The first casualty when war comes is truth, American Senator Hiram Warren Johnson is said to have declared in 1917. In our age of the internet where rumour can reach tens of millions in a matter of minutes, if not seconds, Warren Johnson’s observation couldn’t be more apt. As the world battles the Coronavirus pandemic, what do we know, what do we not know and to whom should we listen?
What is Coronavirus or Covid-19?
Viruses are named by the International Committee on Taxonomy of Viruses (ICTV). This current virus was named Severe Acute Respiratory Syndrome Coronavirus 2, or SARS-COV-2. This name was announced by ICTV on 11th February 2020, because while different, SARS-COV-2 is genetically related to the SARS (Severe Acute Respiratory Syndrome), which tore through China, and other parts of Asia in 2003.
In 2012 Middle East Respiratory Syndrome (MERS) was first reported in Saudi Arabia, from where it spread to other countries.
In communication with ICTV, the World Health Organisation (WHO), chose the official name of Covid-19, to avoid any unintended confusion with the SARS virus of 2003. Corona, because under a microscope the virus cells resemble a crown. V for virus, D for disease. The disease was formerly known as 2019 Novel Coronavirus, now shortened to Covid-19.
All three viruses are members of the grim family of Coronaviruses which unfortunately for us, are adept at cross species transmission (CST), jumping from animals to humans. And unlucky for us, the family seems to expand, and each time, the world’s scientists, and medical professionals have to understand the exact nature of the new variant, to recommend measures that will protect the world from it.
Many of those initially infected by the newest bundle of lethal misery that is Covid-19, either worked or frequented the Huanan seafood wholesale market in the centre of the Chinese city of Wuhan. All that is accurately known is that it too jumped from wildlife to humans. We do not as yet know how, or when. Scientists cannot even categorically state that it originated in China.
What they can tell us, is that unusually for a virus that has made the jump from one species to another, it seems to transmit easily in humans. Without strong measures to contain it, the most robust of which are the measures China has taken, on average each infected person will pass it on to two more, spreading it exponentially.
Since Covid-19 was declared a pandemic by the WHO, most countries of the world have put in place public health measures aimed at containing, and limiting the spread of the virus. The most far reaching, and as we know now, most successful are measures taken by China.
As soon as it realised it had an epidemic on its hands, China locked down Wuhan, the epicentre of the epidemic, allowing no one in, or out of the city. The self isolation, closing down of everything except the essentials that is only now being implemented by the rest of the world began in earnest. Flouting of any of these measures was punishable by law.
The WHO has pointed to China as the standard for dealing with the virus. The world body also recognised the service China has done the rest of the world, by initially containing the virus and limiting its spread outside China.
It is thanks to such measures that China has gone from 15,000 new infections daily in one province alone, in February, to zero internally transmitted infections.
The symptoms for Covid-19 can so mimic flu, that the overlap can throw off even medical doctors. Flu symptoms come on quickly, and include high fever, sore throat, muscle aches, shivering, runny or stuffy nose. Most of the information we have on Covid-19 is from China. Early studies there and elsewhere since, have found that patients who tested for Covid-19 developed high fever, a dry cough, muscle aches and fatigue.
Pneumonia (lung infections) which often leads to breathing difficulties is common in Covid-19 patients. Although a runny nose and sore throat are less common, in Coronavirus patients, the only sure way of telling whether a patient has flu or Covid-19 is testing.
The severity of symptoms will vary. Studies from China found that about 80% of patients had mild symptoms with little infection in the lungs. Around 15% had severe symptoms, shortness of breath, low blood oxygen, or other lung difficulties. Only 5% showed critical symptoms, respiratory failure, septic shock, organ problems. Most at risk are people with pre-existing conditions like diabetes, and heart disease, as well as older people.
Anyone who develops these symptoms is advisable to self isolate, and seek the relevant medical advice. In Rwanda a toll free number 114, has been provided for anyone who thinks they might be infected. People are advised not to go hospital, where they might infect others. The incubation period for Covid-19 is 14 days.
How the infection spreads
Researchers are not yet able to be exact about how Covid-19 crossed from animals to humans. The spread from human to human is however now clear. Basic hygiene, and even good manners can limit the spread of the virus. It is spread through droplets from an infected person when they sneeze, or cough, or when they allow these droplets to escape when they are speaking. You need to be within one or two metres of the infected person when they sneeze, cough, or emit droplets when speaking.
How to protect yourself and others
For such a complex devastating virus, measures to protect individuals from catching it are almost disarmingly simple: when you sneeze, or cough, do so in a tissue, or if you don’t have one, do so in the crook of your arm.
The objective is to prevent droplets from your sneeze, or cough to reach others and infect them. The habits that mothers everywhere have always urged children to adopt turn out to be the scientific methods to stop the spread of the deadly virus. Properly dispose of the tissue after use.
The virus can be picked up from surfaces on which an infected person may have sneezed, coughed or touched with droplets from their mouth or nose. The virus can last on these surfaces up to 48 hours, or even 72 on hard surfaces, so washing your hands cannot be overemphasized. You are advised to wash your hands thoroughly for at least 40 seconds, scrubbing between your fingers, under your nails, the back of your hand, with ordinary soap and water.
Washing your hands when you go out, on your return, when you touch surfaces whose cleanliness you cannot be certain. In Rwanda it is now difficult to find a public area where soap and water, or sanitiser or both are not provided. Avoid touching your face. Use a tissue if you must, then properly dispose of it.
Clean your mobile telephone, the virus can lie in wait on its surface for days. You can use alcohol based cleaner, which should be at least 60% alcohol to wipe it down. Your bottle of brandy or whisky won’t do. Some mobile telephones are water resistant and can be wiped down with soap and water.
It is not yet clear how long the virus can last in clothes, but to be on the safe side, wash any clothing into which you have sneezed or coughed, or which have touched surfaces that may have been infected.
To wear or not wear masks and gloves
A mask can certainly be a protection against someone who coughs or sneezes droplets your way, but they are generally not necessary for most of us. They also can have the effect of giving the wearer a false sense of security. And you can actually be worse off for wearing them, if you rub your face, or remove your mask incorrectly and leave any droplets on your face.
Similarly, with latex gloves, the virus can lie on them for hours, when washing your hands with simple soap and water would have killed it. You can touch your face with an infected glove. Unless you are caring for an infected person, masks and gloves are not recommended.
The mortality rate for Covid-19
Mortality rate figures vary but most researchers now agree on 1% or lower. Deaths are highest among the elderly and those with pre-existing conditions like diabetes and heart disease, but no one is immune. Even among those in 80s and 90s however, 90% will recover.
Vaccine or cure
There is no cure, or vaccine for Covid-19. Efforts to find a vaccine have been unusually quick, compared to say, the Ebola epidemic. Several tests, especially in China, are at an advanced stage, but the WHO warns that a commercially available vaccine is at least a year away. Until then, preventive measures remain the only cure.
Listening to your mother about basic good manners, not coughing or sneezing at people, washing your hands properly, has never been more important. You can save yourself and others by observing these simple injunctions.
And it is your mother who will have told you not to listen to strangers. It is advice that should listen to only your local or national public health officials, advice from WHO, and other reputable sources, like John Hopkins University, Our World in Data. WHO has publishes daily updates on Covid-19.