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Tuesday, May 12, 2020

It’s very natural to compare COVID-19 to the flu. Influenza has been around for centuries, it has caused pandemics in modern times, and we have grown used to hearing about “seasonal flu” and recommendations to get this year’s new vaccine.

But the coronavirus is a different animal. A different virus, that is, with a different family, genus, and species from the flu. Back on Day 59 we talked about seven of them: four coronaviruses that cause the common cold and three, previously found in animals, that are new to the world of human diseases. So new, in fact, that their first outbreaks are both in the 21st century. And this is their first pandemic.

These three new coronavirus diseases are called SARS, MERS, and COVID-19.

SARS (severe acute respiratory syndrome) first surfaced in humans as an atypical pneumonia in November, 2002, in Guangdong Province in China. An infected doctor carried it to Hong Kong, where it spread along international air routes to Toronto, Hanoi, and Singapore. For the SARS coronavirus, with an incubation period of up to 10 days, traveling to Canada was just as easy as traveling to Vietnam.

At first this disease was a puzzle. They tested patients for influenza, anthrax, pulmonary plague and other viral diseases. By March, 2003, the World Health Organization had named it SARS and a month later recognized it as a new coronavirus. By May 8, 2003, there were over 7000 cases reported from 30 countries on 6 continents. In their report, WHO stated, “SARS demonstrates dramatically the global havoc that can be wreaked by a newly emerging infection disease.”

SARS should look pretty familiar to us now. The symptoms are fever, body aches, and a dry cough. It spread in droplets from a cough or sneeze. Researchers sequenced its RNA and developed a PCR test. They studied how long it could survive on various surfaces and whether it was present in different body fluids.

There were only 8 cases in the United States, and all in people who had traveled to the Far East. By 2004 SARS had disappeared, most likely, according to the NIH, “due to intensive contact tracing and case isolation measures” in the places where it had spread.

Work on the vaccine continued. In time a vaccine was developed but never sold. The research on the SARS vaccine is an advantage to our efforts to develop a COVID-19 vaccine today.

What about MERS, the other cousin in the coronavirus family? MERS or Middle East respiratory syndrome was identified in 2012 and spread to 27 countries. Symptoms were–you can guess–fever, cough, shortness of breath. WHO reported 2,519 cases and 866 deaths, over a third. 80% of the cases were in Saudi Arabia and the two cases in the U.S. had lived in Saudi Arabia. There are still cases now and then. Research efforts later led to a “DNA vaccine candidate” for MERS which had clinical testing in 2019.

Here’s what I’ve learned from all my research–purely my own conclusions, but I feel they are supported by the sources listed below.

  • As a coronavirus disease, COVID-19 has much in common with MERS and SARS and is not like the flu.
  • MERS and SARS were defeated by intense epidemiological measures like case identification, isolation, and contact tracing. The vaccines came later. Therefore “herd immunity” did not play a role.
  • Although they had a higher mortality rate than COVID-19, they appear to have been less contagious. Our challenge today is that we are dealing with a coronavirus that spreads very fast.
  • The cooperative international efforts on MERS and SARS were a major factor in defeating them and a major advantage to us now.

Basically, epidemiological measures are our best bet for containment while we work on getting a vaccine as soon as possible.

I don’t always like my conclusions, but there it is.

“What’s to stop a some form of SARS showing up?” Bill Gates, in a November 2014 interview with the Wall Street Journal.

Today’s Notable Headlines

“Why the Economic Recovery Will Be More of a ‘Swoosh’ Than V-Shaped,” Wall Street Journal, Tues. May 12. https://www.wsj.com/articles/why-the-economic-recovery-will-be-more-of-a-swoosh-than-v-shaped-11589203608?mod=searchresults&page=1&pos=3

“WHO sees ‘potentially positive data’ in treating coronavirus,” Reuters, May 12, 2020. https://www.reuters.com/article/us-health-coronavirus-who/who-sees-potentially-positive-data-in-treating-coronavirus-idUSKBN22O1HG

Press release: “Coordinated Strategy to Accelerate Multiple COVID-19 Vaccine Candidates Is Key, NIH Experts Say,” May 11, 2020, National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/news-events/coordinated-strategy-accelerate-multiple-covid-19-vaccine-candidates-key-nih-experts

“Premature end to U.S. state lockdowns could cause needless death, Fauci tells senators,” Reuters, May 12, 2020. https://www.reuters.com/article/us-health-coronavirus-usa/premature-end-to-u-s-state-lockdowns-could-cause-needless-death-fauci-tells-senators-idUSKBN22O1Y7

Sources for this article:

 “Severe acute respiratory syndrome (SARS): Status of the outbreak and lessons for the immediate future,” WHO publication,  Geneva, 20 May 2003. https://www.who.int/csr/media/sars_wha.pdf?ua=1

CDC site: https://www.cdc.gov/sars/

Coronaviruses, National Institutes of Allergy and Infectious Diseases. https://www.niaid.nih.gov/diseases-conditions/coronaviruses

“SARS Vaccine Could Be Stopgap Measure Against the New Coronavirus, Study Suggests,” Discover, Feb. 2, 2020. https://www.discovermagazine.com/health/sars-vaccine-could-be-stopgap-measure-against-the-new-coronavirus-study

“MERS-CoV vaccine is safe and induces strong immunity in Army-led first-in-human trial. Medical Press, July 25, 2019. https://medicalxpress.com/news/2019-07-mers-cov-vaccine-safe-strong-immunity.html

Why am I doing this?

The coronavirus pandemic will be indelibly written on our memories just as the Great Depression or the Battle of Britain left their mark on past generations. It is my intention to journal the events of these days from three perspectives: as a retired medical technologist, a historian (Ph.D., 2014), and an ordinary person living through an extraordinary crisis.

You are on History’s Edge.

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