Is MERS Coronavirus Really A Concern At The 2022 World Cup?

Concerns about the Middle Eastern Respiratory Syndrome (MERS) seem to be spreading on social media. After all, MERS has been trending on Twitter and presumably it’s not due to any surging interest in the Mongoose Express Rest Service. But how concerned should you really be about MERS? Is the coronavirus that causes MERS actually spreading among crowds at the 2022 World Cup in Qatar? Or is not doing the same thing as that other coronavirus? Is MERS even an appropriate name for this syndrome? And what’s all this talk about the so-called “camel flu?”

Ah, so many questions. Well, according to an article in The Sun by Robin Perrie and Nick Parkermay, the U.K. Health Security Agency (HSA) did issue a briefing note stating that “Clinicians and public health teams should specifically be alert to the possibility of MERS in returning travellers from the World Cup.” Hmmm. And an announcement from the Australian Capital Territory (ACT) Health Directorate warned that “Anyone travelling from the Middle East, including returning to Australia from attending the 2022 FIFA World Cup, should be aware of Middle East respiratory syndrome [MERS].” But “alert to” and “aware of” doesn’t necessarily mean “already saw some cases.” Just like “you should be aware of the possibility that your pants may fall down” doesn’t necessarily mean that your pants have already hit the floor while you’re in the middle of giving a TED Talk on leadership and how to think outside the box.

So far, it’s not clear whether any cases of MERS have even been diagnosed among those who’ve been attending the World Cup football tournament. For example, Angela Rasmussen, PhD, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada, stated “AFAIK there is not even 1 case linked to the World Cup” in the following tweet on December 14:

The “AFAIK” used by Rasmussen was presumably an acronym for “As Far As I Know,” rather than a misspelling of “a fake.” While the MERS coronavirus (MERS-CoV) is certainly not fake and as Rasmussen indicated, “always a concern,” she did go on to say that “these specific concerns seem to be imaginary.” Yeah, while one type of coronavirus, the kind that causes Covid-19, keeps spreading and spreading and spreading throughout different parts of the world, there’s no evidence at this point that the MERS-CoV, which is a very different coronavirus, is doing the same.

So why the concerns about MERS? Part of the issue may be the “Middle Eastern” portion of the MERS name. Qatar just happens to be in the Middle East portion of the World. The country has had cases of MERS previously, although having a total of 28 reported cases, which comes out to an incidence of 1.7 per million people in Qatar, doesn’t exactly make MERS super common. The MERS name arose after the virus was first found in Saudi Arabia in 2012 and then went on to infect over 680 people and result in over 280 deaths in that country, largely because of a 2014 outbreak in Saudi Arabia.

Don’t let the Middle East name fool you, though. It’s not as if the virus preferentially seeks people from the Middle East or has remained confined to the Middle East. The virus got its name before the World Health Organization (WHO) declared in 2015 that it’s a bad idea to name infectious diseases after any particular demographic group, culture, or location because doing so might unfairly bring stigma to them. Why did the WHO even need to have a policy? After all, no one would try to call a virus something like the “China virus” or an illness something like “the kung flu” in an attempt to pass off responsibility for allowing a virus to spread in a way that may incite hate against an entire group of people, would they? Well, surprise, surprise, the MERS name may have already generated unfair stigma to those who are currently in Middle East or of Middle East decent.

Another reason for the attention to MERS may be an article entitled “Infection risks associated with the 2022 FIFA World Cup in Qatar” that was published in the scientific journal New Microbes and New Infections just prior to the start of the 2022 World Cup in Qatar did warn about the possibility of MERS at the Cup. They warned that “people with greater risk of developing severe disease are advised to avoid contact with dromedary camels, drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.” This is probably not the only reason why you should avoid drinking camel urine. And if you happen to see camel tartare on the menu, you may want to opt for the fully cooked hot dogs instead. Nonetheless, such warnings do highlight the fact that most of those who had contracted MERS in Qatar indeed had histories of contact with camels.

This is why some have been calling MERS “the camel flu.” Such a moniker is also a misnomer since MERS is not the flu. It’s not like the bird flu or the swine flu, which are caused by influenza viruses. It may not even have originated in camels, as bats may have been earlier hosts who at some point passed it along to those with humps. Yes, this is yet another virus that bats may have eventually passed to humans via other animal. This should add to your list of reasons why snuggling with bats while watching Ted Lasso may not be the best way to spend a Saturday Night. Nevertheless, testing has found the virus in dromedaries in several countries in the Middle East, Africa, and South Asia. And hanging out with camels regularly could potentially put you at greater risk for catching MERS, especially if a camel asks you for a tissue.

That doesn’t mean that human-to-human transmission of the MERS-CoV-2 can’t occur. There have been cases of such transmission, particularly in health care settings. So if anyone tells you that he or she has MERS, your first inclination shouldn’t be to spoon with that person. But to date, the MERS-CoV-2 hasn’t proven to be nearly as contagious between humans as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has.

Although the most common symptoms of MERS are fever, cough and shortness of breath, just because someone is infected with the MERS-CoV-2 and contagious doesn’t mean that he or she will necessarily have symptoms. As with the SARS-CoV-2, influenza, and other respiratory viruses, the MERS-CoV-2 can be spread by those who remain asymptomatic.

MERS-CoV-2, though, is not the same as the SARS-CoV-2. And it’s not the same as the flu or a cold or James “Murr” Murray from the television series Impractical Jokers. It brings a different set of risks. MERS can frequently progress to pneumonia. Gastrointestinal symptoms, such as diarrhea, are also possible. MERS can get bad, really bad, especially for those who are older, have chronic health conditions, or other have weaker immune systems. Those with severe illness can suffer respiratory failure, requiring mechanical ventilation. Unfortunately, there are no effective vaccines against or treatments for MERS. In fact, according to the World Health Organization (WHO), “Approximately 35% of patients with MERS-CoV have died.”

Now the WHO does add that 35% number may be a bit of an overestimate. That’s because not everyone infected with the MERS-CoV-2 may have gotten tested, detected, and diagnosed. Of course, that doesn’t mean that you should suspect MERS every time someone coughs. There are lots of other reasons someone might be cough such as Covid-19, another type of respiratory illness, or an attempt to swallow a whole head of lettuce.

All in all, there’s really no reason to start hoarding toilet paper and worry about MERS spreading throughout the world. Just because something is spreading on Twitter doesn’t mean that it’s spreading in real life. Otherwise, you’d think that France, the Lakers, ElonJet, and other things recently trending on Twitter were really spreading in real life.