Coronavirus - COVID-19 Facts 24th March 2020

COVID-19 Information: Part One

The following report is a very short summary of current knowledge. It is supplemented by my own comments and perceptions.

COVID-19 is the name of a disease brought about by a novel virus of the Coronavirus type. This COVID-19 is not the name of a virus, but of its consequences. The official name of the new virus is SARs-CoV-2. So:

1. COVID-19 is a disease
2. Caused by a virus named SARs-CoV-2
3. Which is a novel virus of the group called Coronaviruses

This has been determined by genome sequencing involving specialist lab work. These viruses are so named because of the crown-like (hence ‘corona’) spikes on their outer casing.

Predictions on how many people will become infected are based on the R0 (pronounced R-nought), which is the basic case reproduction number. That is, how many other people will be infected by one person. The results of tests were used to pronounce a pandemic by WHO, who labelled it a PHEIC (Public Health Emergency of International Concern).

These viruses are spread from animals to humans and have roughly a 2% fatality rate. Compared to other types of contagion, this is relatively small. The idea that the new virus probably came from bats (eaten as food by some Chinese) and bad hygiene in Wuhan live seafood market is correct.

Coronaviruses have many sub-types, all of which produce mild symptoms in the majority of people. A relative few will go on to have more severe symptoms, and an even smaller number will die.

The SARS epidemic in 2002 came from cats, and the MERS epidemic came from the Middle East, from camels. These infections, too, are usually mild in symptomology, but a few can go on to suffer more severe symptoms. COVID-19 is a brand new coronavirus arising from live food markets in Wuhan, starting December 2019. Early cases began in the Huanan Seafood Wholesale Market (because it was wholesale, it quickly infected thousands within days). The idea that it began with bats may or may not be accurate, but the strain of infection is similar to that found in bats.

Coronaviruses typically cause respiratory problems, from very mild (looking like a cold) to more severe, to death. Not everyone with COVID-19 has symptoms, which is why spread can be unknown. Most with the virus will display no or mild symptoms. Look for a persistent new dry cough, perhaps a runny nose, sneezing, feeling tired and a higher temperature/fever. The fever and constant cough are good indicators a person may have COVID-19. Best thing is to telephone a GP and seek advice, and not to assume it is just a cold.

Those most affected – the elderly (70 or over) and/or those with preconditions (existing health problems). 1 in 50 with COVID-19 die of it. These viruses usually transmit via droplets in the air (from sneezing or coughing), or by contact (close contact with another person, or touching objects that droplets have been on, or infected people have touched). This is why a two metre (six feet six inch distance) should be maintained between two people. This is not possible within households, of course, but should be maintained outside the home. If food shopping wear vinyl gloves before entering a shop and only take them off when leaving (place them in a provided refuse bin). I would also recommend using hand sanitizer if you have one, before placing hands on a car door and then the steering wheel, and before AND after putting bags into the car. When in your home wash hands for twenty seconds (see method sent out a while ago, or contact me) before putting food away. Then wash them again after food is put away. I suggest this just in case the packets, tins etc., have had droplets of the virus on them in the supermarket. Remember that the virus can last up to about three days on surfaces.

Scientists are not yet sure of droplets by aerosol (that is, smaller droplets inhaled by other people) can pass the virus on. Most droplets are larger and only go about one metre (3 feet 3 inches) in distance, but distance they travel is determined by how small the droplets are; the smaller ones penetrate into the lungs. Note that you will not be infected because of droplets UNLESS an infected person coughs or sneezes directly in front of you, OR after being near someone who does this, you touch your face (eyes, nose or mouth – all entry points for a virus, including the common cold). Because of the form of spread (near a person with the virus, or things he or she has touched, or coughed/sneezed on) policies to prevent further spread are made. If people do not listen, spread increases, and governments have to implement more stringent rules.

COVID-19 Timeline

The first cases of the virus became of interest because of a cluster of cases of pneumonia (December 2019) in Wuhan City. China immediately alerted WHO (World Health Organisation) via the WHO Chinese office. At that time the cases were of a “pneumonia of unknown origin”, based on criteria agreed upon following the SARS epidemic (2002-3). The seafood market was quickly identified as the source, and China tried to limit spread by treating known cases.

(My own view, not part of the course: The timeline from December 2019 to the present does not appear to support the idea that the virus was a deliberate means to infect the world, even though the communist party in China IS using the spread as propaganda against the West).

On January 1st Chinese authorities closed the seafood market for intensive cleansing and national emergency response action was taken. The incident management system (IMS) began next day, as per WHO plans. From 31st December to 3rd January, Authorities attempted to find the source person who first had the virus, but this proved difficult because 44 people already had symptoms, all in Wuhan. When it was found none of these had seasonal flu, SARS or MERS, labs used ‘deep sequencing’ to determine what the virus was. In this way China identified a novel coronavirus (distinct from others) had caused the initial pneumonia cases. On 12th January China shared the results of lab testing with the world. it has been argued that if China had spoken sooner the spread would be less. However, it takes up to five days to have lab results. Added to this was the fast attempt to find source persons and develop diagnostic tests etc.

Other countries then searched for cases of infection. The parts of Italy that came second in numbers of infections have a very large concentration of Chinese people, all of whom freely travelled to and from China. Each country had to examine its own spread, if any, before it could make public statements and produce suitable policies. All of this takes time, even when working fast. It is essential that public bodies send out a clear signal and not constantly changing policies, based on authoritative clinical sources. Unfortunately, in the USA, Democrats, whose first mission is to destroy president Trump, have not cooperated and Mr Biden has even attempted to set up his own ‘official’ source of virus information in opposition to the source set up by Trump etc. A pandemic event is not helped by conflicting sources!

The first case outside of China was 13th January and it was determined that it was imported from China. (Personal view: It seems there was no attempt to stop Chinese movement into other countries, as we see in Italy). Other Asian countries soon saw infections. Onset of the first 425 cases in Wuhan, as graph:

First case in USA, 20th January. Here we see the big error of the USA authorities by not stopping travel from or to China. The first case had visited his family in Wuhan! About this time China was implementing massive lockdowns and legal ban in an attempt to slow spread. A number of measures were taken in China, by law. Wildlife parks, live food markets were quarantined. These were monitored by international bodies. Yet, by 22nd and 23rd January WHO did not yet consider the new virus warranted being a PHEIC. We can see from timelines etc., that China acted quickly, but it still stands that its live market lack of hygiene was the real culprit.

23rd January – China brought in movement bans and transport restrictions brought in with a ban on large gatherings.

24th January – first case in Europe: France. (Own observation: During the time of the first cases, Islam declared the virus was a plague sent by Allah to kill off infidels, and claimed Allah would protect Muslims, encouraging Muslims to meet in large gatherings and to visit shrines!! This is why it spread so quickly in Iran, and why Trump began to lockdown on illegals entering the country from Mexico. It should be noted that Muslims (as in Paris) who control whole areas of cities, refuse to listen to pandemic control measures, and so they will be a huge source of spread).

30th January – WHO declared the outbreaks to be a PHEIC.

11th February – the new virus was officially named “severe acute respiratory syndrome coronavirus-2”, or SARs-CoV-2, as the cause of the disease COVID-19.

17th February. It took until now to suggest who would be infected and how to identify infections. (Own observation: Though official announcement may have been slow, underlying lab testing was at full speed. Governments could not really make announcements unless they had lab test results to hand. The last thing they want is to keep changing terms. I have noted since the beginning that all announcements remain more or less the same; only details have changed).

27th February – first cases in sub-Saharan Africa (Own observation: Nigeria, a mostly Muslim country with many jihadists).

11th March – WHO declared outbreak as a pandemic.

The next part of the course is more technical, so will not be included here. Suffice to say that deep sequencing lab tests shows a similarity with other bat virusus. This work was done in Wuhan and Beijing by CDC lab experts. China acted swiftly to identify the cause and type of virus and other countries are using its methods. Much work is now being done (after discovering the genome) on immunity, treatments, etc.

Parts of the course on diagnostic tests are also more technical and are based on lab testing. These determine diagnostic testing when people are tested in a hospital. The test takes about 15 minutes to produce a result. Swabs and sputum can be used. Remember that a test can be made too early... the same person could easily become infected hours after having a negative test result. Public health strategies depend on testing results.

Because rate of spread is not yet fully known everyone is thought to be susceptible, even though sever and fatal cases are relatively low. This is why there are so many lockdowns. The rate of infection appears at the moment to be about a week. In Wuhan, on average, one case gave rise to a further three. Defining the rate of infection is very difficult, because different countries and labs are using different definitions. Definitions depend on three factors – how long are people infected? How probably is transmission of the virus to others? What is the average rate of contacts?

(Own observation: When I started one nursing home clinical management job, I lost half the patients in one week, because of a flu epidemic. The rate of transmission was very fast, but slower than the rate that appears to be affected by COVID-19. I later went through several smaller epidemics).

Reducing contact, especially in cities etc., is vital to reduce spread. Spread for COVID-19 is much lower than spread of measles and chicken pox, for example, and similar to the rates for SARS, Ebola, and flu. Border security is vital. (Own observation: Thus the EU insistence on maintaining open borders is grossly untenable, and the wall built by Trump is sensible, as is his travel ban. Note the ‘no-go’ areas in EU countries, which mean a pandemic can spread easily and swiftly amongst Muslims, who refuse to accept warnings). WHO requires certificates of freedom from various viruses before migrants can cross borders. (Thus, Democrats and EU officials are undermining this health barrier for the sake of politics).

Note that WHO PHEIC announcements are not done unilaterally, but after input by worldwide public health experts and actual figures.

“Community engagement is the process of supporting communities to consider themselves partners in an outbreak response, and to have ownership in controlling an outbreak. It is a principle rather than a defined set of activities, and the approaches to this vary depending on factors such as local social structures, community coherence, preferred communication methods, and relationships with authority. Risk communication without proper community engagement takes a more ‘top down’ approach and risks ignoring local needs and mores, and ultimately being less effective as a result.”
(Hana Rohan, Assoc.Prof, UK Public Health Rapid Response Team at LSHTM).

(Own Observation: It is my view that this idea breaks down significantly, if locals consist of the same religious background that denies and ignores Western demands based on science and medicine. In these areas there is little, no, or feigned cooperation between the locals and authorities, as recent Paris events have shown. UNICEF is developing standard ways to gain local cooperation, but they will not help where a community is Islamic. Of course there are other groups who can hinder proper responses, but allowing them input that is incompatible with science puts all of society at risk).

Local involvement is fine when the locals comply with known science and medicine. This is why...

• It is very important to make sure people have the right information, delivered in the right way, to take appropriate and proportionate steps to protect themselves.
• Where possible, effective risk communications should be clear and easy to understand e.g. by focusing on easily achievable tasks (such as handwashing or avoiding face touching).
• A proportionate response to illness is critical to preventing health facilities from becoming overwhelmed with the ‘worried well’, and at the same time, appropriate care-seeking is critical for those who actually are sick (either with COVID-19, or other health concerns), so that they can get the care they need.
• Managing the ‘infodemic’ (an excess of information that makes it hard to know what’s trustworthy and what’s not) and maintaining trust in public health authorities is critical to ongoing management of the outbreak (Rohan)

(Own observation: I agree with the note about ‘infodemics’!! In my own comments I rely only on known factors and facts, issued by authoritative. It is unfortunate that many Christian leaders think COVID-19 is fair game for their own announcements. If these are not the same as governmental statements there is confusion and panic. However, I have read some such reports that comply with known facts. Just beware of inconsistencies, lack of logic, and zealous errors).

Much is made of panic (and I agree):
If there is panic group cohesion breaks down and creates its own problems.
Panic buying of food creates a false impression that there are shortages, and this leads to even more panic and even more panic buying! In effect by panic buying continuously, there WILL eventually be shortages! (Based not just on panic but on sheer greed).
Panic buying of medical aids like masks mean higher prices (as with sanitizer) and a lack of the items for use by health professionals. At this time masks are NOT needed!
Sadly, the same panic has led to stigmatisation of Chinese people and some incidents of aggression.
Also, panic results in loss of local economies, because they have to close.

Simple to use rapid diagnostic tests are being developed in many countries but are still not readily available. (True for the past four days).

Commentary

The situation is still in flux and will remain so for the near future. The above is accurate to today (24th March). Governments are watching what happens closely but lab testing is also still in progress, so things can change. The virus may not start to peak for another few months, and cases may still be with us well into 2021.

As I have said constantly, the major facts are already known, and are mostly consistent. I have given updates from the start, but there are almost no real changes. The only differences are in how government responses to the spread. And some of this will depend on how seriously we all take the risks and the warnings by authorities. For myself, I have kept my wife indoors for about a month and advise family to observe the policies. This presents some difficulties. It is sad fact that I cannot take my wife for fresh air, or myself for a break, even though we wanted to go to remote areas with few people around.

I have also stopped church meetings for now, maybe for the next three months, depending on policies and spread. One of our family may not be with us for much longer, but the policies about gatherings will apply, which also affect funerals. Only immediate family is allowed to attend (spouse and children, and not extended family or friends). This in itself will create emotional upset... but remaining safe is paramount, otherwise attending a funeral could lead to several more.

Because people are panic buying food and several important items, I have to look around for alternatives, but surely supermarkets should be more responsible... how can they allow individuals to stack hundreds of the same item (whether toilet rolls, bread, or potatoes etc) in their trolleys, and not challenge or stop them? Because of all this I cannot really ask someone else to do my shopping, so I put myself at risk even further.

The above is part of societal greed and irresponsibility. Though I was born just after WW2 I still remember neighbours being caring and looking after others. It is no longer like this. I have two new neighbours either side of me – but apart from ‘hello’ (IF I catch their eye!!) there is no neighbourliness. I know of only ONE neighbour a few doors away who genuinely speak to us. And all of this reflects the lack of God and His morality in all of society.

Even so, rely on God as well as on legitimate advice and demands from authorities. God promises to look after those who obey. Yes, pray to be kept safe, but do not think it will necessarily happen if we do not obey, have trust and are faithful. It is no good saying we are saved, when our lives, attitudes and actions do not prove it. NOW is a time to prove ourselves before men and God. For myself, I will not accept someone to be godly unless they show it in every way. That goes for me as well!

I will continue to issue reports when and if necessary. As I keep saying – very little changes, except for more details.

(Selected Information: Based on COVID-19 Course, Part 1, London School of Hygiene and Tropical Medicine, CDC USA, WHO, et al) 

Sources may, or may not, agree with my comments.

© 24 March 2020

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