The covid-19 pandemic has come and…??? Is it really gone? This remains a haunting question in the minds of experts and health laity alike. Three years and several variants, and variants of concern (VOCs) later the world has long heaved a collective sigh of relief and returned largely back to life as we knew it, sans mandatory masks, vaccination, travel restrictions, etc.
Yet, like a dastardly sword of Damocles, the threat of the reentry of a new variant with vastly destructive and disruptive capacities remain hanging over humanity’s fragile head. The need for constant, heightened vigilance therefore remains a top priority for global, national, and regional health bodies alike. The following series, lest we forget, will review the highlights and uneasy essence of this woe-begotten plague, from the point of view, first of a few historical articles previously published in some Nigerian dailies by this writer, then it will go on to explore the current status, trends, and regulations regarding Covid-19.
THE CORONA VIRUS PANDEMIC: SPOTLIGHTING FACTS, FICTION AND APOSTASY
(First published in The Daily Times of Nigeria on February 1st, 2021).
As of the time of writing this article, there has been 2,000,000 cases worldwide of COVID-19-related deaths, from its two pandemic waves to date, with a decline, worldwide, in quality of life and economic indices, all within a year of its being identified, late in December 2019, as a fast propagating, point-source infection, originating from Wuhan, China.
The coronavirus pandemic is the worst public health disaster in recent decades. Yet as devastating as this is, put into historical perspective, it pales in comparison to the Spanish flu of 1918 – in which 50 to 100 million people perished globally, in its two-year wake. The world’s population then was about 1.8 billion. Adjusted against today’s population size, that tally represents a death toll of about 300 million people. Pandemics therefore are not new, and the world has been through and survived worse. Yet with global GDP on average the highest it has ever been since World War II (prior to the pandemic) and given the decline in GDP growth since it began, this pandemic easily represents the all-outcome worst in human history.
Understandably this has generated considerable anxiety and confusion as governments and the general public scramble to understand an ever-worsening scourge in real time. Collectively, in response, the world has made great gains – in a record short time. Yet, a lot remains to be done. And, as with every crisis, reducing communication gaps by expanding educational opportunities remains a potent mechanism for redress.
This article therefore intends to shed clarifying light into the nature and nuances of the disease, and its causative agent, debunking myths and misconceptions, and hopefully driving our collective understanding in the right direction. This seminal survey will not cover the bedside issues. Clinical measurements, manifestations, and management of the COVID-19 illness will be dealt with in another article.
THE NATURE OF A VIRAL BEAST: A virion, not to be distracted by animation representations endowing it with facial features and limbs, is essentially a non-living thing. In the same way, a computer virus is non-living. And like a computer virus, it is simply a program designed to automatically carry out a function. A virus is therefore a simple strand of genetic program remarkably capable of infecting other cells; an organic piece of a code-string, wrapped in a fat-protein envelope, designed to invade cells and hijack their protein manufacturing complex, in order to generate more copies of itself.
The COVID-19 virus belongs to the corona family of viruses, a group of single-stranded, coated viruses causing such diseases in humans as rabies and the common cold. An important, immediate take from this is that this family, like the myriad of other viral groups, have existed since the beginning of time.
Viruses are submicroscopic non sentient, biological entities, 100 times smaller than bacteria, that infect everything else: including animals, plants, and even bacteria. Viral infections and epidemics have been with us from time immemorial. Novel cases of human viral diseases occur when a virus, mostly previously present in other species, finds its way into human populations, resulting in some of history’s plethora of plagues and epidemics: The Plague of Athens of 429 B.C, the Japanese smallpox epidemic of 735 A.D. as well as the 1510 influenza pandemic. And more recently – Ebola, HIV, and the Spanish flu. The common misconception that this is a man-made disease, therefore, ignoring all the other absurdities of that logic, flies in the face of established scientific facts – and of history.
Viruses cause disease when they enter into a living cell and hijack its intracellular facilities to manufacture protein elements – which they need to replicate themselves and create new virions. They do this by using the victim (host) cell’s Xerox machine-like organelles to make copies of the items that the host does not have while stealing the ones that it has. The new visions are coupled together from these components and the host cells are then usually destroyed in the process of releasing the newly formed viruses – which then become free to invade other cells and repeat the circle. The location of the host cells in the body determines the kind of disease the viral invasion process causes.
While antiviral medications exist for some viruses, this group of germs collectively has been notoriously difficult to find pharmaceutical solutions for, as their code program is extremely intrepid at changing its own identity features in order to avoid recognition and evade annihilation. Extremely amazing for a non-living thing but isn’t that always the truth? Except to the truly blind, God’s good earth is an infinite feast of fascination and the search for answers.
A key approach in the war with viruses, and indeed with other germs, has been preventive measures: social distancing and avoiding infection sources – environmental items or airborne. Person-to-person transmission as well as object- and aerosol-to-person contact being the main modes of viral transmission. In this context, another important concept is that of the infecting dose. Who or what you are exposed to from your immediate environment matters but so also does how much of the infecting agent you actually ingest from these sources, at any given time. Ingest little enough, in series, and these sub-infective doses simply stimulate your immune system, in incremental steps, with little or no symptoms, to full immunity. Like in snake charmers, who get scratched and scraped by their snake pets until they are truely immune to the snake’s venom. But a big infecting dose knocks the victim out for the count. The point therefore is this; even if we cannot avoid viral ingression altogether, it is always an advantage to mitigate how much of an infecting dose we get exposed to, ab initio. Evolutions of the Public Health paradigm therefore have consisted mainly of strategies to improve public hygiene and reduce the abundance of germs in the human environment. In specific terms of a viral plague like the COVID-19 pandemic, hand sanitization and face-mask use are therefore huge steps in fighting the virus. Alas, even with all these, historically, it has often been a fight in which the odds and outcome have been stacked against mankind in favour of this remarkable enemy.
Thankfully, since its humble 18th-century beginnings, and exploding in the mid-1900s, an equally fascinating counter-coup exists: the time-honored science, and art, of vaccination: the process of inducing the body into producing antibodies – complex soldier proteins – which then seek and destroy target viruses. This, for more than a hundred years, has been the single most effective tool in our wide-scale disease control arsenal, leading to the elimination of the smallpox scourge and the significant mitigation of (especially childhood) pestilences like measles, chickenpox, and polio.
At this point a term definition is pertinent to furthering this discussion: the Infection Fatality Rate. Any particular disease-causing virus, by virtue of the complexities of its interaction with the host system, creates a disease spectrum ie the illness it causes occurs as a range of severities. This is expressible as its Fatality Rate: the number of of people infected who actually die from it. For COVID-19 it Is accepted to be an average of 2 percent. Meaning that if 100 people catch it 2 will die, the rest experiencing a range of illness severities – from near death to asymptomatic.
Now, for descriptive efficiency, let us derive a formula, both simple and useful, and call it the Lethality Index: R/X x K. Where R is the number of people infected with the virus at any one point in time, and K is the Infection Fatality Rate. X, we will call the A.R.M.: the Aggregate Effective Measures, against the disease, which in the case of the COVID-19 pandemic, are social distancing/hand sanitization, masking, and, when available, vaccination. Therefore, we see that when X increases, R decreases and that even with a constant K, the total deaths also decrease.
This R/x factor, therefore, in the absence of medication, becomes our most effective strategy in fighting this scourge. With the advent of vaccines against the COVID-19 virus, our X factor has increased significantly.
Related link
https://spikevax.com/en-CA
Related link
https://www.who.int/activities/tracking-SARS-CoV-2-variants
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