Staying Ahead of the Covid-19

Part I

There are some missing links in the narrative about the origin of coronavirus.  These gaps produce conspiracy theories.  It does raise an all-important question.  Who stands to benefit by covering the truth?  We need our susegad attitude to calmly scrutinize the entire saga of the coronavirus. We need this exercise to stay against the virus both now and in the time to come.  But to do this we first need to understand viruses and their parasitic self-propagation.   They do self replicate by using the host cell by changing our cellular pathways.  It is important to remember that viruses are non-living entities that do not have a metabolism of their own. They use the host cell that they infect to metabolise and replicate themselves.  The virus-induced metabolism robs the cellular resources and puts them in use for its progress.  As the cell gets enslaved to the virus-induced metabolism the cell pathways that serve our body gets channelled to serve the virus afflicting us with virus-induced sicknesses that range from the common cold to one that we are globally battling today as a result of the covid-19 epidemic. 

Covid-19 like other viruses also infects human cells and replicates. But it being a coronavirus is genetically similar to the SARs virus and produces a pneumonia-like condition that can be fatal to humans who have weak immune systems or have other debilitating conditions like diabetes, kidney problems,   hypertension etc.  While we are battling the covid-19 pandemic, we are rightly engaged with treating the suffering patient and containment of its exponential growth.  Although we do not yet have a vaccine to trigger our bodies to produce antibodies to fight covid-19, plasma therapy that injects antibodies from the blood of a patient who has defeated the infection is thought to be a possible interim treatment along with other drugs like hydroxychloroquine. 

All of us want to be ahead in this battle everywhere. This is why we observe the lockdown, use masks and observe hand hygiene. But with the calmness of our susegad attitude, we in Goa still have to ask some profound questions to our Government and other authorities who are planning our battle against this lethal virus. Ordinary citizens are ahead of the virus by following the virus. But it cannot be the same for the Government and medical authorities.  If they solely depend only on the lockdown, their strategy appears to be reactive and simply follows the virus.  How do they stay proactive and be ahead of the virus? Lockdown can be effective to some extent.  The timeline is set by the virus and hence only tests and tests can be a way of making the lockdown effective. This is why the WHO recommends tests, tests, and tests to fight this virus. Countries that followed the protocol of tests have always remained ahead of the virus.  We may have contained the virus with our lackadaisical approach but the fact that the virus is coming as close as Belganvi may give us reasons to worry. 

Staying ahead of the virus is the way of beating the virus. If we only follow the virus, we may end up delaying the inevitable. The issue becomes complex because we have also an asymptomatic transmission of the virus. These asymptomatic human vectors can be only detected through the tests.  Besides, there are also inherent limitations in the tests. The swap test has only a 60% success rate. Hence those that are certified as covid-19 negative may not be negative.  This probability needs to factor in by repeating the tests to stay ahead in this battle.  While we are grateful to the doctors and the medical staff who risk their life, to stay ahead in this battle we need transparency in the dissemination of information on the part of our Government.   Goans want to stay ahead in this battle and not just follow the virus. This would mean we are not just to firefight the pandemic but have to have to plan ahead and be ready for all kinds of eventuality. 

 We will not succeed in our war against the virus by our reactive response.  We need to be proactive to be ahead in the battle.  A proactive strategy is courageous and is not lead by fear.  Some of us are exhibiting a flight response by opposing the bringing our seamen stranded on their ships abroad.   We do not have to allow our fear or what may be called castration phobia to colour all of them as covid-19 positive cases.  They can be potential vectors. Hence, every one of them has to be strictly quarantined while observing all the precautions.  This is the attitude of courage that we need to stay ahead in this battle.   

This battle cannot make any distinction between the rich and the poor.  The rich will have to save the poor to save themselves. In the same way, we all Goans have to save each other to save ourselves.  The virus is simply a time bomb that is waiting to explode. If we think that our seamen can come later when the world is safe who will tell us that one of them will not bring it to us? This is why it is important to strike when the rod is hot.  It is for our own good not just the good of the seamen and their families that we have to bring them when we are most ready and fighting the virus. It will give us the satisfaction that we saved our very own otherwise we may not be able to forgive ourselves for being insensitive and even foolish in our approach to the battle against coronavirus.   While we fight this nightmare, our minds also want to come to know the truth behind the origin of this lethal virus.  There are missing links in the story of the virus. I may try and place these missing links in another write-up.  To stay ahead of the virus we do not need to settle the truth about the origin of the virus for now. It may have several important lessons for us that are required to stay ahead against the virus or similar disruptive pandemic in the future. 


Part II

Covid-19 is said to have come to humans from the bats.  This is only an interesting conjecture. We do not have any confirmation of this fact.  It was linked to the Huanan seafood market in Wuhan in China but as soon as the disease began to spread the market was closed and rightly sanitized to prevent further transmission of the infection. But it became like destroying the evidence from the crime scene after the crime.  Hence, cannot materially trace the virus in the said seafood market for any evidence of its origin.  Besides, some investigators pointed out that this seafood market did not sell bats, thus raising the question about the site of the spontaneous evolution of the virus. 

The institute of virology of China still announced that 33 of the 585 environmental contained nucleic acid of the novel coronavirus.  This suggested that the virus originated from the wild animals sold at the Huanan seafood market. These claims were disputed by the research paper of Dr Sean Lean, former director of viral disease Branch, Water Reed Army Institute of Research, who was working at the first designated hospital to fight the virus in Wuhan.  He indicates that at least 14 people among the first patient infected by covid-19 have nothing to do with the seafood market in Wuhan. Two other doctors also wrote a research paper that said that 45 infected people were not linked with the said seafood market. This contestation of the site of mutation of the novel virus does not rule out the possibility of it arising from spontaneous emergence.   It only disputes the site of its origin.  

 Covid-19 may have emerged spontaneously and naturally and infected human beings like the earlier coronavirus that we called SARS.  This spontaneous evolution is possible only if a cell of a bat is simultaneously infected by two different kinds of coronaviruses. Bats have a  history of being vectors of several coronaviruses. Now to link the origin of covid-19 to the bats, we will have to study its genetic relations to other viruses that are known to be infecting the bats.  This scrutiny should reveal that covid-19 shares genetic material with at least two of the known viruses that are in bats.  This means we have to compare the gene profile of the viruses associated with the bats with the genetic profile of Covid-19. 

The gene sequence was disclosed on 10th Jan. 2020 by Dr Zhang Yongzhen’s team.  It manifested that the novel coronavirus was closely related to two viruses (CoVZC45 and CoVZXC21) sampled from bats in Zhaushan by the People’s Liberation Army.  It exhibited 89.1% similarity with the nucleotides of virus CoVZC45  and showed  100% in amino acid similarity in the nsp7 and E proteins of the SARS virus. Other scientists confirmed this genetic profile of the novel coronavirus by using a technique that is called blast. Thus scientists discovered that novel coronavirus is highly similar to the SARS virus that had its origin in the bats.  Now that the link has been scientifically established, is it enough to prove its spontaneous and natural evolution? The 100% similarity of nsp7 and E proteins with the SARS virus, unfortunately, raises important questions about its natural and spontaneous emergence. 

It is natural for the virus to jump species.  But the fact that we have found that there is a hundred percent similarity of nsp7 and E proteins it is more likely that it has been generated in a human laboratory through reverse engineering.  Hundred percent similarities of amino acids cannot result from natural mutations. It was further confirmed that the sequence of S protein has high homology with SARS Virus’s S proteins. S proteins are also called spike proteins. They are the most important tools that assist the novel coronavirus to invade human cells. Our cells have a receptor to which it gets locked and invades into the cell to convert it into a factory to replicate it.  Now that S protein is similar to the one that is in the SARS virus,  it can easily drive into human cells.  This means if covid-19 did not have the same S protein it won’t be able to infect human cells.  This is why again there are some scientists who say that it could not have come from the Huanan seafood market.  

This means that the S protein of the novel coronavirus is critical and maybe holding the secret of its origin.  To hunt the origin of this lethal virus, we may have to consider the discoveries of Dr Shi Zhengli a Chinese virologist. Her work in the generation of synthetic viruses is an important path to understand what might have led to the generation of this virus.  She had focused her work on the spread of the coronavirus from the bats and tried to study its spread across the species. The specific attention of her work was on the S protein and its role in the transmission of infections of the coronaviruses in humans.  Her research papers demonstrate that she was aware of the relationship between the S protein and ACE2 receptor and signifies that she had identified the passage of coronavirus into the human body.  Thus, her work becomes a stepping stone that opens the door for the coronavirus to easily infect humans. Her work provoked controversy and scientists did express their fears of the synthetic virus escaping the labs could cause potential threats to public health. 

To this point, science knew about the possibility of generating a corona kind of virus that is afflicting us. What we need here is to put together the pieces. It seems that the virus is a human creation.  But for now, we do not have enough evidence to clearly trace the human culprit. It could be China as America kept trumpeting or it could be America as China points the accusing finger. We seem to have the science of its production but did not have the science to control its spread. For now, scientifically humanity is lagging behind the virus and has to pull the strap of its boots to stand ahead of the virus.   We have to face bio-safety issues for ourselves and humanity all over the world.  Maybe we are facing a biochemical research failure. For this reason, we have the challenge to understand that it is here to stay because it will mutate. The world will not be the same post-covid-19. For now,  science is just following it. What we need is to be ahead of it.  This will take time and we have a long way to go.


Part III

Our world is overloaded with covid-19.  We in Goa surprisingly think that the load on our backs has suddenly disappeared.  Such thinking cannot be thought to be ahead of the virus. It might be like sitting on the branch that we cut under our own feet.  We do not have to overreact but we cannot also underreact to such a lethal virus.  What we need is to stay on top of this virus. This will keep us ahead of it.  What really will keep us ahead in this battle is a set of things that will bring the degree of spread-ability of the virus to zero.  

In this context, we have to understand and consider seriously what epidemiologists talk of R0. R0 calculates the probability of infections  sourced from of single person.   Has the ease of the lockdown in the manner it has been envisaged by the Government considered this?   It does not seem so.  A conservative estimate gives us that R0 exhibits a ratio of 1:3 transmission of infection.  This means one infected person will probably pass on the virus to three other people. In India with our dense population as well as our crowding habits, it is thought that one infected person may infect at least five persons. This shows that we have an exponential possibility of the spread-ability of this deadly infection.   

Lockdown has helped us to decrease this spread-ability but cannot completely eliminate it. This is simply because the timeline of the virus is not set by the Government but by the virus itself. To getter closer to the timeline of the virus, we need what epidemiologists call a series interval (SI). It calculates the time through which the infected person goes through the point of the healing or disappearance of the symptoms. It has been estimated to be 14 days in the case of Covid-19 infection. Each newly infected person has his own period that begins with the day of getting infected and ends with the 14th day on which all symptoms are thought to be disappearing.  The series interval is the time that we measure from the onset of symptoms of patient one to the onset of symptoms of patient two. Shorter this SI is more dangerous is the virus. The larger the SI is there is less danger of the high speed of transmission.  

The average series interval for covid-19 has been taught to 5 to 7.5. It gives us the timeline of the virus from the time one individual is infected to the time the next person becomes infected.  This means covid-19 is slower than the virus of influenza which shows an SI of 2.5. This fact makes it very difficult for us to set a common timeline for the virus. Thus, the SI being relatively high, we are saved from the rapid spreading of the virus.  This is also the reason why we have to be more cautious with easing the lockdown as the SI being high, lack of the spread of the virus for seven days may not necessarily indicate its absence.  The SI of covid-19 has to be considered before be calculate any bio-safety environment infected by it.  It does not appear that our Government did this analysis as it hurried into declaring Goa as a Covid-19 green zone.  We declared lockdown in a hurry and eased it in a hurry forgetting our critical susegad attitude.

 The fact that we have not done enough tests as well as there are negative tests that hide the virus complicates the matter. The situation becomes even more difficult because there are also asymptomatic persons who are infected and are also spreading the virus.   So far, we have done two things as a response to the pandemic: under testing and, hygiene of hands, wearing of masks, social distancing and strict lockdown.  While the lockdown and social distancing, personal hygiene can come a long way but cannot fully eliminate the virus completely. But lockdown and under testing will actually damage or minimize the benefits of the lockdown as there are people who are not tested but maybe covid-19 positive and may have even,  unfortunately,  died without being certified as covid-19 infected patients.  Besides, how are we to identify the asymptomatic patients when we are under testing?  This is why it is difficult to set the timeline only on the basis of the absence of infected patients under a lockdown.  Hence, staying ahead of Covid-19 is harder under full lockdown combined with under testing.  This is so we do not have information about every infected person to do a safe easing of the lockdown. 

 Now that this ease of lockdown may not be turned back by our Government, we will have to add some important measures to stay ahead of the virus.   Under this kind of ease of lockdown, we have to continue testing to be ahead of covid-19. Besides testing, we have to sanitize public places where people frequent like the market places, workplaces, etc.  Along with the enforcement of section 144, the police could oversee that social distance is observed in fish and vegetable markets.  The government now has a health survey of Goans.   It has to be quickly analysed to identify those  Goans who are more prone to infections like the 30,000 people with lung issues and take proactive health measures.  Maybe the medical fraternity could suggest how to boost our immunity at this time of human distress and the Government could provide the same to the poor. Lockdown as well as the gloom of the global pandemic can lead to anxiety, panic attacks as well as depression. This is why we need compassion for all.  Covid-19 is a killer par excellence but we cannot allow it to kill our compassion. It can hurt our compassion as we now see in the resistance of some people and the dilly-dallying attitude of the Government about bringing off the Goan seafarers back to Goa.    Let covid-19 not kill the compassionate Goan. Let’s stay in solidarity in our united fight against this lethal virus. This is the only way we Goykar can stay ahead of covid-19. 

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Hypocrisy is the tribute that vice pays to virtue.

- Fr Victor Ferrao