image is hosted on Flickr; please click on the link, or the image below, it to see a high-resolution version):
The authors state:
We note that this list is not exhaustive, and interventions are often used in combination, such as contract tracing and isolation.
The eight tactics used to combat the spread of an infectious disease are:
- Vaccines: treatments which create an immune memory of the pathogen, so that the immune system can respond more vigorously when challenged with the actual pathogen (please note that, as I reported yesterday, we are probably not going to have a readily-available vaccine for 2019-nCoV for at least a year)
- Antibiotic drugs and antiviral drugs: treatments which interfere with the life cycle of the bacterium or virus within the body of an infected person (for example, there are some reports that antiviral drugs used to treat HIV are being used to treat some patients)
- Social distancing: closing schools and businesses, avoiding crowded places, etc.
- Case isolation: asking people who already contracted the infectious disease to stay home; using negative-pressure rooms in hospitals, etc. (note the key difference between isolation and quarantine, the next point, which is applied to potentially infectious people)
- Quarantine: isolation of individuals who may have already been exposed to the infectious disease, and therefore potentially infectious themselves (this is what China is doing now in many locations)
- Barrier precautions: masks, gloves, condoms in the case of sexually-transmitted viruses like HIV, etc.
- Contact tracing: tracking down the contacts of infected individuals to treat, isolate, or quarantine them (at the moment, most countries are devoting many resources to this)
- Hygiene: hand washing, hand sanitizer, etc.
Dr. Michael Osterholm: “Once it starts to spread, there really is no stopping it”
Now for some bad news. Dr. Michael Osterholm is an internationally recognized expert in infectious disease epidemiology, who led many investigations into infectious disease outbreaks during his 15 years as state epidemiologist at the Minnesota Department of Health. He is currently the director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, and he was interviewed yesterday by the Fox Business News channel (this link is to the 5-minute video, which unfortunately cannot be embedded here).
Dr. Osterholm predicts that this epidemic will likely get a lot worse, given how easily the 2019-nCoV virus seems be transmitted between people. He said in this Fox interview:
It’s acting very much, in terms of transmission, like that of an influenza virus, which means that once it starts to spread, there really is no stopping it, until it decides to stop.
He predicts that hospitals and healthcare systems around the world are going to be overwhelmed with the Wuhan coronavirus in the coming weeks and months, just as those in mainland China are now. Not if, but when.
So, what does all this mean?
Well, referring back to that chart above, we have no vaccine, and we still don’t know how effective existing antiviral treatments will be (although we can expect many scientific research papers to be published as doctors conduct various experiments).
Countries outside China are relying on case isolation and contact tracing to chase down and isolate infected individuals, which may work (although some experts like Dr. Osterholm don’t believe it will be effective enough). Healthcare professionals are using proper hygiene and barrier precautions (personal protective equipment such as masks, gloves, eye protection, etc.) to avoid becoming infected with the virus themselves while treating patients. Many civilians are also starting to use barrier protections when out in public.
That only leaves two approaches which we will begin to see more of in the coming weeks and months: social distancing and quarantine. What this means for you, reading this now, is that you need to prepare yourself and your family for the possibility that you will need to stay in your homes for a period of several weeks, avoiding contact with as many other people as possible, as a wave of illness caused by the Wuhan coronavirus sweeps through your community, forcing schools, businesses, and public transportation and public gathering places like movie theatres and shopping malls to close (as we already seen in Wuhan and many other cities in China). The time to prepare for this is NOW.
I hope that this discussion has convinced you that you do need to start taking this seriously. That means that you need to prepare by stocking up on food and other supplies to last you at least two or three weeks. Start by reviewing the Personal Health Preparedness lists provided by the U.S. Centers for Disease Control and Prevention here.
You will need to have on hand:
- At least two weeks of food and other supplies (toilet paper, first aid supplies, soap and hand sanitizer, garbage bags, etc.). Hardcore, doomsday preppers would argue that you also need to store enough water for each person to last 2 or 3 weeks, but I think it is unlikely that we are going to lose public utilities in first-world countries, such as electricity, water, and sewer services, during an epidemic/pandemic. If stocking up on water makes you feel less anxious overall, do it.
- Refills of all your presecription medications, plus a stock of over-the-counter medicines (talk to your doctor and pharmacist about creating an emergency supply of your prescription medication). You might not be able to get out to your pharmacy because of the imposition of social distancing and quarantines to stop the spread of the virus.
- Power sources (flashlights, extra batteries, car chargers and adapters for your mobile devices, a battery-operated or hand-crank radio if the electricity or Internet do go out, which I still think is unlikely).
Other things that you should do:
- Sign up for any local alerts from your city, state/province, or federal government (or know where to find the information on the Internet). Find out what plans your employer is making.
- If you haven’t yet, get your seasonal flu shot. It can’t hurt, and it will help to figure out whether or not you do have 2019-nCoV if/when you do become sick. Many areas now give out the flu shot for free.
- Watch the following video from the World Health Organization on how wash your hands! (Yes, I’m serious. And stock up on soap. This will also help you avoid catching regular colds and influenza.)
Good Sources of Information on 2019-nCoV
Here is my updated list of good, authoritative resources to learn more about the Wuhan coronoavirus (more formally known as 2019-nCoV):
- the United Nations World Health Organization
- the U.S. Centers for Disease Control and Prevention
- Personal Health Preparedness information from the U.S. CDC
- Health Canada, including an FAQ and a fact sheet
- Public Health Canada
- Information for the Public from the Department of Health and Social Care and Public Health England (U.K.)
- Public Health Ontario (Canada)
- Coronavirus Information for the Public (British Columbia Centre for Disease Control; see also this series of tweets)
- University of Chicago Medicine
- 2019-2020 Wuhan coronavirus outbreak (Wikipedia)
- Dr. Roger Seheult is posting short videos to his YouTube channel, explaining the medical concepts behind the Wuhan coronavirus in an easy-to-understand way
If you want a quick, up-to-date overview of the current situation, here are three good places to check:
- 2019-nCoV Global Cases (by the Center for Systems Science and Engineering at Johns Hopkins University)
- Tracking coronavirus: Map, Data and Timeline by BNO News
- the Wikipedia article on the Wuhan coronavirus outbreak is constantly updated by an army of volunteer editors, and provides a good overall summary of the situation
Sources of Fast-Breaking News on 2019-nCoV (WARNING: News You Read Here May Not Be 100% Credible!)
PLEASE READ: In addition to the sources listed in the previous section, there are other places you can check, which might have reports (including translated links to local social media in China) that have not yet made the mainstream news media. Please keep in mind that the situation in China is chaotic, and that some of the information you find in the sources I list below might be gossip, rumours, hoaxes, conspiracy theories, misinformation, or disinformation!
Please review the information and videos I posted in my blogpost about How to Spot Fake News, BEFORE using any of these links.
- The FluTrackers.com discussion forum (note that it can be difficult to wade through all this information, as it is split up into threads)
- The China_Flu subReddit and wiki with FAQ
- The Intelliwatch Discord server (invite link) is a geopolitical events and crises discussion forum that has three channels devoted to 2019-nCoV/Wuhan coronavirus news, rumours, and speculation.
- The Corona Virus (2019-nCoV) Discord server (invite link)
- If you want a credible list of people to follow on Twitter, epidemiologist Dr. Ellie Murray has compiled a curated list of coronavirus experts that you can subscribe to.