Compehending COVID-19

"Where an epidemic is first detected does not necessarily reflect where it started."

"Research conducted in China and elsewhere since the COVID-19 pandemic began has shown that a range of animals -- including wild and farmed species -- are susceptible to infection, but when and where SARS-CoV-2 spilled over to humans, and from which animal, remains unknown."

World Health Organization report

"Asymptomatic people are probably especially important because from the studies that have been done so far people who have been asymptomatically infected, their antibody levels are lower and they may not be high enough to confer protection [without receiving an inoculating shot]."

"It's very misleading to discuss the overall case fatality rate because there is so much variability between populations and age groups."

"It tends to be the case that viruses that cause really, really high death rates are not well adapted to spread in humans."

Dr.Matthew Miller, associate professor, infectious diseases and immunology, McMaster University, Hamilton

"We should pause to remark that COVID-19 is extraordinarily successful epidemiologically, precisely because it is not extremely lethal."

"[Ebola, by contrast] is a rather stupid virus: It kills its host -- and itself == too quickly to spread far enough to reshape other species' life-ways to cater to its needs."

Dr.Samuel Paul Veissiere, Psychology Today, cognitive scientist, assistant professor of psychiatry, McGill University

There are no longer any reported cases of COVID in the city of 11 million inhabitants, Wuhan, China, where the novel coronavirus first emerged. There, life is resuming a normal pace. While globally the rest of the world struggles with seemingly vain attempts to control the contagion that has taken so many lives worldwide. Globally countries and their cities have experienced several 'waves' of the viral contagion, necessitating lockdowns, while their economies have been shattered, their people demoralized and fearful.

 

There remains two days left in the memorably cursed year of 2020, and when the midnight hour of 31 December arrives ushering in the next year, there will have been 1.8 million deaths worldwide, caused by SARS-CoV-2, and growing day by day. When the initial reports began circulating of a mysterious new respiratory illness, a puzzling, killing pneumonia appearing in hospitals in Wuhan, experts in the field sat up and took notice. China denied there was anything unusual happening, China informed the WHO there was no evidence of person-to-person transmission.

 

Then China closed ingress and egress to Wuhan, effectively locking the city of almost 12 million souls into itself, to contain a disease with frightening potential. Those experts looked on with growing trepidation. The coronavirus had no intention of being locked into Wuhan with its population and soon news coming out of Italy shocked the world as a warning of what was soon to appear on their own unready shores. New York quickly learned what Italy was going through and before long the virus swept the United States.

Chinese President Xi Jinping in Wuhan March 2020

Xie Huanchi Xinhua / eyevine / Redux

"As Washington falters, Beijing is moving quickly and adeptly to take advantage of the opening created by U.S. mistakes, filling the vacuum to position itself as the global leader in pandemic response. It is working to tout its own system, provide material assistance to other countries, and even organize other governments."

"The sheer chutzpah of China’s move is hard to overstate. After all, it was Beijing’s own missteps—especially its efforts at first to cover up the severity and spread of the outbreak—that helped create the very crisis now afflicting much of the world. Yet Beijing understands that if it is seen as leading, and Washington is seen as unable or unwilling to do so, this perception could fundamentally alter the United States’ position in global politics and the contest for leadership in the twenty-first century."

Kurt M. Campbell and Rush Doshi March 18, 2020, Foreign Affairs

 Irrespective of the numbers of people whom COVID-19 has affected it is still not as lethal as an infectious disease as we commonly think it to be, given the horrendous number of victims it has taken. If it is any comfort to anyone at all, SARS-1 was far more deadly, with its one-in-three chance of killing those it infected. Even so, it failed to kill as many people as COVID has for the simple reason that the more lethal a virus is, it succeeds in killing their hosts and with it the virus itself, the opportunity to spread denied it as a result of its very virulent deadliness. 

 

COVID is different and it has behaved differently, its strategy is far more successful in that it kills fewer and infects greater numbers. Numbers so great that the kill-rate far outdistances that of the more deadly viruses that have gone before it. COVID thrives in those it infects and because it is less deadly it is more contagiously opportunistic, adept at transmission in a way that SARS-1 failed to be. Given the numbers it infects it demonstrates that though less deadly it has become more lethal simply through strength of numbers. 

The most common symptoms of infection; shortness of breath, loss of taste and smell, cough, fever and tiredness is a giveaway of the virus's presence. Those failing to show any symptoms are still capable of infecting others, even as asymptomatic carriers' impact on infection spread is still an unknown. Roughly one in five people with COVID have no symptoms, representing around 20 percent of all cases. "But researchers are divided about whether asymptomatic infections are acting as a 'silent driver' of the pandemic'", according to a study in the Nature Journal.

And according to the WHO, "The virus can spread from an infected person's mouth or nose in small liquid particles when they cough, sneeze, speak, sing or breathe heavily. These liquid particles are different sizes, ranging from larger 'respiratory droplets' to smaller 'aerosols'." No longer does science believe that surface contamination is the threat it was made out to be at the beginning of the pandemic; transmission is primarily through respiratory droplets and aerosols.

 

A man with what was then a mystery illness is brought into a Wuhan hospital in January this year. Photograph: Héctor Retamal/AFP/Getty Image

 

A study in ScienceMag illustrates that viruses in droplets "can be sprayed like tiny cannonballs onto nearby individuals", with virus-laden aerosols capable of remaining in the air for hours. COVID is able to remain active on a surface for several hours, even days, yet unless that surface is touched, and hands then reach out for eyes, mouth or nose, there is no threat as long as awareness and simple hygiene methods are followed; the use of antibacterials or rigorous handwashing.

There is relief on the horizon. Vaccines which are rolling out and beginning to be distributed since gaining official permission to proceed. Inoculations are taking place targeting the most vulnerable within society with plans to expedite vaccines for distribution and vaccinating entire populations. That may take as long globally as the length of time the world has been coping with trying to contain the outbreaks. Which is good reason to understand that populations must continue to distance themselves physically, wear masks, observe good hygiene and avoid crowded indoor spaces.

In the interim, other treatments of COVID are being explored. As long as the danger of contracting     COVID continues, alternate treatments fill a necessary gap, and may in fact continue to have applications useful to ward off the effects of COVID. Among them convalescent plasma which consists of using blood from people who have recovered from illness to aid others by using their protective antibodies as a new COVID-19 therapeutic protocol.

Canada has instituted a convalescent plasma trial with a need to recruit new blood donors to study whether the proposed therapy actually works as it is meant to do theoretically. Therapeutics such as this are yet to come to market, but what is available is a few drugs that help overcome the most severe cases of COVID: Dexamethasone, a steroid acting as an anti-inflammatory, proven effective on the most ill patients, and remdesivir, an antiviral which is able to prevent the virus from replicating in a person sick with severe infection.

Lastly, there is 'proning', considered effective in hospitals by reducing the high demand for ventilators with the process of turning a sick individual from their back to their stomach for improved oxygenation.

As far as the World Health Organization is concerned, COVID-19 should be considered a test run. A serious virus that has managed to upturn the world as we know it, but not as lethal as a viral pestilence can conceivably become. The WHO has warned and continues to warn of a severely deadly strain of virus that may eventually arrive. That the discoveries made by science in coping with and trying to fully comprehend the SARS-CoV-2 virus causing COVID may better prepare us for the Big One.

"This is coming at the virus from a different way. It's almost boosting the patient's own immune system by giving them additional antibodies [through administering convalescent plasma]. Like a foot soldier to essentially fight off the infection."

"We're 100 percent reliant on people who have had the infection and have recovered to become blood donors."

Dr.Donald Arnold, associate professor of medicine, director, McMaster Centre for Transfusion Research