‘Tip of the iceberg’: With lessons of SARS in mind, experts watching new virus closely

Experts are concerned the world could see another global outbreak of a new respiratory illness related to SARS — but there are still too many unknown factors to know how serious it is just yet.

As the situation ufolds, the lessons learned from dealing with SARS are top of mind for some.

The new strain of a virus called coronavirus has killed two people in China since New Year’s Eve, with more than 40 infections reported there. Infected travellers have also been confirmed in both Thailand and Japan. The Public Health Agency of Canada has implemented enhanced screening measures at airports in Toronto, Montreal and Vancouver.

Dr. Kamran Khan is an infectious disease physician at St. Micheal’s Hospital and a University of Toronto researcher who studied airport screenings during the SARS and Ebola outbreaks. He is concerned this virus, said to have originated at a fish market in Wuhan, China, has evolved the capability to spread from person to person and could soon reach outside of Asia.

Khan said the fact that the fish market in Wuhan closed on Jan. 1, but there have since been more reported infections, even in the past 48 hours, is an indication that people are getting infected from person-to-person transmission.

It’s unknown how efficient the disease is in spreading from person to person, or how severe and quickly the symptoms develop.

“What we don’t necessarily see are the people who might have the same illness but it’s a much milder form,” Khan said.

“And maybe they don’t wind up going to the hospital. … Whenever there’s a new disease that emerges, we often (at first) just see the tip of the iceberg.”

There are several factors that could make this new coronavirus strain prone to spreading widely. So far, it doesn’t seem as deadly as SARS, meaning infected people are more likely to travel, move around and spread the disease than if they were bed ridden.

“It actually is a little bit early to tell because there’s still many unknowns about this virus. But what I will say is when we look back at SARS we saw something that was very, very deadly,” Khan said, noting that disease had a roughly 10 per cent fatality rate.

“It does not seem to have the same level of severity of illness as we saw during SARS … keep in mind that viruses often are continuously evolving and shifting and changing, and so it is also possible that a virus could start to mutate and evolve in a way that makes it either spread more easily or become more virulent, more dangerous and deadly to people,” he added.

With Chinese Lunar New Year approaching next weekend, there is even greater chance of the disease leaving the Asian region and spreading globally, Khan noted, which is why the next two weeks will be important to watch.

There is also the fact the incubation period for this virus, or the window of time before an infected person notices symptoms, can be up to two weeks. It puts airports and border agencies in a tricky situation because they’re unlikely to detect the virus by individual inspections — people are more likely to develop the illness after they’ve already left the airport.

As of now, Canada has opted to educate travellers on what symptoms to look out for, as the onus is on individuals to report if they are experiencing flu-like symptoms as soon as possible.

Symptoms include respiratory problems, flu-like symptoms including fever, cough, breathing difficulties, pneumonia and kidney failure.

Khan said there are takeaways from his experience researching the SARS outbreak that he could also apply to this new situation.

For one, front-line health-care workers need to be better informed and prepared to recognize signs of infectious disease.

“Our front-line health-care workers … they are the difference between one case in a traveller and an outbreak that could cripple an entire city,” Khan said.

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He added that information about infection and deadly diseases needs to be disseminated much more quickly to prevent deadly outbreaks.

Finally, he worries more viruses will spread from animals to humans due to the “industrialization of agriculture and the disruption of wildlife ecosystems.”

“It’s really something for us to think carefully about is that our health, our well being, our security … it’s very much intertwined with the health and well being of other living systems in the world.”

Omar Mosleh
Omar Mosleh is an Edmonton-based reporter covering inner-city issues, affordable housing and reconciliation for the Star. Follow him on Twitter: @OmarMosleh

TORONTO STAR