Just months after Chinese officials identified a small cluster of unexplained pneumonia cases in the city of Wuhan, scientists around the globe have broken down the coronavirus at unprecedented speed in an effort to save lives and stop its spread.
The first global pandemic of the social media age and the first major outbreak of the internet era has created an explosion of learning. At the same time, studies published on a seemingly daily basis are raising just as many new questions as they’re answering about the deadly virus.
“This whole thing is happening fast. Back in HIV, it took a lot longer to get stuff in peer-reviewed literature,” said David Bangsberg, founding dean of the OHSU-PSU School of Public Health in Portland, Ore. “With the growth of the internet and social media, journals have changed their processes. Information is flowing fast.”
The urgency of an outbreak that has infected more than 2 million people worldwide and killed at least 138,000 has spurred a wave of studies about every facet of the virus and the disease it causes, from its genetic properties, potential treatments and vaccines, and its impact in humans and animals.
Medical and scientific journals can hardly keep up. Since the beginning of February, the New England Journal of Medicine (NEJM) has received at least 20 coronavirus-related submissions every day. In recent weeks, that number has grown to 150 a day. On Monday, they received 174 submissions.
Only a small percentage make it into print, said Jennifer Zeis, the journal’s communications director. But that still means that the country’s premier medical journal had published 64 articles about the coronavirus and COVID-19 since Jan. 24.
By contrast, the Journal published 54 articles and correspondences about the H1N1 influenza in all of 2009, when that strain raced around the globe.
The Lancet, one of the world’s oldest medical journals, has published more than 300 coronavirus items since February, beginning with an editorial that warned the virus was becoming a “serious public and global health threat.”
Some doctors and hospital administrators, who have to keep up with the latest information to properly treat their patients, say they are waking up earlier or staying up later to absorb as much as possible about the heretofore unknown virus. Recent studies published in the NEJM cover new information about how and whether the virus can be transmitted by aerosol droplets, mucosal bleeding and microhemorrhages that developed in a 65-year-old woman and reports from a Long Island hospital in New York that set up an innovative system for handling patients.
“As much as the virus is growing exponentially, our knowledge is also growing exponentially,” said Rob Davidson, an emergency physician in rural Michigan who heads the Committee to Protect Medicare. “It’s been like getting a master’s degree in COVID-19 in hyper phase.”
The research started soon after the first cluster of cases was identified in late December, when Chinese scientists isolated the virus causing the unexplained pneumonia and uploaded its RNA sequence to a medical research website. That allowed scientists across the globe to begin studying its structure, creating tests to diagnose its presence or the presence of antibodies and developing a vaccine that will eventually bring the pandemic to heel.
In past outbreaks, it might have taken weeks or months to isolate the virus, and much longer for that information to get to laboratories around the world. This time, scientists began work on at least one potential vaccine even before the United States reported its first case of the virus on Jan. 21.
“It’s a revolution in molecular biology. The Chinese had the genetic sequence within three days of isolating the virus,” said George Rutherford, an epidemiologist at the University of California-San Francisco.
Several studies have examined the virus’s impact on pregnant women, most of whom do not appear to be at greater risk of severe symptoms than the general populace — unlike influenza, which is more likely to cause complications for pregnant women. Other studies are tracking health care workers who come down with the virus, a growing number in the hardest hit countries around the world. Still more are evaluating possible treatments in randomized tests taking place around the world.
But emerging reports from hospitals inundated by COVID-19 patients also show just how much is left to learn. Early reports showed most patients were displaying fevers, many with a deep cough, and many with difficulty breathing.
Now, the list of symptoms has expanded significantly. Anthony Rosania, an emergency room physician at University Hospital in Newark, N.J., said he treated a patient late Wednesday whose only symptom was vomiting, but that chest X-rays and lab tests showed the patient had the coronavirus. Others have described losing senses of taste and smell, mental confusion, even blood clots.
“I could draw parallels, but there’s definitely no other disease that we’ve seen before that manifests in such a diverse number of ways,” Rosania told The Hill. “It can impact any organ system, any part of the body.”
Many emergency room doctors have said that virtually everyone who walks through their doors these days is likely to test positive for the coronavirus — so they assume everyone has it, regardless of their symptoms.
The speed of new knowledge is equaled only by the speed of the coronavirus’s spread. Many experts said the eventual toll the virus takes on humanity could have been much worse had it broken out only a few years earlier, before the communications advances that have helped draw the scientific community closer than ever.
“If we were in slow motion on this,” Bangsberg said, “we’d be in a whole lot of trouble.”