Case Study – Corona Virus and the World
Coronavirus disease 2019 (COVID-19) is highly transmittable disease caused by severe acute respiratory syndrome coronavirus 2 which belongs to the Coronaviridae family in the Nidovirales order.
Corona represents crown-like spikes on the outer surface of the virus hence the name coronavirus. Coronaviruses contain a single-stranded RNA as its nucleic unit and its size ranges from 26 to 32kbs in length. The subgroups under coronaviruses family are alpha (α), beta (β), gamma (γ) and delta (δ) coronavirus.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first isolated from three people with pneumonia cases initiated from the Hunan seafood market in Wuhan city of China and drastically infected almost 50 peoples. Hunan seafood market is popular for the selling of live and exotic animal species including bats, frogs, marmots, rabbits, birds and snakes.
In 2002 the world witnessed a severe acute respiratory syndrome (SARS) outbreak caused by SARS-CoV in Guangdong, China. Earlier it was believed that this virus could only infect animals. The virus was later confirmed as a member of the Beta-coronavirus subgroup and was hence coined as SARS-CoV.
Early stages of pneumonia symptoms with a diffused alveolar injury were seen which later lead to acute respiratory distress syndrome (ARDS). SARS was initially detected only in Guangdong, China but then it spread rapidly around the world with more than 8000 infected persons and 774 deaths.
Just a decade later in 2012, a couple of Saudi Arabian nationals were diagnosed with pneumonia illness which later resulted in surfacing of another coronavirus of the same family known as Middle East Respiratory Syndrome Coronavirus (MERS-CoV). According to the initial reports published by World Health Organization, MERS-coronavirus infected more than 2428 individuals and caused 866 deaths. Similar to previously detected SARS-coronavirus in china, patients infected with MERS-coronavirus also showed signs of severe pneumonia, followed by ARDS.
There are many myths associated with the origin of coronavirus and how it transmitted to humans. According to all the medical researches done on coronavirus, it is generally anticipated that it’s genetically related to coronaviruses isolated from bat populations. SARS outbreaks in 2003 and in December 2019 were also believed to be related to coronaviruses isolated from bats and then it jumped the species barrier or transmitted through farm or household animals to humans and then spread between humans. As the contact between humans and bats are rarely reported, it is believed that transmission of SARS-CoV-2 to humans happened through an intermediate animal species handled by humans or it actually did spread through bats when taken as a food source.
The initial cases in late December 2019 and early January 2020 came through Huanan Wholesale Seafood Market in Wuhan City, which is a hub for seafood, wild, and farmed animal species. Among the first cases reported, either they were stall owners, market employees or regular goers to the market. Environmental samples were later taken and tested with precise medical examination and they also tested positive for SARS-CoV-2 which further solidified the market in Wuhan City as the epicenter of this outbreak. It was also suggested that the market only played a crucial role in its outbreak but it was not the place of its initial inception as some of the few cases were neither directly nor indirectly related to the market.
Till date no confirmed report suggests that the origin of SARS-CoV-2 to be through bats as the genetic structure is 96% similar to SARS-coronavirus present in bats.
30 December 2019
Three patients with pneumonia of unknown etiology were reported in Wuhan. Real-time PCR later suggested that the virus is similar to Beta coronavirus.
4 January 2020
World Health Organization reported on social media about the surfacing of related pneumonia cases in Wuhan with no reported deaths.
Australia, Canada and United States confirm their first covid-19 case.
The first confirmed case of coronavirus in India was reported in the state of Kerala.
COVID-19 death toll surpasses 2,000 globally.
March 13, 2020
Total 121 countries with 142,095 cases and total of 5,327 deaths were officially reported.
A third of the world’s population was living under government restrictions due to Covid-19.
The World Health Organization reports that there is still no evidence that recovered patients are immune from the coronavirus.
January 6, 2021
Confirmed coronavirus cases reaches 86,957,136 with 1,878,638 deaths in 218 countries and still counting.
Relativity around the world
The world witnessed a global change within their homes and deep into their lives. The pandemic struck everywhere and everyone being unbiased to their country, race, sex, color, or culture. The people around world faced challenges and casualties and fought really hard and some actually survived. Medical treatments and government guidelines were working day and night but with minor successful results at the end. But the world saw a pause, a much needed one. Many lost their jobs and many switched to what they always wanted to do. Many took it as a financial opportunity to rise high and some enjoyed long awaited and priceless moments with their loved ones. But mostly everyone saw some hard times and some did recover from it and some went gently into that good night.
When Anita, aged 60 and her husband, 65, tested positive for COVID-19, it didn’t felt like a shock to them at first. “We were returning from New Zealand on March 15th and a fellow passenger in our flight was sick. We expected to get it.”
As there were few cases reported in India back then, they were not tested for COVID-19 in the beginning but quarantined at their home. Two days later they both were infected with flu. Though they carried on with their regular work and started taking paracetamol after doctor’s advice.
“I felt exhausted and was down with an upset stomach, but these symptoms did not last for more than two days. The protocol back then was that patients would be admitted to the hospital only when they showed symptoms such as respiratory distress. But when my husband’s blood pressure started dropping even after taking regular BP medicines, we got him admitted where he tested positive and was isolated in the COVID ward. They also took a chest X-ray and it wasn’t very good.”
Virginia, United States
Henrico resident Kathy White, 61, when saw a rash on her arms and legs, she rushed to her local clinic, fearing an infection. She was diagnosed with bronchitis and sent home with medication. Later her body temperature kept fluctuating and cough get worsened.
“I got up to go to the bathroom, and it was like the change in altitude on a plane. The weight of the air was on my chest, and I couldn’t breathe.”
Later at the hospital, she was diagnosed with COVID-19 and had fever. She was connected to her family only through video chats and calls as was quarantined in her room and meticulously following all the safety guidelines.
Every life counts
The Chennai Corporation took utmost care of Anita and her husband once they tested positive. Their entire neighborhood had been shut down and sealed which were the most immediate steps. Although it was just one house in the neighborhood that had tested positive still the corporation didn’t leave any loose ends.
“I received three calls every day from the Corporation, enquiring after my health and that was really commendable. The calls were mostly to find out how I was doing. Psychologists from the Corporation checked on my mental health on a daily basis just in case if I was depressed or feeling uneasy.”
Besides isolating them in their homes, the Corporation also tracked every contact that had been to Anita’s house and they also placed stickers outside their door to make others aware.
Virginia, United States
White feels thankful to the nurses for getting her through all the hard times at the hospital quarantine center. One nurse brought hair products for her and another spent an hour at her bedside for soothing her.
During her time at hospital quarantine, she also enrolled in the sarilumab drug trial at VCU. Joining a clinical trial, she said, gave her purpose. “I just felt like, that’s the least I could do to contribute to cleaning up this mess. To be able to survive it, you just feel like you’ve got to do something.”
Her lung function improved just within a week. Her treatment went successful and after seeing the toll the virus took on her providers, who took their own risks to be there, she feels really grateful.
Accessories at disposal
“My children stay abroad and they naturally panicked. As soon as we quarantined ourselves, we also asked all our staff to stay at their own homes, to be safe. All our primary contacts were tested and it all turned out to be negative. I still see people interacting with us become fearful when they hear we are COVID survivors. There was considerable anxiety among them in the fear that we could spread it even after the quarantine period had ended.”
“People were checking with us from time to time to see if we needed any essentials that they could drop outside our home. I didn’t feel alienated at all. My husband’s appetite had gone completely. He lost his sense of smell and taste when he was sick. He refused the food we made and this was all early stage symptoms. During the hospital stay, he lost 4 kg and suffered weakness and exhaustion even when he was declared negative and discharged.”
As earlier the virus is detected before harming person’s physical and mental functions the better. On the very last stage of the virus, problems like breathlessness and lack of taste or even smell starts surfacing and that when they are more concerning. Anita’s husband took 10 days to recover after returning from the treatment and is still trying to regain his weight and strength and the progress is slow but consistent which is normal among Covid-19 survivors.
Virginia, United States
White feels guilty about how she may have spread the virus around before being quarantined. Health department has given her the green light but she still fears going out in public.
“I know I can’t stay in this house forever. But I don’t want anybody to come to my house, and I don’t want to be around anybody, because the thought of passing this to somebody scares me.”
Feeling responsible for the people who may have lost their jobs because of her, White struggles to come to terms with her survival. She also worries about the medical department workers, who gave her a lot of hope while she was at hospital. With brilliant medical assistance and some hardcore fighting spirit inside, she started recovering slowly but steadily.
Piece of advice
“I believe we need to learn to live with the virus. Building immunity is the key at the moment, till a vaccine is available for the population at large. Your immunity is the only vaccine as of now. My husband and I both exercise every day, but I used to go a step ahead by using pepper and turmeric in my diet.”
“Finally, I would say wear a mask and follow all hygiene/sanitation protocols. Stay indoors as much as you can unless it’s absolutely necessary to step out. We also need to remember that a huge percentage of people are in fact recovering, so stay positive and strong. We will all get through this.”
Virginia, United States
Now living at home, White still gets winded easily and she often trembles at times. She’s still figuring out her return to work, and she hopes to attend her first horse race this year. She wishes to looks forward to some good meals and to plant her garden.
“I want people to take the coronavirus seriously. I am concerned about a world in which we can’t be close — where hugs and handshakes are dangerous. Because that’s exactly what the world needs more – love, kindness and forgiveness.”
These two brave stories from two different corners of the world with almost similar symptoms, consequences and medication and end-results tell that there is still hope. There always will be.
Anita and her husband suffered and went into quarantine and took medication and necessary health precautions to get better but there are many who don’t even have the resources to do all that.
Kathy white did quarantine herself in her house but there are many who can’t as they need to go out and earn to live. Anita’s story tells us about the necessity of fitness and health. Even in quarantine they both exercised to do stay healthy which tells us that we all need to take our health at utmost priority.
Kathy had an excellent teams of nurses and doctors working at her disposal but she also did everything she could to help doctors to help her and others.
These two stories shows that when even a disease could be so unbiased why can’t our perspectives. Nobody knows when this virus may end but one thing is certain that people’s perspective has changed towards the need of public health care services and facilities.
Many people still deny the existence of COVID-19, and many go about their business every day without putting on a facemask or maintaining physical distance. After surviving the disease, Anita and Kathy both suggest strongly to people to protect themselves from the coronavirus. We know that the coronavirus will one day be a thing of the past, but it lies in all of our hands to make that happen.
SARS-CoV-2 is till date the seventh coronavirus known to transmit to humans, and the third zoonotic virus after SARS-CoV and MERS-CoV. Bats are the reservoir hosts of a number of additional novel coronaviruses, ones about which we still are in blind, particularly Chinese horseshoe bats, and a number of other novel coronaviruses. It is also possible that other potential cross-species events could occur in the future and might at bigger scale.
There is therefore a strong need to ban unregulated wild animal sales, particularly exotic species, in every place of the world both from a public health care perspective and also to avoid the ecological damage it would lead. Such a ban would be difficult to proceed taking the cultural reasons into account.
One fortunate report that has surfaced is that on 24 Feb 2020 China’s top legislative committee has passed a proposal to ban all trade and consumption of wild animals. It might help in reducing the risk of another novel virus emerging from wildlife in China in the near future if this proposal really works out.
But the virus is not over yet and one of the most depressing facts is that the treatment might take years to come and so as the vaccine manufacturing and distribution process but we need to keep hope and continue our chore with the same pace but keeping all the cultural responsibilities at the utmost priorities.
Now we know how our fates are intertwined. If we are bargaining at a fancy restaurant and having a cheap meal just to save little cuts at the end than we need to understand that we are taking much valued wages off the cashier or waiter’s monthly salaries.
It’s our fault if our neighbour is still going out in public without necessary precautions because we failed to teach him critical thinking and moral lessons at government schools. It’s our fault that we are forcing him to arrive at work if he wishes to get paid and it’s our fault if we our forcing him to pay rents in these tough times. And it’s still our fault if we are seeing him as a bad element whereas we can make our lives more meaningful if we try to help him out a bit. The pandemic will leave sooner than later but we need to keep all the good lessons it had taught us. The pandemic has forced us to stay at homes but has taught us the need to break boundaries.