The first case of an unknown source of the new coronavirus in the United States has just occurred this week in California, 50 miles from San Francisco. The mayor of this city declared a state of emergency. San Diego and several other U.S. counties have done the same, even without having a single case. World markets falter. Trump and members of his cabinet gave a press conference about the new coronavirus, trying to calm the public and the markets.
It is first appropriate to update the new terminology. The official name of the disease is Covid-19, while the virus that causes it is SARS-CoV-2. With this taxonomy, the World Health Organization tries to avoid stigmas against countries or populations. A pandemic is the spread of a new disease worldwide. With more than 83,000 cases and 2,850 deaths in 53 countries, it is reasonable to talk about Covid-19 as a pandemic. China, as the country of where the disease originated, has the highest number of cases (79,000), followed by South Korea (almost 2,000), Italy (655), Iran (245) and Japan (214). In the United States there are 60 confirmed cases, with recent evidence of local transmission, not linked to travelers from China or other endemic countries. It is strange that there are only two reported cases on the African continent — one in Egypt and one in Algeria — when there is a large Chinese presence in Africa. In Latin America, only one case has been reported in Brazil.
The numbers reported above refer only to confirmed cases with a specialized and expensive diagnostic test (called RT-PCR) that is not available everywhere. Many infected people who are asymptomatic or have mild symptoms, and who have not received the diagnostic test, are not counted. The actual number of infected people is therefore much higher. The obligatory question is when the SARS-CoV-2 will arrive in Mexico, or if it is already there and we have not yet detected it: The absence of evidence is not evidence of absence. Mexico has a good epidemiological surveillance system, derived from previous administrations, and a current undersecretary experienced with the previous H1N1 influenza pandemic. However, the existence of a semi-failed state, coupled with deep budget cuts in health, will require a strategic and well-coordinated prevention effort, avoiding complacency.
Covid-19 presents with common symptoms: fever and dry cough in 80% of cases; difficulty breathing with pulmonary fluid in 15%; and need for intensive care in 5%. It is estimated that an infected person infects another 2 or 3 people. The incubation period is on average 5 days. The distinctive thing about people with Covid-19 is that they can transmit the disease even when they are not exhibiting symptoms. It is striking that there have been no deaths in children under 9 years of age. On the other hand, cases in people aged 70 – 79 have a lethality of 8%, and those over 80 of 15%. The risk of death is greater in people who already suffer from chronic diseases, such as hypertension, diabetes or heart disease.
The economic and social consequences of this new pandemic, in addition to human suffering, are incalculable. The supply chain is already being severely affected, as are the tourism industry and international travel. Countless cultural, scientific and business events have been canceled due to fear of contagion. The Olympic games in Japan could be canceled. It is important to avoid panic, as well as conspiracy theories.
The good news is the enormous worldwide scientific progress, which has allowed us to isolate the virus and identify its genomic sequence in a matter of days. An experimental vaccine is already being tested in animals, and a drug (remdesivir) in humans. This new coronavirus pandemic, like the previous ones, will eventually be controlled.
This essay was originally published in Spanish in Reforma. Jaime Sepúlveda is director of the Institute of Global Health at the University of California, San Francisco. George Rutherford is a professor at the same Institute.