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There is legitimate reason to be concerned about the novel Coronavirus epidemic, but that does not mean there is reason to panic. Fear is fertile ground for conspiracy theories, snake oil, and general misinformation, and it seems like we are due for a round of separating fact from fiction about the Coronavirus. Let’s start with some basic background and an update on the numbers.

SARS-CoV-2 and COVID-19

Coronavirus is a genus of viruses that are zoonotic, meaning they can be shared between humans and other animals, and cause respiratory illness in humans. There are four strains known to cause the common cold. There are now three strains that cause severe respiratory illness – SARS (technically SARS-CoV), MERS, and now SARS-CoV-2, as the new strain is officially known. SARS stands for “Severe Acute Respiratory Syndrome” while MERS stands for “Middle Eastern Respiratory Syndrome”. The new virus is similar to SARS, and so is essentially SARS-2.

The illness produced by SARS-CoV-2 is the Coronavirus Disease 2019, or COVID-19 for short. We are still in the middle of this epidemic, and so it will take time to sort out the full characteristics of this illness. But here are the numbers so far: Total confirmed infections: 94,200; Total deaths: 3,219. There are reported cases in over 80 countries. Neither the CDC nor the WHO have declared the disease a pandemic yet, but it seems inevitable and imminent. The term “pandemic” does not have a strict technical definition, but basically it means there is sustained person-to-person spread in multiple countries. If we are not there yet, we are close. In any case, the CDC and WHO are talking about “pandemic preparedness”.

The mortality rate of COVID-19 so far is about 6% (counting completed cases). About 17% of people confirmed to have the disease have a serious illness, while most people will have a mild to moderate illness. These percentages can change depending on whether or not you count people who have the virus but are asymptomatic or minimally symptomatic. But of course, that will also significantly increase the number of cases.

To put these numbers into further perspective, the 2019-2020 flu season so far has seen 32-45 million cases in the US alone, with 18,000-46,000 deaths. A typical flu year kills 646,000 people worldwide. These numbers dwarf the scale of COVID-19 – that’s over 200 times as many deaths so far. But this does not mean there is no reason for concern about COVID-19. The death rate is much higher (6% vs 0.1%). If COVID-19 spreads on a scale similar to a typical flu, the death toll would be in the tens of millions worldwide.

That is what the CDC, WHO, and world governments are trying to prevent. This is exactly why now is the time to take action to limit the spread of COVID-19.

Will COVID-19 spontaneously burn out?

This is a tough question to answer, and has grabbed headlines with President Trump’s declaration that the virus will die out as soon as Spring hits. The bottom line, however, is that no one knows. Flu and other respiratory viruses do not like the heat. They do not last as long on surfaces, and do not spread as easily. This is likely to be the case for SARS-CoV-2, but we simply don’t know how significant this will be. There are other reasons that respiratory viruses spread more in the winter – children are together in schools, and they have less immunity because they have not been exposed to as many viruses.

There are therefore a range of possibilities here. In the best case scenario, spread of the virus will significantly decrease when Summer hits the Northern Hemisphere. However, this is also when Winter will hit the Southern Hemisphere. The worst-case scenario is that the virus will still spread during the Summer, just less, and will bounce back in the Winter (like what happens every flu season). In this case SARS-CoV-2 will become endemic, with continuous seasonal spread around the world. We may have to live with this new virus like we live with the flu.

Prospects for a vaccine

There is both good and bad news for a SARS-CoV-2 vaccine. First the bad news – best-case scenario, it takes 18-24 months to develop and test an effective vaccine, and this is an accelerated timetable. So a vaccine is not going to stop the current outbreak. The race to develop a vaccine is therefore about stopping the future spread of the virus.

The good news is that researchers are making progress. The CDC is able to grow the virus in their labs for study. Researchers have identified the spike protein on the outside of the virus that allows it to bind and infect human cells. Antibodies against this protein could be an effective vaccine. Further, so far the virus has not displayed any extreme mutation, so vaccine targets might be stable over time. Bottom line – the prospects of a vaccine are good, but it’s going to take a couple of years probably.

There is also the potential for drug treatments of the infection. Researcher have also identified a protease necessary for the virus to replicate, and this can potentially be blocked by drugs. Such a drug would likely work against all Coronaviruses. Again, though, this takes time to develop and test.

I think the way to look at drugs and vaccines for COVID-19 is this – if the disease runs its course over 2020 and then burns itself out, then great. If not, then we will have drugs and vaccines coming online soon to help mitigate the disease. But these are not going to help us in 2020, so we need standard procedures to reduce the spread of infection. I already wrote about such techniques – wash your hands with soap for at least 15 seconds. Do this when you are traveling, out in public, or may have been exposed. Masks can be helpful if you wear them properly and consistently in an outbreak area, but don’t rely on them. Stay away from people who may be infected, and if you are sick, stay home. Of course, it’s difficult to get billions of people to all do the right thing at the same time.

COVID-19 pseudoscience

Of course there is also rank pseudoscience taking advantage of the fear and ignorance about COVID-19 and science and medicine in general. Many of the familiar snake oils are making the rounds, such as colloidal silver. This is a dangerous product that should not be taken internally, and there is no evidence it is effective against any infection.

The virus is also an opportunity to spread fear and conspiracies, and use the resulting panic to sell things like bulk food. Alex Jones has perfected this model and continues to do so with COVID-19.

There are too many quack remedies out there to do anything approaching a complete guide. The best advice is to rely on authoritative sites, like the CDC, WHO, or respected research institutions for information. Take the common-sense precautions I outlined above, read the CDC documents on what to do, and don’t panic. Don’t believe conspiracy theories, or claims for miracle cures. Probably any alleged cure out there has already been debunked here and elsewhere, so look for skeptical information on any such claims.

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Posted by Steven Novella

Founder and currently Executive Editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also has produced two courses with The Great Courses, and published a book on critical thinking - also called The Skeptics Guide to the Universe.