This is an unprecedented time in history.
I’ve been working remotely for the past week and now that epicenters of the virus in Nigeria are under lockdown, I’ve been thinking of how long this current pandemic would last. Some experts have predicted that it could take anywhere from 3 months to more than 6months before life in many of the biggest hit countries such as the U.S., Italy, Spain and the UK would begin to look normal.
Periods like this are when you start to critically assess the current state of your health, begin to think about the future of work and the global economy just to name a few. Probably out of boredom, some days ago, I decided to check how much time I had spent learning all about the Coronavirus and low and behold, the results from my Google chrome history showed that I had read about 49 published articles and viewed more than 80 videos of different length on the subject matter in the past month alone.
Whilst I’m not an expert in the medical field, most of my research has been based on “reliable journalism” and the information from the WHO amongst other global medical bodies currently researching or seeking a vaccine for this deadly virus. There’s so much misinformation going on and for those that haven’t had time to sit on their computer all day reading news after news on this topic, here’ a summary of what I’ve learned so far.
What exactly is the Coronavirus and how did we get it?
What we are actually referring to as the coronavirus is specifically, COVID-19 or 2019-nCoV, which is named as such because of the year of discovery. This virus belongs to the coronviridae family, which contains about 39 different coronaviruses of which seven have been reported to infect and cause diseases in humans. In retrospect, most people with COVID-19 will have symptoms similar to the common cold but it’s much worse in fatality, the extent to which we are still witnessing. These classes of viruses are zoonotic in nature, meaning they are passed from animals to humans similar to what we witnessed with the SARS (Severe Acute Respiratory Syndrome) and the MERS (Middle East Respiratory Syndrome) outbreak many years ago. As for the current Coronavirus, it is believed to have originated in Bats and passed on to humans through Pangolins as an intermediary host. If you don’t know what a Pangolin is, don’t worry. I never heard of one until this pandemic occurred. This endangered species is prized as a delicacy and health tonic to many of the Chinese elite.
So, if you were thinking of where this Coronavirus originated from, you already guessed right – CHINA. This is partly the reason why the American President, Donald J. Trump sent out a tweet on March 17, referring to the Coronavirus as the Chinese virus. Whilst this may sound despicable to some, it got me thinking about why so many known viruses have come out of China in recent years. Remember the SARS outbreak I just mentioned that killed 774 in 2003. That was another type of coronavirus that originated from Mainland China.
Historically, a lot of viruses that make humans sick have come from animals. Influenza originated in birds and pigs, HIV from Chimpanzees and the Ebola from Bats.
The current coronavirus has been speculated to have come from one of China’s wet markets, Wuhan, a well-known market that sells a wide variety of animals including wildlife. The reason why this type of market exists in China is because of a decision that its government made in the 1970s after a severe food shortage had killed more than 36m people. The communist party, which had controlled all food supply but was failing to feed its people had to allow for private farming. This led to small farmers catching and raring wildlife for both personal consumption and trade purposes. From a political point of view, since this started to feed and sustain the Chinese people, the government eventually backed it. Subsequently, on March 1st, 1989, the Chinese government enacted the Wildlife protection law, stating that wildlife was a resource owned by the state, protecting farmers that intend to benefit from the trade of wildlife. As of recent, the wildlife industry and wet markets across China are now worth several billions of dollars and those that control large market share have significant lobbying influence on the government. This might seem somewhat surprising as the industry is just a fraction of the country’s GDP, but the reality is that the direct consumers of wildlife are the Chinese upper class. When we had the SARS outbreak in 2002/2003, the virus was traced to Civet Cats in a market in Foshan, Guangdong province. The market was only closed temporarily and once the epidemic subsided, it was reopened. As far as these markets continue to boom and the Chinese government don’t amend their laws to shut down the wildlife market, we’ll continue to see outbreaks every now and again.
Now back to more information on COVID-19 and how you can get it?
The virus can be spread from person to person when droplets of bodily fluids such as mucus and saliva are dispersed in the air by coughing or sneezing. The infected person can transfer it to a new host directly or when someone touches these fluids that remain on surfaces and then touch their face. There are inconclusive data showing that the droplets can remain on surfaces for several hours and sometimes the droplets can be suspended in the air for many seconds. In the event that you do get the virus. Symptoms can vary based on how many droplets entered the body and through which organ(s) the virus decides to replicate itself. If the virus comes into contact with your mouth and enters the oropharynx, it either goes into your lungs or stomach. This is why symptoms such as diarrhea are also widespread as it is possible for the virus to establish itself in the gastrointestinal mucosal tract. You may also develop flu-like symptoms such as a fever and a cough if the virus develops in the respiratory tract. If the virus can replicate itself quickly, the infected person could have difficulty breathing. If you happen to have a strong immune system that doesn’t hyper react, the virus can be contained and you’ll have a better chance of recovery. however, if you have a weak immune system as a result of age or specific medical conditions such as diabetes or cancer, there’s a higher chance that the virus would replicate faster, leading to respiratory failure in which case the lungs are permanently damaged and sometimes this leads to death. This is partly why there’s a huge demand for the manufacturing of ventilators worldwide to help support infected patients breathing. From the global data, we’ve seen that the mortality rate for the elderly is much higher than the young and healthy. It’s difficult to know the exact mortality rate as many Coronavirus cases are mild and go unreported.
COVID-19 spreads like wildfire
One of the most common questions sought on the internet is regards to how quickly the virus is spreading. This is because it grows exponentially; meaning as we go from one day to the next, it multiplies by some constant. Deriving this constant is dependent on the number of cases on a given day, the average number of people someone that is affected is exposed to each day and the probability that each exposed person is infected. In simple terms, if Mr. P is infected and on an average day, he’s exposed to 4 people of which there’s a 50% probability of passing the virus to all these people. It would mean that the multiplier would be 2. Therefore, on each day, the expected rate of new confirmed cases should double. The worst part of it is how easy Mr. P can spread the virus. There have been signs that the virus can be passed by people that are pre-symptomatic or asymptomatic and not just people that are showing some of the symptoms described earlier. This is contrary to how other viruses such as SARS and Ebola spread. Usually, the host would be showing strong symptoms and even be hospitalized before the virus could spread. Hence, those viruses had a higher chance of containment than the COVID-19.
The story (Data) so far
Dec 1 – a patient in Wuhan started to show signs of viral Pneumonia (documented case)
January 13 – first recorded case outside of China, in Thailand
January 23- 581 confirmed cases appeared globally, mostly in China.
January 28 – Germany’s first confirmed case.
January 29 – UK first confirmed case
January 30 – 7,818 cases confirmed globally (WHO declares the Covid-19, a global health emergency)
January 31 – Spain first confirmed case
Feb 3 – In Yokohama Japan, passengers aboard a cruise liner were quarantined. For almost 3 weeks, the passengers were tested and 696 of them were confirmed to have carried the virus.
Feb 11 – the WHO named these type of Coronavirus, Covid-19
Feb 17 – 71,429 cases globally (mostly in China)
February 21 – Italy had its first confirmed case
February 27 – Nigeria’s first confirmed case
March 20 – Global death from coronavirus surpassed 10,000
March 22 – Global confirmed cases has reached 311,000
March 31st – Over 750k have been confirmed to have coronavirus globally.
Therefore, our best bet to reduce the spread of the virus is through social distancing or self-isolating for a minimum of 14 days. This is somewhat more difficult said than done as people have work, school, family and other commitments, making it more difficult to flatten the curve and eventually bring the virus to a crashing halt. So, as you may already have heard, it is just as important to follow other protective measures such as washing your hands very frequently for at least 20 seconds (or using an alcoholic sanitizer), wearing face masks, protective glasses and gloves.
In prevention, we believe
One of the more important lessons during all of this pandemic is to assess how various countries have reacted and are guarding themselves against this virus. It’s been quite difficult for some countries that had a larger base of infected persons, to begin with, such as Italy and Spain. These two countries could likely trace their current high level of cases to one single event; the European Champions League match that took place on February 19, between Valencia and Atalanta. Around 45,000 fans were present in Milan from both countries and many of the coronavirus cases that were confirmed several days after could be linked to that single event. Matter of fact, more than a third of the Valencia FC team tested positive for Coronavirus. By the way, if you’re wondering, Atlanta thrashed Valencia FC 4 – 1.
As at the time of this writing, no other country has had more deaths linked to the Coronavirus than Italy and Spain. Almost 10% of their infected population have died from this disease. On the other hand, Germany, which is listed as the country having the 5th most confirmed cases, has witnessed a fatality rate of less than 1%.
The stark difference in the fatality rates between these European countries could be attributed to several factors;
- Earlier Tests: Germany decided to test quickly and widely as early as January, therefore, mild cases were detected earlier. The country also has one the highest number of intensive care beds and ventilators per capita in the world making it easier for its hospitals not to be overcrowded with sick patients.
- Advisory on movements: Germany political officials also advised against travel to China as well reduce visitations to the elderly, who are said to be of higher risk
- Median Age of Infected People: Spain and Italians have one of the largest population of older people in Europe and the median age of those infected with Coronavirus is much more than other parts in Europe
- Large percentage of Smokers: Italy and Spain have a large percentage of citizens who smoke compared to Germany and as you know, Coronavirus is a respiratory disease that attacks the lungs. If your lungs have already been damaged due to poor habits, the risk of fatality is much higher.
The truth is that some parts of Germany’s low fatality rate is pure luck but nonetheless, other European countries could take a cue from how they’ve responded rapidly to the pandemic. Like I said before, early detection and restrictive movements (e.g. closing borders, social distancing, epicenter lockdowns, etc) are critical in reversing the speed the virus spreads. This is something that Nigeria has now done and hopefully, it yields the desired results in the next few weeks.
Unfortunately, some countries with more severe growth rates such as the United States may need to take more extreme measures to curtail the virus if the political will is there, else, the sheer number of cases is likely to overwhelm its healthcare system and cause many more widespread deaths across various cities. If this happens, not a herd immunity but a vaccine could help slow down the spread and I kid you not, we are unlikely to get one until 2021. Even if this happens, it would be the fastest time that a new vaccine for a disease has been introduced to the market. The Ebola vaccine took 5 years to be approved and distributed for public use and that alone was record-breaking.
Finally, why do vaccines take so long to develop and deploy
Part of it is the significant level of tests and protocols that needs to be done before it can be approved. There have been cases where vaccines have caused more side effects than the sickness it’s expected to cure, leading to unnecessary death. In the case of the coronavirus, the testing has to be quite stringent as it’s likely going to be absorbed by millions of people around the world.
On a very basic level, vaccines generally pass through four (4) phases. The first three phases involve testing the created vaccine from smaller samples to larger samples of test takers; usually starting with non-humans, then moving to humans. In each of the first 3 phases which could take several months and sometimes years each, scientists would monitor immune system responses, vaccination safety, and doses as well as validate that it prevents infection. Only after these clinical trials are done can a developer apply for a license. In the last phase, it’s all about monitoring vaccine efficacy and adverse effects so that it can be updated in the event that the virus mutates and becomes resistant to the vaccine.
The other problem that we’ll face after a vaccine has been approved is deployment to market. Most of the vaccines created are financed by profit-making institutions that need to recoup their investments. Hence, a business case needs to be first made and this is usually where government funding and other charitable organizations could come in to make the decision easier. Nonetheless, even if funding is available, further decisions need to be made about which countries should get the first set of vaccinations. For example, if a Chinese pharmaceutical company creates the vaccine, is it not expected that we’ll have wide deployments of the vaccine in that country before others are considered. To make it even more complicated, there would also be decisions made about pricing and priority of whom within the country should receive the vaccine at the earlier stages.