2019-COVID-19 Novel Coronavirus Outbreak - Updated

Go to the profile of Julie Grishaw, ACNP
Feb 17, 2020

The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have identified an outbreak of pneumonia caused by a novel coronavirus in Wuhan, China.  The coronavirus was initially termed “2019-nCoV”, but was named coronavirus disease 2019 (abbreviated “COVID-19”) by the WHO on February 11, 2020. The outbreak was first reported on December 31, 2019.  This virus was first identified by the WHO as a novel coronavirus on January 9, 2020.   

This post is being updated as of February 16, 2020.  As of February 16 2010, the WHO reports a total of 51,857 global cases.  A total of 51,174 cases are within China, with 1,666 associated mortalities.  Outside of China, 683 cases have been confirmed spanning 25 countries with 3 associated mortalities.  There have been a total of 15 cases in the United States spanning across 7 states with zero associated mortalities occurring in the United States.  Media outlets were reporting a death in the United States, but this was incorrect as of the date of this post according to WHO data. The severity of the outbreak has already surpassed the SARS epidemic in 2002 in terms of infected cases.

Coronaviruses comprise a large family of viruses and are a frequent cause of the common cold. Some cause less-severe disease, but more rarely, can cause severe disease as seen with the 2002 severe acute respiratory syndrome (SARS) and 2012 Middle East respiratory syndrome (MERS) outbreaks. The 2002 SARS epidemic, which originated in China, caused 8,300 illnesses and 785 mortalities.  A total of 1,879 cases of MERS have been reported with a 39% mortality rate.

The mode of transmission of coronaviruses is by respiratory aerosol, though the rates of human-to-human transmission varies between viruses. For example, the primary mode of transmission of MERS was camel-to-human transmission, with the rates of human-to-human transmission being very low. Initially, the likelihood of human-to-human transmission of COVID-19 was thought to be very low. The outbreak has a possible zoonotic origin, as it has been linked to a large seafood and animal market.  However, medical workers caring for patients in Wuhan city have become infected with the virus suggesting human-to-human transmission.  More information is being explored to determine the rates of human-to-human transmission, but safety precautions are currently being utilized to protect patients, providers, and the general public.

There is much to learn about the symptoms, severity, transmissibility and other features associated with COVID-19. The CDC and WHO are actively investigating this outbreak and have taken many precautions to ensure continued public safety. It has been discovered that COVID-19 is a betacoronavirus, which is the same type of virus as MERS and SARs.  These types of viruses originate in bats, suggesting an animal reservoir with animal-human spread. In China, there were initially no reports of human-human spread with reports of animal-human spread after contact with a seafood market.  As the outbreak continued, the Chinese government reported human-human spread.  There have been reports of human-human spread in the United States.  Please refer to the CDC statement on transmission of COVID-19 for more information as information on this topic is rapidly evolving.  Symptoms include cough, fever, and malaise. Symptom severity can range from very mild, such as resembling the common cold to very severe resembling pneumonia requiring ICU-level care. 

According to the CDC, The World Health Organization has declared the outbreak a “public health emergency of international concernexternal icon” (PHEIC). The CDC also reports that on January 31, the President of the United States (POTUS) signed a presidential “Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirusexternal icon“. These measures were announced at a press briefing by members of the President’s Coronavirus Task Forceexternal icon.

The CDC has also developed a real time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) test that can diagnose COVID-19.  

Read more:

Review of Medical Microbiology & Immunology: A Guide to Clinical Infectious Diseases, 15e: Chapter 38: Respiratory Viruses

The Centers for Disease Control and Prevention: 2019 Novel Coronavirus (COVID-19), Wuhan, China

World Health Organization: WHO Statement Regarding Cluster of Pneumonia Cases in Wuhan, China

Go to the profile of Julie Grishaw, ACNP

Julie Grishaw, ACNP

Senior Editor, McGraw-Hill Education

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