Link What is a coronavirus?
Menachery: Coronaviruses are a family of large RNA viruses. They are named for their crown-like appearance. The spike protein of the virus gives it that shape and is the key molecule for entry into a cell. Changes in the spike protein are usually associated with the emergence of new coronavirus strains. These spikes are the "key" to getting into a cell.
We know the new coronavirus is in the same family as SARS. It is distinct, about 20 percent different in terms of its RNA genome, but pretty close to SARS in [terms of] the tools the virus has.
How long could it take for scientists to create a vaccine for the virus?
The process has already started. These vaccines can be ready to test in a few weeks, but require significant safety testing in humans. The longest part will be that safety testing and the regulations associated with that.
Is there any evidence the virus is evolving in a way that might render a vaccine ineffective?
RNA viruses do evolve, although coronaviruses evolve slower. While it might evolve to become more efficient, coronaviruses are not as diverse as influenza and mutations would not be expected to render the vaccine ineffective in the short term.
How does this virus compare to other coronaviruses, or common viruses like influenza, in terms of its spread and impact so far?
So far, it’s hard to predict. There are many cases, arguing the virus is very transmissible. It has already passed SARS in terms of transmission. There have also been deaths, but it is difficult to get a full picture. I anticipate the lethality rate will be lower than SARS, [which had a lethality rate of] 10 percent, but it looks like there will be many more cases. The virus is most severe in people over the age of 50 and with preexisting health conditions.
What takeaway message about this coronavirus outbreak do you want to give people reading along at home?
We still are limited in what we know about the novel coronavirus. More will be learned soon. For people in the United States, the flu is a greater threat than the novel coronavirus and it is not too late to get your flu shot.
Zoom Out: Preparing for an Outbreak
Expert: Saad Omer is the director of the Yale Institute for Global Health and an expert in infectious diseases and epidemiology. He has written about the U.S. public health system and how it can better prepare itself for dealing with serious disease outbreaks in the future.
How prepared is the U.S. to deal with a possible outbreak of this virus?
Omer: We are, as a country, as a public health system, as a scientific community, better prepared than we were for SARS or for past epidemics. Are we as prepared as one would want to be? No, we have room to grow. But we certainly have more tools than we did before.
What are some of those tools?
The [genetic] sequencing from the virus became available very quickly and that wouldn’t have been possible in many of the previous outbreaks. We increasingly have an environment of open sharing of data — that comes with a few asterisks, but overall it’s a good thing. At least 12 entities have indicated they have vaccine programs or are working on a vaccine for this novel coronavirus. The gaps do exist, but we are better prepared than we were before.
What are some of those gaps in the U.S.?
How we deal with this virus could dictate the ultimate size of the outbreak. The way our system in this country works, and it works well, is that you have top-tier public health agencies, like the [Centers for Disease Control and Prevention], and then you have state and local health departments. It works because you have the local knowledge and the central expertise.
But that infrastructure has not received the resources it needs, or has even seen cuts. And that’s my concern. That resiliency has been undermined, or has not been at the level it should be, because it hasn’t received the financial resources it needs.
What are solutions to that problem?
Long term, we need to get out of this habit of pumping the public health system full of resources when we have an outbreak at our doorsteps and then [later] starving the public health infrastructure of resources. We need to have a more strategic approach.
In the short term, what is happening is actually a little bit reassuring. The response is being led by scientific agencies like the CDC, which sets us up for science-based, evidence-based decisions. Those kinds of solutions are our best bet at this point.