M.S. Individualized Genomics & Health Candidate
Johns Hopkins University
In the last six weeks, 2019 Novel Coronavirus (2019-nCoV) has posed a new emerging public health challenge. As of February 4th,, 2020, there’s been over 20,500 confirmed cases of infection (the majority being in China, Hong Kong, and Macau) and 425 including one in the Philippines).1 The virus has spread to 27 countries and there are currently 11 confirmed U.S. cases throughout California, Washington, Arizona, Illinois, and Massachusetts – 82 cases are still pending results.2 The World Health Organization announced the 2019-nCoV outbreak as a global emergency, prompting immediate action from medical authorities and disrupting global markets.
Coronaviruses are enveloped RNA viruses that primarily infect birds and mammals and have been shown to cause respiratory, enteric, hepatic, and neurologic disease in humans. Respiratory illnesses range from upper respiratory tract infections with symptoms such as coughing, wheezing, and shortness of breath, to lower respiratory tract infections that cause more severe illness such as pneumonia or bronchitis.3
The name coronavirus is derived from Latin corona, meaning crown, referring to the crown-like spikes on the virus surface that work as tools to bind, fuse, and penetrate a host’s cells. There are six coronaviruses known to cause human disease, with four of them being relatively harmless, including the typical cause of the common cold.4 2019-nCoV is now the seventh member of the coronavirus family that has a similar but distinct genome compared to the more virulent and deadly coronaviruses, SARS-CoV and MERS-CoV, which carry mortality rates of 10% and 35% respectively.5
In late December 2019, multiple local health facilitates reported clusters of patients with pneumonia due to an unknown cause linked to a seafood and wet animal wholesale market in Wuhan, Hubei Province, China. Details from a report published January 24, 2020 in the New England Journal of Medicine described isolation of the virus from bronchoalveolar-lavage fluid samples taken from patients who presented with severe pneumonia and were confirmed visitors of the Wuhan wholesale market. From more than 20,000 viral reads obtained from the individual specimens, viral genome sequencing results indicate that most overlapping DNA segments of 2019-nCoV show more than 85% identity with SARS-like CoV genome.4 To understand pathogenicity, scientists infected human airway epithelial cells in vitro with 2019-nCoV. Cytopathic effects were observed 96 hours after inoculation.4
Data sharing has been rapid and vast in response to the new emerging 2019-nCoV threat, but it’s still too early to effectively measure virulence. In the meantime, prevention, detection, isolation, and containment must remain collective global priorities. Epidemiological methods such as patient isolation, contact tracing, quarantine, screening at international borders, and infection-prevention measures at hospitals are pivotal during public health emergencies. Multiple countries, including the U.S., have enacted travel restrictions to and from China. In a Wall Street Journal report, a Chinese Foreign Ministry spokeswoman criticized the restrictions as, “overreaching” since the WHO has not endorsed a travel ban; however, over-precaution should not be dismissed when facing the threat of a novel infectious disease.6 The reality is, if uncontrolled, a single-stranded RNA virus could bring a global economy to its knees. Businesses may find short-term economic pain inconvenient and disruptive, but it’s a drop in the bucket compared to the catastrophic consequences a global pandemic could cause on long-term growth and population health.
Until there’s international consensus and notice, persistent vigilance against the spread of 2019-nCoV is warranted in order to contain the virus and prevent further infection. Advancements in next-generation sequencing technology, bioinformatics, drug development, and newly approved detection screening tests will assist in combating the emerging threat but international transparency, collaboration, and cooperation must take precedence. Halting 2019-nCoV will be an outstanding global feat made possible if we continue working together to stop its spread.
1.) Wee, Sui-Lee (New York Times). Beijing Sees ‘Major Test’ as Doors to China Close and Coronavirus Deaths Surpass SARS.
2.)Centers for Disease Control & Prevention (CDC). 2019 Novel Coronavirus.
3.) Schoeman, D., et al. (2019). Coronavirus envelope protein: current knowledge. Virology Journal.
4.) Zhu, N., et al. (January 29, 2020). A Novel Coronavirus from Patients with Pneumonia in China, 2019. The New England Journal of Medicine.
5.) Dobson, M. (2015). Murderous Contagion: A Human History of Disease. Quercus Publishing. Print.
6.) Abbott, B., et al. February 3, 2020. Coronavirus Outbreak a Major Test of China’s System, Says Xi Jinping. The Wall Street Journal.
Coronaviruses (artist’s impression) have a crown-like halo. Credit: Pasieka/Science Photo Library. Source: https://www.nature.com/articles/d41586-020-00253-8