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Thoughts and Concerns Regarding the New Corona Virus
John Hardie BDS, MSc, PhD, FRCDC
The late winter and early spring of 2020 will be earmarked in history as the era of, “The Great Corona Virus Pandemic.” It remains undecided if this designation will be one praising the collective efforts of all to defeat an invisible foe, or if it will be remembered as a public health over reaction which precipitated an economic disaster. As this article is being written in late March to mid April 2020 it would be foolhardy to predict on which side of the equation the pandemic will be judged. However, the author has had a 35 year interest in infectious diseases and has, over the last six weeks, amassed a considerable amount of literature on the new corona virus. Reading this material has identified a recurring theme, an absence [of] actual information on the virus. It has led to the conclusion that the world has rushed to a premature assessment of a virus about which little is known. What follows are the authors thoughts and concerns that have justified this understanding of the corona pandemic.
The New Virus
The presumptive pandemic inducing virus now named SARS-CoV-2 ( previously referred to as: 2019 nCoV) was initially identified in 3 adults with severe pneumonia admitted to a hospital in Wuhan, Hubei Province, China in late 2019. (1). The article describing the investigation of the three cases was published in the New England Journal of Medicine in January 2020. (1)
Patient 1 was a 49 year old otherwise healthy woman admitted with a cough, fever and chest discomfort. Patient 2 was a 61 year old male who presented with fever and cough and increasing respiratory distress during his hospital stay. Patient 3 was a 32 year old male with clinical signs of pneumonia. Similar to patient 2, his previous medical history was not recorded. The diagnosis of pneumonia in the three patients was confirmed by CT scans. Patients 1 and 3 were discharged following a 21 day hospital stay. Unfortunately, patient 2 died 14 days after his hospital admission. (1)
In the laboratory, bronchial fluid from the patients was cultured in human respiratory epithelial cells allowing genome sequencing, real time reverse transcriptase polymerase chain reaction (RT-PCR) and isolation techniques to be used in identifying the virus as belonging to the family of widely distributed coronaviruses known to be a cause of common cold like symptoms.(1) Its unique genome sequencing resulted in the virus being referred to as a “novel” corona virus.
The investigators admit that while their labour intensive research methods had identified the new coronavirus as the “likely” cause of the pneumonia, their study did “not fulfill Koch’s postulates”-a historical method of identifying pathogens.(1)
A little later similar procedures were used by different investigators who determined that 41 of 59 patients admitted to a Wuhan hospital with pneumonia had “laboratory confirmed 2019 nCoV infection.”(2)
It is a concern that in a short space of time a new virus considered a few days before to be a likely cause became universally accepted as the confirmed cause of the pneumonia although it had not be verified as the cause of a viral pneumonia.(3) This is worrying as there ought to be independent studies performed on patients having similar signs and symptoms but in different world –wide locations whose lower respiratory tract samples were subjected to the same investigations as the Wuhan patients. If such studies showed any variation in results from the Wuhan ones, the credibility of the latter must be questioned. Which begs the question, “How new is this novel virus?” Continue reading