Unless you live in some kind of community or personal decision that isolates you from people, social networks, and the news, you are probably well aware of the current coronavirus pandemic. Otherwise, you wouldn’t even be reading this. So you’ve probably also seen a lot of crazy news going around, like that the coronavirus is a biological weapon, that it’s the fault of the Chinese culture for eating bats, or that you have to gargle with chlorine to avoid it. Please don’t do that. But what does “pandemic” really mean? How did we get to this, and what can we do about it? Here we are going to try to clarify all this and more, so that perhaps you, who upon entering to read this decided to inform yourself better and be less dumb, can also save yourself from contracting this mass hysteria led by ignorance.
History repeats itself
In November 2002, a case of atypical pneumonia was reported in Guandong, China. By February 2003 it was clear that an outbreak of one type of coronavirus was emerging. In a matter of 6 months, the cases decreased, travel alerts to certain countries were removed and things appeared to be “back to normal”. We are talking about viral respiratory disease SARS (Severe Acute Respiratory Syndrome). In the 2003 outbreak, 8,098 people were reported infected, of whom 774 unfortunately died. But there’s something else that erupted from the SARS coronavirus, something that the coronavirus could not care less about, as it infects any human being regardless of origin. We’re talking about Sinophobia.
Sinophobia: discrimination directed towards any Chinese person.
It doesn’t stop there. Discrimination, ignorance, and stereotypes carry this fear and hatred towards anyone with East Asian features. The current outbreak of the coronavirus 2019 (called SARS-CoV-2) has raised a new wave of racism. To the extent that, instead of educating everyone on this issue, it is the embassies of East Asian countries that have warned their nationals in the countries where they live to beware of possible incidents of racial violence.
The number of cases that we can find on the internet that have occurred around the world (including other East Asian countries) are so many that there is even a Wikipedia page compiling these cases by country. From people changing cars on public transport, mandatory closures of Asian businesses only, to cases of verbal and physical violence against people with Eastern Asian physical features that have ended up in the hospital. Children from Asian families return from school crying because of discriminatory remarks by other children. Children who are being discriminated against because of physical traits due to distorted news about a country that is not at fault and which they have probably never visited. Even in countries where no cases of the coronavirus have been reported, there have already been cases of racial discrimination.
For countless reasons, people have migrated from China to the rest of the world for centuries. Starting with trading purposes, to the most contemporary reasons such as fleeing communism, wars, and other political reasons. This has led to the establishment of Chinatowns in cities around the world. This was more a result of mass migrations since 1500, accelerated after the signing of the Beijing treaty in the late 1800s. Where are we going with this little history lesson? All over the world, there are second, third, fourth, fifth+ generations of people of Chinese descent. The presence of any person anywhere in the world today is not a novelty. Creating this mental association that if you have East Asian features you are a carrier/transmitter of coronavirus only shows your ignorance and racism. The risk of contracting this virus has absolutely no relation to a person’s origin, nor their skin color, religion, or citizenship.
Racism feeds on the anxiety and fear that arise from ignorance. Unfortunately, so much ignorance paints a monstrous picture of an entire culture, so that discrimination and abuse do not arouse the indignation that they should. People are basically blaming an entire culture for getting sick. Ridiculous, right? If you insist on blaming the whole country (which makes up 20% of the world’s population), please continue reading. This could have happened anywhere in the world.
In addition to these behaviors, there are also those who have even taken advantage to profit while instilling panic. Deplorable all of them.
So much hysteria and discrimination over this virus: is it even that serious?
Many have commented that the virus is “no big deal” and we must “stay calm”. This is partly true. But announcing the need for “panic” is as harmful as announcing that “it’s no big deal”. The excuse of “no cases reported in my town yet” does not mean that we should not prevent it now. It would be very irresponsible and negligent to continue with business as usual. We must take the measures suggested by the World Health Organization (WHO) so as not to make the situation worse.
It is true that panic is unnecessary, and if you are a young person with a strong and healthy immune system, you have nothing to worry about when it comes to your own health. This doesn’t mean that if you get infected you won’t have a hard time. But most non-immunocompromised people infected with the new coronavirus have recovered from it in 2-3 weeks. Now, this doesn’t mean you should still go to work and go out and have fun like it’s really not that bad. If you have symptoms, stay home and isolate yourself for at least 14 days so you don’t put everyone else at risk and play a part in spreading this virus. We, non-immunocompromised young people, have a huge responsibility to protect ourselves from being agents of contagion for vulnerable people.
But if it is supposed to be “not so bad”, what risk do we impose on others?
There are people who are in a disadvantage, whether for reasons of health, age, or both. In older people or people who are immunocompromised (e.g. people with cardiovascular disease, diabetes, liver disease, respiratory disease, malnutrition, if you are taking any drugs (ask your doctor), pregnant women, even smokers) the problem is that their immune system will also try to fight the virus, but the risk for these people is greater because they will weaken faster, have more severe symptoms, and their immune system going on overdrive can be deadly.
You may be feeling fine but consider all of this if you’re going to visit your grandparents or family and friends who fit these descriptions. Before we get to the recommendations for these visits (although it’s best to avoid them now), let’s start clarifying the details of what is known about the virus at this time and what we should do to contain and prevent it (yes, even if you live in a “no reported case” area).
Coronavirus 2019 – SARS-CoV-2 – COVID19 – What is all this?
Maybe reading so many names makes it a little hard to understand, but maybe this analogy makes it clearer: just as the Human Immunodeficiency Virus (HIV) causes Acquired Immune Deficiency Syndrome (AIDS), the name SARS-CoV-2 refers to the virus only, and the name COVID-19 (COronaVIrus Disease 2019) refers to the disease itself.
Coronaviruses are a fairly common family of viruses. In fact, the last time you had a cold, you were probably infected with either a type of coronavirus or a type of rhinovirus. The coronavirus that has jumped to fame this year (SARS-Cov-2) is an RNA virus that goes straight to the lungs. This is why it causes respiratory illness and the most common symptoms we know so far are very similar to those of a common cold: fever, dry cough, and tiredness. In more severe cases, breathing may be difficult. If you have these symptoms, stay home. Don’t go to a clinic to put more people at risk and waste the time of doctors who might be treating people with more severe cases: call your doctor first.
So, where is the virus?
Contrary to what some media have reported, the virus does not live in the air. The virus is distributed in droplets when we sneeze or cough and these are heavy enough to fall quickly (it is estimated that they can “travel” a distance of about 1 meter in front of the person who sneezes before falling). We still do not know how long they survive on the surfaces where they fall, but this is why the suggestion to wash your hands constantly is one of the most important.
We are always touching all kinds of surfaces: keyboards, doors, tables, leaving the cell phone everywhere and then we pick it up again and put it in our hands and face. So here comes the first measure that we should all have been implementing for months now: wash your hands more frequently. Before you eat, every time you go in and out of a meeting or class, when you just get home, after you sneeze and cough, and be very careful not to touch your face if you have not washed your hands. The virus will not infect you just by touching a surface with your hands, it must first come in contact with some mucous membrane (nose, mouth, eyes) that makes it easier for it to reach your respiratory system.
Soap? That is all?
Although it sounds like a joke to many that just washing with soap can make a difference, this actually has a very simple biological reason. That’s why those mandatory biology classes that you hated so much are actually very important to understand this easily and not get to this level of global misinformation.
The SARS-CoV-2 “body” is surrounded by a layer of lipids (fats). Soaps are salts formed by the reaction between fatty acids and sodium hydroxide. At the molecular level, soap molecules are chains with a hydrophilic end (attracted to water) and a hydrophobic end (or lipophilic, attracted to fat). When you are soaping, these fat-loving ends stick to the fats in your hands. This includes those little fats that surround the virus. Soap basically sticks to and destroys the layer of fat that protected the virus. Then, when you rinse with water, the water-loving ends of the soap stick to the water molecules, which rinse down everything with them.
These chemical properties of the soap, along with the mechanical action of rubbing your hands for at least 30 seconds, are more than enough to remove any virus that may be on your hands and minimize the risk you are currently running. It is worth mentioning that you should not turn off the tap with your clean hands, use your elbows or a towel (which you will need to clean more frequently now). Also, disinfect your cell phone and stop biting pens.
Alcohol-based hand sanitizing gels can also be a good alternative when you don’t have the option to soap up. Avoid buying those with glitter and other things that limit their effectiveness. Make sure you buy the ones with a minimum of 60% alcohol (and a maximum of 95%). Why don’t we suggest 100% alcohol? Not only is it not so common to find it in supermarkets or pharmacies, but it also would not be good for the purposes we need. The water content is necessary to dissolve proteins from viruses and bacteria, and the alcohol basically plays the role of soap in “opening” or “exploding” the protective membranes of viruses.
Apply the amount recommended on the label (as each brand will have different formulas and recommendations). For the gel to have enough time to carry out its purpose it should evaporate from your hands in about 5-10 seconds, not less. However, these are a good alternative when your hands are not visibly dirty. That is, if you have just devoured some delicious tacos and you are all greasy: go for the soap.
As for “antibacterial” soaps: they are unnecessary, it is not always true what they say, and they do not have an “antibacterial” function unless you rub them for at least two minutes. We repeat: it’s unnecessary. Don’t wash with vodka either! Washing well with normal soap for 30 seconds is enough. Seriously. We can’t reiterate this enough. We’ve read a lot of myths that are even dangerous. Stick to the soap, please. Practice this hand washing every time you need to touch your face, every time you cough, sneeze, or touch something you haven’t disinfected or something on the street.
But people are dying…
Unfortunately, people have died from COVID19, mostly older people or those with health complications prior to contracting the coronavirus. We are talking about people and families who have been directly affected in this way. Of course, the mortality rate of the virus is something to worry about, but we also ask for some empathy and sensitivity in dealing with the subject and the “number” questions as if it were just a number. These are lives we’re talking about.
There are many numbers published in different news stories about infection rates and death rates. The truth is that at this moment we still don’t know enough to have credible values. We take this opportunity to give you a little tip to critically evaluate the news you read when it comes to science and health: “exact” values are never going to be true. Any good scientist will tell you a range or a value and its uncertainty. All estimation is just that: estimates based on mathematical models that will always have some uncertainty. This does not make them less important or less valid, it is simply reality. Don’t trust anyone who promises you an “exact value”. Besides, many times you are presented with numbers out of context that mean nothing.
At the time of writing (13 March 2020) with the cases reported by the WHO worldwide and compared to this same point in previous pandemics, it does appear that the mortality rate of the current coronavirus is not so high. But, we repeat, the information we currently have is not yet sufficient to be able to “trust” one value, and the proportion and distribution of SARS-CoV-2 is another new story. This brings us to another important issue…
Do we trust the data?
We are not saying that the cases reported are false, but that what is reported is less than the real cases. That is, if you keep repeating that “in my town there are still no reported cases so calm down”, you are doing more harm than you think.
This is due to several factors. First of all, many people without symptoms or with mild cold symptoms who might have SARS-CoV-2 easily mistake it for the common cold and don’t report it. Second, because of misinformation and suggested quarantine measures, many people will not report for fear of being discriminated against in any way or for fear of this “quarantine” (which means nothing bad and the most responsible thing to do would be to report it!). Another problem in under-reporting is that many countries in the Global South do not have the necessary detection capacity. So don’t hide behind that phrase and take the recommended precautions.
Although the different behavior of the virus is being studied in the tropics, it is possible that the lack of reported cases is for all these reasons, and not because they do not exist. But keep a critical eye here, this all is still only a possibility. Besides the tip we gave you above about mathematical models, another super common thing is that for nothing more than getting “more readers” and “more likes”, many journalists make inferences and generalizations from isolated cases or from just one study or news story – watch out for that! For now, don’t rely on headlines and constantly check the WHO website.
But they already said it’s a “Pandemic”
The term “Pandemic” strikes fear in people, but if you ask around you “what is a Pandemic”, few will be able to define it. The terms “epidemic” and “pandemic” have nothing to do with the severity of a disease, they simply describe how it is distributed.
Six weeks ago, the WHO declared a “Public Health Emergency of International Importance” (PHEI) and two days ago (11 March 2020) they declared it a “Pandemic“. This does not change the virulence, or the rate of infection, or the mortality of the virus. This is only a description of its distribution. In addition, categorizing it as PHEI or as a Pandemic helps in the decision-making process by member countries and gives them more obligation to abide by WHO recommendations. Categorizing it as a Pandemic can also facilitate the mobilization of resources for places that need it the most.
The word pandemic is not a negative word or one that implies the need to panic. The most important measure now is still containment, but mitigation measures are already in place for each country. One of the most important mitigation measures now is isolation (canceling schools, working from home as much as possible, etc.). This is in order to reduce the contact and spread of the virus so as not to saturate the health systems.
We understand that stopping work is a privilege and that not everyone can work from home, and that canceling schools when parents have to continue working is a sensitive issue. We do not have a solution to this, this will vary from situation to situation and country to country, but if you have the opportunity and privilege to isolate yourself as much as possible at this time, please take it. The more we are, the better.
None of this is a reason to panic. These are all reasons to prepare and change our behavior. In China the cases have decreased; in the rest of the world, we are still going to see an increase in reported cases. There is no doubt about it. What we need now is to buy time for the health care systems and the scientists who are working hard every day to study this virus, its behavior, and potential treatments. That is why there is a lot of talk now about Flattening the Curve.
If we follow the measures to #FlattenTheCurve, we can help keep the number of people who DO need treatment urgently within the capacity of our healthcare systems (which will be more sensitive in countries with weak healthcare systems). It is for this reason that the actions of even non-vulnerable individuals are extremely important so that those who do need intensive care can receive it, and those of us who can avoid it will not hog the health system and resources that we do not need.
So how do we flatten the curve?
It’s true that all of this is going to have a big impact on the economy, but the better and sooner we act, the smaller that impact is going to be. If we don’t take the precautionary measures, the cases are going to spike exponentially and as the health systems saturate, the medical staff will have to decide who gets to live and who doesn’t.
To avoid this, social distancing is now key. Even if there are no reported cases in your country, it is all the more reason to help decrease the sources of spread (i.e. each of us). Especially if the health system in your country is already saturated and in ruins as in ours (Guatemala).
We understand that we all need work and money, of course, and for many sectors, we, unfortunately, do not have the solutions. But as much as possible please try to work from home, limit meetings, and not overload or over demand from cleaning staff because this is the responsibility of each one of us. If you are the boss, please act now and send everyone to work from home if your type of business allows it. The same for educational entities – fortunately, today there are many options for keeping up with virtual education or postponing homework and exams from the following weeks.
It’s not a vacation. Young people who take the closure of educational institutions as a “vacation” are the ones who can most put the whole population at risk. Speaking of vacations, so many comments about “taking advantage of cheap flight tickets” are extremely irresponsible and you would be putting many more people at risk. Particularly since many of these cheap tickets are to countries in the Global South where there are many vulnerable communities and weak healthcare systems. Travel only if absolutely necessary and maintain strict hygiene practices while traveling.
Let’s Recap the steps we need to take:
- Social distancing. Buy only what you need to isolate yourself for a couple of weeks. Don’t hoard everything because we all need to stock up. If you are only taking care of yourself and not allowing everyone around you to do so, then you are not protecting yourself either. Besides being super insensitive, of course. We understand that you want to protect yourself and your family, but going to buy the whole supermarket does the opposite, because you leave everyone around you vulnerable and that puts you at risk too.
- Wash your hands as if there were no other activity in your life. Especially when going out and coming into a new place. Follow the recommendations we gave earlier about soaping for at least 30 seconds. Disinfect your cell phone and other objects and surfaces with which you are in constant contact.
- Avoid touching your face if you have not washed your hands.
- Only travel if absolutely necessary.
- Stay home if you have symptoms and call your doctor before going to a clinic or health center. Also, don’t call your doctor just to say you’re going to stay home. It’s time to work on our common sense too.
- Masks will only be useful if they are worn by the people who need them: sick people, medical staff, people who work with the elderly and vulnerable people. Walking around with masks everywhere is not only not a real barrier to this virus if you’re not sick or with vulnerable people, but it also increases your own contact with your face because we’re constantly accommodating them. It’s counterproductive if you’re healthy.
- If you’ve already gone out and bought unnecessary amounts of disinfectants and masks, don’t feel bad. Contact health centers in your area and let them know that you have them. These centers and people may soon be in crisis of needing them.
- Prepare yourself, not only shopping, but mentally and emotionally to spend the next few months a little differently than you are used to.
- Don’t panic, think about community and not just as individual, and take the situation as seriously as it deserves.
What is coming is not going to be easy, but by acting well informed and intelligently supporting us we can avoid this getting worse. How each of us behaves now is going to have an impact on everyone around us, particularly the most vulnerable people. We must not panic, but we must act now.
“But wait! I still have many doubts!”
Why can’t it be a biological weapon?
This is probably one of the most outrageous conspiracy headlines. The SARS-CoV-2 genome was rapidly sequenced and shared and it is so evolutionarily “normal” and similar to other viruses in the Coronavirus family that there is no indication of genetic manipulation, much less any indication that it is a threat that warrants being called a “biological weapon”.
Since we’re on this, we clarify that having the sequence of the virus genome is not dangerous. We have also read conspiracies about the reproduction of this virus in the laboratories of those who are studying it. First, let’s remember that it is an RNA virus. To facilitate its study, it is translated into DNA sequences. Scientists reproduce DNA fragments to study them. In no way does this “create a virus” much less something that can “escape”. Having access to the sequence (which we can all access, by the way) makes it easier for scientists around the world to study it to help develop diagnostic tests, improve identification, better understand the behavior of the virus in our cells, and to work on vaccine development. Knowing the genetic sequence also gives us clues to its origin and distribution.
Where did it originate?
If you are still wondering “why does everything originate in China”, then you have fallen for the sensationalist and discriminatory headlines that are not true. Maybe the 2003 SARS virus and SARS-CoV-2 jumped to humans in China, but this is not a matter of blaming one country, it is merely incidental. HIV and Zika were originally identified in Africa, 2009 H1N1 swine flu in North America, smallpox and measles viruses in Europe.
The most important thing to remember is that everyone anywhere in the world plays an important role in this and future epidemics. COVID19 is a zoonotic disease. Zoonotic implies that it is transmitted between non-human vertebrate animals (a reservoir) and humans, without the need for an arthropod/insect vector. Zoonotic diseases are not only caused by viruses, there are also zoonotic diseases caused by bacteria, parasites and fungi, some of which you may already be aware of: rabies, Ebola, MERS, influenza A H5N1 and H1N1. But, of course, here we’re going to focus on SARS-CoV-2.
For an animal to be considered a reservoir for a pathogen, it must show no signs of disease. Many coronaviruses are known to exist, some that have infected humans and others that so far have only been found in animals without “jumping” to humans. The risk of this jump depends on the ecology of the reservoir (vertebrate), behavior and epidemiology of the pathogen (e.g. virus), contact between the reservoir and the host, and biological characteristics of the human to be a host (susceptibility).
In the case of some coronaviruses whose reservoir are bats, it has been seen that spillover events (or “jumps to humans”) are related to an increase in viral load in bats, for which we still have no explanation, although it is hypothesized that it is due to reproductive and nutritional stress. Other infections in bats, such as White Nose Syndrome, are also thought to increase bat susceptibility to coronaviruses. Why have so many viruses been detected in bats? Simply put, because their cells have a unique antiviral response. However, this is an entire field of study and interesting discoveries are continually being made.
This is all very much linked to our unsustainable relationship with nature. Some people insist on blaming that “in China they have living markets”. There are living markets all over the world. One of the biggest problems in living markets (everywhere), besides the fact that endangered species are traded, is the overcrowding in which animals are kept. Small cages, stuck together, no hygienic conditions… it’s a disaster waiting to happen. It’s even surprising that there are no more constant outbreaks.
For the spillover from vertebrate to human, there may be an intermediate reservoir. In the SARS-2003 coronavirus epidemic, the civet was incriminated as a reservoir for the virus, but genetic analysis determined that the origin was in bats. What happened? The problem was that the bats were defecating near the civet cages. The civet then came into contact with the guano and they were the ones that had direct contact with humans.
Food can be a source of some zoonotic infections, but this time we already know that this is not the case. From the molecular analysis, we know that proteins in the virus capsule have an affinity for other proteins in our lung tissue.
Genetic analysis of the current coronavirus suggests that it may have originated in bats too and that the jump to humans may have been from pangolin. This does not mean that bats or pangolins are bad or that they should be killed or “fumigated”. Every day we all receive so many benefits from the ecosystem services these animals provide, it would be a thousand times worse to eliminate their populations. Pangolin is one of the species most threatened by illegal hunting. The animal to blame is humans. We are to blame for this leap of the virus.
Wildlife trafficking not only puts animals at risk of extinction, but also increases the likelihood of the exchange of disease. Humans can also transmit diseases to wildlife and domestic animals.
In addition to illegal wildlife trafficking (which is also a global problem), we need to advocate and demand better land planning from our governments, as the rate of change in land use by poorly planned urban expansion, agricultural expansion, and other causes of deforestation decreases the distance between us and wildlife.
Climate change, habitat destruction, and wildlife trafficking is not only a problem in China. It is global. The decisions we make have led to this situation and it will definitely not be the last outbreak we will see.
Thank you, Science!
It is amazing how biotechnology has advanced. The 2003 SARS genome (first detected in November 2002) was published until April 2003. The SARS-CoV-2 genome took a matter of weeks. We should be very grateful for this too, and grateful for all the scientists and medical personnel who are actively fighting this pandemic on a daily basis. This has made it possible to develop specific diagnostic methods quickly. Along with this, the development of the vaccine is also accelerating. The first prototype is about to enter human testing, something that would normally take longer to achieve.
If anything, this situation has demonstrated the interconnectivity that exists in this world, the need and dependence we have on good community relations and with nature.
Human beings are social beings and the idea of isolating ourselves generates a certain amount of resistance, which leads people with symptoms to hide it. Please report yourself. Practice empathy and remember that not all people have the privilege of access to health centers or appropriate information. Disclose information that is worthwhile and not something that provokes fear. Listen to health professionals and scientists – be careful and keep a critical mind to everything you read.
Wow! This was long. Thank you for deciding to inform yourself better and for reading this. If this was overwhelming and you don’t know what to get out of it, here are the most important things: stay calm, but take the situation seriously; wash your hands frequently and try to avoid touching your face if you haven’t washed them; stay home if you feel you are getting sick; if your job allows it, work from home; the most important thing right now is to #FlattenTheCurve; when this is over, support Asian businesses in your city, and always speak up when you see discriminatory behavior. And don’t forget this, ever, because it surely won’t be the last outbreak of new diseases for humans, and maybe we can react better next time.
If you are going to insist on getting information from social media, keep your critical thinking caps on and check where the information is coming from. In addition to this WHO link and this CDC link that they are constantly updating, if you don’t want to keep an eye on them, the following scientists and science communicators have good resources on their networks and are constantly updating us:
From a Microbiologist: https://www.instagram.com/p/B9jv-wZJ6Dx/
From a Neurobiologist: https://www.instagram.com/science.sam/
From a Nurse: https://www.instagram.com/p/B9pOZMjBUaS/
Listen to several scientists in this Podcast: https://www.alieward.com/ologies/virology
This Post was written by:
Yaimie López, Guatemalan biologist, passionate about disease ecology and zoonotic diseases, with more than 4 years of experience in tropical disease research (Malaria, Leishmaniasis).
María Braeuner, Guatemalan biologist and passionate about scientific communication, learn more here.
Did you learn something new here? Consider supporting me on Ko-fi and get a personalized doodle!
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References (others linked in text):
- Banerjee et al. 2019. Bats and Coronaviruses: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6356540/pdf/viruses-11-00041.pdf
- CDC: Consideraciones con mascotas: https://www.cdc.gov/coronavirus/2019-ncov/php/interim-guidance-managing-people-in-home-care-and-isolation-who-have-pets.html
- CDC: Cómo prepararse y tomar acción para COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/community/index.html
- CDC: SARS 2003 Basic Fact Sheet https://www.cdc.gov/sars/about/fs-sars.html
- Huang et al. 2020. Clinical Features of Patients Infected with 2019 Novel Coronavirus in Wuhan, China: https://www.idsociety.org/globalassets/lancet-jan-24-2020-today-1st-42-patients-ncov.pdf
- Kupferschmidt 2020. Mutations can reveal how the coronavirus moves – but they’re easy to overinterpret: https://www.sciencemag.org/news/2020/03/mutations-can-reveal-how-coronavirus-moves-they-re-easy-overinterpret?utm_source=Nature+Briefing&utm_campaign=dbbbcf30e8-briefing-dy-20200310&utm_medium=email&utm_term=0_c9dfd39373-dbbbcf30e8-44987101
- Lu, et al. 2020. Genomic Characterisation and Epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30251-8/fulltext
- OMS Preguntas Frecuentes: https://www.who.int/es/emergencies/diseases/novel-coronavirus-2019/advice-for-public/q-a-coronaviruses
- OMS Reglamento Sanitario Internacional y Comités de Emergencia: https://www.who.int/features/qa/39/es/
- OMS Reporte Febrero 2020: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
- OMS Vídeo sobre cómo se e sparce el coronavirus SARS-CoV-2: https://www.youtube.com/watch?time_continue=90&v=1APwq1df6Mw
- Plowright et al. 2017. Pathways to Zoonotic Spillover: https://www.nature.com/articles/nrmicro.2017.45
- Rothan & Byrareddy. 2020. The Epidemiology and Pathogenesis of Coronavirus Disease (COVID-19) Outbreak: https://www.sciencedirect.com/science/article/pii/S0896841120300469?via%3Dihub#bib20
- Tamerius et al. 2013. Environmental Predictors of Seasonal Influenza Epidemis Across Temperate and Tropical Climates: https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1003194#s4
- Wu et al. 2020. A New Coronavirus Associated with Human Respiratory Disease in China: https://www.ncbi.nlm.nih.gov/pubmed/32015508
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