We learn a little bit more every day about “Covid-2019”. But time is running out: with more than 2,500 dead in just a few weeks, this virus proves to be extremely contagious and much more devastating than the SARS (2002-2003) which had caused “only” 775 deaths … ‘a year.
The epidemic has spread beyond Chinese borders to Europe, where there are fears of the appearance of new outbreaks after those of Italy. Four countries in the Middle East announced the first cases of people infected on their territory on Monday: Kuwait, Bahrain, Iraq and Oman.
The latest announcements and discoveries deliver some reassuring elements … and others much less. Detailed review.
The reassuring points
• Very quickly, the Chinese authorities communicated the genome of the virus, which enabled the rapid development of an effective diagnostic test, the first step towards research on a treatment, even a vaccine. And a better way to detect the disease, whose symptoms are close to the flu.
China has announced that the first human vaccine trials could take place as early as April. WHO, meanwhile, says it would take at least a year to get a vaccine that is operational and usable on a large scale. And if the virus mutates by then, maybe everything would have to be started again.
Fatal in 2.3% of cases
• Covid-19 is said to be fatal in 2.3% of cases, according to a study by the China Center for Disease Control and Prevention involving 72,314 people. The disease is “mild” in 80.9% of cases, “severe” in 13.8% of cases and “critical” in 4.7% of cases. People over 80 are the most exposed, with a mortality rate of 14.8%. Up to the age of 39, this rate remains very low: 0.2%.
• Dr. Tedros Adhanom Ghebreyesus, Director General of the World Health Organization (WHO), said “that there has been no significant change in the DNA of the coronavirus”. Experts have found that people without severe symptoms recover in about 2 weeks. For the most affected patients, this period can range from 3 to 6 weeks.
• Olivier Véran, Minister of Health, announced that 70 additional hospitals will be “activated” to deal with the possible spread of Covid-19 in France. France will also strengthen its diagnostic capacities.
• The situation remains stable in France for the moment: there are no longer any hospitalized patients in France, according to Minister of Health Olivier Véran.
The worrying points
WHO has declared an international emergency and called on Monday to prepare for a possible Covid-19 “pandemic”. And for good reason: despite these reassuring points, others have cause for concern.
• In China, the death toll reached 2,592 people and more than 77,000 infected. Authorities have “completely” banned the trade in wildlife suspected of facilitating the spread of Covid-19. WHO assures, however, that the epidemic is receding in the Middle Empire.
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• Researchers at the Center for Infectious Diseases at Imperial College London estimate “that about two-thirds of Covid-19 cases from China have gone undetected globally, potentially resulting in multiple chains not being detected of human transmission outside China “.
According to specialists, each patient would infect around 2 or 3 people, but some patients have a higher potential for contamination. Steve Walsh, a 53-year-old Briton who stayed in a chalet in Contamines-Montjoie (Haute-Savoie), was one of these “super-propagators”. It would have infected at least 11 people.
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Transmissions without clearly established link
• WHO is concerned about the increasing number of cases “without a clear epidemiological link”. In Italy, scientists are struggling to identify the “patient 0” of Lomardia and Veneto. Impossible then, to define a precise circle of contaminations. The difficulties in identifying the original patients from the new outbreaks suggest that the contamination could result from an asymptomatic individual.
For Arnaud Fontanet, head of the “epidemiology of emerging diseases” unit at the Pasteur Institute (France), this “community transmission” makes “control much more difficult and suggests a risk of introduction from other outbreaks than China. ” Cases reported in Lebanon and Canada may have originated in the Iranian outbreak.
More deadly than previous viruses
• The number of cases and the number of deaths have reached new levels for a coronavirus. Seven such viruses can infect humans, and the deadliest so far have been SARS (775 dead in 2002-2003) and the Seas (858 dead in 2012). The Covid-19 is therefore already – largely – more deadly.
The peak still not reached?
• The peak seems far from being reached: the number of new cases is increasing every day. Ditto for the number of deaths: increasing from 20 to 30 per day the first weeks, it now increases by a hundred each day.
But above all, we realize that, far from diminishing, the progression of the disease accelerates. A “peak” remains, at this stage, hypothetical. And unpredictable. Impossible therefore to predict the regression, and even less the end of the epidemic.
A fairly long incubation
• This virus can mutate at any time. And become more or less contagious, more or less pathogenic. It would be a new leap into the unknown.
• Incubation could reach 27 days! Enough to make the 14-day quarantine useless … However, the information should be taken with caution: more than half of the patients studied have indeed displayed a very short incubation, the longest cases should therefore remain exceptional. And, above all, it is difficult to know precisely the day on which a person was infected.
Not systematic fever
• Another bad surprise: the fever is not systematic, as we mistakenly believed. Only 88% of patients had it. Especially more than one in two patients did not have one when they were admitted to the hospital. And one in three patients had no cough. What make, again, the detection of patients a little more random …
• The virus was finally detected in the stool of 6.5% of patients, which may constitute an additional mode of contamination.
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