SERIOUS CORONAVIRUS OUTBREAKS
In late 2002, a new coronavirus emerged that was much more serious and deadly than previously known coronaviruses. This virus, ultimately named Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), could cause a critical infection that progressed to pneumonia and respiratory failure. About 25% of infected patients required intensive care,1 and roughly 11% died of the disease.3 This is a much higher case fatality rate than seems to be caused by COVID-19. (Estimates for the case fatality rate for COVID-19 are preliminary and vary widely between countries and researchers. In early September, Johns Hopkins University pegged the case fatality rate in the United States at 3.0%.)4
However, SARS-CoV seemed to be more pathogenic and spread less effectively than the 4 known common cold-causing coronaviruses. Transmission of SARS-CoV appeared to require prolonged contact with an infected person, resulting in many outbreaks in healthcare settings.5
The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) arrived on the scene a decade later, in 2012. While SARS-CoV most likely entered the human population from civet cats, MERS-CoV transmits from dromedary camels to people.6
MERS-CoV is even more deadly than SARS-CoV, with a mortality rate of 35%.2 However, MERS-CoV is not easily transmissible from person to person, much like SARS-CoV. Instead, it survives in dromedary camels and makes repeated jumps to people, “producing single infections or short transmission chains that eventually resolve, with no adaptation to sustained transmission.”7
MERS-CoV infections can be mild, but they can also lead to severe pneumonia, respiratory distress, septic shock, and multi-organ failure.1 More than 2,500 cases of MERS-CoV have been reported in 21 countries, although most cases occur in the Middle East.3