Coronavirus: three of the biggest unanswered questions

Researchers are discovering more about the virus that causes Covid-19 each day, but there are still many things they are yet to learn

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More is being discovered about the new coronavirus each day, with studies providing answers about its symptoms, levels of infection and incubation period.

But there is a lot that is still unknown about the illness, which has infected more than 71,000 people around the world and killed almost 1,800.

In the UAE, there have been nine confirmed cases, the latest of which was announced on Sunday evening in a 37-year-old Chinese man following a routine check-up.

Three of those people have now recovered, with the rest still under doctors’ care.

Scientists are currently scrambling to find out more to try and prevent its spread.

The National explores three of the biggest outstanding questions they are exploring.

We don’t yet know what the virus' mortality rate is

The United Nations has said “at this stage it is still too early to determine how deadly the virus is: thousands of patients are being tested, with [now more than] in a serious condition, and it is not yet known how these cases will evolve”.

So far, there have been 71,709 confirmed cases around the world of the virus, and 1,775 deaths, according to the Johns Hopkins dashboard, which is collating the number of cases based on official government announcements. This suggests the virus has a death rate of around 2.47 per cent.

That 2.47 per cent rate, however, does not necessarily give a true indication of just how deadly the virus is. This is because of the 71,709 confirmed cases, 58,774 are still currently infected, which leaves 12,935 with a known outcome. In total, 11,135 of those, or 86.28 per cent, recovered, and 1,775, or 13.72 per cent, died. However, the good news is the number of recovered patients is growing faster than deaths.

 

We also do not know how many cases there actually are out there. Hospitals in China, particularly in Wuhan, the epicentre of the outbreak, are stretched and many cases – possibly in the tens of thousands – are believed to have gone undiagnosed. If there are actually thousands more mild cases, and studies believe there are, the mortality rate could be overstated.

However, antibody studies need to be conducted in communities across China to suggest how many people have contracted the virus to answer this question.

We don’t yet know why more men are susceptible to the virus

Men appear to be more prone to developing the infection. In one study of 99 infected patients, around two thirds of sufferers were men, while in another study, men represented around 58 per cent of all cases.

There are numerous theories as to why this may be.

It could be because women are proven to have stronger immune systems than men. This gives them a lower incidence of cancer compared to men, better trauma survival rates and possibly lower serious complications from bacterial and viral infections, according to some research. Their stronger immune systems are believed to be due to the makeup of their genes and production of female hormones, like estrogen.

However, researchers think other factors may be at work too.

 

According to studies, 62 per cent of Chinese men have been smokers at some point, compared to 3 per cent of Chinese women. The executive director of the WHO Health Emergencies Program, Michael Ryan, has said smoking was "an excellent hypothesis" for why the virus has mostly affected men.

"There is a marked difference between male and females in this outbreak in terms of severity. And there's certainly a marked difference in those habits in China," said Mr Ryan in a recent press call.

We don’t yet know how far the virus is going to spread

New cases in China are slowing after a big jump last week due to a change in the way the country diagnoses the virus. However, they continue to grow elsewhere, with one area of particular concern - onboard the Diamond Princess cruise ship. The ship was quarantined in Japan after a passenger was found to have later tested positive for the virus after disembarking in Hong Kong. That one case has now grown to 356, prompting fears over the virus’s capacity to spread.

That has led some to speak about the possibility the virus will develop into a pandemic. A Harvard epidemiologist, Marc Lipsitch, who is the director of the Centre for Communicable Disease Dynamics at the Harvard T.H. Chan School of Public Health, was quoted in the Wall Street Journal as saying the virus will "likely" become a pandemic, affecting 40 to 70 per cent of the world's population this year.

Prof Gabriel Leung, the chair of public health medicine at Hong Kong University, agreed. He said if the transmission estimate of 2.5 additional people for each infected rate is accurate, 60 to 80 per cent of the world could become infected.

However, other experts are not so quick to jump to conclusions.

Dr Ahmad Nusair, staff physician in Infectious Diseases, Medical Subspecialties Institute, at Cleveland Clinic Abu Dhabi, said the potential for pandemic “remains a concern”.

“However, there are many things going in our favor,' he said.

"Early detection of the outbreak and implementation of quarantine, providing effective hospital care to the very sick by properly trained healthcare providers, and the international awareness about the virus which resulted in most countries implementing proper screening, early detection and quarantine,” he said.

“There are other important things to remember; international society including the UAE have extended hands to help China deal with the crisis by providing resources, material and expertise.”

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