Education on COVID-19

March 28, 2020

As I read more about Coronavirus, I wanted my family and friends to know about a few things and to call out to God in prayer. 

The definition of pandemic means a disease is prevalent over a whole country or the world. The definition of epidemic is a widespread occurrence of an infectious disease in a community at a particular time. The coronavirus started as an epidemic in Wuhan China and became a pandemic. Coronaviruses are a large family of viruses that cause common colds in people but they also infect other animals and different species. Throughout history, we know that viruses mutate constantly and at times they can become highly infectious and virulent. Corona means the upper portion or crown of a part, as of the head as appears in the electron microscope. This is an example diagram of Coronavirus from Google.

The Severe Acute Respiratory syndrome COronaVirus 2 (SAR-COV-2) and the disease it causes, Coronavirus disease 2019 (COVID-19) is known to have initiated from Wuhan China in December, 2019. The most common symptoms are reported as fever, dry cough and shortness of breath. The test is by polymerase chain reaction (PCR) from a nasopharyngeal swab. The New York Times Coronavirus dashboard as of today reported more than 606,200 people are infected and at least 28,050 people have died. The US Coronavirus cases and the number of deaths are continually rising. On 3/1/2020, New York Times headline reported “How prepared is the US for a Coronavirus outbreak?” and now merely within a month, we know we were not prepared. 

According to the Center for Disease Control (CDC) records, flu season in the US which runs from October through May claims 29,000 to 59,000 lives, with most common cause of death from complications such as pneumonia, heart attacks and strokes. Last year, an estimated 80,000 Americans died of flu which was the highest death toll in at least four decades. The death rate from influenza (flu) is generally a fraction of 1% (0.1% to be exact) but the Coronavirus induced death rate is over 1%, (reaching 4.7% today worldwide),  so it is at least 10 times more than seasonal flu.

In 1918, a flu pandemic caused by an H1N1 virus which lasted nearly 2 years killed more than 50 million and infected 500 million (1/3 of the world’s population). It is reported that H1N1 virus originated from genes of avian (bird) origin. In that era, there were no vaccines, antibiotics and medical facilities with ventilators like today and the only way to combat the pandemic was by isolation, quarantine, good personal hygiene, use of disinfectants and limitations of public gatherings; non-pharmaceutical intervention.

In 1957-58, a new influenza (H2N2) virus emerged in East Asia spreading a pandemic (Asian Flu). This virus was first reported in Singapore in February of 1957, Hong Kong in April of 1957, and in coastal cities in the US in summer of 1957, according to the CDC records. The estimated death numbered 1.1 million, with 116,000 of those in the US. This virus originated from Avian Influenza A.

In 1968, Pandemic H3N2 virus comprised a new mutated Avian influenza A. And again in 2009 a novel (new) influenza A (H1N1) virus (H1N1)pdm09 virus, otherwise known as swine flu arose, implicating its origin from swine, occurred in the spring.

The current COVID-19 is thought to have arisen from smuggled pangolins used for both food and medicine. Another possibility is bats, because these two animals have similar genetic codes as in coronavirus. Exactly how the virus jumped from a wild animal to other animals or humans remains a mystery.

According the recent publication in JAMA, the mechanisms leading to death by coronavirus is by filling the lungs with fluid as seen in congestive heart failure symptoms. Human lung is like a tree branching with the end of the tree twigs having grapes with empty sacs. These sacs have a thin membrane which transports oxygen molecule, which is absorbed into the blood flow to provide life to all cells within the body. With COVID-19 infections leading to death, all these grape-like sacs are filled with fluid which leads to inability for oxygen transport. By imaging, the radiologists describe the condition as the “ground glass opacity”. The ventilator is the only way to deliver some oxygen by pushing positive pressure into the lungs. The strong pressure can cause these sacs to “pop” (causing atelectasis) which will damage to the lung permanently. More chronic consequence is the fibrosis/thickening of sac membrane. COVID 19 infection causes this kind of dire situation very fast (within 1-3 days). As in all flus, the most devastating effects are seen in elderly, diabetes, immune deficient populations and other pre-existing medical conditions. 

Knowing these facts, and the history of pandemics, what can we deduce from then and what do we do now? We wait for the specific vaccine against COVID-19. Until then, we go back to what we do know in how to combat the virus; non-pharmaceutical intervention. As we are changing the life style of norms, it is perhaps easy to blame others-governments, organizations such as CDC, WHO, the people of Wuhan China, the President, by saying “only if… “ Strangely, we are so connected by a few people in Wuhan China; their business of what they eat and do are no longer just their business but we are so intimately affected. Their business is now our business whether we like it or not. So, shall we blame the Chinese? What if the next strain of virus comes from a small town in the US? 

When one thinks like the virus, the success depends on the reproduction, increase in potency and easy transport by new and clever mutation of genetic codes and it has nothing to do with the boundaries, races, ages, genders etc. The question we need to ask is when is the next pandemic, and not if. 

As we fight against with this virus today, the only logical way is to distance from each other to stop the spread which will cause less burden to our health care workers and their resources. Most of the health care workers are prepared to fall and are ready to die for the sick. It is their dedication to sick people and promise to the professional Hippocratic oath.

There are always two perspectives and we can choose to see one way or another. One good thing is we have the social media, a technology to connect to the ends of the earth through your phone. We are not alone and thank God for this.

The other thing we can do together is to pray the prayers David had in Psalm 86, 1-3,11-13.

Bend down, O Lord and hear my prayer, answer me for I need your help. Protect me, for I am devoted to you. Save me, for I serve you and trust you. You are my God. Be merciful to me God, for I am calling on you constantly.

Teach me your ways, O Lord that I may live according to your truth. Grant me purity of heart so that I may honor you. With all my heart I will praise you, O Lord, my God. I will give glory to your name forever, for your love for me is very great. You have rescued me from the depths of death.

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