This FMUL Talk was about COVID 19 due to the evident interest and concern to know more about this virus. It took place on 11 March 2020 and over 200 people attended online the conference of Professors Emília Valadas and Thomas Hanscheid.
At the time of writing this report, there have been, unfortunately, new developments, but most of the information provided in this webinar remains valid and current, as it is credible and comes from serious scientific sources.
Emília Valadas started by mentioning that this was an information session based on scientifically supported knowledge. She defined a pandemic and how it spreads across multiple continents, and gave examples of pandemics such as plague the (75- 200 million deaths in the 16th century), Spanish flu (17 million deaths, early 20th century) and smallpox (300 million deaths in the 20th century), among others, such as HIV and tuberculosis.
On this date, the coronavirus had a lower mortality rate compared to other diseases, including those already mentioned. The overall mortality rate is 3.4% but the virus is very transmissible. As for the mortality rate per country, China has a rate of 3.9% while, for example, Italy has 5% (9 March figures). There is great heterogeneity in the numbers, and health care has influence, as well as basic and genetic diseases in each country.
The article “Clinical Characteristics of Coronavirus Disease 2019 in China” was mentioned, which was published in “The New England Journal of Medicine”, and it has data from patients with coronavirus in China. It shows what they were able to find in more than 4 thousand patients: most patients have mild symptoms, about 80.9% of those infected had a simple cold, 13.8% had a severe disease and 4.7% had to be hospitalized in intensive care.
One of the biggest questions remains the evolution of the disease. The symptoms are the normal ones associated with flu and this explains why diagnosis is difficult due to similar flu syndromes at this time of the year. It is also estimated that 15% of what were mild symptoms at the beginning evolve to severe and 5% of these evolve to very severe. The conclusion is that the situation is static.
The good news is that children do not have the disease or have only mild symptoms. Another good news is that most people recover. On the other hand, after the age of 60, the mortality rate increases. From the age of 80, 1 in 6 infected people die, with a tendency to worsen if they have basic diseases, such as cardiovascular disease, diabetes, blood pressure or respiratory diseases.
Referring to contagion, Emília Valadas also found that a person with COVID 19 can infect about 3 to 4 people, a lower number compared to measles in which each person can infect 9 to 10 people. Nonetheless, it is a significant level of contagion.
She also analysed China’s communication of the event, commenting that everything was very fast. She showed images of the alleged market where the virus started and said that it is necessary to start thinking about ways to prevent it, as it will not be the only case that a virus is transmitted to humans by animals.
To conclude, the infectious disease specialist said that they identified the virus seven days after being reported and that a diagnostic test for the virus already exists. In addition, the situation in China is improving, which means that the measures implemented have worked. At the moment, the number of new cases is decreasing in China.
The WHO sent specialists to China and they realized that 5% of patients needed ventilation and another 15% needed oxygen in large concentrations, only with hospitalization. The measures that worked were measures to contain the infection. And these are the only ones we have.
She was followed by Thomas Hanscheid, who addressed more technical aspects of this infection. Referring to an article published in February, he stated that in relation to this virus, the big problem is not the spread, but the serious cases. For health systems, these cases (about 20%) will be the problem. And so, the importance of “delaying” infections, so that the peak is not high over a short time, and the idea is to have a lower and more prolonged peak over time.
Thomas Hanscheid also said that the coronavirus is not new. There are other types, also in animals. He explained that in the Chinese culture the consumption of animals that are strange to Europeans happens for reasons other than just food. For the Chinese, besides food, the animal has other properties, such as medicinal. Pangolin consumption, for example, is good for kidney problems.
He also talked about aspects related to the virus receptors, the way it binds and genetic material. This virus has the capacity to mutate, and so during this outbreak the virus can evolve, with possible consequences, such as becoming more infectious.
He then spoke of possible treatments, and, unfortunately, so far, there is still nothing really effective. There is an Ebola medicine that is apparently effective, from Gilead, in the United States, which is already being used, but its potential is not yet certain.
In in vitro studies, there is another drug that appears to be effective, chloroquine, which is inexpensive. It has been around for over 50 years and may be important. China is also testing Kaletra, used for HIV, among others.
It was stressed that having a diagnosis of the virus through the genome is very good, but a test that detects antibodies, that is, the human reaction to the disease, is needed. This is important to enable understanding which cases are asymptomatic and who actually had the disease.
Thomas Hanscheid also spoke of infectiousness, showing that, from the onset of symptoms to the elimination of the virus, it can take 2 to 3 weeks, which turns infected people into sources of contagion.
He ended by saying that we have to take care of our elderly and of people with illnesses, who are more predisposed and that we have to take specific behavioural measures to keep distance and ensure social avoidance.
The webinar continued in the chat area to enable participants to ask questions. There were many questions, denoting that people with and without a health background still have doubts. The main questions were related to risk groups, the effects of drugs, the public health measures to be taken and the long-term consequences of this disease.
It was undoubtedly one of the most impactful FMUL Talks to date. We thank the availability of the Professors and colleagues of the Audio-visual unit for their work, even more so at this very complex moment.
For those interested in viewing the Webinar again, this is the link (https://www.youtube.com/watch?v=OMBDtU8fyvM&t=399s)
Sónia Teixeira
Editorial Team