By Dr. Umair Amin
It is a fact that we are in troubling times of the COVID-19 pandemic. The normality as we knew it has been uprooted, a third of the world’s population is under some form of lockdown, social distancing rules are forcing us to re-consider safety and where most of us are ‘tuned-in’ to one news source or another. We are in constant race to find a glimmer of light that could give us a sense of hope and liberation amidst the lockdown. But with all this in backdrop, we are slowing moving towards the brink of second pandemic of 'misinformation.'
As the novel coronavirus sweeps the globe, infecting close to 2 million of its inhabitants and killing over a 100,000 people, this is indeed the greatest health emergency of our times. Much about this new, invisible enemy, a deadly pathogen, a virus, not living but not dead either, is still unknown. The lack of scientifically corroborated data on the virus leaves a vacuum which is easy to fill with pseudo-science, fake news, rumours, hoaxes, opinions and anecdotes. Add to that ignorance, illiteracy and a culture of forgoing science over fleeting fame, and you have a cesspool of false information.
From world leaders touting miracle cures, to unsubstantiated claims by well-intentioned qualified medical practitioners for eliminating the virus, making rounds on social messaging groups, to spiritual healers taking a jab at making sense of the pandemic in the cosmic context, and religious clerics prescribing traditional (read: mystical) remedies to fight the virus, the list is endless.
There has been concerted effort by the World Health Organization (WHO) to counter the misinformation and debunk myths around COVID-19 and the culprit virus, SARS-CoV-2. In addition to providing the most accurate and up-to-date information on the pandemic, WHO has partnered with the popular messaging app WhatsApp to provide easy access to credible information for billions around the world.
While our lives adjust to the new normal during this pandemic, our judicious use of social media and news outlets in the virtual world is perhaps as important as observing distancing practices in the physical world that we inhabit.
We need to wait this one out. By staying at home, we are not only protecting ourselves but protecting others this way, and also doing a huge favor to the healthcare professionals on the frontlines. Only with resolve, patience and allowing us to be led by science, even if it means giving up our cherished religious rituals for the time being, can we win this battle.
More about Virus
The novel coronavirus is a member of the Coronavirus family. The family gets its name from the spikes on the outer surfaces of these viruses, much like on a ‘crown’ (corona in Latin) and, also reminiscent of the sun’s corona.
The coronaviruses cause diseases in mammals and birds. The novel coronavirus, like other viruses, is all but alive as it lacks the essential machinery to carry out the basic metabolic processes essential to life. The complete virus is merely RNA genetic material enclosed in a protein shell. The only life function it can carry out is ‘replication’, the process of making copies of itself. But, it cannot replicate without infecting another living cell, the ‘host’. As the virus infects the host cell, it inserts its genetic material and sets about making millions of copies of itself using the host’s genetic and metabolic machinery. The viral copies go on to infect more host cells and so the infection propagates.
Origin of the virus
Studies have shown that the previous outbreak-causing human coronaviruses have jumped across species i.e. from other mammals to humans, a phenomenon called ‘zoonosis’. The current novel coronavirus causing the covid-19 outbreak is also suggested to have zoonotically transferred to humans after having undergone genetic ‘reassortment’ in its previous mammalian hosts. Genetic studies of coronaviruses found in certain species of bats and pangolins have shown strong similarities in their genetic makeups with that of the novel coronavirus. The nature of the few tweaks observed in the genome supports the argument that the novel coronavirus had acquired mutations naturally that made it capable of infecting humans.
Social media lately has been rife with rumours about certain nations’ agenda to carry out biological warfare by causing epidemics with highly infectious viruses like the SARS-CoV-2. Though, recent studies quash conspiracy theories around the virus being engineered in a lab and rather conclusively argue the virus being a product of natural evolution.
The Infection
The spiky ball virus uses its spike proteins to lodge itself in the upper and lower respiratory tracts. Studies performed in China show the presence of a significant number of viral particles, referred to as the ‘viral load’, in swab samples taken from the nose and throat of individuals with symptoms. An equally significant viral load was also found in the nose and throat swabs of individuals without any symptoms but with a clearly established contact history with other infected individuals.
Further down the respiratory tract, the virus attacks the lungs by gaining access through a special protein called “ACE2”, present in the small airways of the lungs . It is here that the virus causes more severe complications.
Currently, the incubation period i.e. the time elapsed from exposure to the virus to the onset of illness, stands to be within 14 days, with most cases occurring approximately 4-5 days after exposure.
The Diseases
In humans, Coronaviruses are a common cause of mild forms of respiratory illnesses like the common cold, however, there is a spectrum of severity. Historically, Coronaviruses have been associated with outbreaks of more severe and often lethal respiratory illnesses in humans, including Severe Acute Respiratory Syndrome (SARS) in 2003, and the Middle Eastern Respiratory Syndrome (MERS) in 2012. Similarly, a small percentage of people with COVID-19, often in the elderly age group and/or having other underlying medical conditions, fall ill with a severe form of respiratory illness resulting in pneumonia.
The Chain of Transmission
The primary mode of transmission is person-to-person through droplets i.e. when a person is infected with the Covid-19 virus, whether or not showing any signs of illness, coughs or sneezes, and sprays droplets of secretions. These droplets carrying the viral particles may fall on surfaces like table tops or door handles, or on other people where the virus can remain viable for up to 3 days. Anyone else touching these surfaces with their hands or coming in contact with droplets on other people’s hands, and then touching their faces can potentially acquire the infection by allowing the virus to gain entry to the upper respiratory tract through their nose, mouth or eyes. Stopping this kind of transmission is why health experts urge people to wash their hands frequently and avoid touching their faces. And, if you’re caring for a sick person, to wear appropriate Personal Protective Equipment (PPE) and to sanitize all surfaces.
The other measure to break the chain of transmission is social distancing, which works on the same principle of minimising close contact between people, either through closely sharing spaces, like at restaurants, or shaking hands.
For the question whether the Covid-19 virus is also transmitted through air, the answer is, it is very unlikely. But there is still much that we do not know about it. The Covid-19 virus predominantly does not spread through air. In some cases though, the droplets may not fall down immediately and might linger in the air for an amount of time, a process called ‘aerosolization’. But, studies have shown that viral spread this way is significantly less likely as aerosols are not capable of being carried by air over long distances. It is probably more relevant in the case of people caring for Covid-19 patients, such as healthcare workers.
There is no evidence that the virus spreads through food.
Viability on surfaces
A study published in March 2020 in the New England Journal of Medicine tested the survival time (viability) of the novel coronavirus compared to the SARS virus (SARS-CoV-1) on various surfaces and environments from everyday life. The findings showed that the coronavirus survives on different surfaces for different amounts of time. The virus survives the longest on plastic and stainless steel for up to 2-3 days, and on cardboard for upto 24 hours, followed by copper for up to 4 hours, which was the shortest recorded time for the virus’s viability.
The Cure
Simply put, there isn’t one. A vaccine to protect against future outbreaks of this virus, or drugs to kill the virus and treat the infection, are many months away from being approved, provided they work. WHO recently reported that as many as 70 vaccines are in the works globally. Close to two dozen biopharmaceutical companies are working at unprecedented speed to develop a vaccine or cure in the shortest possible time. For the many drugs and non-drugs being touted as remedies on social media and elsewhere, the evidence is, at best, anecdotal.
Dr Umair Amin is a Medical Doctor and Clinical Research Physician with expertise in Clinical Trials and Drug Development. He can be reached at mw.amin@outlook.com