Whether we classify the new coronavirus as a pandemic or not, the issue is serious. Do not underestimate it. In less than two months it has spread over several continents, but the virus does not care what we call it. A pandemic implies a sustained, efficient and continuous transmission of the disease simultaneously in more than three different geographical regions. Perhaps we are already in that phase, but that is not synonymous with death, since the term does not refer to the lethality of the pathogen but to its transmissibility and geographical extension.
What undoubtedly does exist is a pandemic of fear. For the first time in history we are experiencing an epidemic in real time : all the media, several times a day, every day, all over the planet, talk about the coronavirus. We follow the drip of each of the cases live. It has even been headline news that the virus in Brazil has mutated three times!
I insist: the issue is serious, but one of the first victims of the coronavirus in Spain has been the Ibex35. We must report what is happening, but we also need good news. Here are ten of them.
1. We know ‘who’ it is
The first cases of AIDS were described in June 1981 and it took more than two years to identify the virus causing the disease. The first cases of severe pneumonia were reported in China on December 31, 2019 and by January 7, the virus had already been identified.
The genome was available on the 10th. We already know that it is a new group 2B coronavirus, from the same family as SARS, which is why we have named it SARS-CoV-2. The disease is called COVID19.
It is related to the bat coronavirus. Genetic analyzes confirm that it has a recent natural origin (between the end of November and the beginning of December) and that, although viruses live by mutating, their frequency of mutation is not very high.
Phylogenetic analysis of the complete 2019-nCoV genomes and representative Betacoronavirus viruses. The Lancet – Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding.
2. We know how to detect it
Since January 13, an RT-PCR assay to detect the virus has been available to everyone. In recent months, this type of test has been refined and its sensitivity and specificity evaluated.
3. In China the situation is improving
The strong control and isolation measures imposed by China are paying off. For several weeks now, the number of diagnosed cases has decreased every day.
Of the total number of hospital cases, suspects have dropped to only 2.4% and the number (36,271) has decreased to practically half the maximum of February 8 (66,193).
In other countries, very detailed epidemiological monitoring is being carried out. The bulbs are very specific, which can allow you to control them more easily. For example, in South Korea and Singapore.
4. 80% of cases are mild
The disease does not cause symptoms or they are mild in 81% of cases. In the remaining 14% it can cause severe pneumonia and in 5% it can become critical or even fatal.
5. People heal
The only data that is sometimes shown in the media is the increase in the number of confirmed cases and the number of deaths, but most infected people are cured. There are 13 times more patients cured than deceased , and the proportion is increasing.
6. It does not affect (almost) minors
Only 3% of cases occur in those under 20 years of age, and mortality in those under 40 is only 0.2%. In minors the symptoms are so mild that it can go unnoticed.
7. The virus is easily inactivated
The virus can be effectively inactivated from surfaces with a solution of ethanol (62-71% alcohol), hydrogen peroxide (0.5% hydrogen peroxide) or sodium hypochlorite (0.1% bleach), in just a minute.
Frequent hand washing with soap and water is the most effective way to prevent infection.
8. There are already more than 150 scientific articles
It is the time for science and cooperation. In just over a month, 164 articles can be consulted in PubMed on COVID19 or SARS-CoV-2, in addition to many others available in the repositories of articles not yet peer-reviewed (pre-prints). They are preliminary works on vaccines, treatments, epidemiology, genetics and phylogeny, diagnosis and clinical aspects.
These articles are written by about 700 authors spread throughout the world. It is science in common, shared and open. In 2003, when the SARS thing happened, it took more than a year to get less than half the items.
In addition, most scientific journals have left their funds on coronaviruses open.
9. There are already prototype vaccines
Our ability to design new vaccines is spectacular. There are already more than eight projects against the new coronavirus. There are groups working on vaccine projects against other similar viruses and now they are trying to change viruses.
What can lengthen its development are all the necessary tests of toxicity, side effects, safety, immunogenicity and effectiveness in protection. For this reason, there is talk of several months or years, but some prototypes are already underway.
For example, the mRNA-1273 vaccine from Moderna consists of a fragment of messenger RNA that encodes a protein derived from the surface glycoprotein S of the coronavirus. This company has similar prototypes for other viruses.
Inovio Pharmaceuticals has announced a synthetic DNA vaccine for the new coronavirus, INO-4800, also based on the S gene on the surface of the virus. For its part, Sanofi will use its recombinant baculovirus expression platform to produce large quantities of the surface antigen of the new coronavirus.
The vaccine group at the University of Queensland, in Australia, has announced that it is already working on a prototype using the technique called molecular clamp, a novel technology that consists of creating chimeric molecules capable of maintaining the original three-dimensional structure of the viral antigen. This makes it possible to produce vaccines using the virus genome in record time.
Novavax is another biotech company that has announced its work on the coronavirus. It has a technology to produce recombinant proteins that are assembled into nanoparticles and that, with their own adjuvant, are powerful immunogens.
In Spain, it is the group of Luis Enjuanes and Isabel Sola from the CNB-CSIC who have been working on vaccines against coronaviruses for years. Some of these prototypes will soon be tested in humans.
10. There are more than 80 clinical trials with antivirals in progress.
Vaccines are preventive. More important still are the possible treatments for people who are already sick. There are already more than 80 clinical trials to test treatments against the coronavirus. These are antivirals that have been used for other infections, that are already approved, and that we know are safe.
One of those that has already been tested in humans is remdesivir, a broad-spectrum antiviral, still under study, that has been tested against Ebola and SARS / MERS. It is an analog of adenosine that is incorporated into the viral RNA chain and inhibits its replication.
Another candidate is chloroquine, an antimalarial that also has potent antiviral activity. It is known to block infection by increasing the pH of the endosome that is needed for the virus to fuse with the cell, thereby inhibiting its entry. This compound has been shown to block the new coronavirus in vitro and is already being used in patients in whom the virus has caused pneumonia.
Lopinavir and Ritonavir are two protease inhibitors used as antiretroviral therapy that inhibit the final maturation of the AIDS virus. As the SARS-CoV-2 protease has been shown to be similar to that of HIV, this combination has already been tested in coronavirus patients.
Other proposed tests are based on the use of oseltamivir (a neuraminidase inhibitor used against the influenza virus), interferon-1b (protein with antiviral function), antisera from recovered persons, and monoclonal antibodies to neutralize the virus. New therapies with inhibitory substances, such as baricitinibin, selected by artificial intelligence, have even been suggested.
The 1918 flu pandemic caused more than 25 million deaths in less than 25 weeks. Could something similar happen again today? As we see, most likely not. We have never been better prepared to fight a pandemic.
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Ignacio López-Goñi, Professor of Microbiology, University of Navarra
This article was originally published on The Conversation. Read the original.
