The Covid 19 Pandemic: A Historian’s Reading

By Opinion Time of article published Sep 8, 2021

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By Dr Vusi Shongwe

“The single biggest threat to man’s continued dominance on this planet is the virus,” – Nobel Prize-Winning Biologist Joshua Lederberg

My people are destroyed due to lack of knowledge - Hosea 4:6

There is a cult of ignorance in the United States (I dare say the whole world), and there always has been. The strain of anti-intellectualism has been a constant thread winding its way through out political and cultural life, nurtured by the false notion that democracy means that "my ignorance is just as good as your knowledge." – Isaac Asimov

Ignorance is a virus – an old adage - attributed to Neil deGrasse

Few people, if any, given the ragingly and dreadfully deadliest Corona virus, would disagree with Joshua Lederberg. There is absolutely nothing that could potentially do as much devastating damage as a virus. For example, the Smallpox killed up to half a billion people in the twentieth century alone, before its attenuation and, finally, its eradication in the nineteen-seventies. Then came the Ebola virus, which was discovered in 1976 by a Congolese Doctor, Dr Jean Jacques Muyembe Tamfum, who was a microbiologist, who first encountered Ebola before it had been identified. In fact, Dr Muyembe was part of the research team which investigated the first known outbreak of the Ebola virus in 1976. The name ‘Ebola virus” is derived from the Ebola river – a river that was at first thought to be in close proximity to the area in Democratic Republic of Congo, previously called Zaire, where the 1976 Ebola virus outbreak occurred – and the taxonomic suffix virus. Quite bizarrely, history credits Dr Peter Piot, who was the director of the London School of Hygiene and Tropical Medicine, as the one who discovered Ebola. However, as Helen Branswell points out in her article, “History Credits this man (Peter Piot) with discovering Ebola on his own. History is Wrong.” There is a small problem here, however, argues Branswell, Piot did not discover Ebola on his own- and depending on how one defines discovery, may not be able to actually make the claim at all. It would be disingenuous however to vitiate and downplay the sterling work that Dr Peter Piot and his research team did in researching more about the Ebola.

It was during the same year that Karl Johnson, who the International Commission Scientific Director, suggested the name “Ebola” virus to ensure that the Yambuku community was not stigmatized. In the early days of the outbreak, people were calling the disease Yambuku fever, but Johnson argued to name it Ebola because he felt that calling the virus Yambuku fever would forever stigmatize the settlement. Yambuku is a small village in Mongala Province in northern Democratic Republic of the Congo, best known as the centre of the 1976 Ebola outbreak. It is 1,098 kilometres (682 ml) northeast of the capital city of Kinshasa. The Belgian name for the river, l’Ebola, is actually a corruption of the indigenous Ngbandi name Legbala, meaning “white water” or “pure water, although there is some disagreement. Reports conflict about who initially coined the name: either Karl Johnson of the American CDC team or Belgian researchers. It is estimated that as many as ninety per cent of those infected with Ebola will die. Unlike other viruses, Ebola is contagious only when it is symptomatic, and, sadly, by that time people are almost invariably too sick to even walk. As many as ninety per cent of those infected with Ebola will die.

In his piece, After Ebola, Michael Specter opines that Ebola won’t kill us all, but something else might. Like everything living on Earth, viruses must evolve to survive. That is why avian influenza has provoked so much anxiety; it has not yet mutated into an infection that can spread easily. Maybe it never will, but it could happen tomorrow. A pandemic is like an earthquake that we expect but cannot quite predict. As quoted by Specter, David Quammen is of the view that every emerging virus “is like a sweepstakes ticket, bought by the pathogen, for the prize of a new and more grandiose existence. It’s a long-shot chance to transcend the dead end. To go where it hasn’t gone and be what it hasn’t been. Sometimes the bettor wins big.” He’s right, of course argues Specter, it is long past time to develop a system that can easily monitor that process. If we don’t, the next pandemic could make Ebola look weak.

Professor Jean-Jacques Muyembe Tamfum who was part of the research team which discovered Ebola now fears the world faces an unknown number of new and potentially fatal viruses emerging from Africa’s tropical rainforests. He has warned that more pandemics even deadlier than Covid are coming to threaten humanity. He told the CNN “We are now in a world where new pathogens will come out, and that’s what constitutes a threat for humanity. Asked whether he believes future pandemics could be more apocalyptic than Covid-19, he chillingly replied: “Yes, yes, I think so.”

Prof Muyembe now runs the Institute National de Recherche Biomédicale in Kinshasa, capital of the DRC, and warns more zoonotic illnesses - where pathogens jump between animals and humans - are coming. Covid-19 is a zoonotic disease which some fear jumped to humans at a wet market in Wuhan, China, at the end of last year.

Prof Muyembe believes the humans rapidly encroaching into the wild hugely increases the risk of new pandemics." If you go in the forest... you will change the ecology, and insects and rats will leave this place and come to the villages... so this is the transmission of the virus, of the new pathogens," he said. One of the Congo's main exports is "bushmeat" from crocodiles, chimps and other exotic animals which are slaughtered and sold in street markets. Any of these animals could be harbouring a dangerous new virus just waiting to cross over to humans, fear experts. Only 15 years ago it was widely thought tropical foreststeeming with exotic wildlife threatened humans by harbouring the viruses and pathogens that lead to new diseases in humans like Ebola and dengue. But researchers now believe that it is actually humanity’s destruction of biodiversity that creates the conditions for new viruses and diseases such as Covid-19 to flourish.

Like the detection of Tsunamis by scientists, by deploying the Deep-ocean Assessment and Report of Tsunamis (DART) buoy stations, the global public-health system needs to become far more vigilant in detecting new viruses before they spread. One is of course alive to the fact though the information detected by DART is not always helpful because a tsunami can arrive within minutes after the earthquake precedes it, and that not all earthquakes create tsunami, resulting to false alarms, there are nevertheless instances where the detection system helped to avert human catastrophe of apocalyptic proportions.

The Covid-19 virus: A historical background

According to Mahesh Jayaweera, Hasini Perera, Buddhika Gunawardana and Jagath Manatunge in their article titled “Transmission of COVID-19 virus by droplets and aerosols: A critical review on the unresolved dichotomy”, the Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China, in December 2019. The disease is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and asseverated to be transmitted from human-to-human by multiple means, namely, by droplets, aerosols, and fomites. It has been more than 120 days that COVID-19, later declared as a pandemic and highly contagious, was first reported. As of May 05, 2020, there have been more than 3.5 million confirmed cases and 243,401 deaths by the COVID-19 disease worldwide COVID-19 infection triggers severe acute respiratory illness, with fever, cough, myalgia, and fatigue as common symptoms at the onset of illness

Infectious agents may spread from their natural reservoir to a susceptible host in different pathways. There are various classifications reported in the literature for modes of transmission of different infectious agents has presented a classification for virus transmission, including human-human transmission, airborne transmission, and other means of transmission such as endogenous infection, common vehicle, and vector spread. However, many respiratory viruses are believed to transmit over multiple routes, of which droplet and aerosol transmission paths become paramount, but their significance in transmitting the disease remains unclear. In general, infected people spread viral particles whenever they talk, breathe, cough, or sneeze. Such viral particles are known to be encapsulated in globs of mucus, saliva, and water, and the fate/behaviour of globs in the environment depends on the size of the globs. Bigger globs fall faster than they evaporate so that they splash down nearby in the form of droplets. Smaller globs evaporate faster in the form of aerosols, and linger in the air, and drift farther away than the droplets do.

Respiratory particles may often be distinguished to be droplets or aerosols based on the particle size and specifically in terms of the aerodynamic diameter. One could dispute that, unlike larger droplets, aerosols may pose a greater risk of the spread of the COVID-19 disease among many susceptible hosts positioned far from the point of origin. Nevertheless, it has been proven that viral disease outbreaks via aerosol transmission are not as severe as one would think, because of dilution and inactivation of viruses that linger for extended periods in the air. There has been no discernible evidence on the minimum infectious viral load for COVID-19 pandemic, but many researchers speculate that a few hundreds of SARS-CoV-2 virus would be enough to cause the disease among susceptible hosts.

There have been numerous disagreements on the average particle size of droplets and aerosols The World Health Organization (WHO) and Centres for Disease Control and Prevention (CDC) postulate that the particles of more than 5 μm as droplets, and those less than 5 μm as aerosols or droplet nuclei Conversely, there have been some other postulations, indicating that aerodynamic diameter of 20 μm or 10 μm or less should be reckoned to be aerosols, based on their ability to linger in the air for a prolonged period, and the reachability to the respirable fraction of the lung (alveolar region. Small aerosols are more susceptible to be inhaled deep into the lung, which causes infection in the alveolar tissues of the lower respiratory tract, while large droplets are trapped in the upper airways. For easy apprehension, aerosols can be defined as suspensions of solid or liquid particles in the air, which can be generated by either natural or anthropogenic phenomena.

Though social distancing would be promising in combatting the COVID-19, the minimum distances that have been maintained between an infected person and a host are disputable and far from being established based on any scientific evidence. Nevertheless, many have believed that droplets predominate over aerosols in terms of contracting the disease; thus, over time, research work has been focused on acquiring better knowledge on the science of droplet transmission. However, since the recent past, evidence has been provided to refute the former hypothesis and speculated that aerosols also play a major role in transmitting the disease. As such, the controversy on the modes of transmission of the SARS-CoV-2 virus seems to be speculating and puzzled among many researchers, including the World Health Organization. No conclusive studies have been conducted on differentiating between the modes of transmission of viruses via droplets and aerosols; hence, unresolved dichotomy.

It has also been argued that environmental settings, in which the SARS-CoV-2 virus transmits, trigger the disease adversely or beneficially with a susceptible host exposed to more or lesser payloads, respectively. Such adverse or beneficial scenarios are based on plausible changes in the fate of the virus in the environment caused by altered transport phenomena. There have been myriads of hypotheses corroborating that certain threshold levels of humidity, temperature, sunlight, and ventilation will speed up the virus-laden droplet and aerosol transmission, aggravating the spread of the SARS-CoV disease.

As scientists underpin more conclusive evidence on the modes of transmission via droplets and aerosols, facemasks and respirators worn by billions of people around the globe (both infected persons and susceptible hosts) become a common sight in day-to-day activities. In the events of the droplet and aerosol transmission, the efficacy of such personal protective equipment in combating the transmission of the SARS-CoV-2 has been poorly understood.

Ever since the COVID-19 has been declared to be a pandemic with incredibly high morbidities and mortalities worldwide, the database of research on controlling the COVID-19, especially in the indoor environment, has been updated with several evidence-based studies. However, less attention has been focused on the whole in controlling virus-laden droplet and aerosol shedding, their transport phenomena, and plausible methods of their dilution and destruction in different indoor settings. With more COVID-19 cases reported worldwide, evidence-based decisions need to be adhered to in combating the disease, especially for situations in confined environments. The transmission of droplets and aerosols within confined spaces becomes profoundly complex phenomena, and the real trajectories under different micro-climatic conditions are poorly understood. The aggressive nature of the disease is directly connected with the transport phenomena of both droplets and aerosols, and the comprehension of such phenomena is vital in controlling the spread of the disease within such confined spaces. Aerodynamic engineers, therefore, need to network with virologists to fully understand the possible trajectories of the viral spread within such confined spaces. In this context, computational fluid dynamics could be made use of, to simulate the trajectories resulting from coughs and sneezes of an infected person within different confined settings.

How much of a role does airborne transmission play in spreading the Coronavirus Pandemic?

As quoted by James Lloyd in his piece “How does the coronavirus spread”, Dr Hassan Vally, an epidemiologist and infectious disease expert at La Trobe University in Melbourne, Australia. Believes that “this route of transmission is clearly possible, but we don’t know what percentage of new cases it accounts for.” Vally also mentions two more unknowns about airborne transmission: how long the virus can survive inside the smaller droplets, and how many of these droplets you’d need to be exposed to in order to contract COVID-19. Vally further argues that regardless of what new evidence comes to light, he does not think it’s going to change the fact that the predominant route of transmission is the larger droplets. He also points to the fact that social distancing has been largely effective at halting the virus’s spread: “this is further evidence that people are most often getting the disease from close contact with other people.”

Will it change public health advice?

James Llody argues that if the virus does have the potential to become airborne and stay infectious in the smaller droplets, it would mean that people are more likely to become infected without close contact. But Dr Hassan Vally doesn’t think that this would lead to an overhaul of public health policies. He says it would probably just mean that we encourage more mask use, and to stop the droplets reaching us. Another way to reduce airborne transmission would be to ensure that enclosed spaces are ventilated with clean outdoor air, rather than just recirculating the same air. Vally believes that there might be things we can do to reduce the virus’s chance of surviving in aerosols. Perhaps, Vally points out, by altering the [building’s] temperature or humidity, he does not think it’s going to be a game-changer. It’s just another thing to learn about what is a very complex virus.

The vigilance of the global health systems in detecting new viruses before they spread would have to be fast. Dr Michael Ryan, who is the executive director of the World Health Organization says it’s better to act quickly than perfectly to contain the spread of coronavirus and the COVID-19 disease it causes. Sharing the lessons, he has learned from trying to contain Ebola outbreaks in the past, Dr Michael Ryan said the most important thing was to act quickly and decisively. “Be fast, have no regrets. You must be the first mover. He emphasized the fact the virus will always get you if you don’t move quickly. He also warned waiting for the perfect response was too dangerous. He said “If you need to be right before you move you will never win. Perfection is the enemy of the good when it comes to emergency management.” He also pointed out that the speed trumps perfection and the problem in society we have at the moment is that everyone is afraid of making a mistake, everyone is afraid of the consequence of error, but the greatest error is not to move. The greatest error is to be paralysed by the fear of failure. On Wednesday, June 29, 2016, in a news release headlined “Analysis of 1976 Ebola outbreak holds lessons relevant today”, scientists led by Dr. Joel Breman of the Fogarty International Centre at the National Institutes of Health released a report highlighting lessons learned from the smaller, more quickly contained 1976 outbreak. The report stated that “key to diagnosis in 1976 was the relatively quick clinical recognition of a severe, possibly new disease by national authorities,” according to Breman and his co-authors. “International notification and specimen provision occurred within five weeks from onset of the first cases; this did not occur in the 2013-2016 epidemic, when the delay was over three months.”

Commenting about the impact of the Covid-19 pandemic, in an article “ A Pandemic Year in 10 Quotes,” written by Adelaida Sarukhan, Melinda Gates poignantly stated the obvious when she said the pandemic has magnified every existing inequality in our society thus displaying useful content like systemic racism, gender inequality and poverty. Ironically, in South Africa, as observed and tweeted on social media by Ndamumelo Mashapha Ndanzo, with regards to lockdown regulations, most people who were abiding to the lockdown regulations were those who have to better health care, while the poor who don’t even have medical aid are the ones roaming the street unnecessary. Peter Sands of the Global Fund was blunt when he said “without equity, we cannot end Covid -19, HIV or any other pandemic. Sands believes that inequity per se is a pandemic and tackling it should become a priority at national and global level. In her article, A Pandemic Year in 10 Quotes, Adelaida Sarukhan, stated, for example, that seroprevalence results in Spain showed that women who work as cleaners or carers, as well as migrants, were more exposed to the virus than the general population. Seroprevalence is the number of persons in a population who test positive for a specific disease based on serology (blood serum) specimens; often presented as a percent of the total specimens tested or as a proportion per 100,000 persons tested. Sarukhan borrows a line by British writer Damian Barr who said: “We may be in the same storm, but we are in different boats.” Mark Lipsitch, an epidemiologist is instructive when he says “with Covid-19, we’ve made it to the life raft. Dry land is far away.’ As observed by Sarukhan, the speed at which the virus spread took the world by surprise. She makes an interesting observation when she says the first total lockdowns were like jumping from a sinking boat to the life raft. That was the “easy part”. Reaching land safely was trickier. Much time and energy were spent on discussing the best exit strategies. At the end, opines Sarukhan, the second wave showed that it may be necessary to aim for more than simply keeping the virus in check. She points out that New Zealand and other Asian countries showed that Zero-Covid strategy was possible. Most importantly, she believes that we are better prepared now to achieve this as we have faster tests for detecting infections and more knowledge on the settings that favour transmission. In addition, she believes that specific treatments and vaccines are not far away. As if to corroborate Sarukhan’s observation, Jeremy Farrar, who is the Director of Wellcome, rightly sums it up when he says: “science is our exit strategy.” In his article titled “The cult of Ignorance: Isaac Asimov and the Covid -19 Pandemic, Samuel O’Brient opines that science is real and it is only thing that will save us in the long run. To paraphrase Neil deGrasse Tyson, “the good thing about science is that its true whether or not you believe in it.” As the death toll continues to mount, O’Brient, more than ever, wishes more people believe it. He strongly believes that believing in science can save lives, more than ever.

As reported by Dyani Lewis in his article, Is the coronavirus airborne? Experts can’t agree, since early reports revealed that a new coronavirus was spreading rapidly between people, researchers have been trying to pin down whether it can travel through the air. Health officials say the virus is transported only through droplets that are coughed or sneezed out — either directly, or on objects. But some scientists say there is preliminary evidence that airborne transmission — in which the disease spreads in the much smaller particles from exhaled air, known as aerosols — is occurring, and that precautions, such as increasing ventilation indoors, should be recommended to reduce the risk of infection. However, the World Health Organization says the evidence is not compelling, but scientists warn that gathering sufficient data could take years and cost lives. In a scientific brief posted to its website on 27 March 2020, the World Health Organization said that there is not sufficient evidence to suggest that SARS-CoV-2 is airborne, except in a handful of medical contexts, such as when intubating an infected patient. But experts that work on airborne respiratory illnesses and aerosols say that gathering unequivocal evidence for airborne transmission could take years and cost lives. We shouldn’t “let perfect be the enemy of convincing”, says Michael Osterholm, an infectious-disease epidemiologist at the University of Minnesota in Minneapolis. “In the mind of scientists working on this, there’s absolutely no doubt that the virus spreads in the air,” says aerosol scientist Lidia Morawska at the Queensland University of Technology in Brisbane, Australia. “This is a no-brainer.”

Confusing definitions

Dyani Lewis explains that when public health officials say there isn't sufficient evidence to say that SARS-CoV-2 is airborne, they specifically mean transported in virus-laden aerosols smaller than 5 micrometres in diameter. Compared with droplets, which are heftier and thought to travel only short distances after someone coughs or sneezes before falling to the floor or onto other surfaces, aerosols can linger in the air for longer and travel further. According to Ben Cowling, an epidemiologist at the University of Hong Kong, most transmission occurs at close range, says Ben Cowling. But the distinction between droplets and aerosols is unhelpful because “the particles that come out with virus can be a wide range of sizes. Very, very large ones right down to aerosols”, he says. And if SARS-CoV-2 is transmitting in aerosols, it is possible that virus particles can build up over time in enclosed spaces or be transmitted over greater distances.

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Aerosols are also more likely to be produced by talking and breathing, which might even constitute a bigger risk than sneezing and coughing, says virologist Julian Tang at the University of Leicester, UK. “When someone’s coughing, they turn away, and when they’re sneezing, they turn away,” he says. That’s not the case when we talk and breathe. A study of people with influenza found that 39% of people exhaled infectious aerosols. Tang believes that as long as we are sharing an airspace with someone else, breathing in the air that they exhale, airborne transmission is possible

The evidence so far

According to Dyani Lewis in his piece “Is the coronavirus airborne? Experts can’t agree”, evidence from preliminary studies and field reports that SARS-CoV-2 is spreading in aerosols is mixed. Dyani further points out that at the height of the coronavirus outbreak in Wuhan, China, virologist Ke Lan at Wuhan University collected samples of aerosols in and around hospitals treating people with COVID-19, as well as at the busy entrances of two department stores. In an unreviewed preprint, Lan and his colleagues report finding viral RNA from SARS-CoV-2 in a number of locations, including the department stores. The study, argues Lewis, doesn’t ascertain whether the aerosols collected were able to infect cells. But, in an e-mail to Nature, a journal, Lan says the work demonstrates that “during breathing or talking, SARS-CoV-2 aerosol transmission might occur and impact people both near and far from the source”. As a precaution, the general public should avoid crowds, he writes, and should also wear masks, “to reduce the risk of airborne virus exposure”. Another study failed to find evidence of SARS-CoV-2 in air samples in isolation rooms at an outbreak centre dedicated to treating people with COVID-19 in Singapore. Surface samples from an air outlet fan did return a positive result2, but two of the authors — Kalisvar Marimuthu and Oon Tek Ng at the National Centre for Infectious Diseases in Singapore — told Nature in an e-mail that the outlet was close enough to a person with COVID-19 that it could have been contaminated by respiratory droplets from a cough or sneeze.

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A similar study by researchers in Nebraska found viral RNA in nearly two-thirds of air samples collected in isolation rooms in a hospital treating people with severe COVID-19 and in a quarantine facility housing those with mild infections3. Surfaces in ventilation grates also tested positive. None of the air samples was infectious in cell culture, but the data suggest that “viral aerosol particles are produced by individuals that have the COVID-19 disease, even in the absence of cough”, the authors write.

The WHO writes in its latest scientific brief that the evidence of viral RNA “is not indicative of viable virus that could be transmissible”. The brief also points to its own analysis of more than 75,000 COVID-19 cases in China that did not report finding airborne transmission. But Ben Cowling says that “there wasn't a lot of evidence put forward to support the assessment” and, an absence of evidence does not mean SARS-CoV-2 is not airborne. The World Health Organization did not respond to Nature’s questions about the evidence in time for publication.

Scientists in the United States have shown in the laboratory that the virus can survive in an aerosol and remain infectious for at least 3 hours4. Although the conditions in the study were “highly artificial”, there is probably “a non-zero risk of longer-range spread through the air”, says co-author Jamie Lloyd-Smith, an infectious-diseases researcher at the University of California, Los Angeles.

Gaps to fill

Leo Poon, a virologist at the University of Hong Kong, as quoted by Dyani Lewis in his article, Is the coronavirus airborne? Experts can’t agree”, doesn’t think there’s enough evidence yet to say SARS-CoV-2 is airborne. He’d like to see experiments showing that the virus is infectious in droplets of different sizes. Whether people with COVID-19 produce enough virus-laden aerosols to constitute a risk is also unknown, says Lloyd-Smith. Air sampling from people when they talk, breathe, cough and sneeze — and testing for viable virus in those samples — “would be another big part of the puzzle”, he says. One such study failed to detect viral RNA in air collected 10 centimetres in front of one person with COVID-19 who was breathing, speaking and coughing, but the authors didn’t rule out airborne transmission entirely. Lloyd Smith, still quoted by Lewis points out that another crucial unknown is the infectious dose: the number of SARS-CoV-2 particles necessary to cause an infection, says Lloyd-Smith. “If you’re breathing aerosolized virus, we don’t know what the infectious dose is that gives a significant chance of being infected, and an experiment to get at that number — deliberately exposing people and measuring the infection rate at different doses — would be unethical given the disease’s severity.

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According to Julian Tang, as quoted by Lewis in his piece, “Is the coronavirus airborne? Experts can’t agree”, whatever the infectious dose, length of exposure is probably an important factor too, says Tang. Each breath might not produce much virus, he says, but “if you’re standing beside [someone who’s infected], sharing the same airspace with them for 45 minutes, you’re going to inhale enough virus to cause infection”. Still quoted by Lewis, L. Morawska, posits that, by capturing those small concentrations of aerosols that, given the right combination of airflow, humidity and temperature, might build to an infectious dose over time, is “extremely difficult”. She further states that “we could say that we need more data, but then we should acknowledge the difficulty of collecting the data.”.

Cautious approach

As quoted by Dyani Lewis, according to Julian Tang, a virologist at the University of Leicester, the assumption should be that airborne transmission is possible unless experimental evidence rules it out, not the other way around and, in that way, people can take precautions to protect themselves. Lidia Morawska is a Distinguished Professor in the School of Earth and Atmospheric Sciences, at QUT; the Director of the International Laboratory for Air Quality and Health (ILAQH) at QUT, which is a WHO Collaborating Centre on Air Quality and Health; a Co-Director in Australia for the Australia – China Centre for Air Quality Science and Management (ACC-AQSM), as cited by Lewis, posits that increasing ventilation indoors and not recirculating air can go some way to ensuring that infectious aerosols are diluted and flushed out. She further cautions that indoor meetings should be banned just in case. Ke Lan, a virologist from Wahan University in China and other scholars are calling for the public to wear masks to reduce transmission. Virologist Julian Tang believes that if everyone can mask, it is double, two-way protection.

Coronavirus: Endemic Future

Nicky Phillips, in her article, “The coronavirus is here to stay – here’s what that means,” informs us that in a Nature poll, 89% of scientists felt that the virus was either very likely or likely to become an endemic virus. Michael Osterholm, an epidemiologist at the University of Minnesota in Minneapolis, as cited by Phillips argues that “eradicating this virus right now from the world is a lot like trying to plan the construction of a stepping-stone pathway to the Moon. It’s unrealistic”.

Phillips however assures us that failure to eradicate the virus does not mean that death, illness or social isolation will continue on the scales seen so far. The future will depend heavily on the type of immunity people acquire through infection or vaccination and how the virus evolves. Influenza and the four human coronaviruses that cause common colds are also endemic: but a combination of annual vaccines and acquired immunity means that societies tolerate the seasonal deaths and illnesses they bring without requiring lockdowns, masks and social distancing. She further points out that more than one-third of the respondents to Nature’s survey thought that it would be possible to eliminate SARS-CoV-2 from some regions while it continued to circulate in others. In zero-COVID regions there would be a continual risk of disease outbreaks, but they could be quenched quickly by herd immunity if most people had been vaccinated. Christopher Dye, an epidemiologist at the University of Oxford, UK., believes that the COVID will be eliminated from some countries, but with a continuing (and maybe seasonal) risk of reintroduction from places where vaccine coverage and public-health measures have not been good enough. Thus, argues Angela Rasmussen, an American virologist affiliated with the Georgetown University Centre for Global Health Science and Security and the Vaccine and Infectious Disease Organization, as quoted by Phillips, says the virus becoming endemic is likely, but the pattern that it will take is hard to predict, and this will determine the societal costs of SARS-CoV-2 for 5, 10 or even 50 years in the future.

Weiskopf and her colleagues, as quoted by Phillis, are still tracking the immune memory of people infected with COVID-19 to see if it persists. If most people develop life-long immunity to the virus, either through natural infection or vaccination, then the virus is unlikely to become endemic, she says. But immunity might wane after a year or two — and already there are hints that the virus can evolve to escape it. More than half the scientists who responded to Nature’s survey think waning immunity will be one of the main drivers of the virus becoming endemic. Because the virus has spread around the world, it might seem that it could already be classed as endemic. But because infections continue to increase worldwide, and with so many people still susceptible, scientists still technically class it as in a pandemic phase. Lavine, as cited by Phillips, believes that in the endemic phase, the number of infections becomes relatively constant across years, allowing for occasional flare-ups. To reach this steady state, she argues could take a few years or decades, depending on how quickly populations develop immunity, and allowing the virus to spread unchecked would be the fastest way to get to that point — but that would result in many millions of deaths. That path, she says, has some huge costs. The most palatable path is through vaccination.

Vaccines and its Impact

Nicky Phillips points countries that have begun distributing COVID-19 vaccines soon expect to see a reduction in severe illness. But it will take longer to see how effectively vaccines can reduce transmission. Data from clinical trials suggest that vaccines that prevent symptomatic infection might also stop a person from passing on the virus. She believes that If vaccines do block transmission — and if they remain effective against newer variants of the virus — it might be possible to eliminate the virus in regions where enough people are vaccinated so that they can protect those who are not, contributing to herd immunity. A vaccine that is 90% effective at blocking transmission will need to reach at least 55% of the population to achieve temporary herd immunity as long as some social distancing measures — such as face masks and many people working from home — remain in place to keep transmission in check, according to a model developed by Alexandra Hogan at Imperial College London and her colleagues. (A vaccine would need to reach almost 67% of people to provide herd immunity if all social distancing measures were lifted.) But if the rate of transmission increases because of a new variant, or if a vaccine is less effective than 90% at blocking transmission, vaccine coverage will need to be greater to blunt circulation.

With my insatiable quest to always attempt to exhaust whatever I am writing on, I surfed the internet to look for one punchy article that I could use to conclude this piece that I have penned to enlighten myself about this dreadful and deadly coronavirus pandemic. By a stroke of luck, I came across a riveting and pertinent article written by Robin Marantz Henig titled “Experts warned of a pandemic decades ago. Why weren’t we ready.” In this article Henig cites his book called Dancing Matrix: How Science Confronts Emerging Viruses.

Robin Marantz Henig is a science writer, she lives that ideal, often covering subjects that are controversial and, in some cases, taboo. A freelance journalist and author of eight books, including the critically acclaimed novel The Monk in the Garden: The Lost and Found Genius of Gregor Mendel, Henig has written about senility, stem cell research, cloning, the best way to die, the psychological effects of adoption, the categorization of eating disorders, and the effects of erasing memory. In one of her sagaciously engrossing articles she wrote about incurable diseases, she admits that she wouldn't want to know if she had a gene that predisposed her to having an incurable disease. Even so, she said she is "committed to the idea that knowledge is always better than ignorance." Her writing often weaves personal narrative and scientific insight.

In the book, A Dancing Matrix, Robin Henig looks at how and why new viruses ``emerge,'' their possible impact on humanity's future, and what scientists are doing about it. When a virus emerges, it moves out of its original niche in nature and begins infecting a new population. Science writer Henig (coauthor, Your Premature Baby, 1983, etc.) looks at this phenomenon and makes some judgments about the interdisciplinary approach that biology will require to understand and deal with it. Contrary to the scenario of Michael Crichton's inventive The Andromedra Strain, she explains, viruses from outer space aren't the threat; exposure to new viruses is more likely to occur through changes in the environment or in our relationship to the environment—for example, from global warming, urbanization, or road-building in rain forests. Henig provides some fascinating case studies revealing how viruses have crossed from one species to another with deadly effect, and she examines briefly the possible link between viruses and chronic diseases such as atherosclerosis and high blood pressure. Mutations are another means by which new virus strains emerge, and Henig warns that a new influenza pandemic is likely to strike before the century's end. On an upbeat note, she explores how scientists are now taming viruses, ``mankind's tiniest and perhaps most complicated foe,'' and using them in gene therapy. In conclusion, she warns that it's not enough for microbiologists in the laboratory to understand the molecular genetics of a virus; if future epidemics like AIDS or worse are to be prevented, fieldwork and the combined skills of entomologists, anthropologists, veterinarians, and others will be required. Complex science made not just accessible but wholly fascinating and communicated with a sense of urgency yet without sensationalism.

Robin Henig points out that when she started researching A Dancing Matrix in 1990, the term “emerging viruses” had just been coined by a young virologist named Stephen Morse, who would become the main character in her book. In the book she wrestles with why we shrugged at the nightmare warnings and hopes this time will be different. She wrote about how experts were identifying conditions that could lead to the introduction of new, potentially devastating pathogens – climate change, massive urbanization, the proximity of humans to farm or forest animals that serve as viral reservoirs – with the worldwide spread of those microbes accelerated by war, the global economy, and international air travel. Too many of us, she wrote, were blithely going about our business despite the growing threat. Sound familiar?

The single biggest threat to man’s continued dominance on the planet is the virus.” She says she used this searing quote from Noble laurate Joshua Lederberg, who was president of Rockefeller University and Morse’s boss. She says, in the introduction of her book, back then, she thought it was a little bit melodramatic, but now it strikes her as terrifyingly accurate. She tells the story that she once telephoned Stephen Morse who eventually became a professor of epidemiology at Columbia University’s Mailman School of Public Health.

In their conversation Morse said he was discouraged to find that as scientists they were not better prepared for the coronavirus. Morse then quoted Peter Drucker, the management guru, who once asked, “what is the worst mistake you could make?” Morse’s answer was, “to be prematurely right.”

The exact quote is the most serious mistakes are not being made as a result of wrong answers. The true dangerous thing is asking the wrong question.” Equally perceptive and worth quoting, Sociologist Zygmunt Bauman who in his book titled: In Search of Politics, cites the philosopher Cornelius Castoriadis as observing that “the problem with our civilisation is that it has stopped questioning itself. No society which forgets the art of asking questions or allows this art to fall into disuse can count on finding answers to the problems that beset it – certainly not before it is too late and the answers, however, correct, have become irrelevant.”

Robin is at pains to embarrassingly concede that both herself and Morse didn’t get it exactly right, of course, prematurely or otherwise. Nobody did. She says when she was asked on her book tour what the next pandemic was likely to be, she replied that most of her sources said it would be influenza. The infamous 1918 influenza pandemic, which killed more than 50 million people, is the yardstick by which all other pandemics are measured. It was sparked by a type of virus known as influenza A, which originated in birds. Almost all cases of influenza A since then, and all subsequent flu pandemics, have been caused by descendants of the 1918 virus.

There were other journalists who wrote books with the same message as that of Robin. Some of them were huge best sellers. The Hot Zone by Richard Preston and The Coming Plague by Laurie Garrett and Spillover by David Quammen. All these books were follow-up Robin wrote about emerging diseases for National Geographic in 2007. All of hem describe the same dire scenarios, the same war games, the same cries of being woefully unprepared. Why, asks Robin, wasn’t any of that enough?

Dr Vusi Shongwe is the former head of the Department of the Royal Household and Chief Director for Heritage in the Office of the Premier. He is currently the head of the Heritage Resource Services in the Department of Arts and Culture

This piece is dedicated to my friend, homeboy, school mate, university mate, and my neighbour, Edward Muzi Mawelela, who succumbed to the dreadfully and dastardly Covid-19 Pandemic. May his soul repose in eternal piece. In the words of the ancient Gaelic prayer: “May the road rise to meet you; may the wind be always at your back; and, until we meet again, may God ever hold you in the hollow of His hand.” May flights of angels sing thee to thy eternal rest. May our Heavenly Father take you in His arms and reward you with the everlasting happiness that you richly deserve. I have been immeasurably blessed to have had a friend like you. I miss you my friend.

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