COVID-19...There's nothing mild about it

I am sure each of us are reacting to this existential crisis in different ways—from positivity, prayers, gloom and doom thoughts, to downright denial “this is all hype, it won’t happen to me”.  Deep down the root of these reactions is anxiety and anger because for once we are truly not in control—an innocuous trip to the store to buy milk could be life-altering. At a time like this the information we seek, consume, and share becomes even more important, not only for our mental well-being, but for the safety of others as well. There are already millions of articles out on the internet on this disease. I write this post really for my own sanity, it’s my own way of letting off steam because I think I will throw up if I see one more conversation about shit like “build herd immunity” or a horoscope that predicts the “disappearance” of COVID-19.

So here are some phrases/questions that have caught my attention time and again, and I have tried to summarise answers, with reference links if you wish to read more. First things first – COVID-19 is the name of the ‘disease’ and SARS-CoV-2 is the name of the virus which causes COVID-19.

It is important to understand how the immune system works at an individual level. Your immune system is programmed to fight against ‘foreign’ bodies, such as bacteria and virus, that invade your system to cause harm. For your immune system to work well it must identify these as harmful bodies, and attack only such cells. Here is a lousy analogy – for your immune system to “identify” an invader, it must have a blueprint or a photograph – like a police station having the wall of posters with mugshots of “most wanted”.  So when you have a common cold (which you’ve had a number of times over your life course) your immune system is already equipped with a “blueprint” or a mug shot of this invader. So it knows the right weapons to use, or in science terms, it can produce the required “antibodies” to kill each and every invading cell.

What happens when the invader is “new”? Your immune system has no “blueprint”, but still, it is programmed to put up a fight, it knows some foreign body has invaded the system. But it is like fighting against an enemy whom you’ve never dealt with before; the enemy has weapons you’ve never trained on, the enemy uses a strategy you are not familiar with. These are bitter battles – some are won, some are lost. Have you seen footages of war-ravaged cities in the recent past where everything reduced to rubble? That’s your body inside, having waged a war with this new enemy. So don’t be under the false complacency that a virus will not infect you because of your ethnicity. Not only will you endanger yourself, but you will also put others in danger.

If you want to learn more about immunology – please go through these lectures - https://www.youtube.com/watch?v=gKkvTXLvbhsand https://www.youtube.com/watch?v=mFNxXfwlP3A

You can also follow Peter Kolchinsky, a virologist, on twitter who explains, in a very simple language, how viruses work. Some threads for you –

If you want to understand the virus tree of coronavirus, take a look at this infographic –

Well, first of all, “Car accident” or “heart attacks” are not contagious. The “regular flu” is seasonal; most countries have an internal strategy to ramp up resources in their hospitals to treat a heightened influx of patients during flu seasons. In the case of the new COVID-19, here are things we know – it is highly contagious; there is community transmission; it can take down even healthy individuals. In this scenario, what does a lockdown achieve? First, it cuts down community transmission – the less people are in touch, the less opportunity for the virus to spread. Second, it gives the medical infrastructure of a country to gear up. In an ideal scenario, the doctors and hospitals should have been kitted out to take on this new and sudden influx of patients. But as we are sadly seeing in UK and the USA – the governments did not understand, and/or they turned a blind eye to the fact that their medical front-line is not protected and equipped. The latest news is that more than a 100 doctors have died due to COVID-19 in Italy (https://www.france24.com/en/20200409-italy-says-number-of-doctors-killed-by-coronavirus-passes-100). In the UK, as of now 19 health workers have died and the numbers will sadly climb because our gormless health secretary still has no clear answers about providing PPE to the frontline workers.

So coming back to the question about “why the hype” – the fact that doctors and nurses need PPE to treat COVID-19 patients should alert one to the fact that this is not “just a flu”. The fact that countries have shut down – let me repeat that – ENTIRE countries have shut down despite the crippling effect on the economy, should give you a hint why this is so, so serious. Here is an infographic on how the disease spread in South Korea, which should help you understand why COVID-19 is so infectious, and why social distancing and lockdowns are not a hype  –

Unfortunately, there are very few newspapers that have documented lived experiences of this flu. So we must be grateful to those brave survivors who have documented their survival on social media, so the rest of us can be aware. Here are commonalities of this plague based on first-person accounts I’ve read–

Here are two first-person accounts you can read - https://twitter.com/TaranaBurke/status/1248255554398674944?s=20

Bottomline – there is NOTHING mild about this disease. This is not “just a flu”. 

In the true sense, herd immunity refers to a situation where a vast majority of a population has an immunity against a certain disease, so there is very little threshold for a virus/bacteria to take a foothold in that populace. How is this herd immunity built? By mass immunisation measures such as administering vaccines to a large population set.  

In the context of COVID-19, herd immunity was a monstrous strategy allegedly adopted by the UK government when it finally woke up to the situation in the beginning of March. At that point in time, a discourse had been built that COVID-19 predominantly affects the elderly and the immunocompromised. Going by various media briefings, it appeared the UK government’s strategy was to allow as many ‘non-vulnerable’ people as possible to get infected, (they called THIS as building herd immunity), and meanwhile, the health services can then cope with the more critical cases. The sheer inhumanness of this proposal, and the decision to simply ignore WHO’s pragmatic advice to test, track and isolate, caused a widespread uproar in the public as well as in the scientific community (https://www.theguardian.com/commentisfree/2020/mar/15/epidemiologist-britain-herd-immunity-coronavirus-covid-19).  

So now “herd immunity” seems to have caught the fancy of some people, just like pop psychology narratives, especially the antivaxers. The common question is why can’t we just get the disease and build immunity “naturally”? Sure, whatever floats your boat. Why stop at COVID-19? Why don’t you expose yourself to ebola, HIV, or rabies and see how it goes? Stay isolated whilst you build your immunity though.

There is no cure for COVID-19 as of now. A ‘cure’ typically would be a vaccine. A vaccine contains a “blueprint” of the virus – like a specific molecular string or its DNA/RNA – it is like submitting a photograph to your body’s immune system – attack if someone who looks like this enters the body. Given COVID-19 is a pandemic, an ideal situation would be if a majority of us can get vaccinated so the disease can no longer spread.

HCQ is used as a malarial vaccine. The active ingredient of HCQ has been known to reduce inflammation effectively. Hence, HCQ is also prescribed for patients suffering from debilitating rheumatoid arthritis, and lupus which is auto-immune disease that causes inflammation amongst other things. Bear in mind HCQ also has scary side effects. In the case of COVID-19 patients, especially those in the critical stage, widespread inflammation in the lungs has been observed because of a phenomenon called cytokine storm, where your immune system goes on an overdrive in the fight against the disease, potentially killing healthy cells as collateral damage. This kind of inflammation is lethal, and this is what is causing COVID-19 deaths.  It is thought that HCQ can reduce/control this inflammation, giving the body a fighting chance to survive. Remdesivir (RDV) is another drug that is considered as a potential treatment. In this case RDV is known to prevent RNA of the virus from replication. Read more here (https://www.forbes.com/sites/coronavirusfrontlines/2020/04/08/this-virus-expert-explains-what-the-data-really-shows-about-two-treatments-for-covid-19-coronavirus/#e06351d1a356)

Stay informed and stay safe. And maybe in the next election, swallow whatever racial, sexual, and class prejudices you have, and do vote for a party that wants to increase your taxes so that you and your children get a better health system and education system. Because, god forbid, if you are on that ICU bed, that fancy new bomb your government built is not going to help you, neither is your pseudo- national pride. The only thing that stands between you and death is that selfless doctor who, most probably, hails from a community/class/country/gender that you were taught to hate and mistrust.