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4 February 2020

Coronavirus shows why the world must urgently invest in epidemic preparedness

Funding from governments and the pharmaceutical industry to tackle infectious diseases has been waning for years. 

By Michael Barrett

The new coronavirus (2019-nCoV) is now rapidly spreading. At 6am on Tuesday morning (4 February), the Worldometer website, which updates the reported statistics continuously, was showing 20,629 cases with 427 deaths, mostly in China. As of 22 January, when I first wrote for the New Statesman on the virus (which was first reported on 31 December), it had affected around 600 people and killed nine. Since then, the daily reported increase has been around 1.4-fold higher than the day before. The fatality rate is around 2 per cent of those reported ill. It might be lower than this overall as even larger numbers of people may be infected but with relatively mild symptoms and without having been tested. At this current rate, we can predict that by this weekend there will be around 70,000 cases with 1,400 deaths. The virus has reached at least 27 countries, including the UK, and it takes between two and 14 days for symptoms to appear. 

If, by the weekend, the numbers of cases is significantly higher than 70,000, it means the epidemic is actually accelerating. If lower, then the remarkable efforts to contain the disease’s spread might be working. And the global response has been extraordinary. In spite of complaints that the Chinese government didn’t move swiftly enough, the reality is that although they were slow off the mark, their actions are unprecedented.

By 9 January, Chinese scientists had isolated the virus and sequenced its genome. This was enough to place the coronavirus very close to the Sars virus that caused a global crisis in 2002-03. In common with its cousin, the new coronavirus spread from animals, probably bats, via other wild animals to humans. The knowledge that it was comparable to Sars allowed us to consider the measures that were imposed back then when 8,096 people across the globe were affected and 774 died and the virus spread to 29 countries. 

Although the World Health Organisation held off from declaring a global public health emergency a fortnight ago, last week on 30 January it opted to make this declaration, stipulating that its biggest fear was the virus reaching countries with lesser ability to deal with it. (It took months for WHO to declare a similar emergency in the case of Sars.) The WHO also emphasised that there was no reason to impose any restriction on travel or trade. The next day, the US declared a public health emergency and shortly afterwards imposed a ban on entry to the country of any foreign national who had been to China in the preceding two weeks. Several other countries have similarly closed their borders to people travelling from China. 

Within China itself, the response has been extraordinary. The government blocked movement into and out of Wuhan from 23 January and multiple other cities and tens of millions of people are now locked in. The wearing of masks (ostensibly to prevent the transmission of the virus in respiratory droplets) is now mandatory in many cities. We have watched in amazement as hospitals, capable of holding 1,000 people were erected in just a few days in Wuhan, while emergency medical staff have been deployed in their thousands to the most affected areas. Equipping the hospitals with the apparatus needed to support the acute respiratory problems of the coronavirus victims is, however, proving tricky – the Chinese need help, not the kind of racist rhetoric with which they are being taunted by a world in panic mode.

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The country’s economy is suffering too. At one point yesterday, nearly 10 per cent had been wiped from the value of the Chinese stock market, which has just reopened following a six-day closure for the Chinese new year. The government is pumping billions of dollars into the economy through the purchase of shares from anxious investors. However, an economic slowdown seems inevitable given the draconian restrictions put in place within China and this will have global ramifications.

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What chances are there for a vaccine or drugs to treat coronavirus? In reality, there is nothing that can have an impact in the short term. Although efforts are underway, we need to remember there is no cure for the common cold (some cases of which are due to coronaviruses). However, the coronavirus outbreak is a critical reminder of the risks we face from contagious disease.

The Coalition for Epidemic Preparedness Innovations (CEPI), founded in 2017 by the Norwegian and Indian governments along with the Bill and Melinda Gates Foundation and the UK’s Wellcome Trust through the World Economic Forum, is likely to find itself the centre of intense attention. The CEPI yesterday received £20m in UK government money to accelerate the search for a 2019 coronavirus vaccine and the British drugs giant GlaxoSmithKline has joined the quest. 

However, we know relatively little about how to develop an effective vaccine for a virus that emerged this recently and we cannot expect one for at least a year or two, by which time the disease will hopefully have been contained. We must, however, reflect and dramatically increase the seriousness with which we treat infectious disease more generally. 

Investment from governments and the pharmaceutical industry has been waning for years. This is partly due to the increasing rarity of infectious disease in the developed world and partly due to a lack of return on investment in drugs that treat transient disease. The pharmaceutical industry prefers to chase chronic conditions, for which patients must take drugs for an extended period of time, rather than curing them quickly by eliminating a microbe. It seems likely that in addition to the human costs associated with the new coronavirus, this pandemic will end up costing in the order of trillions of dollars. Other epidemics will follow too. Bolstering epidemic preparedness with sustained investment must therefore be considered imperative. 

Michael Barrett is professor of biochemical parasitology at the University of Glasgow