Equally of 23 March, there were 336,000 confirmed cases of COVID-xix in the earth, with more than 250,000 cases outside China. Despite these numbers, much is still misunderstood or unknown nearly the virus which has brought regions of the globe to a standstill and placed huge pressure on the global economic system.

Fifty-fifty what we do know – that elderly people are more at adventure, that this is a new virus but resembles other known epidemics, that information technology is highly infectious – requires more caption.

Here, Belgian virologist Guido Vanham, the former caput of virology at the Plant for Tropical Medicine in Antwerp, Belgium, helps answer questions about COVID-19'due south origins, its behaviour and its future.

This interview, conducted by Maria Epifanova, was originally published by Novaya Gazeta. This English language translation has been updated and authorized for sharing with the World Economical Forum.

I would like to beginning with a full general question: there are a lot of discussions and speculations near COVID-19, but could you summarize the facts that nosotros know about the virus for sure?

It is certainly a new virus for the human population. Information technology resembles very much the SARS virus which emerged in 2003. That also was an epidemic merely information technology was limited to a few g people in several places in the world with the decease charge per unit of almost 10%. It also relates, just less closely, to another virus which emerged a few years afterwards – the MERS virus. Information technology was even more than deadly, it killed one in three people who got infected.

But both of these epidemics disappeared following much less drastic measures than the ones implemented today. The present virus, COVID-19, is conspicuously more infectious and is mainly transmitted via aerosols (from people who cough or sneeze etc), but you lot can also get information technology by contact with objects that infected people, who are not necessarily sick, accept touched.

It has spread all over the world and is nowadays in almost all countries where they are able to test for information technology. This is besides different from the previous epidemics because it took a long time to test for those – now we already have tests. It belongs to a family of viruses that is named "corona" – which comes from the Latin for "crown" and refers to the structure of these viruses as under the electron microscope it looks similar a crown.

This family unit of coronaviruses has been with humans and animals for a long time and causes mild infections like the common cold, but this new virus is much more aggressive than all other members of the family. The symptoms are very similar to some extent to heavy flu but it is much more than deadly; at least 5% of those who become infected and show symptoms might die. In that location may also exist many infected people who do not get sick and that we do not exam.

It is a completely different virus from the Influenza viruses which belong to a very unlike group, meaning that influenza vaccine or influenza medication will not assistance. For at present, we have no medication or vaccine for the virus. The genetic structure of this virus and a flu virus are equally different as we are from dinosaurs.

— Guido Vanham

Many people still compare this virus to SARS and believe the measures taken past governments are excessive. Why should we not compare it with SARS? Is it more dangerous?

We have to compare information technology with SARS because information technology looks very much like SARS. The relationship between this virus and SARS is very shut: they have many identical parts in their genome, so it is really to some extent a SARS-2 virus. It is, still, much more infectious. The interpretation now is that whatsoever person infected with this virus may infect iii other people, which leads to an exponential growth of the epidemic – that was not the example with SARS. It is also clear that people without symptoms can spread the virus.

Tin we explain why it is so infectious?

No. At that place is some understanding of why SARS, MERS and COVID-19 are related and why they produce heavy symptoms, but why this particular virus is much more than infectious than other related viruses is something nosotros still practice not know. That is a matter of research. Remarkably, the previous SARS Cov1 and the present SARS CoV2 apply the same "receptor" for entry in cells and the suggestion is that the "envelope proteins" of the present SARS CoV2 are just more efficient in using the "entry door" into the lung cells and elsewhere in the trunk.

How have fatalities from COVID-19 in China varied by age group?

How have fatalities from COVID-19 in Prc varied past age grouping?

Image: Our World in Information

Why is it ambitious for elderly people only almost harmless to even newborn kids?

I cannot give you a last reply to that simply this is not so uncommon. Other viruses comport less aggressively in children than in adults or elderly people. Children's immune systems react in a less vigorous (in this case also more appropriate) mode and they don't go that ill; the immune system of adults sometimes overreacts to those viruses and that makes them ill.

People who are weaker considering of other diseases are less resistant in full general. Information technology is clear, the older you get the more risk in that location is, simply there are also people in their 30s and 40s in our hospitals who are very sick but most will survive, while many more older people might die.

You've mentioned that people without symptoms can also infect other people, but isn't this mutual for all viruses?

Indeed, virtually other viruses accept this characteristic simply the proportion of people who can transmit the virus without symptoms is different for different viruses. For COVID-19, we have no exact numbers however.

How contagious is COVID-19?

How contagious is COVID-19?

Image: Statista

What tin can we say about people who become the virus and recover? Practise they get immunity? Reinfections have been recorded; on the other hand, the British scenario assumes that herd immunity will develop.

That is very much the question. There is no convincing show at that moment that people who accept gone through the infection and recovered will become allowed and won't be reinfected. There is a suggestion that they tin become susceptible again after a short catamenia of fourth dimension.

The famous "herd immunity" concept may occur in the end but it always requires a big proportion of the population to outset become infected, overcome the infection and then maintain sufficient levels of antibodies to not get infected again. In that scenario, the virus tin no longer spread only has to "wait" until at that place are plenty "new" individuals without immunity (i.eastward. young children) – a scenario similar the classical "childhood infections" such as measles, mumps, rubella, before the vaccination. The other scenario is that the virus mutates and can overcome the herd amnesty, much like Influenza does.

What is the Globe Economic Forum doing about the coronavirus outbreak?

Responding to the COVID-nineteen pandemic requires global cooperation among governments, international organizations and the business customs, which is at the centre of the World Economic Forum'south mission as the International Arrangement for Public-Private Cooperation.

Since its launch on 11 March, the Forum'south COVID Activity Platform has brought together one,667 stakeholders from i,106 businesses and organizations to mitigate the adventure and touch on of the unprecedented global health emergency that is COVID-19.

The platform is created with the support of the World Health Organization and is open up to all businesses and industry groups, too as other stakeholders, aiming to integrate and inform joint action.

Equally an organization, the Forum has a runway record of supporting efforts to incorporate epidemics. In 2017, at our Annual Meeting, the Coalition for Epidemic Preparedness Innovations (CEPI) was launched – bringing together experts from government, business organisation, health, academia and civil order to accelerate the development of vaccines. CEPI is currently supporting the race to develop a vaccine against this strand of the coronavirus.

So now the but way forward is to reduce social contact and then what? Wait for the treatment or await for the vaccine?

Yeah, simply it's doubtful that treatment will exist available inside weeks. The more likely scenario is that this epidemic will continue and will end at some point. Hither we look at China because, according to the official numbers, in that location are no new "endogenous" infections; in China, the epidemic looks to be over.

We know that the Chinese have taken very strict measures and even prevented people from leaving their homes. That is not the case here [in Belgium]; we are not locked up, but social contacts are reduced to a minimum.

But y'all can't stay at home forever.

No, we shouldn't. Today, I went out. We keep a distance and nosotros don't gather more than three people – that is forbidden.

In Republic of latvia, where I live now, dissimilar measures are being taken: schools are closed, public gatherings prohibited, restaurants are closing then on. It is advised to minimize contact. The current measures are in place for a month. What I am trying to understand is what is supposed to happen within a month? If people reduce contact, the numbers are likely to go downwards, but then, when people start living their normal life once more, won't that cause another moving ridge?

That is, of form, the risk if you lot lift the measures also early on – you can get a second moving ridge. It will be very hard to determine when to lift the measures. Simply virtually European countries saw what happened in Italian republic and have taken measures at present, at an earlier stage. Italy was clearly also late, but when y'all are at an earlier stage, the impact of such measures is bigger. That is our hope and nosotros will know in a few weeks if that hope is justified.

Why social distancing works to prevent the spread of COVID-19

Why social distancing works to foreclose the spread of COVID-19

Prototype: Statista

I see your point, merely can we hope, for instance, that the virus will beginning to slow downwards owing to some natural factor (summer or any else), equally happened with SARS?

That is a possibility. The other signal is that for every virus, not every man is equally susceptible. There are ever people in a population who are more than or less susceptible to a certain virus.

In this epidemic, if it follows the natural course, only a sure proportion of the population volition exist infected. That proportion could be bigger than in the surrounding countries who took restrictive measures, but in the subsequently-acting countries, subsequently restrictions are lifted, a second wave may come up. This has been seen in other leaner or viruses but is something we will only know afterwards – nosotros cannot predict information technology. This is simply the law of evolution, merely nosotros don't nonetheless know the proportion of people not susceptible to this virus. This volition depend on the genetic constitution of people and we are all dissimilar.

Information technology also depends on the characteristics of the virus, because the virus will be changing and adapting – that is what happens with the flu and other viruses. A like thing is likely to happen with this virus.

In that case we will all the same live with COVID-19 simply a modified blazon of it?

Personally, I think that is very probable to happen.

In that case information technology is likely to get more or less severe?

Information technology is hard to foresee. I am an HIV specialist and we accept been looking at HIV for 30 or 40 years now. It is difficult to say whether information technology is more or less severe than information technology was 30 years ago. The "problem" (from an evolutionary point of view) is that we have treatment for HIV, so, very fortunately, that natural evolution no longer happens.

The same thing might happen with coronavirus: the treatment or vaccine will go available and we will never encounter this natural evolution. Viruses, peculiarly of those types, tend to be very inventive and they adapt. This virus is new for the man population merely is 96% identical to a virus transmitted within bats. That is very close – with HIV you accept a variation of twenty%, and so 1 type of HIV can exist only lxxx% identical to some other.

Is it good or bad news for united states?

This virus existed and changed at some point – that 4% of difference is of import, equally it ways the virus started to infect people. The aforementioned happened 100 years ago with the simian immunodeficiency virus, the HIV analogue for monkeys, which jumped from monkeys to humans. Now it is a human virus.

This COVID is now a human virus too and will spread into the human population. If we do non stop it with mod technologies, similar a vaccine, information technology will stay with humans for hundreds of years.

The United states has already announced testing of a vaccine. How long should it have?

There is a lot of engineering science bachelor, unlike platforms to apply, but in the end, you cannot predict [how long it will take]. Take the story of hepatitis: in the 1980s, the first vaccine was developed for hepatitis B; at that place is now a vaccine for hepatitis A, but hepatitis C has no vaccine. Furthermore, HIV has no vaccine – and we've been looking for 30 years.

The problem is, at that place are animal viruses related to coronaviruses (the feline enteric coronavirus, for example), where the vaccine proved to exist dangerous: the vaccinated cats got an even more severe infection.

The danger is that people or companies and academics will rush into vaccine trials without taking precautions and accidents may happen. But again, we cannot predict – it could be every bit simple as the measles vaccine. I, along with you and everybody else on earth, do hope and then.

If it appears to be as difficult every bit producing a vaccine for HIV, what is the nearly probable scenario?

Well, I am not that pessimistic; I know HIV very well and I know why it is so difficult. This COVID virus is closely related to the SARS virus – up to 95% – and so perhaps the possibility for the virus to change (it's "genetic space") is not that large. Testing in vitro suggests antibodies for SARS could neutralize this virus, so maybe it will be fine; possibly in half a yr's time we will take a realistic perspective on a vaccine. Just, as I just explained, there are risks that should be taken into business relationship.

We will all live between hope and fear for a while. In the stop, humankind will overcome this challenge too – but we will pay a cost.