The new coronavirus - the opinion of the European Centre for Disease Prevention and Control

In the last days, an increasing number of the new coronavirus COVID-19 cases has been confirmed in various countries around the world, e.g. South Korea and Iran. In the EU extraordinary measures are being taken to limit the outbreak. On 23 February, the ECDC issued a statement on the rapid increase of COVID-19 in Italy. On 24 Febuary, a joint WHO/ECDC mission arrived in Italy to support Italian authorities in managing the COVID-19 situation.

ECDC is closely monitoring the situation and assessing the overall risk for the EU/EEA. The European Science-Media Hub contacted the ECDC and asked for some insights.

What is the most urgent EU could do now? How should EU/EEA countries contain the virus?

The first step to prevent the spread of the virus in the EU/EEA is the timely detection of imported cases, applying appropriate infection prevention and control measures around the cases and, as needed, tracing contacts.
It is important for EU/EEA countries to focus on containment measures that prevent and/or limit secondary transmission in the community and healthcare settings, as part of their risk management capacity.
To this end, countries should ensure early detection, laboratory confirmation, appropriate management and isolation of suspected, probable and confirmed cases under appropriate IPC conditions, along with rigorous tracing and follow-up of contacts. Once local transmission chains are established, public health resources will be better used to focus on mitigation measures.

How big is the risk of pandemia?

At the moment it is regarded as an epidemic, not a pandemic. It is the WHO’s role to declare a pandemic and we should be careful with wording (we are not in the business of speculating).

An outbreak is the occurrence of more cases of a disease than would normally be expected in a specific place or group of people over a given period of time.
The term epidemic essentially means the same thing but tends to connote a more serious occurrence. While an outbreak might suggest something that is geographically limited or constrained, an epidemic infers a crisis situation that can spread. It’s a subtle difference but an important one.
By contrast, a pandemic is an epidemic that is widespread and often global, usually affecting a very large number of people. While the term is suggestive of something more serious than an epidemic, it is only so by scale and not by the severity of the disease.

How can I avoid getting infected?

When visiting areas with presumed ongoing community transmission you should:

avoid contact with sick people, in particular those with a cough;
avoid visiting markets and places where live or dead animals are handled;
follow general rules governing hand hygiene and food hygiene;
wash your hands with soap and water OR use an alcohol-based disinfectant solution before eating, after using the toilet and after any contact with animals;
avoid contact with animals, their excretions or droppings.

Wherever you travel, apply general rules governing hand and food hygiene.

Some information about the new virus

This outbreak is caused by a novel coronavirus and therefore there are still many unknowns and a lot of uncertainty. This includes uncertainties regarding the virulence and pathogenicity of the virus, the severity of the disease in affected patients, its transmission patterns, and its clinical spectrum. Epidemiological analyses available to-date are limited which leads to many uncertainties on the characteristics and the evolution of the outbreak. We know that this virus is a coronavirus and is genetically related to the Severe Acute Respiratory Syndrome (SARS) coronavirus that caused an epidemic in China in 2003. SARS emerged at the end of 2002 in China and more than 8 000 SARS-cases were reported by 33 countries over a period of eight months. At the time, one out of ten people with SARS died.

Coronaviruses were identified in the mid-1960s and are known to infect humans and a variety of animals (including birds and mammals). This family of viruses are known to cause illness in humans ranging from the common cold to more severe or even fatal diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).

Previous severe coronavirus-associated diseases such as SARS and MERS have been less transmissible than influenza but they have been prone to large localised and nosocomial outbreaks. Based on the viral sequences openly shared, this novel coronavirus is genetically closely related to the 2003 SARS virus, hence the name of the new virus SARS-CoV-2.
There are currently no vaccines against coronaviruses. The COVID-19 has caused so far more cases than SARS in a shorter timeframe. This suggests that COVID-19 is more easily transmissible than SARS. Based on preliminary data, estimates of the basic reproductive number (i.e. the average number of cases generated from one infectious case) range from 2.2 to 2.6. The estimated basic reproductive number for SARS was between 2-3. Most estimates of the basic reproductive number for MERS-CoV are less than 1.