12 minute read
COVID 19 Pandemic
Scientists vs COVID 19
Every so often, nature ambushes us and for all our knowledge, we are at its mercy. A lot of people knew this was going to happen one day and now it has. In December 2019, somewhere in the busy, primal Huanan Seafood Wholesales Market in Wuhan, China, the deadly strain of the Coronavirus now known as COVID 19 took hold of one of the caged animals there, like an unexploded viral bomb, ticking away. There were over 100 animals, many wild and illegally trafficked, listed in the market for sale, kept in small cages in unsanitary conditions. The list included bats, beavers, pangolins, peacocks, snakes and wolf cubs, all destined for dinner plates. Such markets are not uncommon in China and in response, since the disaster escalated, the consumption and trade of wild animals has been banned in China. It was here that researchers now believe a bat or pangolin became the link to the human pandemic. COVID 19 leapt from an animal to a human. Human bodies have never seen this virus before and so have no immunity to it. Since that fateful moment in Wuhan, we all know what has happened. Viral grip The coronavirus adopted its name from the word ‘corona’ meaning halo or crown – attributed to its appearance when viewed through an electron microscope as it has protrusions which it uses to attach to host cells. It has seven types and it causes different symptoms in different mammals. For example, cows and pigs can get diarrhea but in humans, it causes respiratory infections. Some strains do no more harm than a common cold but the latest strain, discovered late last year, now known as COVID 19, is different. As well as fever, coughing and breathing difficulty it can cause pneumonia, kidney failure or multiple organ failure and it can kill you, particularly if you are old, frail or have healthcare issues and preconditions.
The true horror of this strain, just like previous virulent, serious strains such as SARS and MERS, is that of course, it is contagious and exponentially spreads (the WHO believe it has the RO around 2.5 – this is the average number of people infected by one person) and in addition, there are no known vaccines or antiviral drugs. It can attach to surfaces, making it easy to pick up, living on surfaces from two hours to nine days depending on material and conditions.
If you catch it, you have to accept there is not much you can do, except hope and wait. It incubates, it travels across borders, it flies with people across oceans and it is now evidenced in 183 countries around the world. Cruise ships with outbreaks have been kept at sea, stadium games and events have been cancelled, hotels have been cordoned off, cities and now countries have been locked down and several transport routes are off limits. It has, at the time of writing, infected more than 350,000 people it is estimated, and claimed the lives of over 15,200 but the true figures are not known as not all cases are recorded. By the time this is published, the figures will have risen. We are living through an historic and terrible pandemic.
These evolving strains are a cycle of nature today and many regard them as inevitable in current human culture. What’s different about this viral outbreak, is the way in which scientists have responded. Normally, The deadly strain of COVID 19 has taken its toll around the world, killing over 15,000 at the time of writing, with a mortality rate of around 2 percent. In the desperation to undo the pandemic, innovation fights nature in an epic battle of science against disease, all across the globe. Right now, there is real terror in the world as the virus spreads like a fire through every population on Earth. It’s mutating, it’s escalating and no one really knows how or when this will end.
By Richard Forsyth
This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19).
vaccines for outbreaks like this can take several years to develop. Because Chinese officials released the genetic code of the strain relatively quickly, governments and research teams around the world responded quicker and with better technology than with previous outbreaks, to work out how it might mutate, and how they can protect people from it. A quick call for collaboration worldwide is speeding up the pace to the response dramatically. Although this has radically sped up the processes for a vaccine – trials may even start in weeks for candidates – it’s likely a vaccine will not be population-ready for a year, which is still an age, when the virus is spreading so aggressively around the world.
Europe’s response The EU has joined the fight against this virus which the World Health Organization (WHO) called ‘a grave threat to the world’. Largescale investment has been secured and is being distributed as a matter of emergency. The European Commission has made a financially backed commitment to tackling COVID 19, funding urgent research relevant to diagnostics, therapeutics and prevention, and every country affected has made it the priority above all else. There seems no upper limits to how much each country is prepared to put into this, with billions of investment pumped into helping people reorganising infrastructure and fighting the disease, set against ever more endangered economies, now in tatters from lockdowns and ceased trading.
There are several EU Projects that have been relevant in the collaborative response, including The Prepare Project, EVA-GLOBAL, ZAPI and COMBACTE-NET.
Some are focused on readiness. For example, The Prepare Project is constantly working out the dynamics of the outbreak, making sure European hospitals are as ready as feasible to respond to mushrooming outbreaks and public health information is ready to go. It is essentially a European-wide network intent on harmonising large-scale clinical research studies on infectious disease. It establishes a common research structure in hundreds of hospitals across the EU and clinical investigators are deployed in 48 hours of an outbreak. The approach
seeks to improve response effectiveness, not missing opportunities to prevent outbreaks spreading, learning from the disease and saving lives. The Prepare Project was quick to respond to the outbreak in Italy, getting on site and dealing with the challenges as best they could.
There is also ZAPI, The Zoonotic Anticipation and Preparedness Initiative. This project creates new platforms and technologies to facilitate a fast, coordinated response to new infectious diseases. This looks at designing new manufacturing processes to deliver antibodies and vaccines to battle emerging diseases in a matter of months from the outbreak.
COMBACTE-NET (Combatting bacterial resistance in Europe) has a mandate to build clinical, laboratory and research networks across Europe, testing novel treatment strategies. There is also pooling of existing knowledge for fast access seen in European Virus Archive – GLOBAL (EVA-GLOBAL or EVag). This provides a virtual collection of human, animal and plant viruses and has to date responded to hundreds of requests from dozens of countries to provide access to the necessary material for diagnosing coronavirus infection. Building knowledge databases and making the relevant organisations aware of them, is a vital part of the coordination against diseases that spread fast.
These projects are now actively involved in dealing with the COVID 19 threat. China and Italy have taken the biggest battering from the virus, with COVID 19 reaching its deadly ‘tendrils’ deep and wide into Europe, now the epicenter of the outbreak. Italy especially experienced a shock, with over 5,000 deaths at the time of writing. Initially across Europe, most of these cases were imported but where the numbers shot up, as they did early on in Italy, it was clear that it did not take long for the virus to be locally acquired. The disease also evolves, which adds to the challenge. Children seemed to sustain a lesser version of the disease whilst the elderly, especially men, and those with underlying health issues, were more seriously affected. One problem with COVID 19 is that it presents similar symptoms to having a bad cold or the flu, including fever and a persistent dry cough. It can also be in someone for two weeks without their knowledge and spread. This makes a huge proportion of people potential victims of the virus as well as aiding its distribution. One of the best pieces of common sense advice has been to wash hands with soap for 20 seconds, as soap breaks down the fatty membrane around the virus, so it falls apart.
Innovation on the frontline Innovations have been helping around the world to tackle the spread of this disease. In China, eCommerce company, Alibaba has gotten together with Beijing-based Global Health Drug Discovery Institute, developing an open source coronavirus data platform. It’s also lent its cloud-based AI powered computing platform to institutions around the world to accelerate gene sequencing, protein screening and research on the deadly strain. AI is good at forecasting and predicting which is also a useful skill for second guessing outbreaks. More accessible, is the WeChat instant messaging app that 1 billion users have, now has an outpatient clinical map so WeChat users can locate nearby clinics. Then there is the amazing ‘sci-fi’-like contribution from TmiRob, a company that has now sent dozens of their medical robots to hospitals in Wuhan and Shanghai. The robots check patients’ temperatures, deliver medication and sterilise areas.
In the hope of preventing its spread across borders and seas, airports have been scanning passengers to take their temperature. Thermal imaging cameras at Sultan Iskandar Muda International airport in Indonesia, for instance, has been taking temperatures of people passing by the camera. Anyone with a high temperature or fever had been stopped and checked. Now, of course many transport routes, including air travel have simply been shutdown to avoid any possibility of spreading transmission.
For some Chinese workers, disinfectant spraying tunnels were
deployed where the workers pass through them to get to work. A mist of disinfectant coats each individual, before accessing safe zones.
Keeping calm whilst carrying on It is worth stepping back a little at the end of this article, to take stock when all the alarms are setting off in the media. The truth is that new viruses like this sound horrendous, scare officials and generally make people anxious and panicky. However, most people who catch this virus experience mild symptoms and fully recover. It’s not a foregone death sentence by any means, and in fact many may have not even realised they had caught it, mistaking it for a more common illness. The advice for this kind of problem is simply tell your nearest healthcare provider and ensure you isolate yourself, stay indoors, stay rested, keep hydrated. If you are a reasonably fit person – this ordeal is maybe simply a story you’ll tell people in years to come. For the unlucky two percent, however, the body’s immunity fights back too hard and causes severe illness and it can be fatal.
COVID 19 shows us that today, disease is harder to contain because of our global access and large interacting populations, but at the same time our advances are such that we learn and adapt and counterattack, just as the virus has. Despite all the coordinated global efforts to thwart it and best it, COVID 19 does show robust determination to thrive. The horror of such outbreaks is going to recur in the future, with new strains and evolutions, so understanding the best strategies for COVID 19 will create vital lessons for future pandemics.
The best way to prevent it before a vaccine is synthesised, does seem to be simply, isolation and quarantine. Whilst several cities have had to endure this torturous isolation on a mass scale, with citizens staying inside their homes and away from the street, the shops and work, this crude solution works better than any other. Diseases need hosts, deprive a virus of hosts and it’s like robbing a fire of its fuel.
DIFFERENT APPROACHES Herd immunity with phased measures in the UK The UK bucked the trend of hardline isolation as the virus erupted within its counties, opting for the natural herd-immunity approach. This is when the population carries on as normal to a degree, with the acceptance of infection, so the majority of people develop natural immunity faster in theory and break the chain of infection. The herd immunity approach was criticised by the WHO, as too little was known about the virus to say if this would work. It also means an initial spread of the disease is faster. In fact, the UK all but abandoned testing protocols, opting initially for soft measures like advising on self-isolation and washing hands as the main population protections. Social distancing measures are introduced in steps as the virus spreads. Building of mega hospitals in China China built mega hospitals at an unprecedented pace in response to the aggression of the virus, and the demands it would place on existing healthcare facilities. China is tackling the virus with a temperature checks at every point of potential contact they can think of, such as transport and buildings. Anyone with a high temperature is then taken away to the special fever clinics to be tested and potentially isolated. Testing everyone in South Korea South Korea has gone for an aggressive ‘trace, test and treat’ methodology, tackling the disease head on by ramping up health care efforts, testing as many people as possible on a large scale. In stark contrast to the UK approach for example, 20,000 people are being tested a day in this country, where people are swabbed in car parks and tests are carried out around the clock in labs. Lockdown in Italy Italy has gone for a simple and brutal approach of locking down populations, keeping everyone as separate as possible so the disease can not spread person to person.
