With the coronavirus now spreading rapidly in Italy, recent concerns that various spring races – most notably this Saturday's Strade Bianche, next week's Tirreno-Adriatico and Milan-San Remo (March 21) – could be affected have now become very real, and their cancellation extremely likely, with the Italian government calling for a halt to all sporting and public events for the next month. Additionally, a number of cycling teams have revealed their own concerns in the past 24 hours about racing in Italy – and at Paris-Nice in France – and many have already pulled out of the races.
The Italian races now seem most likely to be rescheduled for a later date, although RCS Sport – the organiser of Strade Bianche, Tirreno-Adriatico and Milan-San Remo – hopes that their spring events might be able to be rescheduled, with further announcements expected following meetings on Thursday.
But what exactly is the Covid-19 coronavirus? Cyclingnews dug into the facts, as reported by the Centers for Disease Control and Prevention and other sites, in order to be able to explain more about the virus, who it affects and why it is important to control its spread.
Bottom line? Practising good personal hygiene and helping prevent the spread of the virus is the absolute best way to protect yourself, your loved ones, your neighbours and your community, and the world at large.
What is Covid-19?
Covid-19 is the disease caused by a new type of coronavirus. The group is named after the viruses' appearance, with each virion surrounded by bunches of spiky proteins that look like a halo, or the corona of the sun, under a microscope. The virus that causes Covid-19 is actually named SARS-CoV-2.
Coronaviruses are common in animals, and in rare cases can pass to humans from direct contact. It is not yet known which animal was the source of SARS-CoV-2, although it is suspected it may have come from bats. Other types of coronaviruses that have jumped from animals to humans include MERS (Middle East Respiratory Syndrome) and SARS (Severe Acute Respiratory Syndrome). SARS-CoV-2 emerged from the Huanan Seafood Wholesale Market in Wuhan, China.
Myth: The virus came from a genetic-research facility. Scientists have sequenced the entire genome of the virus and found no evidence that it was the result of genetic engineering, which would leave hallmark sequences behind.
How bad is it?
The problem with SARS-CoV-2 is that it is new, so humans likely don't have immunity to it. Immunity from previous infection or vaccination can hamper the ability of a virus to spread, which is why vaccinations like the ones for polio, measles and diptheria are so effective at stopping the spread of the diseases they cause.
Viruses vary in their transmission rate – the rate depends on a number of factors including when and how long a person is infectious, how the virus is transmitted, and how long it can stick around in the air or on surfaces. Scientists have been furiously studying SARS-CoV-2 to determine how it's passed along in order to predict how it will spread.
So far, scientists agree that Covid-19 is spread much like the flu or the common cold, by infected people coughing out tiny droplets of virus-laden moisture that can land on people within a few feet or be left on surfaces that others can pick up on their hands. People then become infected when they touch their eyes or mouth, or inhale the droplets.
As a result, good personal hygiene – hand-washing, and not touching your eyes, nose or mouth – is important. Most professional cyclists already practise this in order to try not get sick during the season.
Why cancel races?
Because there is no vaccination yet for SARS-CoV-2, it is important to slow the spread using other methods, like isolating sick patients and quarantining people who might have come into contact with infected people.
That is why countries are taking steps to limit mass gatherings and sporting events.
To be safe, anyone who may have come into contact with a confirmed Covid-19 case are being asked to remain isolated for two weeks, which is the approximate incubation period of the virus. Extensive testing to identify and isolate infected individuals is key to controlling the pandemic.
To measure how infectious a disease is, epidemiologists calculate the R0 (R-nought) or number of people an infected person is likely to infect. Some viruses like chickenpox or measles are highly contagious because they are carried on smaller vapour particles and can linger in the air much longer. There is little evidence at this point that Covid-19 is as infectious as that. One person with the measles can infect 12-18 people, while one person with Covid-19 typically infects two to three.
But the R0 isn't static; people can bring the infection rates down. According to Scientific American, the SARS outbreak went from about three to 0.4 after people took preventative measures. Once the R0 goes below one, the virus will die out.
The best way to reduce the R0 and make the virus die out is with immunity, which is why scientists are working quickly to find a vaccination. Until then, the next best step is to slow the spread. This is why quarantines and 'social distancing' measures are being imposed in regions where infections have been confirmed.
China's rapidly slowing infection rate has demonstrated that quarantines, awareness and good personal hygiene can be effective in reducing the spread of this disease.
It's important to take this seriously if you have travelled to an area with active contagion.
The outbreak in Italy has caused Milan-San Remo, Strade Bianche and Tirreno-Adriatico to be postponed, and potentially even the Giro d'Italia (May 9-May 31) if the virus continues to spread, with RCS Sport's Mauro Vegni initially telling Cyclingnews of his concern for his races at last week's UAE Tour, and saying on Wednesday that he now hopes that Strade Bianche, Tirreno-Adriatico and Milan-San Remo, if/when declared cancelled, could be rescheduled for June or September.
What are the symptoms?
The main symptoms of Covid-19 are fever, a cough and aching muscles. More severe cases can develop into difficulty breathing and pneumonia, while the most critical cases require hospitalisation. In Wuhan, the death rate has been higher than in other cities because the hospitals there became overwhelmed with patients.
If you've been to an area where Covid-19 is present, keep an eye on your temperature and quarantine yourself if you spike a fever, and be sure to cover your mouth when coughing, and wash your hands to reduce the chances of spreading it to those close to you.
Myth: Healthy people need to wear masks to keep from getting the virus. The masks are actually most effective for sick people to keep them from spreading the germs with their coughs. Masks require precise fitting and training to ensure that air doesn't get around them to your nose and mouth, so it's likely they won't protect you from getting sick if you're healthy.
OMG – am I going to die of this?
The chances are in favour of you surviving the outbreak. Early statistics out of China show that 81 per cent only have mild symptoms from the virus. The reason health officials are so concerned is because of the potential of this virus to spread from human to human in a population without immunity to it. Healthy young people have the least to fear – it's the elderly and other vulnerable groups that are most at risk.
The chances of dying from a virus is known as 'case fatality rate', or CFR. For the flu, the CFR is typically less than 0.5 per cent. Measuring the CFR for Covid-19 is more difficult because there may be many undiagnosed, mild or asymptomatic cases.
Myth: The flu vaccine offers protection against SARS-CoV-2. No, it doesn't. But not getting the flu will help free up medical resources for people who get Covid-19.
The most recent study estimated the death rate of Covid-19 to be 2.3% of those infected in China, making it less deadly than MERS (34.4%) or SARS (9.6%), but more transmissible.
Unlike the 1918 flu – also known as Spanish flu – which struck healthy young adults and children, Covid-19 appears to be more deadly for the elderly and those with pre-existing medical conditions, such as cancer or cardiovascular disease. There have been no deaths of those aged nine or under, but the CFR for people 80 and older in China was 14.8%.
The disease becomes critical when the body's immune system goes into overdrive, producing chemicals called cytokines that signal to the immune system to produce more white blood cells to fight the pathogen. These immune cells then congregate at the site of infection – the lungs – and cause inflammation and fluid build-up as they try to battle the virus. In some patients, the body goes overboard producing cytokines, resulting in a 'cytokine storm' that can lead to organ failure, sepsis and death.
Should I panic?
No. Be encouraged by the fact that 81 per cent of the cases are mild, and that one per cent of people infected don't show any symptoms at all.
Also be encouraged by the fact that scientists are working faster on this virus, and sharing their data more widely, than at any other time, using cutting-edge technology to learn how it works and how to fight it. There are already efforts under way to create a vaccine for Covid-19, and trials for various drugs to treat severe and critical cases.
The key is to buy time for science to come up with a vaccine to prevent the spread of the virus and to find effective treatments for the severe cases. It took less than a year for the SARS virus to be fully contained, and while Covid-19 has infected more people, there's still time to stop it in its tracks.
What about the bike races?
The biggest risk to professional cycling is travel restrictions because of quarantines. Many of the largest races pass through regions with active outbreaks and where government bans on public gatherings are being put in place. If the spread of the virus cannot be stopped there could be more widespread cancellations.
The summer will be unpredictable, with officials speculating that if the virus is not contained by May, this summer's Olympic Games in Tokyo, Japan, could be cancelled.
But don't worry – there's always e-racing...
