How to try to stop an epidemic like the Wuhan coronavirus so that it does not spread throughout the world

Wuhan coronavirus numbers continue to grow. The 2019-nCov continues to be confirmed in more and more people, while the deceased grow. However, the progression of those affected follows the calculated expectations.

Furthermore, luckily, it does not seem to have gone out of control. The number of infected continues to be limited to China and the closest areas. At this time, the public health threat remains in the country, but there is no international alert. Why? This is largely due to the measures taken to control a possible pandemic. And what measures are we talking about?

How is a pandemic controlled so that it does not occur?

The World Health Organization (WHO) considers new diseases spreading globally or between two or more countries to be a pandemic; that is, a pandemic occurs when an unknown virus or a new strain of known viruses spreads in various countries of the world due to the lack of defenses against it.

So is 2019-nCov a pandemic? No. It is not precisely because of the measures imposed to prevent an epidemic, limited to a national territory (China in this case), from spreading uncontrollably between several countries. Yes, cases beyond China have been confirmed, of course. But at this point they are already controlled and there are no new cases from them.

In order to reach this situation, a series of measures must be taken, some characteristics of the virus and some luck. WHO and authorities generally rely on three phases in order to control a pandemic. Each of them, in turn, has different actions, depending on the specific situation.

First phase: predict

This phase precedes everything we are experiencing. It basically consists of generating data, investigating and applying models (done in the next phase, as we will now see) to predict potential pathogens and their behavior. We know who our main enemies are and we use that knowledge to be prepared, have a battery of data and prevent how a potential situation will develop.

Initially, this coronavirus was immediately identified as such due to our extensive experience with these, especially with the sadly celebrated 2003 SARS. So the first thing the researchers did, before discovering that it was a potential pandemic, was to compare the genetic code with existing coronaviruses. From there they discovered that this is more like a typical bat beta-coronavirus. With these data they began to predict, in the first days, how it would behave. At the moment the forecasts are being fulfilled with enough accuracy.

In fact, an algorithm predicted at first how it would spread by jumping from the Chinese region to Bangkok, Seoul, Taipei and Tokyo in the days after it appeared. And yes, he did it before it happened, as the word implies. The algorithm developed by a Canadian company specialized in monitoring the spread of infectious diseases, had already discovered the outbreak and notified its customers of the news. Interestingly, this algorithm collects information from Internet news and announcements, generating patterns and contrasting them with those expected from the virus.

Second phase: modeling and controlling

We are in this phase, mainly. When we come across a new virus, such as the Wuhan coronavirus, researchers immediately begin, using the data we were talking about, to contrast and generate new models that allow us to predict in the short term how the epidemic will spread. How many people does a patient infect? What fatality does it have? What is the incubation period? All of this information is collected as infections proceed and models are generated or corrected. These data will be used, when everything starts again, in the first phase.

During this phase, too, the necessary measures are generated to control the spread of an epidemic, preventing it from becoming a pandemic. The goal is to mitigate your data. Fortunately, with our technology and medical advances, today we can control a virus quite efficiently, which, although not very lethal, has been shown to be terribly contagious.

In the specific case of the Wuhan coronavirus, we are seeing how the control phase materializes in the suspension of flights to the country, including Spain. Advised by the WHO emergency, the rest of the countries are minimizing the opportunities for the virus to pass to new patients, spreading. Airways, due to their speed, range and, also because of the closeness with which they work with passengers, are especially important.

Phase Four: Treat

Overlapped with the previous phase, there comes a time when the disease begins to be treated. This may consist of treating a specific therapeutic target of the virus or treating its symptoms in a palliative way. The latter is what is usually done with coronaviruses, which do not have very effective treatments or vaccines and try to alleviate the symptoms to prevent them from becoming worse.

This phase works to mitigate infections and reduce the capacity for expansion by treating and controlling those affected. Normally this phase occurs at the same time that the disease begins to subside in number of cases. For the time being, it will take several months, at least, for effective vaccines to be developed against this new virus.

At the moment, an Australian laboratory has already managed to reproduce the 2019-nCov in the laboratory. This is an essential step in understanding how it works, what mechanisms work, and how we can use them to our advantage. In fact, this section is essential in order to develop a vaccine.

The secret is in control

Although all phases are important, and are also inseparable, we can probably highlight the special importance of control. The news of the closure of Wuhan and its surroundings, which has quarantined some 40 million inhabitants, already came to the fore a few days ago. But, despite how tremendous it seems, this is actually one of the most effective actions.

First, we are largely unaware of transmission mechanisms. This means that we cannot confidently stick to a model: is it transmitted in the incubation phase? Are there asymptomatic carriers? How many people can a patient infect? Without these data, there is only one answer: maximum prevention.

Part of this prevention also involves closing the means of transportation to prevent spread. To this we add routine bottleneck checks, such as airports and customs. In these controls, a basic analysis of symptoms and temperature is made. Even so, this is not enough, in light of the information that exists to date, so it is necessary to exercise extreme caution, even if this is annoying for travelers.

In the worst case, the movement of people and goods is completely cut off, waiting for the quarantine to pass. These measures, although economically and socially painful, are the best way to control a disease so that it does not go from epidemic to pandemic, allowing the rest of the phases to develop more efficiently.

Images | CNN, Wikimedia

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