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In Beijing, coronavirus 2019-nCoV has created a siege mentality

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m516 (Published 07 February 2020) Cite this as: BMJ 2020;368:m516

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Re: In Beijing, coronavirus 2019-nCoV has created a siege mentality

Dear Editor

The possible spread of coronavirus (2019-nCoV) may have been aggravated by the gush in domestic travel between January to February 2020 at Wuhan city, Hubei Province, China. The report until January 25, 2020 has confirmed 1409 cases out of 2032 suspected cases of 2019-nCoV infections [1]. The primary reservoir for virus proliferation, including Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV, transmitted from camels to humans) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV, transmitted from exotic animals in markets to humans) are bats. From the substantial evidence gained from SARS-CoV and MERS-CoV, several scientists believe that large droplets would be the key reason for the transmission of 2019-nCoV [3]. On February 10, 2020, pangolins were claimed to be the primary source of 2019-nCoV repository. As on February 11, 2020 WHO has coined 2019-nCoV as COVID-19. Alarming report issued in public interest by WHO further showing demographic hike on 43,103 infected cases reported globally of which 42,708 cases reported alone in China [4], which keeps China at high alert.

It’s really heart breaking for the researchers and scholars involved in the process of drug discovery to see the epidemiological updates on mortality and death incidence reported on an hourly basis in and around China with respect to COVID-19. Hats off to the professional practice of all the physicians and health care providers who are constantly striving for controlling the infection rate on a war footing basis.

There are many drugs of biological origin which are currently under different phases of clinical evaluation for prominent efficacy against human coronavirus [5,6]. It imposes costly penalty in terms of time and clearance on safety and efficacy of such molecules for clinical applications. Need for immunonutrient remedies shows upsurge in activity globally. China being rich in the heritage of availing traditional complementary medicine since several centuries [7] may now adopt some policies on utilizing indigenous preparations on prophylactic basis. It has been already reported that high levels of circulating inflammatory cytokine and chemokines are majorly responsible for respiratory distress and organ dysfunction in recent COVID-19 infectected patients [8]. Hence paradigm of higher priority shall be imposing on drugs with excellent anti-inflammatory, Immunomodulatory, anti-oxidant properties. Traditional medicines which claim high level of safety and efficacy may readily be available for immediate therapeutic interventions as therapeutic and prophylactic as well. It was believed that physicians' support, people's belief and researchers' hard work will definitely revoke the country from the setback caused due to COVID-19 infection at the earliest.

References
1. World Health Organization. Novel Coronavirus (2019-nCoV). Situation Report 5. Issues in January 2020.
https://www.who.int/docs/default-source/coronaviruse/situation-reports/2...
2. WHO advice for international travel and trade in relation to the outbreak of pneumonia caused by a new coronavirus in China.
https://www.who.int/ith/2020-0901_outbreak_of_Pneumonia_caused_by_a_new_...
3. Stanley Perlman. Another Decade, Another Coronavirus. Editorial release.The New England Journal of Medicine. Jan 2020. DOI: 10.1056/NEJMe2001126.
4. World Health Organization. Novel Coronavirus (2019-nCoV).Situation Report 22. Issued in February 2020.
https://www.who.int/docs/default-source/coronaviruse/situation-reports/2...
5. Kato, H.et al. Development of a recombinant replication-deficient rabies virus-based bivalent-vaccine against MERS-CoV and rabies virus and its humoral immunogenicity in mice. PLoS ONE ,14,1-17, (2019). https://doi.org/10.1371/journal.pone.0223684.
6. Ayman, M. et al, Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Infection, Immunological Response, and Vaccine Development. Journal of Immunology research, 1-18, 2019. https://doi.org/10.1155/2019/6491738.
7. Foon Yin Fung , Yeh Ching Linn. Developing Traditional Chinese Medicine in the Era of Evidence-Based Medicine: Current Evidences and Challenges. Evid Based Complement Alternat Med. 2015; 2015: 425037. doi: 10.1155/2015/425037.
8. Chaolin, H. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020. DOI:https://doi.org/10.1016/S0140-6736(20)30183-5.

Competing interests: No competing interests

13 February 2020
Sivaraman Dhanasekaran
Scientist
P.S.Pradeep , S.Sundar Manoharan
Sathyabama Institute of Science and Technology , India
Centre for Laboratory Animal Technology and Research, Col.Dr.Jeppiaar Research Park, Sathyabama Institute of Science and Technology , Jeppiaar Nagar, Rajiv Gandhi road, Chennai - 600 119, Tamil Nadu, India