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China coronavirus should be on “everybody’s agenda,” says vaccine expert

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m476 (Published 05 February 2020) Cite this as: BMJ 2020;368:m476

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  1. Elisabeth Mahase
  1. The BMJ

Novel coronavirus (2019-nCoV) should be on “everybody’s agenda,” says Seth Berkley, chief executive officer of Gavi, the Vaccine Alliance. He said that, while some responses may be “over-reaching,” what is currently known about the virus suggests that it should be treated seriously.

Berkley, who spoke at a briefing in London on 4 February, told The BMJ that, although we “do not know enough right now to honestly answer the question [of over-reaction],” it is better to prepare now than to wait and see.

“Does that mean that we should be having travel bans everywhere in the world and all of those other responses? I think there are certainly things that are over-reaching, but I think that the world is taking this seriously, and that is the right thing to do. When we have a better understanding of the disease, maybe we will change that,” he said.

Lockdown

Countries around the world have been preparing and reacting to the 2019-nCoVoutbreak, which has led to 20 697 cases and 427 deaths as of 4 February. On 31 January the World Health Organization declared the situation to be a public health emergency of international concern.1

Chinese authorities have placed on lockdown much of the Hubei province—where the outbreak began—and the millions of people within it. Many countries have also imposed flight restrictions and evacuated their citizens out of Hubei.2 The UK government has advised all British nationals in China to return to the UK “to minimise their risk of exposure to the virus.” Meanwhile, in Hong Kong some healthcare workers have gone on strike to pressure the government to fully close the border with mainland China.3

Berkley said that WHO’s decision was “correct based on the knowledge we have today,” highlighting the international spread of the virus and the documented human-to-human transmission.

“Our best hope—since we do not have a vaccine or treatment—is going to be public health control,” he said. “Therefore, getting this on everybody’s agenda and making sure people are responding to that is the right thing to do.”

Touching on whether there should be such a focus on 2019-nCoV, considering that common conditions such as influenza kill many people without prompting the same attention, Berkley said, “We don’t want to just say that ‘influenza kills more people’ and then see this thing [novel coronavirus] spread like flu but with a higher mortality rate and kill more people.

“We do not yet know what the spread rate is going to be. Is this going to adapt to humans and spread more easily, or is it going to slow down? We do not know all the answers, but all the information we have gained since it began has tipped us towards the more serious than the less serious way.”

Insufficient focus on prevention

Speaking on the importance of preparing for such situations, Berkley said that, although 2019-nCoV was currently at the top of the news agenda, as with the Ebola outbreak there was insufficient focus on prevention. It would soon become yesterday’s news, he warned.

“With an increasing population and global warming, we are going to continue to see outbreaks of infectious disease,” he said. “This is not the first coronavirus that’s changed—this is the third one we have seen. Why would we not expect a fourth one?”

Coronaviruses are commonly found in animals, including camels, cattle, cats, and bats. In some rare instances they can infect people and then spread between humans. This has occurred with Middle East respiratory syndrome related coronavirus (MERS), severe acute respiratory syndrome (SARS), and now with 2019-nCoV. Symptoms of this novel coronavirus include fever, cough, and shortness of breath.4

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