Truths and tensions: On DOH confirmation of first nCoV case in PH

In December 2019, a newly identified disease from Wuhan, China caused an outbreak. 

The epidemic has since spread across other locations, including, Macau, Taiwan, Australia, Cambodia, Canada, France, Germany, Japan, Malaysia, Nepal, Sri Lanka, Singapore, Thailand, The Republic of Korea, United Arab Emirates, United States, Vietnam, Hong Kong, India, and the Philippines. 

Now, 7,824 are confirmed to have been infected by the outbreak with 170 confirmed dead. As of press time, the first case of the novel coronavirus in the Philippines was announced by the Department of Health (DOH) on the afternoon of January 30, while 29 other individuals are being closely monitored for the virus.

Virus origins

Coronaviruses are an infamous family of viruses that originate from numerous animal species. In an interview with The LaSallian, Dr. Esperanza Cabrera, University Fellow and microbiologist, describes these infections as zoonotic or diseases that commonly circulate among animals—specifically, camels, bats, and cats—and in rare instances, they evolve and infect humans. These conditions may affect the sinuses, the vocal cords, and lungs, making it difficult to breathe normally. Those infected with the virus have shown symptoms similar to the common cold, including cough, runny nose, headache, and fever. However, people with underlying medical conditions are more vulnerable to the virus, possibly developing severe diseases such as pneumonia and kidney failure. Children and the elderly are also vulnerable to the disease.

The newly-identified coronavirus, dubbed the novel coronavirus or 2019-nCoV, is considered a cousin of the Severe Acute Respiratory Syndrome coronavirus (SARS-CoV)—a different strain that caused 774 deaths out of the 8,098 infected individuals across 17 countries, including the Philippines, during the SARS-CoV outbreak of 2003. 

Another strain discovered in 2012—the Middle East respiratory syndrome coronavirus (MERS-CoV)—also exhibited similar symptoms such as fever, cough, shortness of breath, and pneumonia. 

All two coronaviruses have similar symptoms, modes of transmission, and origins. In terms of severity, meanwhile, the mortality rate of the new virus is currently at two percent, while SARS-CoV and MERS-CoV were at 10 and 34 percent, respectively. However, the 2019-nCoV’s relatively low mortality rate of the new strain does not completely indicate how deadly it could be, as there could still be further developments of the outbreak. Additionally, it appears that symptoms of the 2019-nCoV take longer to develop than SARS-CoV and MERS-CoV. Symptoms start to manifest after a week for SARS-CoV and MERS-CoV, while 2019-nCoV symptoms may appear after 10 to 14 days.

A developing epidemic

Cabrera attributes the transmission of the 2019-nCoV from animal to human from “the close association of man with animals carrying the 2019-nCoV.”  This led to the prevailing theory that the virus emerged from a wet market in Wuhan, a place where various animals that could carry the virus are sold. 

An article in the Journal of Medical Virology suggests that snakes are the most likely animal reservoir for the 2019-nCoV—a claim which received criticism from experts. “There’s no consistent evidence of coronaviruses in hosts other than mammals and Aves (birds),” University of São Paulo Virologist Paulo Eduardo Brandão tells Nature, expressing his skepticism on the ability of snakes to carry coronaviruses at all.

Meanwhile, researchers have also linked bats to the virus. A report by scientists from the Wuhan Institute for Virology found that the 2019-nCoV is 96 percent similar to a coronavirus found in bats—which are commonly sold at Wuhan’s wet market. 

Since then, more people have been infected with the virus. Further, coronaviruses can also be spread by coughing or sneezing, or by contact with contaminated objects, food, and drinks.

In terms of how fast the virus is spreading, there are still no concrete findings. “It’s estimated that one infected person can transmit the virus to four people in a close distance,” Cabrera explains. To prevent the disease from causing an outbreak, its reproduction rate must be brought down to below one percent, she explains.

In an effort to shed light on this mysterious disease, scientists from all over the world are studying the virus. In Melbourne, Australia, researchers have successfully recreated the 2019-nCoV in their lab after receiving samples from an infected patient—a feat that may be used to create a new early-diagnosis test for people who are suspected of having the infection. Dr. Mike Catton from the Peter Doherty Institute of Infection and Immunity told BBC that this breakthrough can also be used in the development of vaccines for the 2019-nCoV.

Staying safe

The first case of the 2019-nCoV in the Philippines is a 38-year old female Chinese patient who arrived in the country from Wuhan last January 21. Before she was admitted to a public hospital in Metro Manila on January 25, the patient was said to have also visited Cebu and Dumaguete. 

Prior to the announcement of the country’s first case of 2019-nCoV, isolation units have been assembled at the San Lazaro Hospital in Manila, where two patients are currently under observation for the virus. Dr. Ferdinand De Guzman, the spokesperson of the hospital, announced that the Pediatric Infectious Diseases Critical Care Unit, Adult Infectious Diseases Critical Care Unit, and Payward will all be utilized as isolation units. The aforementioned units are negative pressure rooms equipped with ventilation systems designed to filter contaminated air before it leaves the room. Afterward, the organisms in the air are then killed by sunlight. De Guzman reiterates that the aforementioned patients cannot have visitors.

With these developments, DOH and the University’s Health Services Office (HSO) urge people to remain vigilant, recommending proper hand and respiratory hygiene by washing hands with soap and water to prevent infection. They also advise covering one’s nose and mouth when sneezing or coughing to avoid further transmission and avoiding close contact with sick individuals and wild animals. The HSO also recommends that students who have traveled to places with confirmed cases of the novel coronavirus consult the clinic for signs and symptoms.

The 2019-nCoV outbreak continues to escalate, with important questions yet to be answered—such as how quickly the virus spreads and how deadly it could get. Scientists have yet to develop a vaccine or specific treatment for the virus. Nonetheless, the World Health Organization recommends that the global community “demonstrate solidarity and cooperation” as efforts continue toward understanding and containing the virus.

Correction: January 30, 2020, 7:41 pm
The original article incorrectly stated that there were three patients under monitoring in San Lazaro Hospital, where there are only two
as of press time. The publication apologizes for the oversight.

Update: January 30, 2020, 8:15 pm
An additional sentence was added to include a recommendation of the University’s Health Services Office.

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