After new cases of the new Sars-CoV-2 coronavirus, it is still not clear how the outbreak will develop. The chance that the virus can still be contained in China is still there, but it is getting smaller every day. Some researchers believe that we are already in the early stages of a pandemic, such as Neil Ferguson from Imperial College London.
Charité virologist Christian Drosten also says that one has to be prepared for a pandemic. But what does that mean? What would it look like if the virus spreads further in Germany?
Pandemic sounds like death and destruction. After the Spanish flu, for example, the 1918 probably more than 50 millions of people fell victim. But not every pandemic is so devastating. If the new virus spreads in Germany, this could also become noticeable as a flu wave, which is a cold for most and only becomes life-threatening for some.
If a Covid – 19 – If a pandemic should come, the country is currently most likely to be suffering from a severe flu outbreak, said the President of Robert Koch Institutes, Lothar Wieler, on Thursday evening in Berlin. And for this scenario, there is a lot that speaks so far about Sars-CoV-2.
From throat to throat
The most important point is that the virus can obviously reproduce quite well in the throat. “This is a big difference to Sars,” Drosten also said on Thursday.
Initially, because of the similarity of the new corona virus to the Sars pathogen, researchers had assumed that the new virus would also multiply, especially in the deeper airways. This is because there are important binding sites that apparently use both the Sars corona virus and Sars CoV-2 to slip into the cells.
“A virus like this has to be inhaled into the lungs, and that's a long way to go,” said Drosten. With influenza, however, the virus multiplies in the throat. Researchers believe that is precisely why the flu is spread so easily. Because the way from throat to throat is not as far as from lungs to lungs.
“Based on initial patient observations, we now suspect that the novel coronavirus is also multiplying in the throat, as is the case with influenza.” said Drosten. Even in early infected patients, the virus can regularly be isolated from throat swabs in the laboratory.
An important key figure is still missing
There is yet another point that the virus could trigger a flu-like pandemic: the mortality from the pathogen. According to Drosten, data outside of China indicated that the chances of dying from the viral disease were in the 0.2 percent range. This is similar to the typical influenza pandemics of 1957 or 1968.
Even if the information is still “very woodcut-like”, it is an overall picture, “which now indicates a course similar to a flu pandemic, even if it becomes a pandemic.”
To find out how quickly the virus can spread, however, scientists need further information from China – for example the “attack rate”. This epidemiological figure shows how many of the people who can be infected have actually been infected. It is also used to predict the number of victims from an epidemic. This helps to provide resources for medical care and to produce vaccines and medicines.
Drosten hopes that this measure will soon be derived from the outbreaks outside of China. One communicates intensively with these countries, said RKI boss Wieler. China itself is “extremely challenged with this huge outbreak and is certainly not in a position to deliver all possible figures now”.
“There is no culprit”
Like all countries outside of China, one is currently in the containment phase, said Wieler. That means you want to prevent long-lasting infection chains in the population. So far there have been cases in Germany 16, of which 14 due to the infection by a Chinese employee of the automotive supplier Webasto. Infections that do not originate in China are not yet known.
“So far there has been optimism that containment can keep the spread of the virus at bay,” said Wieler. But of course you can't promise that.
“At some point it will probably happen that unnoticed infections are suddenly noticed,” said Drosten. The most important thing then is to make it clear that there is no culprit and nothing to scandalize. “This is a natural phenomenon.”
“We want to save time and decouple”
Even in the USA, it would not be possible to prevent “the virus from entering our country”, said Peter Redfield, director of the American Center for Disease Control and Prevention (CDC), the online portal Stat. But you can save time by extending the containment phase as much as possible.
RKI boss Wieler is also counting on this: “A major goal that we currently have is to decouple these two waves – the current wave of influenza and the corona virus that may come.” That is why they are so reliant on containment outside of China. “We want to save time and decouple,” said Wieler. This is to prevent the health system from being overwhelmed.
As soon as infection chains occur in Germany that don't As a result of contact with China, experts believe that the containment of the virus has failed. Then you could assume that the virus made it into the population and you would have to change the strategy.
Then the focus would no longer be on containing the outbreak elsewhere, but on mitigating its consequences.
For most people only one cold
If the new corona virus really started a second wave of influenza, it would be difficult to maintain normal supply, said Drosten. Planned surgeries may then have to be postponed because intensive care beds that are actually needed for surgical patients are full.
In addition, the health offices, which are sparsely staffed, would then be “completely overloaded”. “Doctors' offices will be full of patients and normal patients with other diseases will have to wait,” said Drosten.
The virologist does not see any reason to panic: “We have zero risk in Germany at the moment Population”. It is important to inform yourself and to deal with it. For the vast majority of patients, the infection – if it did come – will appear as a cold.
And in contrast to influenza, preliminary data shows that children are infected but “practically not” become more seriously ill. Pregnant women are also not particularly affected – this is also a major problem with influenza. According to the current status, the risk groups of pneumonia due to the new coronavirus mainly include older and previously ill patients, men more than women.
“All of this is available knowledge,” said Drosten. He thinks it makes more sense to use this knowledge to prepare for a possible wave of illness than to “look spellbound at China, where things happen with dramatic television pictures that are still very small extracts from reality”. (with smc)