How Many Coronaviruses Are There?

In order to better understand the COVID-19 and SARS-Cov-2 virus, the disease it leads to, from an infectious disease viewpoint, some specialists recommend seeing coronaviruses categorically as “new” and “old” as far as how long the viruses have been infecting human beings.

A Cleveland Clinic pediatric infectious disease expert, Frank Esper, MD, states that genetically they’re differentiated into 4 groups: delta, gamma, beta, and alpha coronaviruses; only beta and alpha coronaviruses have been discovered to infect human beings.

The older coronaviruses in humans were originally identified in the 1960s, yet have probably circulated in human beings for hundreds of years. Those include HKU1 (beta coronavirus), OC43 (beta coronavirus), NL63 (alpha coronavirus) and 229E (alpha coronavirus).  Those older iterations mainly present with mild respiratory infections, except for beta coronavirus HKU1, which also can trigger gastrointestinal infection, according to Dr. Esper.

The doctor refers to newer coronaviruses as “the true emerging infectious diseases.” Those include SARS-CoV-2, MERS-CoV (MERS), and SARS-CoV (SARS). According to the doctor, those are strains which have gone through recent animal-to-people transition. It may occur when a virus mutates right to human beings, or via a second species which then further mutates to a human pathogen.

He adds that it’s what we witnessed with SARS in the years 2002 and 2003 and MERS in the year 2012 and probably what just occurred with SARS-CoV-2.

Such viral mutations mainly occur in animal species — and mostly remain in animals — however, when a rare mutation permits transmission into people, our immune systems are actually less-equipped to deal with the disease. It’s the case with those more massive epidemics we’ve seen; even though, it is vital to bear in mind, just because a mutation is showing human transmission, does not mean it is reproducing well.

In instances of SARS-CoV-2, SARS and MERS, reproduction was successful enough to spread from animal-to-person then from person-to-person, yet that does not mean there was enough evolution to become a persistent pathogen to humans.

According to Dr. Esper, when those virus mutations enable transmission to people, their survival becomes dependent upon optimization of virus infection between people. A fast response from the public health may mitigate the likelihood of that by restricting the spread of infection in people and, thereby, decreasing the opportunity of more efficient, new viruses from coming on the scene. In some instances, unpredictable variables also might work to suppress the virus’ spread, such as weather conditions or additional circulating pathogens.

Dr. Esper adds that they’re still speculating why SARS vanished. One theory is that while SARS had the ability to cause transmission from one person to another, the virus did not have the ability to go from one season over to the next. It pretty much got its single winter transmission season and mostly vanished and never returned.

In order to put the more modern-day coronaviruses in perspective, the case/death rate for SARS was 9.6 percent; the virus infected 8,098 humans during the outbreak of 2003 and 774 of those cases were deadly. The MERS 2012 outbreak, unlike SARS, continuously infects multiple dozens of individuals every year. According to The World Health Organization, since September of 2012, there’ve been 858 fatalities and 2,494 confirmed cases. a case-death rate of 34.4 percent.

The SARS-Cov-2 virulence remains to be seen, though it has shown substantial adaptability to spread from one person to another in areas of outbreak and also outpaced SARS in quantity of documented fatalities and cases. According to Dr. Esper, the actual quantity of infected individuals still will take time to confirm.

‘New’ Coronaviruses and Globalization

In addition, the “new” coronaviruses have taught humans a lot about infectious disease within an age of globalization.

It has been almost two decades since the outbreak of SARS occurred. According to Dr. Esper, that was a time in infectious disease history which emphasized the implications of a pandemic, for better and for worse, within an age of increased global connectivity.

He adds that it was a wake-up call. They witnessed the virus’s capability of circulating rapidly across countries and within new global areas. On the flip side, they also witnessed a significant collaborative response among regions and countries to stop and prevent its spread.

WHO created a global outbreak response and alert network right after the outbreak of SARS. They’ve continued to strengthen those efforts in order to equip clinicians with resources and tools that manage the care of patients and offer safety alerts and real-time data to the general public.

However, it stands to reason that they aren’t playing catch-up as much with this particular virus as they were with the prior MERS and SARS pandemic influenza or coronaviruses, where by the time they realized there was a fresh virus strain, it had already spread somewhere else in the world.

What is next?

Currently, there isn’t any COVID-19 vaccine, even though efforts at developing one are underway. According to Dr. Esper, developing a vaccine is just a part of the task. You must ensure that this vaccine is effective, safe, and may be stably transported to humans who require it, and not only in a single country yet around the world. Growing this virus to create a viable candidate for a vaccine is a critical step; however, there still are several others.

In the United States, a clinical trial is evaluating using a broad-spectrum antiviral medication referred to as remdesivir that treats COVID-19, yet thus far there isn’t any data to validate the drug’s efficacy to treat this disease strain.

These swiftly evolving circumstances means clinicians must stay vigilant and updated on public health guidelines, bearing in mind that there’s still a lot more we’re going to learn about the virus.

Dr. Esper concludes by noting that at this point, there isn’t any treatment. There isn’t any vaccine. The best thing to do is provide everyone the data needed about how to protect themselves, which also will help to mitigate further spread.

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