I wanted to continue my discussion of the novel coronavirus (Covid-19) that was first identified in Wuhan City, China. It is spreading quickly and leaving it’s mark. Many are succumbing to the grips of the virus, particularly our elderly population, those with underlying respiratory conditions and/or immunocompromised. To date, there are over 320,000 confirmed cases of the infection, claiming almost 14,000 lives worldwide. In NC alone, almost 6500 test have been administered, resulting in 255 confirmed cases. Gratefully, none of those positive tests have resulted in any fatalities. However, the efforts of the COVID-19 response team lead the governor of our state to issue several Executive Orders, including declaring a state of emergency, closing all schools and restricting restaurants and mass gatherings. These are unprecedented measures being taken at an attempt to flatten the predicted bell curve that represents the course of this viral disease. Flattening the curve would result if we are able to avoid too many people getting sick at the same time especially since resources are limited. If less people are infected then the peak of the curve would be lower than expected and we would be successful in flattening the curve.
One of the interesting findings that has emerged from the review of Covid-19 cases is the problem of asymptomatic transmission. Researchers in Texas, in the field of infectious disease found that at least 10% of cases, in a chain of transmission, included patients that were infected by somebody who has the virus but does not yet have symptoms. They were able to calculate the serial interval to be 4 days. To the measure serial interval, the scientists take into account the time it takes for symptoms to appear between two infected people: how long it takes for the infection to spread. Apparently, the 4 day serial interval is very short , attributing to why the COVID-19 outbreaks is spreading so quickly and is predicted to be difficult to eradicate which is the reason why officials are moving quickly and aggressively to curb the impending threat. In fact, asymptomatic transmission makes containment more difficult and explains why “extensive control measures including isolation, quarantine, school closures, travel restrictions and cancellation of mass gatherings may be warranted.” A CNN report of 24 passengers on a flight to Israel where seven of the 24 passengers tested positive for coronavirus. Interestingly, four of the seven passengers displayed no symptoms, yet when specimens were tested, it was discovered that the viral load of the four asymptomatic specimens were higher than the viral load of the three symptomatic specimens. The viral load tells us the relative concentration of virus in someone’s respiratory secretions and a higher load is synonymous with someone that is more likely to spread the infection to other people.
Speaking of spreading infection, I read an interesting article entitled, “A coronavirus cautionary tale from Italy: Don’t do what we did”. The article revealed how citizens refused to change their behavior because Italians failed to take the virus seriously. Also, the information coming from the government were less-than-urgent appeals to the public to slightly change habits regarding social interactions. However, many Italians “just didn’t see the need to change our routines for a threat we could not see.” The result of ignoring a situation that could have been preventable is that now the country is in lockdown and thousands of people are needlessly dying. Apparently, the number of deaths are disproportionate in Italy due to its large elderly population. Additionally, the hospitals were not equipped to handle the massive number of cases and it reminded a health care worker of “war time” where difficult triage decisions needed to be made about who to treat and who not. Many are saying that the overload to the health care system put it on the verge of collapse. Consequently, there just wasn’t enough beds for everyone so some people who were not able to get medical care were just dying in their homes. The warning went out to the US because we only have roughly 45K ICU beds but the outbreak is predicted to need more that 200K ICU beds if we are not successful in flattening the curve. The author remorsefully remarks that “when everybody’s health is at stake, true freedom is to follow instructions.” I hope many of us heed the warning and stay home as much as possible so we don’t have regrets and lose countless lives prematurely in death because COVID-19 created inconveniences in our lives that we didn’t want to adhere to.
Microbiology and You 