An epidemic of viral pneumonia of unknown etiology emerged in the city of Wuhan (Hubei Province, China) in December 2019. On January 9, 2020, the discovery of a new coronavirus (first called 2019-nCoV then officially SARS-CoV-2, different from the SARS-CoV virus, responsible for the SARS epidemic in 2003 and MERS-CoV, responsible for an epidemic evolving since 2012 in the Middle East) was officially announced by the health authorities China and the World Health Organization (WHO). This new virus is the agent responsible for this new infectious respiratory disease called Covid-19 (for CoronaVIrus Disease).
Some highlights
After an epidemic outbreak in China in January-February, the epidemic situation has changed globally since the weekend of February 22-23, 2020. With the intensification of outbreaks in South Korea, Japan, and Singapore, and the appearance of new outbreaks in Iran and Italy. In these countries, we are witnessing community dissemination, with no identified link with cases imported from China.
At the end of February 2020, two months after its appearance in China, the epidemic seems to have peaked there. On March 9, 2020, the Chinese authorities announced the reopening of public places and the closure of field hospitals, while the number of new cases is in sharp decline in the country.
On March 10, 2020, all countries of the European Union are now affected by Covid-19.
On March 11, 2020, the WHO announced that Covid-19 could be described as a pandemic, the first triggered by a coronavirus.
On March 14, 2020, at midnight, France entered “stage 3” of an active epidemic on the territory. To slow down dissemination on the territory and reduce the risks of tension on the hospital system for the treatment of the most serious forms, social distancing measures are reinforced, with the closure of all places of non-essential groupings (cafes, restaurants, cinemas, discos …). Food stores, pharmacies, banks, tobacconists, petrol stations remain open and busy.
On March 16, 2020, the President of the French Republic decided to take measures to minimize contact and travel. A containment system is in place throughout the territory from Tuesday, March 17 at 12:00 p.m., for a minimum of fifteen days. Travel is prohibited except in certain cases: see Gouvernement.fr.
On March 16, 2020, the WHO counted almost as many cases in China as outside of China: 165,515 confirmed cases worldwide, including 81,077 in China and 86,438 outside China (in 143 different countries). And 3,218 deaths in China and 3,388 outside China.
Cause
This pneumonia is an infectious disease caused by a virus belonging to the coronavirus family, currently identified as SARS-CoV-2. The virus reservoir is probably animal. Although SARS-CoV-2 is very close to a virus detected in a bat, the animal responsible for transmission to humans has not yet been identified with certainty.
Several publications suggest that the pangolin, a small mammal consumed in southern China, could be implicated as an intermediate host between the bat and humans.
Symptoms
- The duration of the incubation is on average 5 days, with extremes of 2 to 12 days. The onset of symptoms is done gradually over several days, unlike the flu which starts suddenly.
- The first symptoms are not very specific: headache, muscle pain, fatigue. Fever and respiratory signs occur secondarily, often two or three days after the first symptoms.
- In the first descriptive studies from China, it takes an average of one week between the appearance of the first symptoms and admission to the hospital in the state phase of the disease. At this stage, the symptoms combine fever, cough, chest pain and respiratory discomfort and the performance of a chest scanner almost always shows pneumonia affecting both lungs. Other clinical signs have been described since the first studies: signs of damage to the central nervous system, expressed in particular in the elderly in the form of disorientation; sudden loss of taste and / or smell, an event that remains infrequent but which confirms the diagnosis of Covid-19.
- The severity of the clinical signs requires that approximately 20% of patients remain in hospital and 5% require admission to intensive care. The most serious forms are observed mainly in people who are vulnerable because of their age (over 70 years) or associated diseases.
Privileged observational studies (such as that carried out on passengers on the cruise ship Diamond Princess) as well as modeling work have shown that the infection can be asymptomatic or paucisymptomatic (causing little or no clinical manifestations) in 30 to 60% of infected subjects.
A rapid diagnostic test set up by a Breton company
With a simple drop of blood, this strip test, reserved for hospitals, can identify the presence of antibodies to the coronavirus in just 15 minutes.
A test capable of telling in barely a quarter of an hour whether or not you have been infected with the coronavirus and as easy to interpret as a pregnancy test?
“This is the first ultra-rapid blood test manufactured and clinically validated in France”
Dr. Alain Calvo
A test to find out if you are immune or not:
Currently, the CoVid-19 diagnostic test is based on the method called PCR (for Polymerase Chain Reaction): carried out in city laboratories and in hospitals, it consists of a nasopharyngeal sample using a swab. Secretions are analyzed to detect the presence of the virus. A few hours or even days are necessary for the patient to obtain the result. If this test allows to know if one is infected at the moment, it does not allow to detect a past contamination.
It is just as important, however: knowing whether you have been infected or not, whether you have had symptoms or not, is the same as knowing whether you are immune to the disease, if only short term. This makes it possible to identify the people who can, after confinement, “go out without problem”, as well as to know “the circulation map of the virus on the territory”, explained to Doctissimo doctor Gérald Kierzek, emergency doctor.
This is the whole point of the rapid serological test developed by NG Biotech: “This test on a strip will allow, from a drop of blood [taken at the fingertip, Editor’s note], to identify, in 15 minutes, specific antibodies produced by the body, says Dr. Calvo. […] It can be performed outside the conventional laboratory and allows the results to be transferred in real time. ”
A tool reserved for hospitals
The NG Biotech serological test, which is intended to be complementary to the PCR test, “can prove to be very useful for healthcare staff and people at risk. It also makes it possible to quickly locate healthy carriers who can infect other people around them. ” This is why the company wishes in the first place to make it available to hospitals, so that they can “ensure better stratification of patients as soon as possible and monitoring of immune status”, says France Bleu CEO Milovan Stankov Pugès .
The test has obtained CE marking and is therefore marketable. “For the moment, we are negotiating with the ministry, explains Dr. Calvo, in particular to fix the price. We are hopeful of achieving it quickly. ” The company is already said to be able to produce between 50,000 and 70,000 tests for the month of April, and expects to go up to one million in July.