In September I wrote a column about the coming flu season. I warned about the very serious threat of a new virus that would cause a pandemic.
It wasn’t a case of, I said, but when.
So will Covid-19, the coronavirus infection that has devastated China, prove to be a pandemic – a disease that is battling the world and causing widespread death and destruction? It is too early to say, but it is definitely starting to look that way.
Just like many of the worst viral outbreaks in recent years, such as Sars, Mers and Ebola, Covid-19 almost certainly originated from bats. The thing about bats is that when they get infected, their bodies exhibit a particularly rapid and fierce immune response.
This protects them against infections, but it also means that the viruses that succeed in gaining a foothold have ‘learned’ how to reproduce quickly in a very hostile environment.
So when these viruses jump from bats to other species of animals, including humans, they are battle-resistant and not only able to reproduce quickly, but are also highly transferable.
Will Covid-19, the coronavirus infection that has devastated China, prove to be a pandemic – a disease that is engulfing the entire world and causing widespread death and destruction? It is too early to say, but it is definitely starting to look that way. (Above, a residential area in Beijing was disinfected on Saturday)
Although many coronaviruses start in bats, they usually come to us through other creatures.
For example, Sars, who killed ten percent of those infected, reached people through the Asian palm civet (a mammal of a cat). Mers, who killed one in three, came through camels.
We don’t know for sure which animal, if any, acted as an intermediary for Covid-19, but the best candidate is a creature called the pangolin – a scaly, ant-eating animal that, despite being threatened, is still widely used in traditional Chinese medicine.
Can malaria drugs help fight this bug?
Covid-19 has killed more than 1500 people and theoretically has the potential to kill at least 50 million more. That is about the number of people who died of the Spanish flu a century ago.
Like other forms of flu, the new virus spreads through coughing, sneezing and close contact.
But what makes it different from normal flu is that it is brand new, so that few people are resistant.
And here’s how you wash your hands … the right way
You have to use soap and water, and you have to wash your hands for about 20 seconds, make sure you rub the ends and get into the openings between the fingers.
Much less than 20 seconds will not be effective, much more could risk damaging your skin.
One way to estimate 20 seconds is to sing the entire Happy Birthday To You song twice.
You have to use soap and water, and you have to wash your hands for about 20 seconds, make sure you rub the ends and get into the openings between the fingers. One way to estimate 20 seconds is to sing the entire Happy Birthday To You song twice
It is especially important that you wash your hands when you come in by mixing with others and when you are about to eat.
If you can’t wash your hands, alcohol wipes and those that you get from pharmacies are better than nothing, but they are certainly not that good.
We can only hope that, like Sars, Covid-19 will pop out before it becomes a complete pandemic. I’m not optimistic.
That said, most people who get infected experience something mild, more like a cold. Only when it becomes pneumonia do you run a high risk of dying.
The current best guess is that it will kill about one percent of the people who get it, making it considerably less deadly than Sars.
Our best long-term hope is a vaccine that most experts agree has been available for at least 18 months. Only a few existing medicines can help.
For example, there is an antiviral agent called remdesivir, originally developed to combat Ebola.
Last week, the New England Journal of Medicine reported the case of an American who had recently returned from China and was diagnosed with Covid-19. He showed signs of pneumonia and got remdesivir and he got better within 24 hours.
Laboratory tests have shown that both remdesivir and chloroquine, a common malaria drug, are very effective against this specific corona virus.
But more tests need to be done before either is used on a large scale.
Don’t become a super spreader
The speed at which a virus spreads makes it get a basic reproduction number, usually RO. This virus appears to have an R0 of 2.6, which means that on average every person who gets it gives it to 2.6 others.
But there are people who only get slightly infected and then pass it on to many others.
They are known as super-spreaders, and Steve Walsh, a British businessman who was revealed last week that he had infected at least 11 people, is a good example.
In addition to super-spreaders, who are infected but don’t know it, others quickly develop important symptoms that make them sneeze and cough vigorously.
By the time they do something about their ‘cold’, they have spread their viruses everywhere.
Many seem to be convinced that wearing a fabric face mask – such as surgeons worn in operating rooms – is the answer to reducing this spread. But I wouldn’t mind.
Many seem to be convinced that wearing a fabric face mask – such as surgeons worn in operating rooms – is the answer to reducing this spread. But I wouldn’t mind
If you are infected, there is a small chance that wearing a mask will prevent you from spreading to others – and might protect you if someone coughs directly in your face.
But as soon as that happens, you must immediately remove the mask. A dirty, moist mask is worse than useless.
The best defense is much simpler and cheaper: wash your hands well. Most of us already know this, but few people make the effort to do well, probably because we cannot see germs on our hands.
Meet my hero for hand hygiene
One of my medical heroes is Ignaz Philipp Semmelweis, a Hungarian doctor, who showed more than 170 years ago how important hand washing can be.
In the 1840s he worked in a hospital in Vienna and noticed that a larger number of pregnant women died of maternity fever – also known as child bed fever – in the departments where they were cared for by medical staff, rather than midwives.
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He decided that this was because the doctors came directly from the mortuary, where they had examined corpses, to the bed, where they would do intimate, internal examinations of their female patients.
Although this was long before we knew about the existence of microscopic germs, Semmelweis was convinced that the doctors had to wear something on their hands.
He insisted that they wash their hands in a solution with chlorinated lime and that the mortality rate due to maternal fever dropped dramatically.
But his fellow doctors considered hand washing to be fashionable and were indignant about the implication of killing their patients.
So they walked together and had him removed.
One of my medical heroes is Ignaz Philipp Semmelweis (photo), a Hungarian doctor, who showed more than 170 years ago how important hand washing can be
Poor Semmelweis had a mental illness and was taken to an asylum, where he died of an infection at the age of 47 after being beaten by his guards.
Years later, his claims about the importance of hand washing were generally accepted.
Depressed is that even now studies have shown that only about 70 percent of people wash their hands after going to the toilet.
And of those who do, only 50 percent use soap and water for the recommended 20 seconds.
Researchers calculated that if we could simply increase hand washing at airports to triple the current rates (studies show that only one traveler in five has clean hands), this would delay the spread of diseases such as coronavirus by 70 percent.
The moral of the story is that the best way to protect yourself and the rest of your family is to wash your hands, especially if you’ve been to a busy area, such as an airport or train station, where you might have picked something up.