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Coronavirus: What we know and what isn’t yet clear

There are still more questions than answers about the disease which has infected more than 70,000 people in China, killing more than 1,800. Worldwide, 500 people are infected in 30 countries and three people have died.

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This undated electron microscope image made available by the U.S. National Institutes of Health in February 2020 shows the novel coronavirus SARS-CoV-2, yellow, emerging from the surface of cells, blue/pink, cultured in the lab. Also known as 2019-nCoV, the virus causes COVID-19. The sample was isolated from a patient in the U.S.

U.S. National Institutes of Health

SALT LAKE CITY — As the world reels from the coronavirus epidemic in China and the contagion’s spread to other parts of the world by way of global travel, one of the biggest questions is how severe the outbreak will be.

Already, more than 70,000 people have been infected in China and more than 1,800 have died. Worldwide, 500 people are infected in 30 countries and three people have died.

The coronavirus has been confirmed in seven states: Washington, California, Arizona, Texas, Illinois, Wisconsin and Massachusetts.

But Americans are not likely at severe risk at the moment, Dr. Anthony Fauci, longtime director of the National Institute of Allergy and Infectious Diseases, told USA Today. The United States has fewer than 30 diagnosed cases even after evacuating 14 people who developed coronavirus while quarantined on the Diamond Princess cruise ship and flying them home for treatment.

The Centers for Disease Control and Prevention has amassed a large amount of information about this coronavirus, now being referred to as COVID-19. Coronavirus is a category of viruses with proteins shaped like a crown. The disease currently causing concern is one of many coronaviruses. Symptoms include fever, cough and shortness of breath. The pneumonia associated with the illness can be deadly.

A panel of experts explored the illness’ lethality during the annual meeting of the American Association for the Advancement of Science last week in Seattle. Scott Dowell, deputy director of vaccine development and surveillance for the Bill and Melinda Gates Foundation, reported that dividing the number of deaths by the number of lab-confirmed cases of coronavirus indicated a possible 3% risk of death.

But the number is far from certain, in part because the disease is moving so fast that data for deaths may lag behind data on the number of people infected. And it’s also possible that milder cases have not been diagnosed, which could tilt the death rate far lower. Officials put the death rate from seasonal flu at no more than 0.2%. But how this novel coronavirus compares to that isn’t clear because of the uncertainty regarding what share of cases have been diagnosed.

Dowell reported that for each person who gets coronavirus, 2.5 more are infected, on average.

The United Nations reported that “by comparison, around 25% of MERS cases (a respiratory illness that flared a few years ago in the Mediterranean) resulted in the death of the patient. However, at this stage it is still too early to determine how deadly the virus is: Thousands of patients are being tested, with more than 8,200 in a serious condition, and it is not yet known how these cases will evolve.”

According to coverage of the AAAS panel discussion, “Some of these uncertainties about the virus have persisted because ‘China is not open and transparent,’ said Jon Cohen, a senior correspondent for Science magazine. ‘If you watch WHO’s press conferences or the U.S. CDC’s press conferences, Hong Kong has done this as well, they’re daily, they’re open, journalists get to ask questions … that’s not happening out of China, and my sources in China are largely reluctant to speak.’”

Multiple media reports have emerged of the Chinese government punishing people for talking about the virus. The most notable case was Li Wenliang, the Chinese doctor who initially reported the Wuhan coronavirus and was punished. He died of the very illness he tried to warn officials was a public health crisis, according to CNN and other sources.

Fauci said public health experts are puzzled over why children don’t seem to be as vulnerable to this coronavirus, when they along with old people are typically at higher risk than most others with other respiratory-borne illnesses. “I mean, there are no cases of kids less than 15 years old. Does that mean for some strange reason they’re not getting infected, or the illness is so mild in children that we’re not noticing it? It’s very clear the median age is 56 or 59,” he told USA Today.

Here’s some of what’s known — and what isn’t known:

It likely started with bats and was somehow transmitted to humans. It is now spread human to human through respiratory droplets from coughing and sneezing and from touching freshly contaminated surfaces. There is believed to be little risk from touching items shipped from one country to another over the course of days, the CDC reports.

A vaccine is months away — maybe more. While manufacturers are jumping into the race to create a vaccine, it will likely be close to a year or longer before any resulting medication is ready for the marketplace. Any potential vaccine has to be tested for safety first, then tested for efficacy and it all takes time.

Bloomberg reported that Sanofi Pasteur is teaming up with the U.S. Biomedical Advanced Research and Development Authority, a federal agency that funds research and development related to health threats. Sanofi’s approach is recombinant DNA technology, which exactly matches proteins on the virus surface. The company previously worked on a vaccine for SARS and its head of vaccine development, David Loew, said a prototype could be ready to test in the lab within six months, with human testing six months to a year after that.

BARDA’s also funding some of Johnson & Johnson’s research into a vaccine. Meanwhile. GlaxoSmithKline is part of the Coalition for Epidemic Preparedness Innovations, its approach focused on enhancing the body’s immune response to the virus.

Theories that it’s a bioweapon are probably wrong. According to Fauci, “There isn’t a bioweapons lab in Wuhan. There’s a biological containment that’s studying countermeasures against natural outbreak. Whenever you have a virus that you know has been studied in a lab, and virtually every virus is studied in a lab, and there’s an outbreak of a new virus, there’s always the suspicion that something either accidentally or deliberately was released. So, I mean, I can’t say absolutely that’s not the case. It is extremely unlikely that that’s the case, but you can find out if it is or not. And there are people who are actually looking at that right now. So I think we’re going to get some sort of an answer about that.”

People can help protect themselves and each other. The CDC recommends people take normal precautions against not just coronavirus, but against cold and flu. Those include getting a flu vaccine, washing your hands regularly with soap and water and staying away from others if you’re sick.

People who have recently traveled from China or been in contact with such travelers are asked to limit their contact with others for 14 days, which is believed to be the maximum incubation period for the illness.

A mask is more helpful to keep from spreading it than from getting it. While someone who is actively coughing and sneezing should wear a mask to prevent spreading respiratory secretions, most readily available masks are not completely effective at keeping illness out, health experts warn. They’re better at keeping your own secretions in.