Coronavirus update: widespread diagnostic testing, bioRxiv, and two public health futures

Feb. 5th: 28 countries have confirmed cases

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Photo by Dimitri Karastelev on Unsplash

The outbreak of a new coronavirus is a global public health emergency that has spread to at least 28 countries so far. There's a lot of news and it can be hard to make heads or tails of it all. It's a little overwhelming. Here are a few key updates that we think you should know about. 

A diagnostic test has been authorized for use at public health labs across the U.S.

Until now, samples from suspected cases of the new coronavirus — dubbed "2019-nCoV acute respiratory disease” (where "n" stands for "novel" and "CoV" for "coronavirus") — had to be shipped to Centers for Disease Control and Prevention (CDC) labs. In an announcement on Tuesday, the Food and Drug Administration issued an emergency use authorization to fast-track the diagnostic test and permit its use at any CDC-qualified public health laboratory. The test itself converts specific regions of coronavirus's RNA genome into DNA, makes many copies of it using a process called amplification, and then tests it for the presence of these amplified bits with a glowing dye. Scientists hope that the availability of the test will prevent backlogs and enable the preventative measures that come with a real-time diagnosis.

Preprint repositories are spreading information, and misinformation

Preprint servers like bioRxiv have allowed scientists to share their research faster than ever before by giving papers a place to be read and shared before the peer review process. For perhaps the first time, we are now seeing how these repositories are helping and hurting in a public health response. Data sharing, through for forums like virological.org and the GISAID Initiative, have allowed researchers to sequence and start analyzing the coronavirus at unprecedented speed. At the same time, some scientists worry that publishing (and publicizing) before peer review is placing quantity over quality in this outbreak. 

One preprint has already been withdrawn following widespread criticism, and bioRxiv has put up a banner on top of every page, cautioning viewers that the research posted there has not gone through peer review.

Two futures for 2019-nCoV

In one of my epidemiology classes this week, we split up into groups and underwent a coronavirus-themed crisis management case study. This is obviously just a simulation, but by day 21, the virus was everywhere and we had to transition from containment to mitigation.

I was struck by a recent article in STAT, which lays out two scenarios of what a future with endemic 2019-nCoV might look like:

One possibility adds this virus to the already four endemic human coronaviruses, which cause common cold and are a lower concern than something like the seasonal flu. Another possibility is a seasonal cycle in which coronavirus transmission dips during summer months due to their intolerance of higher heats and humidity.

We’ll keep checking in with these short roundups, so stay tuned.