"Call for calm and caution". This is the mantra that provided the background to the long chat I had with Xavier Stranges. Head of Epidemiology and Biostatistics Department to the Western Ontario University in London, in Canada. I have the pleasure and honor of having him as a friend. I thought of him to write something that could be useful in what, even before an epidemic, is presenting itself as a wave of terror with few precedents. The so-called Coronavirusin fact, it has also arrived in Italy.
Coronavirus, constantly evolving
The six-hour time zone does not help but, despite the amount of commitments these days, the Italian scientist does not deny himself and finds time for what will be a very interesting chat. "Keep in mind that what I tell you could be proven wrong within a few days, it is a constantly evolving situation". It is precisely for this reason that Saverio invites me to be cautious several times. “I want to say that before this chat I had the opportunity to read up and be able to speak with Michael Silverman Head of the Infectious Diseases Department of our University Hospital". As I later found out, in the past, Silverman has also actively engaged in research in the field ofHIV and SARS. "By virtue of the data in the possession of the scientific community, today we can categorically deny one thing: the Coronavirus or COVID-19 is absolutely not a laboratory experiment".
“It is simply part of that category of viruses that mutate and that, precisely because of this mutation, are able to transfer the infection from animals to humans. In fact, it is no coincidence that the markets were indicated for the first Coronavirus outbreaks, as for the SARS. Among the animals recognized as natural reservoirs of viruses there are certainly bats ". According to the website ofHigher Institute of Health, these mammals are recognized as containers of over 100 viruses (including, for example, MERS and Ebola). “Let me also say something in favor of the Chinese National Health System which is one of the most advanced in the world. There are colleagues who have worked in China for years and they are a cutting-edge medical scientific community in many sectors. And, without a doubt, if a vaccine were to be obtained in a short time, it will also be thanks to the work of Chinese researchers ".
Coronavirus: high contagiousness
"What is worrying is undoubtedly the high rate of contagiousness". And here we enter a field that has left me speechless. “According to the latest data published by JAMA (one of the most famous scientific journals in the world ed) as of February 24 the infectiousness index is 2,28 ". Basically, an infected person could infect up to 2,28 people. To give some examples: normal flu has an index of 1,3, SARS between 1,8 and 2,4 and Spanish flu 2,0. Undoubtedly numbers that are scary. The average incubation is approximately 14 days while the survival of the virus on the surfaces with which it comes into contact (and which could be touched inadvertently) is not yet known.
“The mortality rate is about 2,3%, also taking into account the data from Ground Zero and, that is, Wuhan, but it is a figure that could also change according to the evolution of the epidemiological picture. The lethality of the normal seasonal flu is estimated at around 0,1%. It must also be taken into account that this mortality rate is probably an overestimate, because the denominator contains only the confirmed cases, not counting the many cases not yet detected. Obviously, if it were to become a pandemic, the percentages would be destined to change and to be revised ". Obviously, in this case, one must necessarily take into account the fact that, at this moment, the infections are "limited" to some countries and not to the whole world. “It would have been important, as far as Italy is concerned, to be able to trace the movements of patient zero with certainty. I am developing the idea that the virus has been circulating in Italy for quite a while since the outbreak of the epidemic. This is also probably why it was not possible to find patient zero. I'm afraid they closed the barn when the oxen had run away ".
Hopes for the future
“The people most at risk are certainly those who already have complex clinical pictures, or elderly people with pre-existing chronic conditions." The research, after the first ineffective tests on drugs used for example to fight malaria and HIV, is moving towards the study of a vaccine solution. These are obviously situations to be managed calmly and with great caution, the whole situation is, in fact, still evolving. We trust in the heat, so that it can, as has already happened in the past, mitigate or drastically reduce the effects of the contagion ".
“The invitation is obviously to use the most elementary rules for personal hygiene, but I would advise everyone to give an example of great civic sense if they are or must pass through those places where outbreaks of contagion have occurred. Only in this way will it be possible to better contain the epidemic and drastically reduce infections ". We too appeal to common sense, cold blood and civic sense of each and every one, so that this period can soon be a bad, very bad memory.
We would like to clarify that the situation is constantly evolving so the estimates are only the current ones and could, therefore, change with the evolution of the epidemiological picture.
