Since the emergence of the novel coronavirus, SARS-CoV-2, many rumors began circulating surrounding preventative measures, modes of transmission, and treatments/cures. Some people are taking this outbreak less seriously than others comparing it to past pandemics and/or other viruses that affect humans such as the flu. One common statement that has been surfacing online is that this whole situation is being blown out of proportion, as more people die each year from the flu. If this is true, why must we take such drastic measures such as social distancing and self isolation? The flu has certainly never forced us to take such precautions, so what is different with COVID-19? We are still learning more and more about corona viruses everyday, but we are limited by the few examples of this class of viruses that have affected humans in recent years. How does this new disease, COVID-19, compare to other past viral outbreaks, and how can we use that data to our advantage?
It is true that many people die annually due to complications from being infected with the flu virus. Though comparing the flu and COVID-19 is a comparison between two viruses, it is not really a fair comparison to make. Strains of influenza have been studied for decades, and patterns of transmission and infection have become much more predictable as a result. This is not the case for corona viruses. Human corona viruses were not discovered until the 1960s with severe strains surfacing only within the past 20 years. This makes their behaviour difficult to anticipate. How do the different strains of influenza viruses compare to corona viruses in terms of mortality/morbidity from the current available data? The percentage of infected individuals in need of hospitalization is ten times higher than individuals with the flu. Only 1-2% of flu cases become severe whereas 20% COVID-19 cases become critical. That number may still seem low, but under the current circumstances, many already over-burdened hospitals are not equipped to handle that volume of cases which makes the drastic measures taken more important. Hospital stays are also twice as long on average for COVID-19, which puts even more strain on the healthcare system. Finally, COVID-19 seems to be spreading much faster for multiple reasons. It is not seasonal like the flu, humans have no built-up immunity to the virus, and there are currently no vaccines available. Though viruses all fall under the same class of infectious agents, they are so different in the way they behave and propagate, it is like comparing cats and dogs. Sure, they’re both animals, but ultimately, they must be handled very differently, just like these two classes of viruses.
In terms of comparisons, it is more effective to look at previous corona viruses and determine what we have learned from these past infectious outbreaks. Previous corona virus outbreaks that have largely affected humans include, severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS). In November of 2002, SARS emerged in China and developed over the subsequent months through to April when the World Health Organization (WHO) released a travel advisory requesting people to postpone travel unless completely necessary to prevent the spread of the disease. Over 8000 cases have been documented with a 10% mortality rate. Additionally, SARS has a higher transmission rate than COVID-19 from the currently available data. For every person infected with SARS they will, on average, infect 2-4 people, whereas every person infected with COVID-19 will infect 2-3 people. In September of 2012, MERS had emerged. WHO released an alert soon thereafter though as time went on, it seemed as if the virus was not able to spread from person to person as efficiently as SARS. For every person infected with MERS they would, in turn, infect only 1 or fewer people. Over 2000 MERS cases have been confirmed with the disease leading to a 37% mortality rate. It is also worth noting that these corona viruses all originated from animals with SARS arising from bats, MERS arising from camels, and COVID-19 likely also arising from bats. It is unclear how MERS got transferred from camels to humans; however, it has been accepted that SARS and COVID-19 most-likely originated from live markets in China where exotic animals were being sold for food.
With COVID-19 appearing in China 17 years after SARS first appeared, health officials were able to use what they had learned from the first corona virus outbreak and implement it during this current epidemic. In contrast to the SARS outbreak, the Chinese government reported the existence of a new virus, COVID-19, soon after its discovery, where they did not report the existence of SARS until 4 months after it had emerged. Once COVID-19 was discovered, immediate action was taken to shut down the live markets from which SARS had originated. Finally, China’s immediate action in notifying international leaders of COVID-19 allowed for the DNA of the virus to be analyzed in mere days compared to the 5 months it took for SARS. They found that the DNA of COVID-19 was 70% similar to the SARS virus. Experiencing SARS has enabled us to take what had happened during previous outbreaks and ensure that the same mistakes were not repeated.
The development of several vaccines for COVID-19 is underway, though it is estimated that it will be many months to a year before any vaccine will be approved. Considering vaccines, treatments, and diagnostic tests, what have we developed for SARS and MERS that can be used as potential starting points for the development of new drugs for COVID-19? Healthcare professionals were able to release a diagnostic test for COVID-19 so quickly because they developed a test using DNA sequence data they had obtained from the SARS virus. Being a close relative to COVID-19, testing developed during the SARS pandemic could act as a sufficient means of testing until they gathered more information about this new coronavirus. In developing treatments, antivirals used to combat the effects of Human Immunodeficiency Virus (HIV) had been effective in treating some aspects of SARS, and so they have also been investigated for use against COVID-19. Similarly, for vaccines and other treatments, computational research is being done on drugs used for SARS that can also hopefully shine light on some options for treating COVID-19 as well.
Living in such a globalized world has made it extremely easy for infectious diseases like this to spread across nations. Having experienced pandemics in the past has given us insight into handling situations like the one we are currently facing with COVID-19. Aside from travel restrictions and social distancing practices, given time, the hope is that adequate vaccines and treatments can be produced more efficiently with help from the knowledge we have gained from past pandemics.
Further Reading:
Zhou, Y., Hou, Y., Shen, J. et al. Network-based drug repurposing for novel coronavirus 2019-nCoV/SARS-CoV-2. Cell Discov 6, 14 (2020). https://doi.org/10.1038/s41421-020-0153-3
https://www.livescience.com/new-coronavirus-compare-with-flu.html
https://www.npr.org/sections/goatsandsoda/2020/03/20/815408287/how-the-novel-coronavirus-and-the-flu-are-alike-and-different
https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-disease-2019-vs-the-flu
https://www.ynhhs.org/patient-care/urgent-care/flu-or-coronavirus
https://www.technologyreview.com/2020/03/10/905405/flu-vs-coronavirus-6-differences/
https://www.marketwatch.com/story/coronavirus-vs-the-flu-its-just-like-other-viruses-and-we-should-go-about-our-normal-business-right-wrong-heres-why-2020-03-09
https://www.medicalnewstoday.com/articles/how-do-sars-and-mers-compare-with-covid-19#MERS
https://www.aljazeera.com/news/2020/04/coronavirus-comparing-covid-19-sars-mers-200406165555715.html
https://www.niaid.nih.gov/diseases-conditions/covid-19
Nkengasong, J. China’s response to a novel coronavirus stands in stark contrast to the 2002 SARS outbreak response. Nat Med 26, 310–311 (2020). https://doi.org/10.1038/s41591-020-0771-1
https://www.nature.com/articles/d41591-020-00002-4
https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/publicat/sars-sras/pdf/sars-e.pdf











