The Coronavirus surprise: a lesson in classical public health

Eskild Petersen | maj 2020 | COVID-19 |

Eskild Petersen
Adjunct Professor, Institute for Clinical Medicine, Faculty of Health Sciences, Aarhus University Denmark
Visiting professor, Infectious Diseases, Department of Molecular Medicine, University of Pavia, Italy
Co-chair, ESCMID (European Society for Clinical Microbiology and Infectious Diseases) Emerging Infections Task Force, Basel, Switzerland

As most EU/EEA countries are starting to ease the current lock down, we at BestPractice Nordic think it is time to zoom out and get an overview of the situation. In this COVID-19 perspective MD and professor at Institute for Clinical Medicine, Aarhus University Denmark, Eskild Petersen gives an overview and share his thoughts about the pandemic, including immunity, community control, the potentially second wave and prospects to a vaccine. During January 2020 China experienced an outbreak with a new Corona virus, SARS-CoV-2, genetically closely inked to the SARS outbreak also starting in China in 2003. I think it is fair to say that in January few of us had predi cted that it would cause a global pandemic, with millions ill and hundred of thousands deaths and severe disruption of the global economy. The initial data from China did not look very disturbing with an attack rate of 1.1 per 1000 population and a mortality of 4.8 per 100,000.1 However, these numbers do not add up. We have a respiratory virus not previously seen in humans and based on the experience with SARS in 2003, probably a certain mortality and a population attack rate of 1 per 1,000 is simply not credible. So five months later – what have we learned?: a lot Can we predict what will happen in the next 12 months?: no Why is SARS-CoV-2 so infectious? Peak virus excretion of SARS-CoV-2 happens when people start having symptoms and probably one to two days before.2,3,4 This is like influenza and means that quarantine at time of diagnosis is too late given that diagnosis will often be one to three days after the start of symptoms. This is in contrast to SARS where the peak virus excretion was at day five to seven after start of symptoms,5,6...