Corona’s Global Gallop Path Still An Enigma!

Bibekananda Ray

Originating from the family of viruses that affect respiration, like   the SARS and the MERS  (Middle East Respiratory Syndrome), Corona’s at least eight strains, together called by the acronym, NCOVID’19, are sweeping across more than 180 countries and territories since January this year; in five months thereafter it practically foiled mankind’s all efforts to rein, or prevent it. China where it first broke out in a wet animal market in Wuhan city in December last year played it down, initially but soon it spread to faraway Italy, from there to Western Europe and then crossing the Atlantic to the American continent. India which had its first three cases in January in Kerala had initially a low toll but despite continuous lockdown since 24th March has become the ninth highest with daily infections hovering around 7000 or more, taking its total toll to nearly a lakh. Like other nations, India is following the WHO prescriptions in hygiene as no vaccine or therapy has yet been invented, despite frantic researches in laboratories, pharmaceuticals and health institutes across the world. Recently, the WHO has alerted that it may not die, or disappear soon, and mankind may have to live with it, as with other deadly viruses which ones swept the world, e.g., plague, tuberculosis, malaria, polio, HIV, Ebola, Swine ‘flu and Encephalitis. A senior WHO official admitted gaps in the UN body’s knowledge of the path of transmission of this newest virus which is still an enigma; unless it is correctly known, a barricade against it will not be possible.  Over 2000 generic sequences of it, submitted from laboratories across the world to an open-source project, Nextstrain.org indicate that it is migrating into new subtypes. Except in Antarctica, it is taking on an average 15 days to mutate benignly, i.e., instead of making it more fatal it is helping researchers understand its origin and behaviour. They debunk the ‘conspiracy theory’, mooted by President Trump that the NCOVID’19 was an accidental leak from Wuhan Institute of Virology in China, where bio-weapons are secretly developed with hefty US aid.  The USA suspended all aid to the Institute, alleging China’s deliberate withholding of data in collusion with the WHO and on 30th May, suspended hefty aid to the UN body too.

Unknown Territory
Dr. Jeffrey N. Martin, a professor of epidemiology in the University of California admit: “There's a lot we still don't know about the way the virus that causes COVID-19 spreads. I don't think, anyone can take a group of people with COVID, say how each person has become infected, and then say that xx% got infected with droplets and yy% got infected via touching surfaces. In most individual persons, we do not know how the person got infected".  It is a respiratory virus and as such, it is mainly transmitted between people through ‘respiratory droplets’, when infected people sneeze or cough. Gravity causes those large droplets (which are bigger than five microns, in size) to fall to the ground within six feet from the infected person but that six-feet prescription is more like a ballpark estimate than a hard and fast rule. Large respiratory droplets can travel fairly far with favourable airflow. The three to six feet rule is based on a few studies from the 1930s and 1940s, which have been proved wrong, because droplets can travel farther than six feet.

Another problem is that at least a quarter of people who have been infected initially by proximity with a victim may not have any symptoms; they may not have  cold, catarrh, coughs and sneezes; it's not known, whether simply breathing out spreads the virus, or as one talks. In over 75,000 COVID-19 cases in China, it was not found to have been airborne. Transmission may also occur through fomites (i.e., articles that have been in contact with infection and can transmit it) in the milieu around the infected person. Thus, transmission can occur by direct contact with infected people and indirect contact with surfaces around them, or with objects used on the infected person, e.g., stethoscope or thermometer.  Seldom has COVID-19 caused intestinal infection, or been present in, and transmitted through, faeces of the infected.

In view of the above, the WHO continues to recommend precautions against droplets of coughing and sneezing and contacts with them on hard surfaces but still the US and the European Centres for Diseases Control & Prevention continue to alert vulnerable people against airborne transmission and advise wearing of face masks. The WHO which later veered to advising wearing of face masks, also recommended use of Personal Protection Equipment, or PPE by all medical personnel treating the infected, besides maintaining personal hygiene, respiratory etiquette and cleaning and disinfecting the environment, physical distances and avoid close, unprotected contact with people with fever or respiratory symptoms. It is not known, whether a woman can transmit SARS-CoV-2 in utero, through childbirth, or breast milk but it is better, infected mothers and suspects stay away from their new-borns, to avoid risk of transmission.

The world has in sincerity tried to barricade this path of Corona’s transmission, as outlined by the WHO but infections and deaths are spiking. Could it be that being the newest virus to affect mankind, its exact path is still not known? As a result, 24X7 lockdown that most affected countries are following is unable to “break the chain” of Corona’s transmission. Despite frantic researches across the world, efforts to develop a successful vaccine and a drug are not succeeding. The WHO initially ruled out the virus being airborne and transmission through faeces but its emphasis on wearing masks and maintaining ‘social distance’ imply that the contagion could spread through breath and proximity. Does it travel horizontally, vertically or cyclically? It somewhat responds to the regimen prescribed and tried for treatment of SARS and MERS. Why are doctors in affected countries and states not disclosing their lines of treatment to help the infected recover and return home? No such exchange of information has been reported by the media. A Chinese study admits return transmission by the cured, because it stays in the body for at least two weeks after symptoms disappear, as in cases of other germs but as long as it persists in the body, the cured are unlikely to be re-infected.

With Corona graph continuing to spiral in every affected country, the helplessness of governments and medical communities are staring in the face. With lockdown slackening, life is returning to normal in many countries but is still fraught with risks of return or another wave of NCOVID’19 or any other deadly virus. After four consecutive phases of lockdown spanning 70 says since 24th March, India extended it for another 30 days, until 30th June but relaxing restrictions outside the containment zones. The government admits that the sudden spike  in infections and death in April was caused by random dispersal of Muslim clerics who had assembled in Nizamuddin in south Delhi for an annual jamboree in mid-March. To this has been added another eventuality it did not quite foresee, the return home with families by migrant workers, pilgrims, students’ etc. en masse. Trains and other transport are bringing back those who can afford the fares; thousands are trekking on foot in pathetic conditions. They are potential carriers of the virus and when manifest, can complicate the situation. Some vaccines and a drug have shown promise in trials on animals but are yet to pass human tests. With Hydroxychloroquine (HCQ) being discouraged by the WHO and the US FDA, there is no therapy on the anvil. In China, younger victims were cured of it by taking Oseltamivir, better known under the brand name of ‘Tamiflu’ an anti-viral drug. Therefore, a breakthrough has become very urgent to save mankind; it will not be possible unless the exact path of NCOVID’19 transmission is known and barricaded by vaccines or therapies. Along with researches for development of a vaccine and drugs, therefore, the path of transmission of the virus, being circulated by the WHO should be re-examined to reach the truth.

What if Corona pandemic never ends but continues to dog mankind, hopefully with fewer infections and deaths? The world has to live with it, as it had to do with other viral diseases, like HIV, small pox etc. When plague broke out in Kolkata in early 1896, Rabindranath treated nephew Abanindranath’s 10-year old daughter with homeopathic medicines but could not save her. In a letter, the poet wrote that from Day One of evolution, mankind had to adjust and live with millions of teeming viruses and bacteria, both benign and malignant that abound on earth; it has to live with plague virus too, because it may never die. The advice is relevant today, when mankind fights with a far more ubiquitous pandemic; it has to learn to live with NCOVID’19, if it cannot be conquered, or eliminated forever. 

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Frontier
Jun 3, 2020