COVID-19 - Wayne Petherick, YHQLD

What the Hell Would I Know? 

First off let me begin by saying I am not a medical doctor. I do have 11 years of tertiary education and have been teaching in the tertiary sector for 22 years. My life as a student involved reading and interpreting scientific research and evidence, and in my life as an academic I have been teaching students to do the same. 

If I had another bite at the career apple, I would have liked to have been a virologist. Seriously. “Outbreaks” have interested me for as long as I can remember. One of the first “grown up” books I ever read was written by a guy who made his living hunting Ebola virus in the wild. 

In my reading list are books like Killer Germs, The Hot Zone, Pandemic, GERMS!, and Deadliest Enemies. My iPad is full of scientific articles about Ebola, SARS, MERS, and now Corona. 

In short I get my information from reputable sources like books written by scientists and articles written by scientists and researchers, and I have been following this thing closely since it broke.

Here is some information for you which will help you understand where this came from, why some of the decisions have been made, and what you can do about it as part of a socially responsible community!
What Should I Believe?

Sadly there is a lot more misinformation than good information on the Internet. Just because someone has an opinion that doesn’t mean it should be shared or trusted. No doubt you would have all seen Facebook posts and shared posts from people about a bunch of different things like anonymous doctors telling us to drink more tea, and that the government made this in a lab as a form of population control. 

In short, don’t believe this stuff you read on the Internet. It is doing more harm than good. There are some reliable sources you can turn to though including government websites like Queensland Health and various Facebook pages like I F&*cking Love Science and others like them. Many of these pages are moderated by scientists or people with training in science. They heavily vet these pages and the information posted to them for accuracy, and they only tend to post information from the scientific community, but it is written in a clear and accessible way. 

If you have to get your information from Facebook, get it from places such as this, not Aunty June who posted a repost that claims Corona was genetically engineered in a lab. 

Not only are you doing yourself harm, you are harming those who read your posts and reposts that are, at a minimum, partially incorrect or false. 
What is Coronavirus Anyway?

Coronavirus is a type of Severe Acute Respiratory Syndrome (SARS) virus. It is called Coronavirus as it is surrounded by a corona of surface proteins (the sun also has a corona): corona means crown or halo (when a new royal is anointed the throne we have a coronation where they are crowned). Despite common use of the name, this virus is NOT called COVID-19. It’s official designation by the International Committee on Taxonomy of Viruses is SARS CoV-2 (Severe Acute Respiratory Syndrome Corona Virus 2nd edition). 

COVID-19 is actually the name of the respiratory illness caused by the SARS Cov-2 virus. Viruses like SARS Cov-2 were most recently discovered around the 1960s and there have been a number of global outbreaks since, including SARS CoV in the early 2000s and MERS (Middle Eastern Respiratory Syndrome) from 2012 onwards. 

It is a novel Coronavirus because it is a new strain that has not been previously identified, novel meaning new. 
Did Coronavirus Come Out of a Lab?

Despite what Aunty June posted online last night after watching YouTube videos for the past week, this is a wild virus that made the jump from animals to humans in late 2019. Specifically, scientists have sequenced the virus and they have established conclusively that this jumped from animals to humans (called zoonosis) in the third week of November in 2019 (ain’t science AMAZING?) 

Bats are a natural reservoir of the virus (camels have become a reservoir for MERS). A reservoir is an organism or environment where a virus lives and reproduces. So why haven’t the bats all died off? A bat’s immune system is very efficient at stopping viral proliferation which is the point at which a disease overwhelms an organism’s immune system and you get sick. 

A specific type of bat, the Rhinolophus (horseshoe bat) is responsible in the case of SARS CoV-2, with the virus in humans being 96% genetical identical to the bat version. A virus very close to SARS Cov-2 was identified with 99% of the genes in an animal called a pangolin, which is the most trafficked animal in the world. However, there is also some similarity to a form found in a type of monkey called a palm civet. 

The best information we have right now is that the virus from two sources (bat, pangolin, civet?) combined somewhere along the path. In short, two viruses became one and this is called chimerism. We have not yet found which animal it was or along which part of the pathway the viruses combined, or which animal specifically was responsible for the passage into the human population. 

There is an infectious diseases laboratory in the city of Wuhan in China. It is quite close geographically to the wet market which has been identified as the source of the virus. This proximity to the market has sent the world’s conspiracy theorists into an absolute flap and they are sharing misinformation as fast as they can. The location of the lab is just a coincidence though and they are not responsible for Coronavirus (seeing patterns like relationships that don’t actually exists is called patternicity or apophenia). 

In China, wet markets like the one in Wuhan supply the population with all animals for food such as palm civets, bats, pangolins, dogs, ducks, geese, chickens, and all manner of other wildlife. Yes, I said dogs. It is a wet market because animals are mostly live and can be killed and cut up for you by the vendor. Videos coming out of these wet markets are disturbing and gut wrenching, especially for animal lovers. 

So when one animal is a natural reservoir for a virus, and it exists in very close proximity in its wild form to humans, the jump from animal to humans is not that hard to make. All it takes from there is a small mutation to allow the virus to infect humans, and boom. Potentially deadly new disease. 

SARS CoV-2 has had at least two genetic mutations so far (that we know of). The first was when it mutated to infect humans, and the second was when it diversified into two strains. So to make matters worse, we have two strains of the virus – S and L. This is not unusual though and not necessarily more deadly. Viruses create copies of themselves once they have infected a host, and each time they copy there are changes or potential changes in their structure. The good news so far is that this strain appears to be mutating slowly. 

How Infection is this Thing?

Very. One of the reasons it has spread so far and so fast and become a pandemic rather than an outbreak is that it is very easy to pass on. 

The basic reproduction rate, or R0 (pronounced R nought), is the number of cases that can be expected from one case. In basic terms it is the number of people you will infect if infected. When an R0 is below 1, spread dies off very quickly. When an R0 is 1 or just above there is a slow rate of “exponential growth”. With a higher R0, the spread of an infection is much, much higher and gets out of control much quicker. 

One of the fastest spreading diseases is measles with an R0 of 12 - 18. Ebola is 1.5 – 2.5. Influenza, is 1.3 – 1.4. SARS Cov-2 is 3. 

Influenza outbreaks are easy to contain, generally speaking, because of a variety of reasons. The flu is a “human virus” meaning that even after mutation our immune system “remembers it” and is primed to fight it off. In addition to this, we have herd immunity, which is the immunity conferred by the herd or population. This means that more people have developed immunity to the disease and therefore do not get it or spread it. The other reason is because we have a vaccine for the flu. All of these things together mean that while flu outbreaks are common (we have regular flu seasons) it is relatively easy to contain. Ebola is relatively easy to contain because it is a “hot” virus. This means it has a very high mortality rate with a small window during which one person can infect another. Ebola also requires the transmission of bodily fluids through direct contact. It cannot yet be passed indirectly such as through the air (it is not airborne). 

SARS CoV-2 is a much bigger problem. Not only can it live on surfaces for a very long time (it has been found on surfaces on cruise ships 17 days after infected people have been removed), it can be passed through droplets in the air and by contact with other items. It has been shown to survive on surfaces such as carboard, plastics, and metals anywhere from 24 hours to 3 days and more. Touch that, touch your face, potential new case. Another reason this one is so problematic is that you don’t become symptomatic for as long as 14 - 21 days. In short, because you don’t know you are sick, you do not see a doctor and you do not isolate. During this time you are able to pass the infection onto others, while with some viruses you are not infectious until you are symptomatic.  

Exponential growth refers to the way something increases in quantity over time. The higher the R0, the higher the exponential growth. You might have heard health officials referring to this as a hockey stick, because the rate of growth looks like a hockey stick laid flat on the ground with the curve poking upwards into the air. So how does the flu compare to SARS Cov-2? 

This is what the numbers look like (based on an average of 1.35 people infected by the flu and 3 being infected by an infected person with Corona): 
Flu                                                        SARS CoV-2 
You      Others                                    You        Others
1.35      1.,35                                          3             3
            1.82                                                         9
            2.46                                                        27
            3.32                                                        81
            4.84                                                      243
            6.05                                                      729
            8.17                                                      2187
           11.03                                                    6561
           14.89                                                   19683
 

Each time the infection is passed on to another this is called a generation. So if you originally contract the infection and pass it to another, that is one generation. The numbers above show 10 generations of transmission, that is, the infection has been passed along 9 times from the originally infected person. If you have flu, after 10 generations (including you) you have infected 14.89 people. That’s not a horrible situation. But what does it look like for SARS CoV-2? If I pass the infection along and that lasts for 9 more generations I have infected 19,683 people. That’s how we end up with pandemics. 

So why don’t we have 19,683 cases? Because we have testing for those at high risk, we have isolation for proven cases, and because social distancing and good hygiene are helping to slow the spread. The above numbers are an “if we do nothing” scenario, which is why doing SOMETHING is vital. 
Why Didn't the Schools Close?

The schools remained open for a variety of reasons. The infection profile for Australia had very, very few cases in those under 19 years of age. Up until recently, there were only 20 cases Australia wide in those 19 years or younger. Scientists haven’t yet figured out why, but children and young adults don’t seem to be getting this infection. To add to this, about 30% of healthcare workers and 50% of retail workers have children in school. The numbers for other emergency services are also quite high. Taking children out of school takes these workers out of the workforce gutting our first line responders to the pandemic and limiting our ability to slow its progress. 

In short, school children were not getting infected and it was a calculated risk to leave them in school so some industries weren’t gutted. Based on information we have right now, that did not increase the rate of infection at all. 
What Can I Do About It?

This things is bad. Not only is it going to create a massive burden on health systems worldwide, it has already created large scale unemployment and global stock markets have taken a hit. Small businesses will be the first to go under, and the longer this lasts the more businesses will suffer. But all is not lost. 

The government has enacted certain measures but this has not been decisive or swift enough. Other countries that had already gone into lock down begged us to follow suit, but we started with small measures that had no effect in flattening the curve, in fact, our curve keeps getting steeper and steeper. 

What does flattening the curve mean? The curve means we have a growing rate of infection while we need the opposite. This needs to flatten out because as the number of cases increases the general burden on the healthcare system increases, as does the potential for fatal cases. While you would have heard “it’s just like the flu for most people” or “it only affects elderly people” many of these came from the start of the infection cycle and are no longer necessarily true (though it is true for many they will have mild symptoms). For example, the infection profile for Australia is relatively flat at the moment that means young people are almost equally likely as older people to contract the virus. This means that SARS CoV-2 is infecting both the young and the old alike. The global infection profile has 40% of the infections between 30 and 59 years of age. It is true however, that it is more dangerous for elderly people. But it is also dangerous for those with poor immune systems, people with cancer, people with pre-existing respiratory problems, and a number of other conditions. 

If we don’t flatten the exponential growth, then the health system with only so many ICU beds with become absolutely overwhelmed with critical care cases. There literally will not be enough beds and ventilators to help everyone. Our doctors will have to make the same gut churning decisions that doctors in Italy and elsewhere are having to make: deciding which of the patients lining the hospital hallways gets to live and which has to die. This scenario is not some Orwellian nightmare. It is playing out in European hospitals as you sit reading this. 

So what can you do to help flatten the curve? It is actually very simple and easy. Small changes can make big differences. Failing to do this though will mean tougher and tougher restrictions from the government, which will mean more and more job losses and crippling effects on the economy. 

1. Wash your hands. Pretty simple right? One of the easiest ways to infect other people is by carrying virus particles around on your hands. Wet your hands first, then apply soap. Rub the palms together, then rub the back of the left hand with the palm of the right and vice versa. Lace the fingers together and get deep into the webbing of the fingers. Then bend the fingers towards the palm and lock both hands together, rubbing side to side. This needs to be done for 20 seconds or about as long as it takes to sing happy birthday to me, twice. When you rinse off your hands, rinse from the wrist down removing any remaining nasties into the drain. 

2. Stop touching people. Seriously, cut it out. A woman got corona from taking a selfie with Tom Hanks. Hugging friends and people you run into on the street and shaking hands is an easy way to communicate corona. How do you think the royals and other politicians got it? Going to meetings and shaking hands! They estimate that shaking hands has an over 90% chance of passing along corona, a fist bump reduces this to 75% or so, and an elbow bump to less than 25%. Doing none of these things, they estimate the chance as significantly less than 5%. 

3. Wash and disinfect surfaces regularly. If this thing can live on surfaces cleaning them with good disinfectant will significantly reduce yours and your family’s risk of getting sick. Carry a bottle of sanitiser with you and use it after you use a public bathroom or go to the shops. Carry wipes in the car with you and wipe down fuel pumps and other surfaces before use. Wipe down gear sticks, indicators, and door handles regularly, especially if you have had other people in the car. 

4. Work from home if you can. Scientists estimate that if 80% of people stayed home we could nip this in the bud very quickly. That’s because it reduces incidental infection. This means we could flatten the curve more quickly. 

5. Don’t go out unless you have to. Yes, I get we all like fishing. I get that kayak fishing is a social distancing activity by nature. I get that this sucks, and that people are scared and frustrated. But the more we go out the greater chance there is of spread. Using walking tracks etc is good for your mental and physical health, and no you don’t hug everyone you meet on the path (I hope!) But there are cases of transmission where there is no physical contact between people which means that you can get coronavirus through close contact alone. You don’t know whether someone on the path before you sneezed into the air, and you don’t know that gentle southerly breeze blowing into your face and keeping you cool doesn’t carry viral particles with it. Research has shown that viruses can carry for hundreds of metres on the wind. You don’t know that the handrail you used to climb that stair isn’t covered with viral particles from the last person who touched it. You might realise you forgot your water and must stop at a servo to grab a bottle, or you might really feel like a Krispy Kreme on your way out. This will all increase your risk of infection and slow the flattening of the curve. 

6. Follow the advice given on public gatherings. This is based on the best medical and scientific advice we currently have. While you might think it is OK to grab a group of your mates together, you are risking spreading the infection should anyone have it. A group of 35 people defied the warnings and had a party. One person had Coronavirus, now all 35 people have it. Doctors have stopped doing non-necessary surgeries now not because they need the beds, but because we really can’t afford for doctors to get sick and be taken off the line right now. Directives are given for a reason. 

If we don’t all do these simple things, we are almost guaranteeing that increasingly tougher measures will be introduced, this will mean greater loss of income and industry, less and less fishing, and a much, much, much longer recovery period. Not only from the virus, but from the effects of a pandemic. If things should miraculously go back to normal at some point in the not too distant future, we should all still live cautiously. We all need to work as members of a group at this point, and put our own personal interests in the back seat, for now at least. If we don’t, we will all pay the price in the long run. 

And we are almost guaranteed a second wave of this thing without a cure or vaccine. so being prepared and being compliant will dictate how much of an impact this has on all of our lives.
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