Where did this new coronavirus come from?

The virus, designated as SARS-CoV-2, is believed to have originated in bats, as indicated by the U.S. Centers for Disease Control and Prevention (CDC). The first human cases were reported in December 2019 in Wuhan, China, with early instances linked to individuals who visited a large animal and seafood market. Previous outbreaks of coronaviruses, such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), also have their roots in bats.

How contagious is this coronavirus?

Current knowledge suggests that the virus spreads between humans, though the exact level of contagion remains uncertain. Viruses can vary greatly in their transmission efficiency; for instance, measles is significantly more contagious than the preliminary assessments of this coronavirus suggest, according to Nancy Messonnier, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases.

A potential reason for the rapid spread may be delays in confirming early cases in various countries, particularly since testing capabilities have only recently expanded beyond a few specialized laboratories, including those in China and at the CDC.

“As the confirmation of cases improves, reporting will seem faster—not necessarily due to increased spread of the disease, but rather because of quicker identification and confirmation,” states Dr. Wilbur Chen, associate professor of medicine at the University of Maryland School of Medicine. “Nevertheless, we believe that 2019-nCoV spreads efficiently, which suggests a rapid transmission rate.”

The swift transmission observed on the Diamond Princess cruise ship, where at least 690 individuals were infected and three fatalities occurred, indicates that close living conditions may facilitate rapid spread.

How deadly is it?

Currently, a definitive fatality rate cannot be established as the outbreak is still unfolding, making comprehensive analysis difficult. However, WHO reported on February 24 that the mortality rate was estimated to be between 2% and 4% in Wuhan, with a rate of 0.7% in areas outside of Wuhan.

How do people catch it?

While scientists are still exploring the exact transmission methods of this coronavirus, it is generally thought to spread through respiratory droplets, as indicated by the CDC. Therefore, close contact with infected individuals is key to its transmission.

Recent research released in mid-February indicates that the virus can persist in human feces, implying that it may spread through diarrhea or unsanitary restroom conditions, similar to the rapid transmission of norovirus, often called "stomach flu."

The duration that the virus can survive in droplets on hard surfaces, such as doorknobs or countertops, remains unknown. However, it is known that the common cold virus, which can be a strain of coronavirus, can survive “from a couple of hours to a few days,” depending on various factors such as temperature and humidity, according to Amesh Adalja, MD, an infectious disease expert at the Center for Health Security at Johns Hopkins University. He suggests that while the same may apply to this virus, surface transmission is unlikely to be the primary method of spread.

For instance, it is improbable that any coronavirus could survive as a stowaway on packages sent from China to the United States. “Due to the limited survivability of coronaviruses on surfaces, which is typically measured in hours, the risk of transmission from products or packaging shipped over several days or weeks in ambient temperatures is exceedingly low,” Messonnier states.

Masks can serve as a crucial defense against disease transmission in healthcare settings, yet there is limited research on their effectiveness for the general public. The essential factors are proper fit and consistent usage of the mask.

How can you protect yourself and others?

Preventive measures align closely with strategies for avoiding the flu, colds, and other diseases:

• Wash your hands frequently and thoroughly with soap and water for at least 20 seconds, particularly after using the restroom or before preparing food. If soap is unavailable, hand sanitizers are a secondary option but are not preferred.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Clean and disinfect frequently touched surfaces and objects.

If you are feeling unwell, it’s important to stay home. Cough or sneeze into a tissue or your elbow, avoiding your hands or the open air.

Do surgical masks help?

While masks are vital for disease transmission prevention in hospitals, little research exists regarding their efficacy for the general populace. Experts assert that properly fitted and consistently worn masks may provide some protection. “They don’t cause harm and may offer a degree of safety,” Adalja notes. However, if an infected hand is introduced under the mask to scratch an itch, the mask's effectiveness is nullified.

“Currently, we do not recommend face masks for the general American public,” Messonnier stated on January 31. “This virus is not spreading within your communities. Although it is flu season, we do not routinely advise the public to wear masks to prevent respiratory illnesses, and we are certainly not recommending that for this new virus at this time.”

Should you be concerned about air travel or travel in general?

“Do not travel to China,” advises the U.S. State Department, issuing a Level 4 travel alert, the strictest level.

Health officials have not raised concerns regarding air travel in general; however, the CDC does recommend avoiding cruise ships that travel to or within Asia. Federal authorities have not advised limiting domestic travel.

Routine health screenings are conducted for travelers arriving from other countries displaying signs of illness, along with specific coronavirus screenings at 20 U.S. airports where travelers are likely to arrive from China. Incoming travelers undergo temperature checks using non-contact thermal devices, while officials observe for coughing or sneezing. Passengers also respond to questions concerning their travel history, any symptoms, and potential exposure to infected individuals.

What are the U.S. quarantine and travel rules?

New regulations effective February 2 aim to mitigate disease spread, as announced by Alex Azar, Secretary of Health and Human Services, and Chairman of the President’s task force on the novel coronavirus:

• U.S. citizens returning from Hubei Province, the outbreak's epicenter in China, within the last 14 days will face up to 14 days of mandatory quarantine upon return “to ensure proper medical care and health screening.”
• U.S. citizens who have visited other parts of mainland China within the last 14 days will undergo proactive entry health screening at designated ports and may face up to 14 days of monitored self-quarantine to confirm they have not contracted the virus.
• “Foreign nationals, excluding immediate family members of U.S. citizens and permanent residents, who have traveled to China within the last 14 days will be denied entry to the U.S.”

What are the symptoms of coronavirus?

Some individuals infected with the virus report few to no symptoms, according to the CDC. In others, symptoms can include fever, cough, and shortness of breath, ranging from mild to severe, with potential fatal outcomes. A CDC representative informed Elemental that it is premature to identify additional symptoms. However, a February 7 study of hospitalized patients revealed that about one-third experienced body aches, and around 10% reported nausea and diarrhea.

Much remains to be understood regarding symptom progression; the CDC suggests symptoms may manifest anywhere from two to 14 days post-exposure, a timeframe similar to that observed in MERS. U.S. officials now state that infected individuals can transmit the virus even before displaying symptoms, increasing the risk of rapid spread.

Recovery time can take approximately two weeks for mild cases and up to six weeks for severe cases, as reported by the WHO on February 24.

How can you differentiate coronavirus symptoms from a cold or the flu?

“You really can’t,” Adalja comments. The symptoms are “indistinguishable” from those of flu and other respiratory infections. Given the current high incidence of flu cases in the United States, you might suspect coronavirus infection only if you have traveled to China or another affected area or had contact with someone diagnosed with the virus. In such cases, the CDC recommends contacting a healthcare professional.

Is there a vaccine?

No. Researchers at the National Institutes of Health and other organizations are working on developing one, but it is advised not to hold your breath. Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, expressed cautious optimism on January 28, suggesting that a vaccine candidate may soon be ready for initial clinical trials. However, the testing and evaluation process will likely take several months before any vaccine could be available for widespread use.

Are there any treatments or therapies for this virus?

“There is no established treatment,” but there are antiviral medications that have proven effective in previous outbreaks, Fauci states. The CDC and various agencies are examining samples from infected individuals in laboratory settings to ascertain whether any of these treatments could be beneficial against this specific strain of the virus.

How severe could the outbreak become?

At this moment, no one can definitively predict the outbreak's future course, and health officials are hesitant to speculate. The potential severity of this outbreak hinges on its transmission efficiency among humans, a factor scientists are still working to fully understand.

“We face an unprecedented public health threat,” Messonnier stated on January 31. “We are preparing as if this could be the next pandemic, but we remain hopeful that it will not be.” She reiterated on February 21 that the virus is not spreading within any U.S. communities, thanks in part to vigorous quarantine measures.

However, as Elemental reported on February 5, some experts argue that COVID-19 already meets the criteria for a pandemic or soon will, even without a formal definition. On February 24, following sudden increases in cases in South Korea, Iran, and Italy, WHO director-general Dr. Tedros Adhanom Ghebreyesus downplayed the necessity of labeling the situation, suggesting it could induce unnecessary fear.

“WHO has declared a public health emergency of international concern—our highest alert level,” Tedros remarked. “Currently, we do not witness uncontrolled global spread of this virus, nor do we observe widespread severe illness or death. Does this virus have the potential to become a pandemic? Certainly, it does. Are we there yet? Based on our assessment, not yet.”

As of February 24, COVID-19 had spread to over two dozen countries and caused more than 2,500 deaths, including around two dozen outside of China. “We are observing epidemics in various regions globally,” Tedros stated.

Is this the worst viral outbreak ever?

In terms of sheer numbers, no. However, its impact is starting to resemble some significant past outbreaks.

In recent years, two other highly infectious coronaviruses have troubled humanity. The 2003 SARS outbreak affected 8,098 individuals across four continents, resulting in around 10% mortality; only eight confirmed cases occurred in the U.S., with no fatalities. MERS appeared in humans in 2012, affecting 2,494 individuals across 27 countries, claiming about a third of those infected.

For context, other viruses transmitted from animals to humans include HIV/AIDS, which has caused approximately 32 million deaths. Several Ebola outbreaks, a virus carried by fruit bats and now transmissible between humans, have typically killed around half of those infected, with some instances reaching 90% fatality rates.

Annual flu viruses are responsible for between 291,000 and 646,000 deaths worldwide. In the U.S., influenza infects between 9 million and 45 million individuals each year, resulting in 12,000 to 61,000 deaths annually.

A century ago, the Spanish flu pandemic of 1918–19 led to over 50 million deaths within a single year (some estimates suggest double that figure), including 675,000 in the U.S.—all at a time when the global population was only one-fourth of today’s total. Experts estimate that one-third of the global population contracted the flu that year.

Coronavirus Myths & Hoaxes

A number of misleading and even hazardous myths about the coronavirus are circulating on social media. “Every outbreak has its ‘infodemic’... an epidemic of rumors and false information,” notes Dr. Sylvie Briand, director of WHO’s Infectious Hazard Management Department.

Here are some clarifications: - Gargling with mouthwash, even if marketed as germicidal, will not provide protection against this coronavirus, according to WHO. - Rinsing your nose with saline has not been shown to protect against this coronavirus or any respiratory infection. - While eating garlic may be beneficial for health, no evidence supports its effectiveness in preventing the coronavirus. - Antibiotics combat bacteria, not viruses. Therefore, antibiotics do not work against the coronavirus. - Household disinfectants, such as bleach, effectively eliminate the coronavirus on surfaces, while sesame oil does not. - Although coronaviruses do circulate among some wild animals, including bats, there is no evidence to suggest that consuming meat sold in the U.S. poses a risk. - Your pets, including dogs and cats, cannot transmit this coronavirus.

The data on global flu-related deaths and travel alerts have been updated.

The coronavirus outbreak is evolving rapidly. To stay informed, refer to the U.S. Centers for Disease Control and Prevention, as well as your local health department. If you are feeling emotionally overwhelmed, please reach out to the Crisis Text Line.