Can we defeat novel coronavirus?

It is an open question, and the answer remains to be seen.

A health worker checks the temperature of a traveller in coronavirus screening at Kotoka International Airport, Accra, Ghana. (Francis Kokoroko/REUTERS)
A health worker checks the temperature of a traveller in coronavirus screening at Kotoka International Airport, Accra, Ghana. (Francis Kokoroko/REUTERS)

It started in Wuhan, the bustling capital of Hubei province in central China in December last year and quickly spread infecting as much as 80,000 people and causing more than 2700 deaths globally. Several theories abound about its origin, from flat-out lies to wild conspiracy theories. It is widely believed, however, to have started from a local seafood/wild animal market near a research facility in Wuhan.

 

What is Coronavirus Disease (COVID-19)?

It is part of a large family of viruses that mostly cause common colds and occasionally, fever and upper and lower respiratory symptoms. The viruses circulate among animals like bats, camels, cats and cattle. Sometimes, these animal coronaviruses evolve into human coronaviruses that can infect people and then spread between people. In 2002, the first coronavirus outbreak occurred known as SARS (Severe Acute Respiratory Syndrome) and again in 2012 as MERS (Middle East Respiratory Syndrome).

More than 80, 000 people have been infected by the disease since China first reported the outbreak last December. That is 10x more people than the Severe Acute Respiratory Syndrome of the early 2000s. More than 2700 deaths have also been recorded. In China, the pandemic appears to have peaked and infection rates are progressively slowing. Meanwhile, infections outside China has spiked. South Korea reported 256 cases in one day and Iran, the epicentre of the outbreak in the Middle East reporting disputed fatality figures that hover around 34, while its own hospitals are reporting over 200 deaths.

How deadly is the virus?

COVID-19’s deadliness lies in the ability of the virus to be transmitted even before symptoms are visible (asymptomatic transmission). It also appears that a large percentage of fatalities are elderly people, around the ages of 55 – 60 (15%) who also have previous health issues. The virus does not seem to affect children as much as it does for older people. In less than 3 months, the virus has infected and killed more people than the SARS epidemic of 2002 – 2003.

Source: @heshmatAlavi

How prepared are we?

Not much. Africa suffers from very severe shortages in health facilities, with many doctors leaving the continent to work elsewhere. Nigeria, for example, has one doctor for every 6000 people. The WHO recommendation is one doctor per 1000 people. Until a few weeks ago, only Senegal and South Africa had the capacity to test for the virus. That number has now risen to twenty-seven. After several weeks of suspense – and hope – that COVID 19 does not reach Africa, two of Africa’s most populated nations, Egypt, and Nigeria have confirmed one case each of COVID-19. 25 other countries in Africa are still monitoring suspected cases of COVID-19.

Dr Xie Jiang in Wuhan thinks the outbreak can easily overwhelm any healthcare system. He is happy that they now have more ECMO (Life support machines) and ventilators. Such life-saving equipment is not readily available in many hospitals in Africa. A few weeks ago, social media was awash with China’s 1000 bed capacity hospital that was completed in 14 days. In Africa, with crumbling health facilities, inadequate staffing and frustrating bureaucracy, a Wuhan scale infection could rapidly go out of hand and cause far more fatalities. That said, countries like Nigeria, Senegal and Mali which were previously hit by the Ebola epidemic should have invaluable experience and already existing isolation centres that will assist in containing a rapid spread of the virus.

A reason to hope…

Blind panic will not help contain the spread of the virus and will almost certainly worsen the situation. So far, the situation remains largely under control, even as research laboratories around the world scramble to develop, test and deploy a potent vaccine against the Sars-CoV-2 virus and the global markets take a direct hit. Most governments in Africa have implemented travel restrictions on China, with the notable exemption of Ethiopian Airlines and the recent flight originating from China that was permitted to land in Kenya.

As new cases from China drop and infections in other regions skyrocket, Africa governments may need to pay more attention to travellers originating from other countries, including places where significant cases have not yet been recorded.

The African continent remains the most vulnerable. However, the virus has not spread as significantly as expected, especially given the high volume of Africa-China trade and travel. There is also the hope that with the return of warmer temperatures, the spread of coronavirus disease will slow and eventually pass. Of course, it is all guesswork, we still do not know enough about the virus and statements like these are based on assumptions that COVID-19 will behave like influenza (which is also caused by another type of coronavirus). If that is true, then Africans have little to worry about, since we’re already one of the hottest regions in the world. That might also explain why very few detections have been made (it is actually possible that more people are infected and don’t just know it since about 80% of people infected develop only mild symptoms before recovering). This and the fact that most of the African population are young people who seem to be less susceptible to fatalities. According to the Chinese Center for Disease Control, less than 0.5% of people under the age of 50 who were infected with the virus have died.

Thomas Pietschmann is a molecular virologist at the Center for Experimental and Clinical Infection Research, in Hanover, Germany. He thinks women may have a slight advantage in combating the coronavirus due to estrogen, “Some immune-relevant genes, for example, genes that are responsible for recognizing pathogens, are encoded on the X chromosome. Because women have two X chromosomes and men have only one, the female sex has an advantage here… Some immune-relevant genes also have binding sites for estrogens, where these genes are switched on. This means that these genes are also controlled by the hormones”.

In the end, this scenario may be a loud warning to African governments to place more priority on developing proper healthcare systems for the continents 1.2 billion residents. You and I need to prioritize good hygiene and if you live in Nigeria as I do, you may want to be more worried about the Lassa Fever outbreak than COVID-19.

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