What is COVID-19? 
COVID-19 comes from the same family as severe acute respiratory syndrome (SARS), a respiratory illness first identified in southern China in 2003 that killed more than 700 people; and Middle East respiratory syndrome (MERS), which emerged in Saudi Arabia in 2012. Scientists still aren’t sure how humans first became infected with COVID-19, but suspect that the virus arose from bats, Relman said.

“That’s the best guess, simply because all of the most closely related viruses we know of in the world are ‘bat viruses,’” said Relman, who is a senior fellow at FSI and an expert on emerging infectious diseases.

Where Did the Virus Come From?
While many of the first cases of COVID-19 have been linked to the Huanan Seafood Market in Wuhan, recent data suggests that about half of the earliest cases appear to have no obvious connection to the market.

“Could they have been indirectly connected somehow, or could they too have been exposed through the movement of animals that ended up in the market? These are things that are unknown,” Relman said. 

Meanwhile, there has been speculation that the virus did not originate at the market and was instead created in a laboratory. Relman acknowledged that while he thinks it’s possible that scientists in China could have been studying the virus and let it out by mistake, he doesn’t think that’s what happened in this case.

Why Has COVID-19 Spread So Quickly?
The rapid transmission of the virus likely has to do with how it interacts with the human host. Most likely, it is growing to large numbers in the upper parts of the respiratory tract, and is therefore primed to be transmitted more easily, Relman noted.

“One of the biggest questions is whether people are contagious before they have symptoms,” Relman said. “And that is perhaps the most critical question as to whether this is going to be contained in the very near term or not.” 

What’s Been the Effect on China?
China was much better prepared for this epidemic than it was 17 years ago for SARS, said Eggleston, who is also a senior fellow at FSI and director of the Stanford Asia Health Policy Program. Still, China’s economy and connectivity within the global economy mean that this time around, it’s even more of a crisis, Eggleston said.

Many of the people who have died from the virus were healthcare workers who weren’t properly protected, due to a combination of strained resources and a shortage of testing kits and protective gear, she added. 

How Damaging is COVID-19 Going to Be?
If COVID-19 can be transmitted before people are exhibiting symptoms, it’s much more likely that the virus will spread broadly within China and be passed on to more people in other countries, said Eggleston.

Relman predicted that the number of new cases of the virus will decline over the next few months into the summer, but that it will continue to pop up in certain parts — or “hotspots” — around the world.

“We’re probably looking at a future that now includes the persistence of this virus periodically, especially in winters for the next several years,” he warned.