Coronavirus – What you should know

The current spread of coronavirus across several continents has the potential to elicit significant anxiety and worry amongst the general public. As health professionals, it is important that we are equipped with the most up-to-date knowledge of this outbreak so that we are able to give a measured response with appropriate recommendations.

Whilst the trajectory of this outbreak is impossible to predict, and the situation is rapidly evolving, here is what we know so far about the current coronavirus outbreak.

[Information correct as at date of publication, 29 January 2020.]

Human coronaviruses (HCoVs) have long been considered inconsequential pathogens, causing the “common cold” in otherwise healthy people. However, the emergence of the SARS-CoV in the early 2000s and MERS-CoV in 2012 caused global epidemics with alarming morbidity and mortality.

The current outbreak is caused by a novel strain from the coronavirus family. This virus is so new that it does not yet have a name – it is currently being labelled by the World Health Organization (WHO) as the 2019 novel coronavirus or 2019-nCoV.

The virus is thought to have originated from a seafood market in Wuhan, a central Chinese city. Currently, all 5 confirmed cases of the virus in Australia are in individuals who have recently visited Wuhan with no human-human transmission occurring in Australia, although such cases are expected, and have occurred in China.

At this point in time, the virus has been responsible for approximately 130 deaths. [As at time of publishing this blog, 6 February 2020, this stands at 493 however the current estimated fatality rate below of 2–3% remains relevant.] In all of these cases, the individual has suffered from an underlying condition, was elderly or frail, and therefore had reduced ability to mount an appropriate immune response. Currently, there are no available effective medical treatments.

The main causes for concern relate to what is not known about the virus.

  • It is not known how virulent this strain of coronavirus is.
  • It is not known how it is transmitted or how long it lives on surfaces; however, it is thought that coming within a 1-metre radius of an infected person increases the likelihood of transmission.
  • It is not known if the person is able to transmit the virus before symptoms appear.
  • Thankfully, the 2019-nCoV appears to have a much lower fatality rate than previous coronavirus outbreaks such as SARS and MERS, or other deadly viral diseases such as Ebola. The current estimated fatality rate of the 2019-nCoV is approximately 2–3%. Individuals who have died from this coronavirus are individuals who would have been at similar risk from a common seasonal influenza, which helps to contextualise the lethality of this outbreak. However, it is possible that the virus could mutate and become more deadly. For perspective, the mortality rate of SARS was 10%, MERS was 36%, whilst the Ebola virus killed 50% of all individuals infected.

 

Current recommendations to help prevent the spread of the virus are common-sense recommendations which are applicable to viruses such as influenza, and especially apply to people travelling or working in healthcare.

The WHO recommendations include:

  • Regularly wash your hands with soap and water for at least 20 seconds.
  • Cover your nose and mouth when sneezing or coughing with a tissue or flexed elbow. Avoid coughing into your hands. Throw the tissue into a closed bin.
  • Avoid close contact with individuals who display cold and flu-like symptoms.
  • Avoid touching your eyes, nose and mouth. A face mask may help you to remember to not touch your face.
  • Avoid travel if you have a fever or a cough.
  • Avoid travel if you are immunocompromised or have a chronic illness, or if you are regularly in close contact with individuals with such conditions.
  • If you have a fever, cough or difficulty breathing, seek medical care early and share your travel history with your health care provider. Let your doctor know before you present to their clinic that you have respiratory symptoms so that you are not kept waiting with other patients.
  • If you feel unwell during your travels, notify your travel crew.
  • Eat only well-cooked food while travelling.

Whilst we still do not know a lot about this virus, supporting your immune system during this outbreak – particularly those planning to travel or who are healthcare workers or for individuals who work in public spaces – is a prudent preventative approach.

A naturopathic approach should take a heavy focus on immunomodulation. Excessive stimulation of the immune system may be detrimental. In the case of the SARS-CoV, it is not known whether the virus itself is the causal fatal agent or whether macrophages recruited to the lungs in response to infection with SARS-CoV cause fatal immunopathological changes, leading to acute respiratory distress.

A range of naturopathic prescriptions are helpful for improving immunity, supporting the respiratory system and also treating viral and bacterial infections. Factors such as a wholefood diet, staying physically active and nutrients and herbs such as vitamins C, D, A, E, zinc, selenium, NAC, green tea and medicinal mushrooms have been shown to provide comprehensive immune support.

Written by BioMedica Nutraceuticals & Karly Fisher, Naturopath