This is not a warning! Along with the first case of coronavirus being confirmed in our very own state of Kerala (a medical student who returned to Thrissur from Wuhan), the World Health Organisation (WHO) has officially declared the new virus a “public health emergency of international concern”. The virus has been detected in 21 other countries according to the WHO. The total death toll globally stands at 170, as of now. This is deeply disturbing as another case has come to light in which a ten year old boy was infected along with his family but didn’t show any discernible symptoms. More cases such as this might have gone undetected at airport screenings, children may not exhibit apparent symptoms can further complicate matters; India has screened nearly 50,000 inbound travellers and one case has been detected. Unlike the SARS epidemic of 2003 where detection was easier, this novel virus, officially called the “2019-nCov” might have already spread further than anticipated. From the epicentre; the Chinese city of Wuhan, some reports indicate that the virus was developed as a biological weapon (Wuhan is the only city in China where biological weapon is sanctioned): chemical and biological warfare is banned across the world according to United Nations Conventions. There are 7700 registered cases in China alone. 

Coronaviruses occur in animals, though most of these strains do not affect humans and most of them are undocumented, very few of them “evolve” into deadly epidemics which are spread from animals to humans (like MERS-Middle East Respiratory Syndrome and SARS-Severe Acute Respiratory Syndrome). These viruses cause respiratory ailments such as the common cold, most people suffer from very mild viral symptoms and carry on with their lives, at worst these can cause pneumonia or bronchitis. The symptoms the virus has exhibited thus far include fever, cough, runny nose, difficulty in breathing, muscle aches, headaches, sore throat and loose stools. And in some cases, lead to Severe Acute Respiratory Infection (SARI), Pneumonia, Renal Failure, Multi Organ Damage Syndrome (MODS). 

There is no cure as of now; experts are rushing across the globe to develop a vaccine. Death from the virus is caused due to respiratory failure. So if a person has weakened lungs from smoking or other reasons; he/she is at greater risk. The mortality rate stands at around 10%. Cases of kidney failure have also been reported. The incubation period ranges anywhere between 4 days to 2 weeks. What makes matters worse: the lack of complete understanding. Opinions are divided, as people are languishing in quarantine across the world. 

The virus, like SARS; seems to have spread from “wet markets” where live animals are sold alongside other cuts of meat in dingy narrow stalls and without much hygiene. They are called “wet” because animals are slaughtered in front of customers; which means the virus can easily spread through air in the form of an aerosol. China is infamous for being the world’s biggest importer of illegal wildlife, some of these poor animals are carriers of the virus and as they are not screened upon entry and exit from countries; they can very easily transmit the virus into meat which will be consumed by humans. Both SARS and 2019-nCov are coronaviruses; these are “zoonotic”, meaning they are transmitted from animals to humans. Bats seem to be the original hosts of these, though some reports see the Chinese cobra as being genetically closest to the virus. Nevertheless, illegal trafficking of animals is downright wrong and must be emphatically banned, no excuses, no exceptions.

The Emergency Committee of the WHO has convened a rare meeting amidst declaring this a global epidemic. Cases of person to person transmission have been reported even in the United States which boasts the world’s most comprehensive screening examinations upon reentry into the country. What should concern Indians in general is how poor airport screening is here. How many people may have already entered the country before the severity of the virus came to light? Around 800 people who have travelled back from China are in quarantine in Kerala, how many more are roaming about, witless and unquestioning; spreading the disease? These are truly shocking times and governments will not report the full picture, ever. It is people, people who might feel such symptoms, people who might want to share information or awareness: it is people who can help each other by standing up and taking care. WHO Director-General Tedros Adhanom Ghebreyesus said the "continued increase in cases and the evidence of human-to-human transmission outside of China are, of course, most deeply disturbing."

Obviously , travel to China must be avoided , great care must be given to even common cold , report to a hospital in case you believe your symptoms resound those of the 2019-nCoV , advise family and friends , keep away from crowded spaces, spread awareness , this is the best way to fight ; even if the times seem helpless.

with Dr. Akshay Budhraja

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