A question we keep hearing about the Covid-19 pandemic: Isnt this disease a lot like the flu?
A quick unambiguous answer: No, this is not like the seasonal flu. It is worse.
Yes, some of the symptoms of Covid-19 resemble flu especially fever and coughs. But this virus is worse for the destruction it may cause, not only in human lives, but to our society.
This is not to downplay the flu; that disease is still an annual blight we could be even more proactive about fighting (annual flu shots are important!). And its still true that tens of thousands of people die from the flu each year in the US.
But also, keep in mind: Thats in a given year. Covid-19 hasnt been around a year or even half a year. Before January, this virus was not known to science, at all. Its just getting started. And while there is still a lot of uncertainty over this virus, and how it will play out, from what we know so far, this is a threat to take extremely seriously.
While the exact death rate is not yet clear, the evidence so far does show the disease kills a larger proportion of people than the flu (and its particularly lethal for people older than 80).
It also has a higher potential to overwhelm our health care system and hurt people with other illnesses.
Currently, there is no vaccine to combat it, nor any approved therapeutics to slow the course of its toll on the human body. (Doctors can treat cytokine storm syndrome, an immune response that may in some cases be dealing the fatal blow to those dying of Covid-19.)
Sober-minded epidemiologists say that 20 to 60 percent of the worlds adult population could end up catching this virus.
Biologically, it behaves differently than the flu. It takes one to 14 days for people with Covid-19 infection to develop symptoms (five days is the median). For the flu, its around two days. That potentially gives people more time to spread the illness asymptomatically before they know they are sick.
Around the country, health care providers are worried about their facilities being overrun with an influx of patients, and having to ration lifesaving medical supplies. Some flu seasons are worse than others but facilities are anticipating flu cases, and prepare for them. Many hospitals, as Voxs Dylan Scott has reported, and struggling in their preparations for Covid-19.
Four or so months ago, this virus is believed to have made the leap from animals to humans for the very first time. No human immune system had seen it before November, so no human had any natural immunity to it. That means its more contagious than the flu about twice as contagious, perhaps more; the numbers are still being worked out.
The threat of it causing massive outbreaks that overwhelm health systems around the world is serious. Its bad enough to roil our stock markets, put people out of work, and potentially cause a recession. It could potentially kill millions, both here and abroad.
Its possible that Covid-19 will become endemic meaning it will be a disease that regularly attacks humans and will not go away until theres a treatment or a vaccine.
Again: Yes, flu variants kill tens of thousands of people a year in the US. But imagine if there was another kind of flu, except potentially with a higher case fatality rate, Angela Rasmussen, a Columbia University virologist, told me recently. Which is definitely a problem because the seasonal flu kills 30,000 to 60,000 Americans every year. And even if its the same case fatality rate of seasonal flu, that still presents a substantial public health burden.
We do not want this to happen.
COVID-19, the disease caused by the novel coronavirus, has been much deadlier in older people but more anecdotes are popping up of young, healthy people getting critically ill and even dying of the disease.
Two 29-year-old health care workers became seriously ill in Wuhan only one survived, a report in The New York Times detailed. Other stories about people under 50 coming down with serious symptoms are making the rounds on social media, along with questions about whether seemingly healthy young people ought to be more concerned. What do these cases tell us about the disease?
There are reasons for people in every age group to be cautious, health experts say, but not because our understanding of who is most vulnerable to the virus is changing. Just because older people are more likely to develop a severe case or die from the disease, it doesnt mean some young people wont. That smaller number of severe cases among young people still doesnt disprove the data that shows that seniors are the most vulnerable.
The US will likely see more young people get really sick over the next several weeks simply because the pandemic is still growing. Days can pass before someone starts feeling the symptoms of COVID-19. So experts anticipate a jump in the number of cases in the US as those who have been in incubation periods start feeling ill and more people get tested for the virus.
I think its almost a math problem in some ways, right? says Benjamin Singer, an assistant professor of medicine in pulmonary and critical care at Northwestern University Feinberg School of Medicine. Even with a lower likelihood of younger people getting critically ill, a certain percentage will get critically ill, and since the denominator is growing and growing these cases are popping up more and more.
Underlying health conditions can also make younger people susceptible to a severe case of the virus. Where you find severe cases or even death in young people, we dont really have full information on these patients, says Lee Riley, chair of the division of infectious disease and vaccinology at the University of California, Berkeley. Its possible that some of those people might have had medical conditions that we just didnt know about. Chronic conditions that can affect young people, like diabetes, can make it more difficult for someone to recover from the disease.
Even younger people who feel perfectly healthy need to take the pandemic seriously because they can spread the virus even if theyre not feeling any symptoms, Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases said. Dont get the attitude, Well, Im young, Im invulnerable. Fauci said at a press briefing today. You dont want to put your loved ones at risk, particularly the ones who are elderly and the ones who have compromised conditions. We cant do this without the young people cooperating. Please cooperate with us.
A 48-year-old woman from a small town in Ohio is recovering in quarantine after a scary diagnosis of COVID-19, the disease caused by the novel coronavirus. She's only the second known victim in Summit County.
After logging on to Facebook over the weekend and seeing people question how "real" the pandemic is, Amy Driscoll had enough. She finally decided to tell her community just how "real" it can be by sharing her experience with the disease.
"For all the non believers and those who are not taking this seriously, if you need [to] KNOW someone who has been diagnosed with the COVID-19, well if you are reading this you know me," Amy Driscoll began her Facebook post, which has gone viral.
Driscoll told BuzzFeed News she hopes her experience serves as a sobering wake-up call for people who don't think the virus can affect them. She said her symptoms dramatically escalated and sent her to the hospital in the middle of the night last week.
"It was so surreal," she said. "I was really sick and I knew something was wrong."
Driscoll, ne Brock, said she felt completely "fine" on Wednesday as she headed in to work. Within hours, she was lethargic, ran a fever, and had difficulty breathing.
In her Facebook post, she wrote that she had woken up in the middle of the night to her heart racing; her "chest felt tight" when she coughed, she wrote. She recounted similar symptoms to BuzzFeed News and added that she had even joked with her colleague at work that she had been affected by the pandemic earlier in the day.
"She laughed and said, 'Oh, its probably COVID-19,' and I thought, 'Thats funny.' We were joking, but in retrospect it was not a funny joke," Driscoll said.
After consulting with her cousin who's a nurse, Driscoll made the rapid decision to leave her family at home and drive herself to the emergency room at 4:30 a.m. Thursday.
She was met with medical personnel, who had all of their protective gear on and immediately tested her and admitted her to a quarantine room. She would spend the next few days there in complete isolation.
"Everyone that comes in is completely gowned head-to-toe covered that was really weird," said Driscoll. "I was very isolated. ... You're just trying to go through everything on your own."
According to Driscoll, she received pain medication for her headache and antibiotics in case her infection turned out to be bacterial. She didn't receive her official positive diagnosis of COVID-19 until close to midnight on Friday.
Fortunately, by then, she said she had already started to feel better.
"The next day [on Saturday] the doctors came in and said, 'We're going to send you home. But don't stop anywhere, go straight home. Be quarantined until we tell you when you're not,'" she recounted.
Driscoll said she was just happy to be in recovery and back with her family until she logged on to Facebook. She saw many of her Facebook friends posting about not believing in the severity of the pandemic and not understanding why strict restrictions were being imposed on them.
"I saw a lot of postings of how people couldnt believe we were going through all these restrictions. People were like, 'Lets get together and have a corona party,'" she said.
"I was trying to ignore it, but then a friend from high school had posted, 'I dont know anyone with COVID-19. Is it real? I cant believe were going through all of this.'"
The post struck a nerve for Driscoll.
"I am the face of this infection. It is brutal and I'm a healthy 48 year old with no underlying conditions," she wrote in her viral post. "I'm not 100% better but I'm home resting. Please take this seriously. People you love, their lives may depend on it."
Driscoll told BuzzFeed News she's still "weak" with limited abilities to move around her house, but she is "healing." After her Facebook post went viral, she was also uplifted by all the support she's received from her local community.
"Quarantine is not fun, but I would much rather be in quarantine and know Im not exposing anyone else to this and Ill take that," she added.
mark pazniokas :: ctmirror.org
Dr. Matthew Cartter, the state epidemiologist, said while Connecticut has logged 68 cases of COVID-19, there are likely more than 6,000. Testing is still limited, he said.
While Connecticut has now recorded 68 cases of COVID-19, the illness caused by the new strain of coronavirus, more than 6,000 residents likely have contracted the disease, Dr. Matthew Cartter, the states epidemiologist, said Tuesday.
We dont test everybody. But we know that for every person who tests positive for flu, there are probably 100 others out there whove been sick with the flu who never get tested, he said. Right now, if we have 68 positives, you should assume there are at least 100 people out there who have COVID-19 for every single positive, which puts us around 6,000 or so and that might be a low estimate.
The majority of the states cases 48 are in Fairfield County. Another eight are in New Haven County, seven are in Hartford County and five are in Litchfield County. Twenty-six people are now hospitalized with coronavirus. No one in Connecticut has died from it.
While there have been no positive tests in the eastern part of Connecticut, Gov. Ned Lamont said Tuesday that its only a matter of time.
Its been accelerating through the state, he said. Fairfield County is where the bulk of the incidents are, but now Litchfield County, Hartford County and New Haven County [have cases]. Southeast Connecticut is, thankfully, the last to have an incident. But we know its coming.
As hospitals prepare for a surge in patients, Lamont said the state is expediting certification for trainee nurses and reaching out to retired nurses to bolster staffing. He called on day care centers to remain open, so parents who work in hospitals or provide other emergency services have a place to turn to for child care.
Dr. Matthew Carter, state epidemiologist
The state expects to receive additional federal funding to expand Medicaid, known as HUSKY in Connecticut, and is opening enrollment on Access Health CT, the insurance exchange, for people who find themselves without coverage.
In an interview on CNBC Tuesday, Lamont said he was concerned that the states supply of ventilators wouldnt be enough to handle a dramatic increase in patients. He did not say how many more ventilators were needed, or when the crush of patients was expected to roll in.
New York Governor Andrew Cuomo estimated that the coronavirus outbreak would peak in his state in 45 days. Health officials there have said that in the worst-case scenario of a flulike pandemic, New York could be short by as many as 15,783 ventilators a week at the height of the crisis.The state has logged 1,374 cases of COVID-19. Twelve people have died.
As hospitals in Connecticut continued to prepare and introduce new sites for testing, several businesses across the state announced temporary closures. Among them were department stores like Macys and Nordstrom.
State unemployment claims skyrocketed to 25,000 in four-and-a-half days. The Department of Labor announced it has begun at-home practice drills to ensure claims processing will continue amidst the coronavirus crisis.
Gov. Ned Lamont
The University of Connecticut said Tuesday that classes would remain online for the rest of the spring semester and the school has canceled its May commencement ceremonies. Several other state colleges have moved campus courses online for the foreseeable future.
Lamont on Sunday ordered all public schools closed, and on Monday he directed all bars, restaurants, movie theaters, concert halls, gyms and other businesses that draw large crowds to shut their doors until further notice. Restaurants and bars may stay open to fulfill takeout orders only.
The Mashantucket Pequot and Mohegan tribal nations agreed Monday night to close Foxwoods Resort and Mohegan casinos for the first time since they opened in the 1990s.
Lamont said Tuesday that hes not yet ready to consider a shelter in place mandate, which would prevent people from leaving their homes except under certain circumstances, such as a trip to the grocery store or the doctors office. New York City Mayor Bill de Blasio has warned his residents to prepare for that directive.
I think the people of Connecticut understand the scope of what were confronting, and on a voluntary basis, theyre stepping up and doing the right thing, Lamont said.
SPRINGFIELD, Mass (WWLP) The COVID-19 outbreak is a global pandemic, and with that comes a lot of false information on the internet.
There are many myths about COVID-19 that have been circulating through social media. Here are some of the most common ones, according to theWorld Health Organization.
Truth: The CDC and the WHO have said this from the start: the most effective way to protect yourself from COVID-19 is with frequent handwashing with soap and water or using hand sanitizer with at least 60 percent alcohol. The WHO says there is no reason to believe cold weather can kill the new coronavirus, or other diseases, for that matter.
Truth: Protective measures, like proper handwashing and social distancing, need to be taken no matter where you live. COVID-19 can be transmitted anywhere, regardless of how hot or humid the air is.
Truth: This myth has been stemming from the false idea that cold and hot temperatures can kill the virus. Just like the cold weather and hot and humid climate myths, this is not true. Your body temperature stays relatively stable even when you take an extremely hot bath. This just leaves you at risk for a burn. Still, the best way to prevent getting COVID-19 is to wash your hands often. This prevents viruses on your hands from infecting you when you touch your face.
Truth: As temperatures continue to warm as we dive into spring, mosquitoes will become more common again. That typically brings a risk of Eastern Equine Encephalitis (EEE) and West Nile Virus, but the increasing population of mosquitoes does not create another channel in which you can get COVID-19. From the WHO, there has been no information nor evidence to suggest that the new coronavirus could be transmitted by mosquitoes. This is because the new coronavirus is spread primarily through droplets when someone with the coronavirus sneezes or coughs. This is why social distancing and frequent hand washing is so important.
Truth: The heat from a hand dryer alone is not enough to kill the new coronavirus. However, in combination with washing your hands with soap and water for at least 20 seconds, this method is very effective. You can also dry your hands after using paper towels, or instead use an alcohol-based hand sanitizer.
Truth: Its too soon to tell whether UV light is an effective way to kill the new coronavirus, and the World Health Organization does not suggest its use. It should especially not be used on hands or your body as it can cause irritation. UV lighthas been known to kill the flu virus, however.
Truth: Thermal scanners, like thermometers, can detect people who have a higher-than-normal body temperature due to infection from COVID-19. But not everyone who is infected with the coronavirus has a fever yet. According to the WHO, it takes between 2 and 10 days before people who are infected become sick and develop a fever.
Truth: This will not cure you of COVID-19 if it has already entered your body. Spraying alcohol and chlorine all over your body can be harmful if it gets into your eyes or mouth. The World Health Organization says they both can be used to disinfect surfaces, however.
Truth: The WHO says, Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenza type B vaccine, do not provide protection against the new coronavirus. COVID-19 is a respiratory infection, yes, but it requires its own vaccine, which is in thetesting phaseright now.
Truth: The World Health Organization says there is some evidence that regularly rinsing your nose with saline can help you get over the common cold more quickly. But this does not apply to COVID-19 and other respiratory infections. The same applies to gargling with a saline solution.
Truth: There is no scientific evidence that eating garlic prevents you from being infected with the novel coronavirus. However, according to the National Institutes of Health, it does have someantimicrobial properties.
Truth: The World Health Organization says people of all ages need to take steps to protect themselves from COVID-19. The best ways are frequent hand washing, the use of hand sanitizer, and social distancing. However, people who are older are more vulnerable to becoming severely ill with the new coronavirus. People with preexisting conditions are also at an increased risk for more severe complications, such as people with heart disease, diabetes, and lung disease.
Truth: Antibiotics are used to fight bacteria, not viruses, which is what COVID-19 is. This myth may have stemmed from the fact some people who are hospitalized for coronavirus have received antibiotics, but thats because bacterial co-infections are possible with COVID-19, according to the WHO. The antibiotic does not treat the virus itself.
Truth: The World Health Organization is helping with research and development efforts to find treatments for coronavirus, however, they are still under investigation, and must be tested through clinical trials. Right now, there is no medication recommended to prevent or treat COVID-19. You can use medication to relieve symptoms, but those with severe symptoms from coronavirus should seek help from a medical professional.
What is the best public policy to counter the health risk from the Coronavirus, COVID-19? This is the question on everyones mind.
It is wise to try and learn from the current situation in China, where the rate of COVID-19 infections was extinguished as a result of a lockdown, and Italy, where hospitals are full and doctors have to make life-death decisions about patients because there are not enough beds to treat everyone in need. The mortality fraction of infected people appears to be higher by an order of magnitude when hospitals are overcrowded, so suppressing the rate of new infections serves the important purpose of allowing those in need to be treated.
If we do nothing, the current state of affairs is likely to worsen dramatically in the coming weeks. To gauge how bad circumstances may become, lets examine publicly available data.
Our first plot shows the reported number of infections over time. For each country, Wikipedia has a continuously updated Web site with links to the original official sources such as the World Health Organization, research institutes and health ministries. The plotted curves show the cumulative number of known infections per country as a function of date. Colored points show the current situation as of this writing on March 15.
The data exhibit exponential growth in all countries, except for China and South Korea. Because of the rapid growth, early action is crucial in moderating the number of infections. Extrapolating the curves all the way to the edge of the box implies that the United States will reach a million infections at the beginning of April, with four million for Spain and about 0.1 million for the United Kingdom, Netherlands and Sweden, respectively. If no effective action is taken by April 10, the U.S. and the European countries could reach the 10 million mark.
The doubling times appear to evolve, as shown in our second plot. These values represent the slopes of the growth curves, averaged over a period of eight days.
But the number of reported cases must be smaller than the actual number of infections. Many countries, including the U.S., were limited until recently by the availability of COVID-19 test kits. It is possible that there are many more cases than those in public reports. We label those invisible infections. South Korea performed many more tests than the U.S. and succeeded in flattening its curve. The COVID-19 tests in the U.S. had a positive fraction that was three to 10 times larger than in South Korea, implying a substantial invisible population.
If the correction factor due to the "invisible population" is a factor of approximately 10 and only about 20 percent of people infected show symptoms (based on the Diamond Princess cruise ship statistics), then the actual number of people exposed to the coronavirus at this time is already five million. This implies: (i) with an approximately 2 percent mortality fraction out of the infected population, at least 100,000 people will die; and (ii) we are only about 10 doubling times away from having most of the worldwide population being infected if no social distancing is established. Given that the measured doubling time is a few days, this implies that uninhibited exponential growth will saturate within a month, leading up to some 100 million deaths. But if many countries flatten the curve, as we all hope, then saturation will take a much longer time and the number of deaths could be reduced.
What does all of this imply? The wisest policy at the moment is to flatten the curves and lengthen the doubling times as much as possible by suppressing social interactions. The virus does not move on its own. It is transmitted by humans and survives a few days on contaminated surfaces. To flatten the curves, all nations must engage immediately in social distancing as well as in extensive testing and comprehensive isolation of patients with COVID-19 symptoms and people who had been in contact with such patients.
This policy will reduce crowding in hospitals and minimize the mortality rate in the short term. But one should keep in mind that it does not eliminate the virus and will likely lead to a yo-yo behaviorwhere, as soon as mobility of people is enabled months from now, the spread of COVID-19 will resume. The spread will saturate once most of the population is infected, as forecast by Angela Merkel, or a vaccine is widely distributed in about a year.
This short-term policy does not take into consideration the economic impact that could lead to a major recession due to loss of income by small businesses, tourism, travel and entertainment, over an extended period of time. The financial implications, combined with the societal and psychological impact of a lockdown, could deteriorate the livelihood of many communities. Bad economic times could lead to deaths of people with low income who are most vulnerable to an economic downturn. There must be a sweet spot that balances the negatives associated with crowding of hospitals versus economic downturn. This sweet spot should be the long-term goal that policy makers aim at.
Overall, there is no doubt that many people will be exposed to COVID-19. As of now, delaying the growth is crucial for reducing the total number of deaths that the COVID-19 will amass. The situation is analogous to waiting after rush hour before driving our cars in order to minimize the death toll from collisions. The optimal strategy of policy makers must be to buy as much time as possible, so that hospitals will not be overcrowded. Lets all work together to flatten the growth curves shown above. By doing so, we could save many lives. And as stated in the Talmud: whoever saves a single life, saves the whole world.
Read more about the coronavirus outbreakhere.
Here is a 3D image of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), formerly ... [+] known as the 2019 novel coronavirus (2019-nCoV). (Image: Getty)
Dont you just love conspiracy theories? Especially when two groups of people have pretty much the same conspiracy theory about each other?
Some folks including politicians in the U.S. and China have both suggested that the COVID-19 coronavirus (SARS-CoV2) thats causing the pandemic may actually be a bioweapon that was manufactured in a lab. The only difference between their conspiracy theories is whos being accused of doing the manufacturing.
On the one corner are some people in the U.S. who are hinting or in some cases openly claiming that China put together this virus. For example, look at what Senator Tom Cotton (R-Arkansas) tweeted out back on January 30:
Then, Steve Mosher wrote on February 22 an opinion piece for the New York Post entitled, Dont buy Chinas story: The coronavirus may have leaked from a lab. Take a wild guess at what Mosher wrote about in his piece. By the way, Mosher is not a biomedical scientist, but instead is the president of the Population Research Institute and author of book called Bully of Asia: Why Chinas Dream Is the New Threat to World Order. So chances are that he didnt love China in the first place. But who knows, love works in mysterious ways.
So what evidence have Cotton, Mosher, and others provided to support these suggestions or claims? Incriminating pictures? Suspicious emails? Some awkward selfies? Any kind of scientific evidence?
Well, as Cotton picked out, there just happens to be a biosafety level-four (BSL-4) laboratory situated in Wuhan, China, the city where the whole outbreak started. Oh, and the lab had housed some types of coronaviruses among other pathogens. Yep, thats the evidence.
As you probably know, proximity alone should not imply guilt. That would be like claiming that you farted whenever theres a bad smell and you happen to be in the vicinity. Sure you may have intestines but that doesnt mean that every foul stench emanated from your guts.
Plus, its a lot easier to leak a pocket of air though your butt than a virus from a BSL-4 facility. BSL-4 facilities maintain the highest level of security among bio-laboratories since they do work on dangerous potentially life-threatening agents such as the Ebola, Lassa fever, and Marburg viruses. So its not as if the people inside these labs are playing throw and catch with the viruses and stuffing them into their pockets. To be designated as a BSL-4, the lab has to have the appropriate ventilation systems, reinforced walls, security systems, and construction to keep the wrong things inside and the right things outside.
Is it unusual then to have a BSL-4 facility in a city like Wuhan, China? Not really. There are already at least six BSL-4 facilities in the U.S. in Atlanta, GA, Frederick, MD, Galveston, TX, Hamilton, MT, and San Antonio, TX. According to the Federation of American Scientists website, seven others may be planned, under construction, or possibly finished in various cities such as Boston, MA, and Richmond, VA. These labs in the U.S. also study and house a range of dangerous pathogens. So again having a lab that studies bad pathogens does not mean that the lab released anything.
Not to be outdone, some in China have made similar suggestions, except that its the U.S. that built the virus and released it in China. Well, thats original. For example, take a look at these three tweets from Zhao Lijian, Spokesperson and Deputy Director General, Information Department for the Foreign Ministry of China:
Yes, the claim is that the U.S. released a virus in China so that the U.S. can then eventually suffer the consequences of the spreading virus just a couple months later. Makes a whole lotta sense, except that it doesnt. Where exactly is the real evidence that the U.S. military created SARS-CoV2?
The back-and-forth dialogue has continued with President Donald Trump then referring to SARS-CoV2 as the Chinese Virus as can be seen here:
When questioned why he was using this label rather than the real scientific name of the virus, Trump claimed that it was in response to the claim that the U.S. military had created the virus. The video accompanying the following tweet shows the exchange:
Back and forth. Back and forth. Back and forth.
So, it looks like conspiracy theorists on both sides havent really provided any compelling evidence that SARS-CoV2 was produced in a lab, whether in the U.S., in China, or in the Hogwarts School of Witchcraft and Wizardry.
In fact, there is not only a lack of evidence supporting these conspiracy theories, there has been growing strong scientific evidence against both of them. Scientists, you know the ones who are actually trying to find the truth and solve a problem rather than blame people, have been conducting genetic analyses to determine where the virus came from and how it ended up infecting humans. Although viruses arent exactly like people as they dont seem to have feelings or spread rumors, viruses do have genetic material like people, except their genetic material is not quite as complex as those of humans. Nevertheless, like humans, viruses still pass along such materials when they replicate and evolve. Its not as simple as The Jerry Springer Show using genetic testing to find out if a guy is someones father, but scientists can use more advanced genetic analysis to figure out the origins, the family tree of SARS-CoV2.
Indeed, strong clues had already emerged by February 26, 2020, when a Perspectives piece was published in the New England Journal of Medicine. In the piece, David M. Morens, M.D. and Peter Daszak, Ph.D. from the National Institute of Health (NIH) and Jeffery K. Taubenberger, M.D., Ph.D. wrote: Of course, scientists tell us that SARS-CoV-2 did not escape from a jar: RNA sequences closely resemble those of viruses that silently circulate in bats, and epidemiologic information implicates a bat-origin virus infecting unidentified animal species sold in Chinas live-animal markets.
This wasnt exactly a case of same bat channel, same bat time. But the first, more deadlier SARS virus seemed to cause the 2002-2003 outbreak after it had managed to jump from bats to humans via intermediate hosts such as masked palm civets. Yes, some masked beings may have inadvertently partnered with bats to bring the original SARS virus to humans. So it wouldnt be too surprising if something like that happened again for SARS-CoV2.
This illustration shows a close-up of the protein spikes on SARS-CoV2. (Image: Getty)
Even more evidence of a natural rather than human-made origin for SARS-CoV2 has emerged from a study described in a research letter just published in Nature Medicine. In the letter, a research team (Kristian G. Andersen from The Scripps Research Institute, Andrew Rambaut from the University of Edinburgh, W. Ian Lipkin from the Mailman School of Public Health of Columbia University, Edward C. Holmes from The University of Sydney and Robert F. Garry from Tulane University) described how they had analyzed the genetic sequences that code for the protein spikes on the surface of SARS-CoV2. The virus looks sort of like a medieval mace with multiple spikes sticking out from its spherical shape. These spikes arent just for show as the virus uses them to latch on to a cell that it wants to invade and then push its way into the cell. Very medieval stuff.
Apparently, portions of these spike proteins are so effective in targeting specific receptors on human cells that it is hard to imagine humans manufacturing them, not with known existing technology. The researchers then concluded that this feature and thus the new coronavirus could have in all likelihood only evolved over time naturally. You see humans can make useful stuff like ride-sharing apps but are still quite puny compared to nature when it comes to making stuff like viruses.
In fact, the research team found that the SARS-CoV-2 structure in general is quite different from what humans would have likely concocted. If a human had wanted to create a viral weapon, he or she would have started with the structure of a virus thats already known to cause illness in people. Naturally, if you want to make a weapon, you may want to start with something like a grenade launcher rather than a smoothie maker, not that the virus looks like either. Instead, the structure of SARS-CoV2 is quite similar to those of viruses known to infect bats and pangolins.
So all of this further supports the theory that the virus jumped from bats to humans via some intermediate animal host. This doesnt necessarily mean that the virus started causing trouble as soon as it started infecting humans. An alternative possibility is that it jumped a longer time ago and hung out among humans for a while before eventually evolving into its current troublesome selves. This latter possibility would be somewhat analogous to inviting someone to live with you because he or she initially seemed relatively harmless but then over time finding out that this flat mate has become a terror.
The findings from the genetic analyses are consistent with how SARS-CoV2 is currently behaving. The virus is not acting like a bio-weapon right now. The best bio-weapons kill at a much higher rate and can be readily transported and released. Imagine being told that a bio-weapon might take the lives of 1% to 3.4% of the people that it infects but you dont quite know specifically which ones. The difference between SARS-CoV2 and pathogens like the Ebola Virus or anthrax is like the difference between a bunch of sofas and a collection of missiles. Sure, the former can cause harm but not in a predictable and consistent manner. If someone actually decided to develop SARS-CoV2 as a bio-weapon, that person needs to find a new job.
So there you have it: scientific evidence trumping conspiracy theories. Will all of these scientific findings finally quash the virus-was-made-in-a-lab-and-it-is-your-fault rhetoric between the politicians and on social media? Probably not. Since when has science stopped such political rhetoric. Maybe, though, it will get more people to focus on the much more important matter at hand: trying to control this pandemic together.
Early detection and early response. In an ideal world, this will contain an outbreak of infectious disease and prevent it from establishing in a population and becoming an epidemic.
Containment typically involves isolating and testing suspected cases, tracing their contacts, and quarantine in case any of these people are infected. The more thorough the testing and contact tracing early on, the better the chance of containment. These measures work well, especially for diseases like Sars, where symptoms coincide with infectiousness it is easy to recognise people who are infected.
In the case of Covid-19, detection is much harder because some transmission is possible before people show obvious symptoms, in this case a fever and cough. If there are no symptoms, it is impossible to identify people who are infected unless they are tested and their infection is confirmed in a laboratory, which is why airport screening at arrival is not very effective for Covid-19. This makes the virus much harder to control. Sooner or later, an infected case escapes detection and starts a chain of transmission, and quickly leads to a growing number of cases, which can become impossible to contain. As a result, containment has failed in a number of countries and the World Health Organization has declared a pandemic that is here to stay for months, if not longer.
So how does an epidemic spread through a population and how do we control it? In outbreak analysis, we measure transmission using the reproduction number (otherwise known as R), which tells us how many other people a typical Covid-19 case will infect on average. If one person is expected to infect more than one other person, the infection will grow and create an outbreak; if a person infects less than one other, the infection will peter out.
The larger the value of R, the easier the virus spreads through a population and the higher the number of infections. For seasonal flu, one infection leads on average to 1.4 new infections. For Covid-19, one infection leads to 2-3 others in the early stages of an outbreak. How many other people we end up infecting depends on several things: how many susceptible people there are in the population, how long we are infected for (the longer we are infected the more chances there are to pass on the infection), the number of people we come into contact with, and the probability of passing on the infection to those contacts.
In order to control the epidemic, we need to reduce R below 1. For diseases such as measles, we can achieve this by vaccinating a large enough proportion of the population so that the disease can no longer spread. Exactly what proportion we need to vaccinate to reach community immunity depends again on R. For R of 2, we need to immunise half of the population to interrupt transmission; for R of 3 we need to immunise two thirds of the population to get R below 1.
However, an effective vaccine for Covid-19 is unlikely to be available for another 12-18 months at best.
Shortening the duration of infection could also reduce transmission, and for some infections, such as influenza, this can be achieved with antiviral therapy. There are currently more than a hundred clinical studies in progress, which could produce therapies that reduce the duration of infection or infectivity. However, both of these control options are not yet available.
Another option to reduce the duration of infection is continued testing; this is a measure that can be effective throughout the epidemic. Finding infected people and advising them to self-isolate for the duration of the infection minimises the risk of them passing on the infection, which therefore slows down the spread. This is again a basic intervention method that we know works well, but in order for it to be most effective, results need to be processed quickly (in the UK it takes 2-4 days to get the results, in Wuhan it is under 4 hours).
If we cant easily reduce susceptibility or duration, we are left with two things: the probability of transmitting the infection upon contact and the number of different people we come into contact with. Both of these are things we as individuals can change by modifying our behaviour. Washing hands frequently for 20 seconds with hot water and soap, not touching our faces, covering our coughs and sneezes, staying at home if we are sick all of these reduce the risk of getting infected or passing on the infection to someone else.
Cancelling large gatherings, working from home and school closures are all social distancing measures aimed at reducing the number of contacts between people, each of which is an opportunity for passing on an infection. But this will not be a simple case of just cancelling events and closing schools for a couple of weeks. More severe measures will be necessary to bring the infections to low enough levels to keep the pressure off the health-system long-term. As individuals, we must all reduce the number of different people we come into contact with on a daily basis, and be prepared to do so for a prolonged period of time.
But what sorts of contacts are most important for transmission? Together with Adam Kucharski, also from the London School of Hygiene and Tropical Medicine, I have recently collaborated with the BBC on a massive citizen science project, led by Professor Julia Gog from Cambridge University. Called BBC Pandemic, the project collected information on how people of different ages interact with one another in different contexts (home, work, school, other) from over 35,000 volunteers. We have recently been fast-tracking the release of contact data to help inform UK Covid-19 modelling efforts and potential intervention strategies.
What we have found in this data is that adults aged 20-50 make most of their contacts in workplaces. If those of us who can work remotely start doing so now, it will contribute to lowering overall transmission in the population. Another important finding is that people over 65 who are particularly at risk from severe Covid-19 illness make over half of their contacts in other settings (not home, school or work), such as shops, restaurants and leisure centres. By avoiding these interactions, people who are most at risk from the new coronavirus could halve their risk of infection. By changing our behaviour now, and sustaining these changes throughout the outbreak, we can significantly reduce our own risk of infection, and the risk to others, and by doing so help protect those most vulnerable.
Sustainability is key here; these measures may reduce the reproduction number R, but as soon as they are lifted we could see transmission again, and another outbreak.
We must all take individual action to reduce Covid-19 transmission and slow down its spread, limit the number of infections and reduce the pressure on the health system so that everyone who needs medical care can get it. Starting now, and for the duration of this epidemic, we all have a role to play and a responsibility to modify our behaviour in order to protect the ones who are most at risk.
Dr Petra Klepac is assistant professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine
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As a COVID-19 coronavirus disease pandemic spread throughout the world in early 2020, the World Health Organization (WHO) urged countries to test, test, test for the virus in order to stop it from spreading. WHO officials said the global health organization had provided 1.5 million tests to 120 countries.
You cannot fight a fire blindfolded, said WHO Director General Dr. Tedros Adhanom Ghebreyesus during a March 16 press conference. And we cannot stop this pandemic if we dont know who is infected.
The global health leaders comments came as state and local governments across the United States began instituting social distancing measures that included shuttering bars and restaurants and instructing residents to stay home and avoid large social gatherings. Despite these aggressive actions,the U.S. as a whole was lagging behind other countries and struggling to ramp up diagnostic testing for the disease despite intense pressure to do so and confirmed cases that mounted into the thousands.
The first case of COVID-19 was reported in the U.S. in Washington state in late January 2020. Around that same time, officials in China quarantined Wuhan, the city where the disease was initially detected. By the end of January, the WHO deemed the new virus a global health emergency.
Nevertheless, the U.S. was still in the early stages of rolling out testing for the disease weeks after its first case was reported, resulting in something of a scandal, as cases that could be confirmed multiplied.
According to news reports, diagnostic tests developed by the Centers for Disease Control and Prevention (CDC) were sent out by early February 2020 to public health labs in the U.S. Days later, however, labs were reporting back that the tests werent working due to a manufacturing defect. The defective tests, coupled with regulatory red tape that prevented state laboratories from using their own tests, caused further delay.
This resulted in a bevy of accusations that the U.S. shunned or refused working tests available from WHO even as its own testing protocols fell short. As the BBC reported, The US declined to use a test approved by the World Health Organization in January instead, the CDC developed its own coronavirus test. However, there were manufacturing defects with the initial CDC tests which meant many of the results were inconclusive.
The accusation was even echoed on the presidential election debate stage, with 2020 Democratic candidate Joe Biden saying: Look, the World Health Organization offered the testing kits that they have available and to give it to us now. We refused them. We did not want to buy them. We did not want to get them from them. We wanted to make sure we had our own.
We sent emails to the CDC and WHO asking about WHOs test and why it was not adopted in the U.S., but did not get a reply in time for publication. However, WHO told PolitiFact that the organization had never discussed providing testing kits to the United States, and The Washington Post reported that its typical, historically, for the U.S. to develop its own methods under such circumstances:
China developed its own test. Leading laboratories in Germany published their own version, which was adopted by the World Health Organization. Many countries, including the United States, developed their own tests.
The traditional U.S. strategy for devising new diagnostic tests starts with the CDC. That is supposed to ensure new tests are accurate and reliable, but it also meant that other parallel approaches were not aggressively pursued.
In an interview with CNN on March 12, 2020, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, stated that it would have been nice to have the WHO tests as a back-up to the CDCs tests, but characterized it as a case of hindsight being 20/20.
[DR. SANJAY] GUPTA: And, Dr. Fauci, I want to echo what Anderson said as well. Thank you very much for your service. People may not know this, Dr. Fauci is 79 years old and, I mean, you have the energy I think many of us emulate. Let me ask one more question though about this testing. I know youve talked a lot about it, but I think, you know, Dr. Fauci, there was a test.
It was being distributed around the world. WHO was using this test, I believe it was created in Germany, in Berlin, and it was being used, and yet we did not use it in this country even as a stopgap measure, even as we prepared to make our own test. And as a result, we got behind. Thats a problem. And Im just wondering, was that a mistake? Should we have used that test? Why didnt we?
FAUCI: Well, you know, Sanjay, Im not sure that it was a mistake. But certainly, you know, if you look back and Monday morning quarterback, it would have been nice to have had a backup. But what the CDC has done over many, many years when we have things like this is to develop their own test, which is always really a good test, and to roll it out in a way that we call a public health-directed, where they give it to departments of public health.
You have a physician-patient relationship. They come in. They order the test. They get the test. It was not designed for the kind of mass distribution that we need now that weve seen in other countries. Thats behind us. Looking forward, were going very much in that direction, Sanjay, very much so.
And I think really within a relatively short period of time, you know, a week or maybe even less, were going to start to see the ratcheting up of the availability of test. So, you know, rather than go back and play Monday morning quarterback, lets just direct where were going.
Although Trumps political opponents and some media sources accused his administration of refusing to use the WHO test, Faucis comment and various credible news reports on the topic indicate that the CDC has a standard procedure for handling diagnostic tests during an outbreak, and that protocol doesnt include using tests provided by WHO (or any other external organization). We therefore rate this claim Mixture.
Mayibout 2 is not a healthy place. The 150 or so people who live in the village, which sits on the south bank of the Ivindo River, deep in the great Minkebe Forest in northern Gabon, are used to occasional bouts of diseases such as malaria, dengue, yellow fever and sleeping sickness. Mostly they shrug them off.
But in January 1996, Ebola, a deadly virus then barely known to humans, unexpectedly spilled out of the forest in a wave of small epidemics. The disease killed 21 of 37 villagers who were reported to have been infected, including a number who had carried, skinned, chopped or eaten a chimpanzee from the nearby forest.
I travelled to Mayibout 2 in 2004 to investigate why deadly diseases new to humans were emerging from biodiversity hotspots such as tropical rainforests and bushmeat markets in African and Asian cities.
It took a day by canoe and then many hours along degraded forest logging roads, passing Baka villages and a small goldmine, to reach the village. There, I found traumatised people still fearful that the deadly virus, which kills up to 90% of the people it infects, would return.
Villagers told me how children had gone into the forest with dogs that had killed the chimp. They said that everyone who cooked or ate it got a terrible fever within a few hours. Some died immediately, while others were taken down the river to hospital. A few, like Nesto Bematsick, recovered. We used to love the forest, now we fear it, he told me. Many of Bematsicks family members died.
Only a decade or two ago it was widely thought that tropical forests and intact natural environments teeming with exotic wildlife threatened humans by harbouring the viruses and pathogens that lead to new diseases in humans such as Ebola, HIV and dengue.
But a number of researchers today think that it is actually humanitys destruction of biodiversity that creates the conditions for new viruses and diseases such as Covid-19, the viral disease that emerged in China in December 2019, to arise with profound health and economic impacts in rich and poor countries alike. In fact, a new discipline, planetary health, is emerging that focuses on the increasingly visible connections between the wellbeing of humans, other living things and entire ecosystems.
Is it possible, then, that it was human activity, such as road building, mining, hunting and logging, that triggered the Ebola epidemics in Mayibout 2 and elsewhere in the 1990s and that is unleashing new terrors today?
We invade tropical forests and other wild landscapes, which harbour so many species of animals and plants and within those creatures, so many unknown viruses, David Quammen, author of Spillover: Animal Infections and the Next Pandemic, recently wrote in the New York Times. We cut the trees; we kill the animals or cage them and send them to markets. We disrupt ecosystems, and we shake viruses loose from their natural hosts. When that happens, they need a new host. Often, we are it.
Research suggests that outbreaks of animal-borne and other infectious diseases such as Ebola, Sars, bird flu and now Covid-19, caused by a novel coronavirus, are on the rise. Pathogens are crossing from animals to humans, and many are able to spread quickly to new places. The US Centers for Disease Control and Prevention (CDC) estimates that three-quarters of new or emerging diseases that infect humans originate in animals.
Some, like rabies and plague, crossed from animals centuries ago. Others, such as Marburg, which is thought to be transmitted by bats, are still rare. A few, like Covid-19, which emerged last year in Wuhan, China, and Mers, which is linked to camels in the Middle East, are new to humans and spreading globally.
Other diseases that have crossed into humans include Lassa fever, which was first identified in 1969 in Nigeria; Nipah from Malaysia; and Sars from China, which killed more than 700 people and travelled to 30 countries in 200203. Some, like Zika and West Nile virus, which emerged in Africa, have mutated and become established on other continents.
Kate Jones, chair of ecology and biodiversity at UCL, calls emerging animal-borne infectious diseases an increasing and very significant threat to global health, security and economies.
In 2008, Jones and a team of researchers identified 335 diseases that emerged between 1960 and 2004, at least 60% of which came from animals.
Increasingly, says Jones, these zoonotic diseases are linked to environmental change and human behaviour. The disruption of pristine forests driven by logging, mining, road building through remote places, rapid urbanisation and population growth is bringing people into closer contact with animal species they may never have been near before, she says.
The resulting transmission of disease from wildlife to humans, she says, is now a hidden cost of human economic development. There are just so many more of us, in every environment. We are going into largely undisturbed places and being exposed more and more. We are creating habitats where viruses are transmitted more easily, and then we are surprised that we have new ones.
Jones studies how changes in land use contribute to the risk. We are researching how species in degraded habitats are likely to carry more viruses which can infect humans, she says. Simpler systems get an amplification effect. Destroy landscapes, and the species you are left with are the ones humans get the diseases from.
There are countless pathogens out there continuing to evolve which at some point could pose a threat to humans, says Eric Fevre, chair of veterinary infectious diseases at the University of Liverpools Institute of Infection and Global Health. The risk [of pathogens jumping from animals to humans] has always been there.
The difference between now and a few decades ago, Fevre says, is that diseases are likely to spring up in both urban and natural environments. We have created densely packed populations where alongside us are bats and rodents and birds, pets and other living things. That creates intense interaction and opportunities for things to move from species to species, he says.
Pathogens do not respect species boundaries, says disease ecologist Thomas Gillespie, an associate professor in Emory Universitys department of environmental sciences, who studies how shrinking natural habitats and changing behaviour add to the risk of diseases spilling over from animals to humans.
I am not at all surprised about the coronavirus outbreak, he says. The majority of pathogens are still to be discovered. We are at the very tip of the iceberg.
Humans, says Gillespie, are creating the conditions for the spread of diseases by reducing the natural barriers between host animals in which the virus is naturally circulating and themselves. We fully expect the arrival of pandemic influenza; we can expect large-scale human mortalities; we can expect other pathogens with other impacts. A disease like Ebola is not easily spread. But something with a mortality rate of Ebola spread by something like measles would be catastrophic, Gillespie says.
Wildlife everywhere is being put under more stress, he says. Major landscape changes are causing animals to lose habitats, which means species become crowded together and also come into greater contact with humans. Species that survive change are now moving and mixing with different animals and with humans.
Gillespie sees this in the US, where suburbs fragment forests and raise the risk of humans contracting Lyme disease. Altering the ecosystem affects the complex cycle of the Lyme pathogen. People living close by are more likely to get bitten by a tick carrying Lyme bacteria, he says.
Yet human health research seldom considers the surrounding natural ecosystems, says Richard Ostfeld, distinguished senior scientist at the Cary Institute of Ecosystem Studies in Millbrook, New York. He and others are developing the emerging discipline of planetary health, which looks at the links between human and ecosystem health.
Theres misapprehension among scientists and the public that natural ecosystems are the source of threats to ourselves. Its a mistake. Nature poses threats, it is true, but its human activities that do the real damage. The health risks in a natural environment can be made much worse when we interfere with it, he says.
Ostfeld points to rats and bats, which are strongly linked with the direct and indirect spread of zoonotic diseases. Rodents and some bats thrive when we disrupt natural habitats. They are the most likely to promote transmissions [of pathogens]. The more we disturb the forests and habitats the more danger we are in, he says.
Felicia Keesing, professor of biology at Bard College, New York, studies how environmental changes influence the probability that humans will be exposed to infectious diseases. When we erode biodiversity, we see a proliferation of the species most likely to transmit new diseases to us, but theres also good evidence that those same species are the best hosts for existing diseases, she wrote in an email to Ensia, the nonprofit media outlet that reports on our changing planet.
Disease ecologists argue that viruses and other pathogens are also likely to move from animals to humans in the many informal markets that have sprung up to provide fresh meat to fast-growing urban populations around the world. Here, animals are slaughtered, cut up and sold on the spot.
The wet market (one that sells fresh produce and meat) in Wuhan, thought by the Chinese government to be the starting point of the current Covid-19 pandemic, was known to sell numerous wild animals, including live wolf pups, salamanders, crocodiles, scorpions, rats, squirrels, foxes, civets and turtles.
Equally, urban markets in west and central Africa sell monkeys, bats, rats, and dozens of species of bird, mammal, insect and rodent slaughtered and sold close to open refuse dumps and with no drainage.
Wet markets make a perfect storm for cross-species transmission of pathogens, says Gillespie. Whenever you have novel interactions with a range of species in one place, whether that is in a natural environment like a forest or a wet market, you can have a spillover event.
The Wuhan market, along with others that sell live animals, has been shut by the Chinese authorities, and last month Beijing outlawed the trading and eating of wild animals except for fish and seafood. But bans on live animals being sold in urban areas or informal markets are not the answer, say some scientists.
The wet market in Lagos is notorious. Its like a nuclear bomb waiting to happen. But its not fair to demonise places which do not have fridges. These traditional markets provide much of the food for Africa and Asia, says Jones.
These markets are essential sources of food for hundreds of millions of poor people, and getting rid of them is impossible, says Delia Grace, a senior epidemiologist and veterinarian with the International Livestock Research Institute, which is based in Nairobi, Kenya. She argues that bans force traders underground, where they may pay less attention to hygiene.
Fevre and colleague Cecilia Tacoli, principal researcher in the human settlements research group at the International Institute of Environment and Development (IIED), argue in a blog post that rather than pointing the finger at wet markets, we should look at the burgeoning trade in wild animals.
It is wild animals rather than farmed animals that are the natural hosts of many viruses, they write. Wet markets are considered part of the informal food trade that is often blamed for contributing to spreading disease. But evidence shows the link between informal markets and disease is not always so clear cut.
So what, if anything, can we do about all of this?
Jones says that change must come from both rich and poor societies. Demand for wood, minerals and resources from the global north leads to the degraded landscapes and ecological disruption that drives disease, she says. We must think about global biosecurity, find the weak points and bolster the provision of health care in developing countries. Otherwise we can expect more of the same, she adds.
The risks are greater now. They were always present and have been there for generations. It is our interactions with that risk which must be changed, says Brian Bird, a research virologist at the University of California, Davis School of Veterinary Medicine One Health Institute, where he leads Ebola-related surveillance activities in Sierra Leone and elsewhere.
We are in an era now of chronic emergency, Bird says. Diseases are more likely to travel further and faster than before, which means we must be faster in our responses. It needs investments, change in human behaviour, and it means we must listen to people at community levels.
Getting the message about pathogens and disease to hunters, loggers, market traders and consumers is key, Bird says. These spillovers start with one or two people. The solutions start with education and awareness. We must make people aware things are different now. I have learned from working in Sierra Leone with Ebola-affected people that local communities have the hunger and desire to have information, he says. They want to know what to do. They want to learn.
Fevre and Tacoli advocate rethinking urban infrastructure, particularly within low-income and informal settlements. Short-term efforts are focused on containing the spread of infection, they write. The longer term given that new infectious diseases will likely continue to spread rapidly into and within cities calls for an overhaul of current approaches to urban planning and development.
The bottom line, Bird says, is to be prepared. We cant predict where the next pandemic will come from, so we need mitigation plans to take into account the worst possible scenarios, he says. The only certain thing is that the next one will certainly come.
This piece is jointly published with Ensia
