The Coronavirus, the Flu and You

The recent outbreak of the coronavirus in China and consequential confirmed cases of the virus in the UK, emphasises the impending threat of a pandemic impacting global and personal health. The World Health Organisation has declared the coronavirus outbreak an ‘official global health emergency’, with over 17,000 confirmed cases, more than 361 fatalities in China and up to 98 reported cases across 18 other countries to date^[1]. It is evermore relevant and necessary in regard to the preservation of personal health to understand the risks associated with the coronavirus pandemic, ways to reduce the risk of catching the flu and how you can most effectively treat the flu. Furthermore, it is important to understand the risks posed by virual outbreaks and the challenges that countries face to attenuate virus transmission.

What is the coronavirus and how does it compare to known respiratory viruses?

The coronavirus is a virus which causes respiratory infections, similar, but different to influenza. Previous coronavirus outbreaks consist of SARS (Severe Acute Respiratory Syndrome) (2003) and MERS (Middle East Respiratory Syndrome) (2012). Coronaviruses describe contagious respiratory illnesses that can take the form of many strains, varying in tracsmissions characteristic, severity and mortality. The new coronavirus responsible for the outbreak in Wuhan City, China, is called Novel coronavirus (2019-nCov) and is a unique strain, exhibiting rapid transmission and causing severe symptoms with a significant risk of mortality^[2].

Most known respiratory viruses exhibit a low/moderate transmission rate due to available vaccinations and knowledge of effective treatment, so typically, they can be more easily controlled. Vaccinations are often recommended in time for the flu season (December - February) where the risk of encountering the flu dramatically increases. However, occasionally a new virus strains, such as Novel coronavirus, can cause an outbreak; where symptoms are unknown and both transmission and mortality rate can be significant.

Generic Flu Symptoms

The onset of viral symptoms are often rapid and they take effect quickly. The flu differs distinctly from a cold in that the symptoms are debilitating and significantly disruptive to daily life. Common symptoms^[3] of the flu consist of:

Coronavirus Symptoms

The current known symptoms of novel coronavirus consist of^[4]:

Where do viruses come from and how do epidemics and pandemics occur?

The exact origin of viruses, including flu viruses in general, are unknown and inexact. They are speculated by virologists to be a consequence of evolution, whereby genetic elements of the host organism have evolved to move between cells and hosts^[5]. An epidemic describes a significant outbreak of an infectious disease that is abnormal for any given population, whereas, a pandemic describes a global virus outbreak. Pandemics and respiratory virus outbreaks are not a recent phenomenon, but they continue to pose a risk to global health; the notorious H1N1 influenza virus (Spanish Flu) in 1918 was one of the most prominent flu outbreaks, where almost a third of the global population at the time was infected, responsible for approximately 50 million fatalities^[6].

Flu viruses are common in animal populations and often pose the threat of cross-species transmission where the virus is zoonotic, meaning it is passed on to humans from another species, triggering an outbreak due to the uniqueness of the virus strain. The virus can then be transmitted from human to human by physical contact or airborne transmission such as respiratory functions (breathing, coughing, sneezing etc.). Previous virus pandemic examples involving cross-species transmission include Ebola (2013), Swine Flu (2009) and Bird Flu (1997). The Ebola virus was suspected to have originated from bats and is transmitted through physical contact. Whilst the mortality rate for ebola was high, the transmission rate was relatively low, compared with respiratory transmitted viruses such as influenza viruses.

The challenges that arise when attempting to cope with a virus outbreak are extensive; countries and health care practises often regularly practise emergency responses to a virus outbreak. The initial unknown and unpredictable nature of a new virus in terms of transmission rate, symptoms and other characteristics can make early response difficult. Usually, vulnerable populations with weakened immune systems are most at risk of life threatening health complications; the elderly (over 65 yrs), young (children and babies) and those with health complications often record the most fatalities following flu outbreaks^[7]. Furthermore, the risk of an epidemic becoming a pandemic is highly likely with the flu, given the ease of the virus being spread through migration and travel (such as the risk posed by the coronavirus outbreak occurring amid the largest annual migration event; the Chinese New Year). Furthermore, many viruses can infect a host and not show symptoms whilst the virus still remains highly contagious.

Reducing the risk of getting the flu

Keeping up to date with official announcements and advice is crucial; especially pertaining to the Novel coronavirus outbreak. Other recommended steps are also necessary to reduce the risk of possible transmission and are standard practise for general flu virus preventative measures^[3]:

• Ensuring that good hygiene is maintained is recommended to minimise transmission.
• It is important to get available vaccinations against flu strains that pose a threat.
• Use of a facemask when combined with other preventative measures may help to reduce transmission.
• Avoid crowded places if possible, especially if an outbreak is known to be in a particular area.

Treating the flu

Due to the current coronavirus pandemic, it is strongly advisable to seek urgent medical advice should you experience flu-like symptoms. Usually, with known flu strains and diagnosis, the following advice is essential to recovery^[3]:

• Comply with advice given by the health service or a professional.
• Rest and recovery.
• Keep hydrated.
• Use of over-the-counter painkillers for relief of aches and pains.
• Use of Tamiflu is recommended for high risk populations vulnerable to complications. It should be taken immediately following the onset of symptoms.

Sources

1. BBC. 2020. Coronavirus declared global health emergency by WHO.
2. GOV.UK. 2020. Coronavirus: latest information and advice.
3. NHS. 2020. Flu.
4. BBC. 2020. Coronavirus: What it does to the body.
5. Holmes, E.C., 2011. What Does Virus Evolution Tell Us About Virus Origins?
6. Johnson, K.E., Song, T., Greenbaum, B. and Ghedin, E., 2017. Getting the flu: 5 key facts about influenza virus evolution. PLoS pathogens, 13(8).
7. Boggess, K., 2019. The Deadly Influenza Virus and Its Changing Forms. DU Quark, 3(2), pp.19-27.