Fig. 9. Strategies to combat coronavirus outbreaks.

The early stage of a potential or declared outbreak requires immediate nonpharmaceutical interventions to prevent pathogen spread. Genomic sequencing can be used to identify coronavirus strains, which guide the clinical use and/or development of vaccines and antiviral drugs. Steps involved in antiviral development are shown, which typically progress from target and hit identification to preclinical development, clinical evaluation and drug authorization and marketing. ACE2, angiotensin-converting enzyme 2; APN, aminopeptidase N; CC₅₀, half-maximal cytotoxic concentration; DPP4, dipeptidyl peptidase 4; EC₅₀, half-maximal effective concentration; HCoV, human coronavirus; IC₅₀, half-maximal inhibitory concentration; ICU, intensive care unit; RCT, randomized control trial.