Coronavirus: the 21st century evil
The pandemic is caused by a virus that cannot produce outside a cell, as it is solely dependent on a host; it is imperative at this stage to slow and break the virus chain
The Coronavirus or COVID-19 is a 21st century pandemic. A pandemic means an epidemic that has spread across a large region, for example the dismal Small Pox in the 19th Century that killed more than 300 million people globally. We now have a new evil.
Structurally, COVID-19 is an RNA virus which is similar to the SARS or MERS epidemic. Coronavirus has been described for more than 50 years. With more than five lakh cases reported in over 200 countries, it has claimed more than 22,000 souls since January 22, 2020. This mysterious virus was present in 2013 in China, but has reemerged probably because of the oversight then.
If we are to believe, it originated in a seafood market where wild animals including bats, rabbits, marmots and even snakes are traded legally in a place called Wuhan (a place also popular for biological warfare) in Hubei Province in the Republic of China. The virus is known to jump from animals to humans and thus this cycle begun.
'Shaped like a crown'
Coronavirus symptoms a similar to any other virus, which include a dry cough, headache, fever, extreme fatigue, a running nose, sore throat, nasal congestion, diarrhoea and even loss of smell (anosmia), anytime from day 1 to day 14 of contact. It is transmitted from person to person through droplets from the nose or mouth. It is nasty enough to remain on some surfaces for even weeks!
The worst hit by this novel Coronavirus are China (where it started), Italy (large elderly population, second only to Japan), Spain, USA, Iran, France, Germany etc. Paradoxically and fortunately, countries (Africa, India, South America) which have endemicity to malaria are less affected now.
'Only lockdown can stop spread'
India is in a state of lockdown like many other countries. For a country with the world's fifth largest economy as per nominal GDP, it is estimated to lose a whopping R35,000 - R40,000 crore a day over the next three weeks alone. A country with a 130 million population, India is not equipped to handle the pandemic if it hits hard. A nation with 1/5th of the world's population, 29 states having more than 19,500 dialects, a lockdown is the only way we can prevent a spread. It is difficult to imagine even if 5% (6.5 million) of our population is hit, 20% (1.3 million) requiring hospitalisation, and 5% (6.5 lakh), requiring ICU/ventilators.
The incubation period of the disease is from 2 to 14 days, which is also a potential transmission period. Like any virus, COVID-19 exists only by replication.
It cannot be produced outside a cell, as it is solely dependent in a host (humans/animals) to survive. It is imperative at this stage to slow and break down the virus chain. If we were to learn lessons and avoid following the trajectory from the Italian experience, we will not face a catastrophe, which could be unmanageable.
Although, the mortality is not that high, it often attacks the elderly (above 60 years ), the immunocompromised, patients with hypertension and heart diseases more virulently. The highest mortality is seen in these subjects. As we have more than 100 million people above the age of 60 years, we may have more numbers at stake than any other province or country in the world. The young often get away with just a milder infection.
As per the global data, the first 1,00,000 people were infected in 67 days. It only took 11 days to infect the following one lakh, and just a meagre 4 days to infect the following third lakh !!
Follow the five
As moral and ethically responsible citizens of India, we must abide by this lockdown which could be extended farther as per circumstances. As the era of the physical high fives has halted, I would urge to follow and spread the message of these five:
Hands: Wash them often, thoroughly at least for 20 sec with soap and water or an alcohol-based rub
Elbows: Cough into your elbow or in a disposable tissue
Face: Do not touch any part of your face without washing your hands
Distance: Maintain a safe distance of at least 3 feet or 1 metre. Physical distancing rather than social distancing to keep the sanity
Home: Stay at home and spend time with your family
As we get spruced up for more testing, a lesson learned from South Korea to flatten the curve quickly - mass and rapid testing will help break the chain quicker.
Masks and protective equipment is generally only for healthcare workers at large.
At this moment there is no definitive pharmacotherapy, so to prevent ourselves from getting infected, the above rules must be followed. There are several reports of drugs like the old anti-malarial Chloroquine and other agents, it is only time and experience that will guide us farther. Intensive research and trials are ongoing for the treatment and vaccine for COVID-19.
Until then, "namaste" is the best way to greet as the "I" and the "U" will only disappear from the "virus" with efforts by U and Me.
As the soldiers of this war fight tirelessly, relentlessly, looking at no caste, creed. religion or their family, and sometimes even playing with their potential death, hats off to their courage to cannon down this virus. It's only wise and important not to panic or be fearful, and stay calm. Let's all get together and turn this virus from COVID to GOVID!!
Dr PRATIT SAMDANI is professor, md, fcps, fsccm, dnd, fcard, Breach Candy, Jaslok, Bhatia and Saifee Hospitals
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