It is all over the internet and the conventional media, panic has stricken people from all around the world as the World Health Organisation declares COVID-19 as a Pandemic. Sikkim and the neighbouring North-Eastern states, as of this day, Monday, 16th March, hasn’t had any confirmed cases of Coronavirus patients so far, but what does this mean for the days to come? Before I begin with the article, I would like to state that whatever information that I am going to share is derived from interviews, research and talks presented by the trusted professionals. However, I recommend that you read this article with a grain of salt because I am just a guy on the internet hammering his keyboard. Having said that, I will be providing the links to the materials I have studied (while writing this article) below.
Sam Harris interviews Nicholas A. Christakis, MD, PhD, MPH, the Sterling Professor of Social and Natural Science at Yale University, where he directs the Human Nature Lab and is the Co-Director of the Yale Institute for Network Science.
A mathematician named Adam Kucharski who uses mathematical models to understand the spread of Pandemics and how it can be controlled. His models have been used during the outspread of Ebola and Zika to understand the spread of these diseases.
Alanna Shaikh talks about the spread of COVID-19 and how can an individual stay resilient in such tumultuous times.
4. WHO, World Health Organisation: Almost all the resources and research I have studied have been compiled by what I have learned by compulsively scrolling through the WHO website.
I was recently going through a TED Interview featuring Adam Kucharski, a mathematician who created mathematical models to understand how and why pandemics spread across the world and what could be done to mitigate the risks of such diseases. He has very recently released his book called, The Rules of Contagion: Why Things Spread and Why they spread on and I was inclined to read the summary which quite strongly talks about the spreading of diseases leading to a Pandemic. It does not specifically touch upon Coronavirus per se, but can be used to understand how it spreads from person to person. I will be using his mathematical models, as done by various other professionals studying this disease to understand the spread of COVID-19. Don’t worry if math isn’t your cup of tea, it isn’t mine either. The formula he gives in his book is fairly simple to understand.
In his book, Kucharski gives a mathematical formula that helps us calculate how fast a particular disease might spread and how can we stop them:
The formula is: R= Duration X Opportunities X Transmission Probability X Susceptibility
Where R denotes the Reproduction factor or how many times a person is likely to be infected by the virus and to pass it onto to someone else. The aim is always to get R below 1. If it is above number 1, it means that the disease is currently being spread and is growing.
The spread of the Coronavirus is found to be very easy as when an infected person coughs and sneezes, the virus lands on the surface and has the potential to stay alive for several hours- as a recent study showed that the virus remains alive in surfaces made of plastic and stainless steel for up to 72 hours and on cardboard for up to 24 hours.
To calculate the Reproduction factor, we need to know Duration, Opportunities, Transmission Probability and Susceptibility or in short, DOTS.
When a non-infected person touches the contaminated surface and touches their face, mouth or eyes, they get infected. There is no vaccine for any of the Coronavirus because creating vaccines for emergency pandemics become very tricky as the investors do not necessarily want to invest in the drug industry in the chance that a pandemic might occur. Pandemics occur for a short period and it is not a vested interest of any investors to invest and reap the profits for only a small time.
As far as the ‘D’ of the equation is concerned, which is duration, it simply means how long has a person been infected. If someone is infected thrice as long, then they are thrice as likely to spread the disease. In the case of Coronavirus disease, the symptoms do not appear until one or two weeks of being infected by the virus. Which means to say, that you might be infected multiple times before even showing any symptoms at all.
Coronavirus belongs to a larger family of Coronaviruses, which includes the virus that led to the SARS outbreak in 2002 and Middle East Respiratory Disease that sprung up in 2012. The official name of the Coronavirus is “Severe Acute Respiratory Syndrome Coronavirus 2” or SARS-COV-2 which was detected in December 2019 in Wuhan, China. This virus causes a disease named as COVID-19. Almost 80% of the infected population recover without any special treatment and about 1 in 6 infected people end up developing a serious illness, older people with underlying medical ailments are more likely to come down with serious issues. India has witnessed two deaths so far, one in Karnataka and the other in Delhi,
The “O” in the equation stands for opportunity and it suggests the number of infected people you get in touch with every day. In the case of Coronavirus, an infected person who is not showing any symptoms is also very highly likely to spread the disease and you might also be interacting frequently with an infected person without even realizing it. India has by far reported 110 cases of COVID infected patients.
Coronavirus affects the lungs and is not spread from Mosquitoes, getting goods manufactured from China and the disease can not be cured by taking garlic, cow urine, and aloe vera juice. Recently, my sister who resides in Bangalore got told by the Autowala to return to China, and I want to state that you can’t stop the spread of Coronavirus disease by telling your friends from Northeast India to go back to China.
The “T”, which is the Transmission probability, is the measure of the chance of the infection getting spread from one person to another person in a single interaction. Since Sikkim Government has allowed for travel restrictions, that too is affecting the transmission probability such that it remains low as it was seen in Wuhan, China, that the transmission had gone down after restricting travel. However, new outbreaks are likely to emerge. Finally the “S”, susceptibility is measured by the chance of the non-infected person to catch the disease in one interaction. One thing to be wary of is the mortality numbers in a particular area. If there is a single death in an area, it suggests that the person was infected about nearly three weeks ago. Initially, there might have been 100 numbers of people being affected by the person who died and during the three weeks, the number could have been increased exponentially to 500 or 1000.
Masks are mostly for the medical health providers and besides, it does very little to safeguard yourself from the disease. There is a worldwide shortage of masks and it would be a whole lot better if we didn’t stack it in our shelves. Hand sanitizers appear to be sold out in the markets and it will be restocked soon, but that does not mean it is the only solution, a good soap can do wonders if you use it regularly. Also, I don’t think cancelling schools is a good idea, because a lot of our health-care providers have children going to school, and we don’t want to make the situation worse for them than it already is. In the TED talk presented by Alanna Shaikh, she states very clearly that washing our hands and sanitizing our phones are the biggest changes we could do to prevent the outspread of the disease.
As far as the progress on vaccines is considered, a biotech firm known as Moderna has had a promising head start so far by using the m-RNA technology, yes, the messenger RNA we studied in Biology class, to develop a vaccine candidate for the Coronaviruses vaccine research. It took Moderna 42 days after the genome of the Coronavirus was decoded by a Chinese scientist in January 2020 to develop their first vaccine candidate. They plan to start the first human trial of their vaccine in Seattle, Washington but it will take three months or more to show that it is safe and after that, the Phase 2 of the trial will begin to show if it works. This is necessary to ensure that the vaccine does not prove to be counterproductive and to check for its effectiveness.
Despite so many deaths happening all around the world, business is as usual in Sikkim. I do not mean to instil panic or state that we are not doing enough but a slight bit of overreaction could take us a long way. I understand that there haven’t been any cases of COVID-19 as of this day, but that does not mean we need not prepare. There’s a high chance that the disease might enter the gates someday and if it catches us unprepared, there’s only little we could do. We should start building cues and routines to wash our hands, to avoid touching our faces and most importantly, staying indoors if we suspect any illness at all. Most cases appear to be mild, but it is potentially dangerous for the elderly.
Johnson & Johnson is also working with a company named as Barda to develop the vaccine for Coronaviruses using deactivated Coronavirus but the most promising company according to the World Health Organisation (WHO) is Gilead and its drug Remdesivir which is currently being tested at the epicentre of the outbreak in Wuhan, China. Within a few months, the drug will run through multiple trial phases to check for its usability and effectiveness and if it works, its implementation will be done as soon as possible. However, accelerated testing will lead to even greater risks and we don’t want to make it worse than it already is. In terms of vaccines, the US has moved into a pace we have never seen before but it will still take a year to year and a half until they have a vaccine broadly available to deploy.
Instead of waiting for the disease to arrive, we should all start taking the precautions very seriously. This is all a common advice you hear from a day to day basis, but that does not make it less true and again, yes, you need to wash your hands. Set a reminder in your phone, set a trigger, wash your hands regularly and if you might rub your clean hands with cut onion, you might stop it from touching your face that often. So as long as the vaccines and medications are being developed, teach yourself all the precautionary steps. Other than that, immunity plays a huge role and there are various methods or techniques you could implement to increase your immunity. Please don’t forward false information in such tumultuous times, you are simply adding fuel to the fire if you are doing so and try to self isolate as much as possible. Remember that this Pandemic can be stopped only if we come together (not literally) and prevent it from spreading by taking the necessary actions.
The Redendron team wishes you and your family well.