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In just a matter of days, Italy has reported an increasing number of cases linked to the novel coronavirus that is spreading rapidly across the globe. The coronavirus disease (COVID-19) has emerged in China late in December 2019 and has so far reached 30 countries.

Italy has now reported 155 confirmed cases of the novel coronavirus, with three deaths. Meanwhile, other countries have issued travel warnings and stopped trains from Italy in fears of patients with the virus to enter their borders.

ITALY, BERGAMO- 22 February 2020: medical services at the airport Bergamo-Milano investigate aircraft passengers who have arrived in Italy to minimize the risk of the spread of the coronavirus epidemic. Image Credit: Grabowski Foto / Shutterstock

The Italian government announced that neither entry not exit to the Veneto and Lombardy regions is allowed without having special permission. Prime Minister Giuseppe Conte said the government is working to control the situation and prevent a large-scale outbreak in the country.

Authorities have been ordered to strictly monitor the entrance and exit of residents, with fines imposed on violators. Further, the education sector of the country has said that classes and academic activities in the affected regions would be suspended between Feb. 24 and 29.

In abundance of precaution, Austria has stopped all trains from and to Italy after two passengers manifested coronavirus-like symptoms. At the border, officials denied entry to a train from Venice to Munich on Feb. 23 in fear that the two passengers may be infected with the deadly virus.

The country has placed about 50,000 people under quarantine in the affected regions.

Coronavirus is spreading

The World Health Organization (WHO) increases efforts to contain the virus and prevent its spread to other countries, fearing that if it infects people in a country with a poor healthcare system, it can cause devastating results.

As of writing, there are 79,152  confirmed cases of the coronavirus disease (COVID-19), which has spiraled into a global threat. Most of the cases were reported in mainland China, particularly in the ground zero of the outbreak, Hubei Province. There are 2,470 deaths linked to the coronavirus, prompting countries to impose travel bans, quarantine millions of people, and isolating ill patients in an attempt to stem the spread of the deadly virus.

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On the Diamond Princess cruise ship in Japan, where more than 3,000 people where quarantined, the last passenger has left, but the risk of infection still lingers as the ship crew, and health officials are still onboard. Also, raised fears of the possibility of the virus still spreading exist as a woman who tested negative days prior has now developed coronavirus-like symptoms. She has tested positive after returning home to Tochigi prefecture north of Tokyo by train from the ship.

The health minister of Japan, Katsunobu Kato, has also apologized after 23 passengers were allowed to leave the ship without being adequately tested. He said they would trace the passengers and have them retested.

Meanwhile, four of the 32 passengers from the Diamond Princess cruise ship taken to Arrowe Park, Merseyside, UK, have tested positive for the coronavirus. The total number of passengers from Europe who tested positive is 13.

Hurtling into a pandemic

A pandemic, according to the WHO, a pandemic is the worldwide spread of a new disease.

Though the WHO has not declared the coronavirus outbreak a pandemic, it had raised concern when a sudden spike in cases was reported in South Korea, Italy, and Iran.

“The window of opportunity is still there, but the window of opportunity is narrowing. We need to act quickly before it closes completely,” Tedros Adhanom Ghebreyesus, WHO Director-General, said.

During the first weeks of the outbreak, health officials meticulously traced all the possible contacts of every person who becomes infected with the coronavirus. Everyone with close contact with the patient will be advised to self-quarantine for 14 days and will be closely monitored for any symptoms.

However, with the number of current infections reaching 80,000, contact tracing can become impractical. If the coronavirus becomes a pandemic, a large proportion of the population across the globe will become infected. Though the term pandemic sparks fear, it pertains to how wide is the spread of the outbreak, not how fatal it is.

If stopping the spread of the virus from spreading is increasingly out of reach, public health officials and health agencies will have to move on to a new stage – to prepare for a pandemic, by strengthening the healthcare system of countries, fast-tracking treatments and vaccines for the infection, and providing care for those who are already infected.

Sources:

World Health Organization (WHO). (2010). What is a pandemic?. https://www.who.int/csr/disease/swineflu/frequently_asked_questions/pandemic/en/

World Health Organization (WHO). (2020). Coronavirus disease 2019 (COVID-19) Situation Report – 34. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200223-sitrep-34-covid-19.pdf?sfvrsn=44ff8fd3_2

Back in February 2018, the World Health Organization (WHO) talked about a new virus that will emerge and wreak havoc across the globe. Disease X was the term used for this new unknown pathogen that might cause a future epidemic.

Two years later, the novel COVID-19 coronavirus, has evolved from a mild to deadly virus and is spreading across the globe. This begs the question, is COVID-19 the dreaded Disease X that the WHO predicted back in 2018?

Disease X is a placeholder name adopted by the World Health Organization (WHO) for any new unknown pathogen that may cause disease and potentially an epidemic in the future. Image Credit: Lightspring

What is Disease X?

Disease X is a deadly plague and an outbreak of a flu-like illness, which can result in a pandemic that can kill millions of people worldwide. In 2018, the WHO classified Disease X as more deadly than the Lassa fever and the Ebola virus disease.

Disease X also represents the knowledge that a serious international epidemic could be caused by an unknown pathogen to cause morbidity and mortality. During that time, the diseases being studied by the WHO include the Crimean-Congo hemorrhagic fever (CCHF), Lassa fever, Ebola virus disease, Marburg virus disease, Nipa and henipaviral diseases, Middle East Respiratory Syndrome coronavirus (MERS-Cov), Severe Acute Respiratory Syndrome (SARS), Rift Valley fever (RVF), and the Zika virus.

Coronavirus infection magnitude

The coronavirus disease (COVID-19) is thought to have emerged in late December 2019 in a seafood market in Wuhan City, Hubei Province, China. Since then, the virus has spread to 30 countries across the globe.

As of writing, there are 79,152 confirmed cases of the deadly virus, and it has killed 2,470 people, most of whom in the epicenter of the outbreak in Hubei Province. The majority of the cases were in mainland China, while outside the country, South Korea reported the greatest number of infections, with 763 cases, followed by Italy with 155 cases.

The WHO has declared the coronavirus a global health emergency on Jan. 30 due to the rapid spread of the virus. Many countries have already closed their borders from countries with many confirmed cases.

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South Korea has seen the rapid spread of the disease in the country, prompting officials to declare the highest alert advisory. The number of cases increased from 31 on Feb. 18 to a staggering 763 six days after. The sudden spike in infections can be traced to the city of Daegu. Officials have identified a religious group, the Shincheonji Church of Jesus, as a coronavirus hotbed, where an infected woman attended masses for several occasions.

The virus has spread to 30 countries, including South Korea, Italy, Japan, Singapore, Hong Kong, Iran, Thailand, United States, Taiwan, Australia, Malaysia, Germany, Vietnam, the United Arab Emirates, France, Macau, Canada, the United Kingdom, Philippines, India, Russia, Spain, Lebanon, Nepal, Cambodia, Israel, Belgium, Finland, Sweden, Egypt, and Sri Lanka.

Is the coronavirus the Disease X?

The coronavirus is fast spreading, and if it is not contained, it can become catastrophic. The WHO director-general Tedros Adhanom Ghebreyesus raises concern about the increasing number of the coronavirus without a clear epidemiologic link.

He added that what they fear is if the virus spreads to a country without a sound and strong healthcare system. He fears that if the virus reaches these countries, which have weak healthcare systems, it can be devastating.

Now, scientists caution that the virus’s way of infection is still unclear. During the first weeks of its spread, the incubation period was estimated to be a couple of days to 14 days, but new cases have emerged with longer incubation periods. Further, the disease can be transmitted from human to human, with aerosol and droplets as a possible mode of transmissions.

With several things still unclear about the virus and how it spreads, scientists say that the novel coronavirus fits the disease X category.

“Whether it will be contained or not, this outbreak is rapidly becoming the first true pandemic challenge that fits the disease X category, listed to the WHO’s priority list of diseases for which we need to prepare in our current globalized society,” Marion Koopmans, head of viroscience at Erasmus University Medical Center in Rotterdam, and a member of the WHO’s emergency committee wrote in the journal Cell.

“Time will tell whether the consolidated efforts of the Chinese authorities and the international public health and research community will succeed. But we also need to understand how we make this model of preparedness future-proof,” she added.

Sources:

World Health Organization (WHO). (2018). Prioritizing diseases for research and development in emergency contexts. https://www.who.int/activities/prioritizing-diseases-for-research-and-development-in-emergency-contexts

World Health Organization (WHO). (2020). Coronavirus disease 2019 (COVID-19) Situation Report – 33. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200222-sitrep-33-covid-19.pdf?sfvrsn=c9585c8f_2

Zhang, Y., Koopmans, M., Yuen, K., Andersen, K., Perlman, S., Hogue, B., and Eckerle, I. (2020). The Novel Coronavirus Outbreak: What We Know and What We Don’t. Cell. https://www.cell.com/cell/pdf/S0092-8674(20)30171-9.pdf