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[As of the morning February 27,2020,

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there were at least 82,000 confirmed[br]cases worldwide of the coronavirus

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and 2,810 deaths from it.

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TED invited Dr. David Heymann to share[br]the latest findings about the outbreak.]

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[What happens if you get infected[br]with the coronavirus?]

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This looks like a very mild disease,[br]like a common cold,

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in the majority of people.

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There are certain people who get infected[br]and have very serious illness;

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among them are health workers.

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It's a very serious infection in them,

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as they get a higher dose[br]than normal people,

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and at the same time,[br]they have no immunity.

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So in the general population,

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it's likely that the dose of virus[br]that you receive when you are infected

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is much less than the dose[br]that a health worker would receive,

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health workers having[br]more serious infections.

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So your infection[br]would be less serious, hopefully.

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So that leaves the elderly[br]and those with comorbidities

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to really be the ones[br]that we have to make sure

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are taken care of in hospitals.

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[Who are the people who should be[br]most concerned about this?]

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Well, the most concerned are people

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who are, first of all,[br]in developing countries,

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and who don't have access[br]to good medical care,

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and may not have access[br]at all to a hospital,

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should an epidemic occur in their country.

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Those people would be at great risk,

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especially the elderly.

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Elderly in all populations are at risk,

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but especially those[br]who can't get to oxygen.

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In industrialized countries,

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it's the very elderly[br]who have comorbidities,

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who have diabetes,[br]who have other diseases,

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who are at risk.

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The general population[br]doesn't appear to be at great risk.

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[What preexisting medical conditions[br]put people at higher risk?]

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First of all,

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pulmonary disease existing[br]as a comorbidity is also important.

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In general, the elderly[br]are at greater risk,

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especially those over 70,

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because their immune systems[br]are not as effective

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as they might have once been,

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and they are more[br]susceptible to infections.

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In addition, in some instances in China,

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there's been a coinfection with influenza

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and at the same time,

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there have been some[br]bacterial superinfections

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on the pneumonias that are occurring.

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[Where can we find[br]up-to-date information?]

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The Center for Disease Control[br]in Atlanta keeps track,

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and has updates on a regular[br]basis on its website.

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Also, the World Health[br]Organization in Geneva,

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which is coordinating many[br]of the activities

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going on internationally,

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also has a website with daily updates.

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It's our responsibility[br]to get that information as individuals,

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so we understand

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and can make sure that we can[br]contribute in our own way

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to prevention of major spread.

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[You led the global response[br]to the SARS outbreak in 2003.

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How does this outbreak compare?]

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That's the same problem[br]with all new infections.

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This is an infection[br]that's coming to humans

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who have never been exposed[br]to this virus before.

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They don't have any antibody protection,

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and it's not clear whether[br]their immune system

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can handle this virus or not.

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This is a virus that usually finds itself[br]in bats or in other animals,

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and all of a sudden, it's in humans.

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And humans just don't have[br]experience with this virus.

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But gradually,

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we are beginning to learn a lot,[br]as we did with SARS.

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And you know, there are certainly[br]a larger number of deaths

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than there were with SARS.

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But when you divide that by a denominator[br]of persons who are infected,

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there are many, many more persons infected[br]than there were with SARS.

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The case fatality ratio,

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that is the ratio of deaths[br]to the numbers of cases in SARS,

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was about 10 percent.

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With the current coronavirus, COVID-19,

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it is two percent or probably less.

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So it's a much less virulent virus,

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but it's still a virus[br]that causes mortality,

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and that's what we don't want[br]entering human populations.

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[Have we responded adequately[br]at border crossings, such as airports?]

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It's clearly understood[br]that airports or any land borders

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cannot prevent a disease from entering.

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People in the incubation period[br]can cross that border,

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can enter countries,

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and can then infect others[br]when they become sick.

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So borders are not a means of preventing[br]infections from entering a country

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by checking temperatures.

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Borders are important because[br]you can provide to people arriving

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from areas that might be at risk[br]of having had infection,

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provide them with an understanding,

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either a printed understanding[br]or a verbal understanding,

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of what the signs and symptoms are[br]of this infection,

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and what they should do[br]if they feel that they might be infected.

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[What's the time line for a vaccine?]

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Vaccines are under development right now,

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there's a lot of research going on.

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That research requires first[br]that the vaccine be developed,

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then that it be studied for safety[br]and effectiveness in animals,

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who are challenged with the virus[br]after they are vaccinated,

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and then it must go into human studies.

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The animal studies have not yet begun,

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but will soon begin for certain vaccines.

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And it's thought[br]that by the end of the year,

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or early next year,

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there may be some candidate vaccines

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that can then be studied for licensing[br]by regulatory agencies.

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So we're talking about at least a year[br]until there's vaccine available

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that can be used in many populations.

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[What questions about the outbreak[br]are still unanswered?]

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It's clear we know how it transmits,

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we don't know how easily[br]it transmits in humans,

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in communities or in unenclosed areas.

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We know, for example,

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that in the enclosed area[br]of a cruise ship, it spread very easily.

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We need to better understand

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how it will spread once it gets[br]into more open areas

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where people are exposed[br]to people who might be sick.

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[What about the global response[br]could be improved?]

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A major problem in the world today[br]is that we look at outbreaks

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in developing countries

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as something that we need to go and stop.

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So when there's an outbreak of Ebola,

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we think, "How can we go[br]and stop this outbreak in the country."

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We don't think about[br]"How can we help that country

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strengthen its capacity

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so that it can detect[br]and respond to infections."

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So we haven't invested enough

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in helping countries develop[br]their core capacity in public health.

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What we've done is invested[br]in many mechanisms globally

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which can provide support[br]to other countries

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to go and help stop outbreaks.

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But we want to see a world[br]where every country

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can do its best to stop its own outbreaks.

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[Will we see more emerging[br]disease outbreaks in the future?]

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Today, there are over[br]seven billion people.

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And when those people come into the world,

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they demand more food,

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they demand a whole series of things,

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and they live closer together.

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In fact, we're in an urban world,[br]where people live in urban areas.

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And at the same time,[br]we're growing more animals,

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and those animals are contributing[br]food to humans as well.

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So what we see

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is that that animal-human interface[br]is becoming closer and closer together.

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And this intensive agriculture of animals,

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and this intensive increase[br]in human populations

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living together on the same planet

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is really a melting pot[br]where outbreaks can occur and do occur.

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We will eventually have[br]more and more of these outbreaks.

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So an emerging infection today[br]is just a warning

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of what will happen in the future.

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We have to make sure

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that that technical[br]collaboration in the world

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is there to work together

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to make sure that we can understand[br]these outbreaks when they occur,

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and rapidly provide the information[br]necessary to control them.

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[Is the worst behind us?]

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I can't predict with accuracy.

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So all I can say[br]is that we must all be prepared

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for the worst-case scenario.

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And at the same time,

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learn how we can protect ourselves[br]and protect others

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should we become a part of that epidemic.

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