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Virus here to stay

More than 800 000 cases of Covid-19 has been confirmed across the globe at the time of going to press on Wednesday (01/04).

According to the World Health Organisation (WHO) it took more than three months to reach the first 100 000 confirmed cases, and only 12 days to reach the next 100 000, a sign that the speed of transmission is increasing.

In a recent major coronavirus outbreak, SARS, in 2002 to 2003, it took six months for cases to exceed 5 000 in mainland China. Covid-19 did that in just one month.

David Duong, an instructor in Global Health and Social Medicine at the Harvard Medical School and a director of Global Primary Care and Social Change, and a member of the World Economic Forum’s (WEF) Global Future Council on Health and Healthcare, and his colleague Todd Pollack, assistant Professor of Medicine at the Harvard Medical School and country director for the Partnership for Health Advancement in Vietnam, a Harvard Medical School Global Program, explain some of what we know about Covid-19.

Pollack says there are two major ways that the virus is thought to spread – from person to person through respiratory droplets when an infected person coughs or sneezes, and from contact with contaminated surfaces, where the virus can survive for hours to days at a time. In this case, a person can get Covid-19 by touching a surface that has the virus on it, and then touching their eyes, nose or mouth.

Pollack says that with influenza there is a seasonal pattern – it spikes up in the winter and goes down in the summer. But is it the virus itself or are there other factors? The four factors to look at are the environment, so the temperature and humidity. Then the human factor: we tend to stay indoors, closer to one another (in winter months) and that increases transmissibility. Pollack says the third influence is our immune system.

“There is some hypotheses that our immune system is lowered in colder months because those of us in the northern hemisphere don’t see the sun as much and the sun helps generate vitamin D, which is an immune-system booster. The fourth thing is the ability for the virus itself to replicate given the number of susceptible hosts – as the proportion of susceptible contacts declines, the epidemic peaks, and eventually declines,” he says.

Pollack says we have to take all those factors into account.

“Coronaviruses are enveloped viruses and the envelope itself tends to be a bit more fragile with increased heat and increased humidity. But that is not the case for all enveloped viruses,” says Duong.

Studies that came out of the Middle East around MERS-CoV, the last coronavirus epidemic, found that it did prefer colder temperatures and lower humidity. With the SARS one, it tended to follow that as well. But it did not go away because of warmer weather, but rather because of the political choices that were put into place to control that epidemic, such as social distancing and isolating cases and quarantining their contacts.

“And that was the major reason we saw the SARS epidemic go away; SARS did not go away because of the warmer temperature effect. So, with the new virus, the SARS-CoV-2, which causes Covid-19, although we could expect it to behave like other coronaviruses, at this point in time, we just don’t know. And we don’t have enough data because it’s so new, so for entire economies or countries to make policy decisions based on the behaviour of other similar viruses would not be prudent or advisable,” says Pollack.

He says people should understand that even if they are at lower risk for serious health consequences, they can contribute to the continual spread of the virus in their community, which affects those who are at higher risk of a bad outcome. That is the purpose of social distancing and everyone should take it seriously even if their individual risk is low.

“This is a ‘novel’ virus for a reason. Because it’s so new, we don’t understand much about it and the science is still changing. Howe­ver, given what we do know, the best thing that the general public can do right now, is to ‘flatten the curve’ through social distancing measures. And we know that soap and water helps kill the virus. So wash your hands, practice social distancing, and if you have symptoms, report them and pay attention to them. But we need to be prepared for uncertainty.

“We should all be prepared for the fact that Covid-19 is likely to be an issue for some time to come,” concludes Pollack. WEF

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