Since a mysterious illness first appeared in the central Chinese city of Wuhan in December, there have been few hard facts about a virus that has now spread to 18 nations, including the United States.

On Tuesday, U.S. health officials shared new insights about the virus at a Washington D.C. press conference. There is a race to find answers to the outbreak — before it finds us.

Q: How is coronavirus diagnosed?

A: There’s a sophisticated new test called Reverse Transcriptase PCR (RT-PCR), which measures the amount of viral RNA, a chain of cells that carry genetic information, in a patient’s sputum, serum or blood.  That’s why all samples are being shipped to Atlanta and tested at the Centers for Disease Control labs.

 
Once the test is perfected and standardized, it will be released to states. Meanwhile, experts are now trying to build a test that is quicker, easier and cheaper — something like an HIV test, for instance, that can detect simple antibodies.

Q: How deadly is it?

A: About 106 of 4,500 patients have died in China — a 2.3% mortality rate. About 17% of total cases are severely ill, according to Chinese authorities.

But the true course of the illness could be more benign.

Experts say that, like other epidemics, it was first detected in very sick people — because they’re the first to seek medical help. These patients tend to be older or have other illnesses.  People with mild sniffles don’t show up.  So the true mortality rate may drop over time as doctors study a broader set of cases.

Q: Does it spread easily?

 
A: According to a report, one person will infect, on average, 1.5 to 3 people. That’s far less scary than measles, where 12 to 18 people are infected by one sick person.  But it assures continued spread of the virus. To get an outbreak under control, the transmission rate must fall below 1.

Q: How long does it take to get sick, after I’m exposed?

A: For related viruses, the so-called “incubation period” ranges from 2 to 14 days.

That number could be higher or lower for this virus.

Q: Can I catch it from someone who isn’t sick?

A: That’s controversial. In other coronaviruses, the disease only spreads when a person has symptoms.  In this outbreak, China says it has identified infections that were acquired from people who seemed healthy. But there are only a few cases.  And they haven’t been confirmed by international experts.

If true, it could influence how we respond to the outbreak. Yet healthy carriers rarely fuel major epidemics.  Sick people — who cough and sneeze, spreading germs — are a far bigger problem.

“Asymptomatic people have never been the driver of outbreaks,” said National Institute of Allergy and Infectious Diseases director Dr. Anthony Fauci.

Q: Do we know the genetic sequence?

A: Yes. Chinese scientists posted it publicly within a few days, so international teams can start studying it without obtaining a sample of the live virus.

Q: Is there treatment?

A: No.

Unlike bacterial infections, which are generally easily treated by antibiotics, viruses are tough to combat.  And because coronaviruses aren’t common, they haven’t gotten the full attention of the pharmaceutical industry.  But there’s good news. Scientists report some success in treating related viruses, called severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). So this research is accelerating, and will be applied the new virus.

These promising new agents include: AbbVie’s Aluvia, Inovio Pharma’s INO-4700, Biocryst Pharma’s Galidesivir, Regeneron’s REGN3048-3051 and Novavax’s MERS coronavirus vaccine candidate.

Q: Is there a vaccine?

A: Not yet. Human testing will start within three months, according to NIAID’s Fauci. The first trials, called Phase 1, will test safety and evidence of an immune response.  If results look promising, research will move into Phase 2 trials, which seek effectiveness.

Sources: Department of Health and Human Services secretary Alex Azar; Centers for Disease Control and Prevention director Robert Redfield; National Center for Immunization and Respiratory Disease director director Nancy Messonnier; National Institute of Allergy and Infectious Diseases director Anthony Fauci..

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