How prepared is Europe for an outbreak of the novel coronavirus?
Air travellers wear masks as they arrive at Ivalo Airport, Finland on January 24, 2020 [Lehtikuva/Tarmo Lehtosalo/Reuters]
Europe’s health infrastructure is well prepared to fight the spread of a new coronavirus that has already spread to 17 countries worldwide, medical experts told Al Jazeera.
The virus, named as 2019-nCoV, was first detected in December and has infected more than 4,500 people globally and killed 106.
All deaths so far have been in China, with most around the southern city of Wuhan, the epicentre of the outbreak.
So far, only four cases of the coronavirus have been detected in Europe, three in France and one in Germany.
While those in France had recently travelled to Wuhan, German health officials confirmed that a man in the southern city of Starnberg is the continent’s first reported case of human-to-human transmission.
The 33-year-old man in Germany, who contracted the coronavirus from a Chinese colleague visiting from Shanghai, tested positive on Monday but remains in good condition in hospital.
Jens Spahn, health minister, said despite the case, the risk to the German public is low and the country was “well prepared.”
France has announced plans to evacuate up to 1,000 of its citizens from Wuhan, and Germany around 90.
The UK has also said it will offer evacuation to up to 300 British citizens in Hubei province, of which Wuhan is the capital.
The European Commission is planning a meeting of health ministers to coordinate a response to the potential spread of the disease.
“We’ve had two similar diseases over the last 20 years – we’ve had SARS (Severe acute respiratory syndrome), which came from China, and MERS (Middle East respiratory syndrome), which comes from the Middle East, which are both coronaviruses,” Paul Hunter, professor at Norwich Medical School, told Al Jazeera.
“So we know a lot about how this type of infection spreads. We’ve got experience in managing it so that the patients are more likely to survive and also less likely to infect others, especially healthcare workers, nurses and doctors.”
SARS, another flu-like virus which also originated in China, infected almost 8,000 people across 17 countries in late 2002 and early 2003, killing nearly 800 people.
The spread was largely confined to Asia, with only 34 cases confirmed in Europe.
MERS was deadlier, but did not have a global outbreak.
While with SARS and MERS, carriers showed symptoms, reports suggest that the new coronavirus can be passed on by people who have not yet shown signs of infection, complicating efforts to limit the spread of the disease.
We’ve completed one clinical trial with a MERS vaccine and we have started the second one in Saudi Arabia, and so we’re using that technology to make a novel coronavirus vaccine.
Sarah Gilbert, professor of vaccinology at the Jenner Institute at Oxford University
The World Health Organization (WHO) has declared the global risk of the new virus as high, but stopped short of designating it a public health emergency of international concern, a term reserved for only the most severe outbreaks.
“If the virus comes to Europe and spreads, we need to trace the carriers, we need to test them and if they are positive they need to be quarantined. So in that case, we need rapid diagnostic tests,” said Herman Goossens, director of the Platform for European Preparedness Against (Re-)emerging Epidemics (PREPARE), an EU-funded network that supports clinical research to address the outbreak of infectious diseases.
PREPARE works with more than 1,000 hospitals and labs across 42 European countries to ensure clinical trials for new diseases are rolled out quickly, so countries can begin to detect and treat patients with speed.
It is currently circulating standardised case report forms to gather case information, and assisting diagnostic labs with developing tests for the coronavirus.
“What we are doing now is to devise the protocol, prepare the hospitals, prepare the contracts and get ethical approval … and then we would start the trial immediately as the number of cases are increasing… it depends on the number of cases in Europe,” Goossens told Al Jazeera.
Early signs of this outbreak suggest it will not be as dangerous as Sars, according to Goossens, who said the current two to three percent mortality rate would drop as more, previously-unreported cases emerge.
“There are a lot of cases outside of hospitals that are not in the statistics,” he said. “So I think that’s where mortality will be below one percent. It will be much, much less violent or aggressive than the Sars virus.”
Chinese researchers published the 2019-nCoV sequence on a public database earlier this month, launching an immediate race to develop a vaccine.
“[Unlike with Ebola in 2014,] nobody’s got a vaccine ready to test against novel coronavirus, because we’ve never seen it before,” Sarah Gilbert, professor of vaccinology at the Jenner Institute at Oxford University, told Al Jazeera.
“It’s going to be a minimum of three months before anybody is ready to start doing the first clinical testing.”
Vaccines typically take so long to develop that epidemics have mostly subsided before they are widely available, but that may begin to change with the use of vaccine platforms.
This new technology allows immunologists to develop new vaccines from older, proven models, rather than starting from scratch each time.
Experts can now react much quicker to outbreaks of infectious diseases, said Gilbert, whose own lab has already started research using this approach.
“We’ve completed one clinical trial with a MERS vaccine and we have started the second one in Saudi Arabia, and so we’re using that technology to make a novel coronavirus vaccine.
“Because we got good immunogenicity results, good strong immune responses in our MERS vaccine trial, we would expect to do the same again with the novel coronavirus.”
These advances in medical technology could produce a vaccine in a fraction of the time older methods require – sometimes up to 10 years – but would still require a minimum of one year before it could be used on a large scale, meaning public health approaches focused on detection and containment will remain vital until then.
“It’s going to take months to contain the outbreak initially, and we may then see small clusters of cases coming up in various different places,” said Gilbert.
“At that point, if we then have a vaccine ready to us, that will be very helpful in finally wrapping up the outbreak.”