A world in shock

05 Apr 2020

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The writer is an infectious disease specialist.
The writer is an infectious disease specialist.

IT feels as though the earth has stopped turning. There is a pervasive sense of gloom over our disrupted lives as we wake each morning wishing for pre-pandemic times. Alas, each day is like the other, with worsening news erupting by the hour from across the globe. The graph of Covid-19 fatalities in Europe and North America climbs relentlessly, raising waves of panic. In Pakistan, three sets of counterproductive reactions are evident: blissful complacency, outright denial and stubborn defiance, while unscientific claptrap messages provoke frenzied emotions and hysteria. Here I present rational and scientific explanations to frequently asked questions.

The Influenza (flu) virus, as well as several other respiratory viruses, belong to distinct groups, although most produce similar or overlapping symptoms of fever, cough and body ache, and are diagnosed accurately only by specific and targeted laboratory tests. The novel SARS Cov-2 virus belongs to the coronavirus family and has been named Covid-19. All respiratory viruses are transmitted from one to the other through nasal secretions or sputum, but this novel coronavirus is by far the most easily transmissible and is highly virulent.

Covid-19 remains mysterious to scientists. As yet, only its general effects on the body are known, and since its structure has been identified, diagnostic tests have been developed. It will take perhaps a year or more to understand its seasonality, ie how it will fare in extreme climates. More confounding is whether it will make a comeback in areas where its presence has been reduced or even eliminated and, most intriguingly, whether a single attack will confer permanent immunity.

How a patient responds to any infection, be it viral or bacterial, depends upon the quantity and the potency of the microorganisms that invade the body, and the response of the defence or immunity cells of the host individual. Thus, there is an ongoing battle between the invader and the victim. Antibiotics selectively kill bacteria but not viruses. There are proven antivirals against the AIDS virus, but none known to work definitely against Covid-19.

At present, the only way to battle the virus is to avoid it.

While the epidemic raged in China and South Korea, medical literature emanating from there demonstrated that over 80 per cent of patients suffered mild symptoms and recovered with no specific treatment and 14pc were sick enough to be hospitalised; they were given empirical combinations of antimalarial, antiviral, anticytokine and plasma therapy. Few recovered, but it is unclear which treatment could be given credit for the cure. Five per cent were critically ill with severe pneumonia and were admitted into ICUs to receive breathing assistance on a ventilator, and nearly half of them died. Surprisingly, European countries are reporting much higher attack and death ratios, for which various theories are being considered. When the tempest subsides we will analyse the outcome disparities, if any, between Caucasian and Asian races.

Scientists in Western countries reeling from the Covid-19 pandemic are feverishly attempting to produce a vaccine. The process of developing an effective and safe vaccine is complex, and involves several phases of trials on volunteers; after receiving the trial vaccine, the antibody levels in their blood will be assayed over several months while they are observed for side effects. If all goes well, the trial will proceed to the next phase and more people will be tested. Barring unacceptable complications in volunteers, production will speed up. However, making enough doses for 7.3 billion people around the globe is a daunting challenge, hence the most vulnerable population will be prioritised. Assuming all hurdles are crossed, it is only realistic to expect that the vaccine will not be deployed before late 2021. By then, Covid-19 may have vanished, or we may have developed mass immunity.

As treatment and vaccine are still distant visions, the only way to escape the virus is to avoid it by physically distancing oneself from obviously infected persons and even symptomless carriers. Like Russian roulette, only chance picks the next victim. Practising strict personal and environmental hygiene is always good for preventing all infectious disease. In the time of Covid-19, you cannot be overcautious.

Compounding the issue are idle people who while away time making outlandish predictions and spouting baseless remedies that, with a click of the finger, spread around the world faster than the coronavirus itself, preying upon vulnerable minds. Please listen only to genuine scientists. If you are concerned about your own condition, link up to covid19.tih.org.pk and you will be guided to next steps.

It is beyond comprehension that a nanoparticle creature torments the world and humbles prince and pauper alike. We must endure, but we shall overcome.

The writer is an infectious disease specialist.

Published in Dawn, April 5th, 2020