Professor Hui’s update on therapy of Novel Coronavirus

The World Health Organization has announced that “COVID-19” is now the official name for the illness caused by the deadly novel coronavirus. The epidemic is raging globally. Up to 12 February, there were more than 40,000 confirmed cases, with a death toll of more than 1,000. More than 4,000 people have recovered. Behind these figures, we may have a lot of questions in mind. In a family, why are some members infected and some members not? Will a recovered person be infected again? Are there any medicines, any vaccines for this infectious disease? We’ve invited Professor David Hui of CUHK, who is in Geneva attending the international experts meeting convened by World Health Organization to explain the details.

Q: Why do some confirmed cases show no symptoms at all? In a family, why are some members infected and some members not?
A: As a matter of fact, most infected people do show symptoms. According to the existing statistics, around 98% of confirmed cases have fever, 70-80% have coughing, and around 3% have diarrhea. It is true that some infected people do not have fever, but they do show other symptoms after some time. Close contact is required for disease transmission. In general, family members (e.g. spouse and children) with mild disease may recover. Caring for the index patient at close distance may be infected through inhalation of respiratory droplets and contact with fomite. Patients with mild disease may recover spontaneously.

Q: What are the conditions of the infected cases?
A: Around 20% of them are in a serious condition, and most of these have a chronic illness such as diabetes, preexisting organ failure, immunocompromised conditions and obesity. The majority of the remaining has relative mild disease.

Q: Is there any treatment for COVID-19?
A: There is no specific medicine for this virus for the time being. Nonetheless, from the experience of SARS and MERS, doctors do have some medicines for patients. For example, there is an enzyme called protease in the virus. Kaletra is the medicine for containing the enzyme. There are also drugs called Ribavirin and Betaferon. We usually combine two to three medicines to fight this virus. And there is a drug developed in America called Remdesivir. This drug is currently under clinical test for mild, medium and serious patients in Wuhan Jinyintan Hospital.

Q: What is the progress of vaccine development?
A: Experts around the globe are working around the clock on vaccine research and development. Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, estimated that the first vaccine could be ready in 18 months.

Q: Will those who have recovered from the disease be infected again?
A: The causes of this virus are 80% similar to those of SARS. From SARS we know the antibody exists for up to 3 years while the antibody in MERS disappears after a few months. Currently it is unknown how long the antibody can last following infection with 2019-nCoV.

Q: What is the origin of this new virus?
A: According to the gene mapping of this virus, 80% of its gene is the same as that of the virus causing SARS while there is 96% similarity at the whole genome level to a bat coronavirus. From this understanding, we believe that the primary reservoir of this novel virus is the bat. But as to what the medium is between bat and human, we are still investigating and researching.

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