The novel COVID-19 outbreak has ramped-up exponentially, puzzling experts to include a host of medical doctors, epidemiologists, researchers, international and other related health organisations.
In the history of virology, the outbreak continues to puzzle every echelon of experts, especially concerning its origin, the manner and speed at which it spreads and the exacting impact it’s imposing on economies already collapsing under its weight.
The virus is spreading rapidly and is classified as a pandemic by WHO, with alarming cases confirmed in multiple countries across the world. The virus is virulent and projected to reach the 1 million mark in infections in the shortest time possible in spite of the concerted effort to avert it.
Epidemiological investigations first referred to the strange virus as the ‘Wuhan Virus’. But with probable stigmatisation that name would cause, nomenclature changed to COVID-19, an acronym for Corona Virus Disease 2019.
COVID-19 is one of the zoonotic coronaviruses comparable to Severe Acute Respiratory Syndrome (SARS) coronavirus and Middle East Respiratory Syndrome (MERS) coronavirus but also different in so many ways. Zoonotic diseases are infectious diseases that spread from non-human animals, usually vertebrates, to humans caused by bacteria, viruses, or parasites.
COVID-19 was first identified in China in December 2019, although its actual origin remains a mystery. Epidemiologists reveal that the outbreak first started in the seafood market of Wuhan, where a variety of live wild animals such as hedgehogs, badgers, snakes, and birds (turtledoves)’ and carcasses and animal meat were being sold. The virus is associated with certain species of bats common in Asia and Europe. Despite this understanding, investigations reveal that no bats were sold in the Wuhan seafood market at the time of the COVID-19 outbreak. What remains probable is that the virus is traced back to China, since the country was the first to report its presence to WHO.
Symptoms and diagnosis
COVID-19 is related to other SARS-like coronaviruses previously found in bats in China. The disease manifests itself through severe respiratory difficulties, fever, dizziness, and cough. Diagnostics adopted from patients in Wuhan Hospital in December 2019 reveal fever, chest tightness, unproductive cough, pain and weakness within a week of presentation. Medical tests also determine that the patients usually suffer from hypoxemia, a medical condition known to cause oxygen deficiency or abnormally low levels of oxygen in the blood.
Confirmation of COVID-19 requires nucleic acid testing of the respiratory tract samples such as throat swabs. Clinical diagnosis may also be made based on symptoms such as exposure and chest imaging. In the US stool samples have also been used.
Spread and transmission
COVID-19 is a highly infectious disease possessing an increased sequence of variability. Because it’s a zoonotic disease, the initial source of infection was a zoonotic spill-over probably from seafood markets in China.
Human-to-human transmissions are thus far known for the widespread of the virus, with China initially reported as the epicentre. As transmission ebbs in China, new local frontiers continue to increase in Italy, Spain, and the US; Iran, Japan, and Korea.
The spread of the virus was first detected among travellers from Wuhan, Thailand, Japan, and Korea. In global circumstances, the pervasion of the coronavirus is an import proving highly virulent and difficult to contain at the moment.
Evidence reveals that human-to-human transmission is spread through respiratory droplets of infected persons coughing or sneezing amidst people within 6 feet of their reach. Transmission is also possible through touching contaminated surfaces such as tables, handrails, telephones and doorknobs, etc.
Lack of personal protective equipment, especially among health workers has been found to aid secondary transmission in many hospital settings across the world and familial households where those infected are being cared for by their loved ones.
Another dangerous twist in the spread of COVID-19 is what epidemiologists term as asymptomatic cases. This is a situation where an individual tests positive on viral nucleic acid test but does not exhibit any symptoms such as fever, dizziness or dry cough, etc. found to be consistent with the infection.
Human vulnerability and fatality
Case series from China and other places indicate that anyone, irrespective of age is vulnerable to COVID-19 infections and that this novel coronavirus is highly contagious.
Findings reveal a grim situation for people of advanced age and those with pre-existing medical conditions in regard to fatalities. Studies conducted in China confirm that the majority of deaths are of patients found to be 60 years or above old, and those exhibiting pre-existing conditions such as hypertension, cardiovascular disease, and diabetes.
Prevention, treatment, and control
Globally, concerted effort is being exerted to prevent and find effective drugs for the treatment of the new pandemic. Nonetheless, the absence of a cure or a vaccine has prompted a number of preventive measures to limit human movement.
To avert the spread, the Reproduction Number represented as–R0–has to be controlled. It needs to be understood that if R0>1, the transmission of the virus will increase but the transmission will decrease if the R0<1. It is this calculus that is reinforcing the need for social distancing, isolation, and quarantine that most leaders across the world are promoting, as a medical solution is contemplated. The exponential growth of the virus is explained by the fact that the Reproduction Number (R0) currently stands at 3.28 outpacing the 1.95 the WHO had earlier estimated.
The absence of antiviral agents and vaccines prompts the deployment of numerous measures to limit movement since human interaction is known for the exponential spread of the virus. China has focussed on traditional public health outbreak response applied before, especially during SARS, to include crowd isolation, quarantine, social distancing, and community containment. The same cue is being applied by leaders of other countries to prevent infections.
‘Isolation’ is the measure undertaken to separate infected persons from non-infected persons in order to prevent the spread. Isolation is done in hospital settings, in rooms equipped with negative pressure to reduce transmission via aerosols.
‘Quarantine’ is an old and most effective method to control communicable diseases, and means movement restriction of a person or group of persons for a certain period of time and applied to homes or designated facilities. Quarantine is either voluntary or mandatory but is monitored for the manifestation of symptoms and if symptoms occur, those infected are then isolated.
‘Social distancing’ is a reduction in interaction within broader community settings where people are suspected to be infected but have not yet been identified or isolated. Social distancing is significant in the sense that it gives ample distance to limit the transmission of respiratory droplets between people. Social distancing measures include the closure of schools, office buildings, and suspension of markets and cancellation of gatherings.
Lockdown, which is similar to community containment is applied to entire communities, cities or regions, designed to restrict interaction except for minimal personnel to ensure vital supplies.
Others measures are temperature screening at major airports and busy transportation terminals.
In developed countries, a resurgence of specialised emergency such as building new hospitals is being witnessed and deployment of medical equipment and medical staff in their hoards is being done.
In China, the state council of the country has also indicated that a medical solution is in the pipeline. Chloroquine phosphate and hydroxychloroquine, old drugs known for the treatment of malaria, have demonstrated marked efficacy in dealing with COVID-19 associated pneumonia. Clinical trials of 100 patients spread in ten renowned medical facilities in China have demonstrated that chloroquine phosphate is effective in the control and inhibition of the exacerbation of pneumonia. Chloroquine phosphate has also been found to promote virus-negative conversion and shortening the course of the disease.
With no adverse effects after its administration, Chinese experts including government and regulatory authorities have agreed to use chloroquine phosphate as a potent activity against COVID-19. This attribute has led to the drug being recommended for inclusion in the next version of guidelines for the prevention, diagnosis, and treatment of pneumonia caused by COVID-19.
Passive Antibody Therapy as a medical alternative to stem COVID-19 is also being studied. The therapy has a long history since the 1890s. It involves the administration of human convalescent serum or antibodies to susceptible individuals. The therapy is currently known to be the only method that can provide quick immunity to susceptible persons. Previous trials during the 2013 SARS outbreak, show that convalescent sera extracted from patients who had recovered contained neutralising antibodies against the virus. The therapy was also used in West Africa in the containment of the Ebola epidemic. In the current outbreak, the therapy has been applied in China, and available information implies that the method reduces viral load and is safe, although a paucity of its detailed application exists.
WHO and many health authorities across the world are also emphasising a catalogue of preventive measures. They advise social distancing, staying at home; hygiene procedure of using masks in crowded places and for those who are infected and those attending to the infected; using gloves, washing hands with alcohol-based hand rub or sanitisers and with soap and warm water where possible; avoiding touching eyes, nose and mouth; practicing respiratory hygiene through covering the mouth and nose with the elbow when coughing or sneezing, and disposing of used tissue materials immediately.
Capacity to limit local cycles after importation of COVID-19 is highly dependent on a country’s ability to detect, prevent and control infections. Measures include and many others besides: heightened surveillance, rapid identification of suspected cases, patient transfer and isolation, rapid diagnosis, tracing, and follow-up of potential contacts. Capacity is dependent on a country’s public health system and resources.
Impact of COVID-19
COVID-19 may be hard to substantiate at the moment in terms of the damage it is currently causing. The disease has already had short-term effects experienced in lockdowns, shortages in supplies, local business standstills, global economic disruption, human movement and social interaction limitations, etc. The overriding short-run and hard-hitting impact COVID-19 has caused is the death of scores of people across the world.
At the time of reporting, infections are first approaching the 1 million mark. Microsoft Power BI (2020) a website tracking the global status of real-time incidence, indicates that the total confirmed infection cases stand at 810,123 but as previously noted, the count changes all the time. The site also shows the total death at 39,572 (4.88% death rate) and recovery at 172,531 (21.32% recovery rate).
Mainstream and social media are also awash with reports of fatalities. New milestones are reached every day, with occurrences in both infections and deaths, especially in the developed countries, changing like clockwork. Countries with the highest infection rates are: USA (166,214), Italy (101,739), Spain (94,417), Germany (68,180) and France (44,550) among others. At the moment, Italy and Spain have the highest death rate at 11.39% and 8.76% respectively (Microsoft Power BI, 2020).
What the pandemic shows is that if infection rates increase in developing countries the situation is likely to be dire due to compromised health systems in many countries.
Analysts state that the pandemic will certainly have direct and indirect economic implications and that its impact will have a heavy bearing on policymakers to formulate appropriate macroeconomic policy response after its impact has been clearly assessed.
It is thus far proved that COVID-19 is a pandemic that will have far-reaching and long term consequences as the reality of its spread begins to set in. COVID-19 is highly infectious with its exponential growth attributed to high human interaction.
COVID-19 can be managed through stringent measures of social distancing, homestays, quarantine and economic lockdown and hygiene procedure.
COVID-19 and other coronaviruses may continue to mutate over time, to become more virulent but capacity needs to be marshalled to stem it. The lesson learned is that lack of immediate response, as the COVID-19 exponential growth demonstrates, can shutter economies even those with highly developed systems.
This article has been written with input from different scholars whose sources I have greatly benefitted from to inform others. Thanks go to the numerous people that in their respective capacities are doing whatever it takes to prevent the COVID-19 infections and to save lives. For a full paper with bibliography, forward your request to firstname.lastname@example.org
As I remain ‘huddled’ in my apartment, I pray for my parents Hajji Bilal and Mrs. Janet Basajjabaka to go through these very trying moments of the pandemic, as they are of advanced ages.