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Coronavirus diary – Part 15

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Much cannot be said about the unknown. COVID-19 challenges us daily. Sometimes we are befuddled; other times, a ray of hope. However, fear is not going away. In Nigeria, the federal government back-pedaled on the reopening of the school. The Nigerian Guardian newspaper had advised against a hurried opening. In a streak of humanism, the Minister of Education, Adamu Adamu was not willing to risk the lives of our children. In his words, “This is not the right time to reopen.”

Similarly, the Association of School and College Leaders (ASCL), the largest union representing secondary heads in the UK has also discountenanced the guidelines for re-opening of schools in the UK. The association had urged the government to get a “sense of reality”. They wondered at the prospect of re-opening over which “The logistics of keeping apart many different ‘bubbles’ of children in a full school, including whole-year groups comprising hundreds of pupils, is mind-boggling.” It bears repeating that the fear is always there because we are yet to conquer the COVID-19 universe.

Two recent developments merit our reflection. The first is the claim that asymptomatic people cannot infect others credited to Dr. Maria Van Kerkhove, WHO Technical lead on COVID-19 pandemic. She had told Newsmax that “Formal data that we have, it still seems to be rare that asymptomatic person can actually transmit to a secondary individual.” This was literally taken to mean that infectious people without manifest symptoms cannot infect others. In other words, asymptomatic people cannot infect others.

This was celebrated by Greg Kelly of Newsmax who asked for the comments of Dr. David Samadi, Director of Men’s Health, St. Francis Hospital. “The big thing is that the hysteria and panic are out of the door”. Not Dr. Samadi and Kelly were caught alone in the euphoria of a relief somewhat. Equally, my classmate at the University of Lagos in the late 1980s, now a UK resident, was caught in the triumphal relief. It meant for them that infected patients neither needs to be isolated and quarantined nor require social distancing. But a cautious me said to him to note the word asymptomatic and not symptomatic.

Therefore, it was not yet Uhuru. This initial enthusiasm was soon doused by public health experts who controverted the information thereby forcing Dr. Kerhove to allege a “miscommunication” and a clarification to the effect that WHO was “…constantly looking at this data and we’re trying to get more information from countries to truly answer this question.” For WHO, the known is that “The majority of transmission that we know about is that people who have symptoms transmit the virus to other people through infectious droplets…But there are [is] a subset of people who don’t develop symptoms, and to truly understand how many people don’t have symptoms, we don’t actually have that answer yet.”

Experts’ comments alleged that the miscommunication may have arisen from the hermeneutics or definitional universe of the word asymptomatic. It is sometimes misapplied to people who have been infected and have yet to exhibit symptoms, often referred to presymptomatic. Research, it is argued, has shown that people become infectious before they start manifesting the symptoms of COVID-19, namely, shortness of breath, coughing and sneezing, loss of sense of smell, and so on during that presymptomatic period. What is not in doubt is that there are infected asymptomatic people, data from countries that have done comprehensive contact tracing are “not finding secondary transmission onward” from those cases. According to Dr. Kerhove, “It’s very rare”.

Everything about COVID-19 is like open sesame. In the beginning, the virus came from the Wuhan seafood market or escaped from the lab in Wuhan. A conspiratorial web was spawned. You know COVID-19 is an expert business. The Chinese virus, apologies to President Donald Trump, is said to have been lying low waiting for conducive climatic conditions to manifest itself. This is the latest postulation from Dr. Tom Jefferson, a professor at the Centre for Evidence-Based Medicine (CEBM) at Oxford University who pointed to a series of recent discoveries of the virus’s presence around the world before it emerged in Asia.

This, he argued, is an indication of the virus global origin. Also, it is argued that traces of COVID-19 have been found in sewage samples from Europe and South America pre-dates its discovery in China. For example, an unpublished study claims the presence of SARS-CoV-2 genomes in a Barcelona sewage in March of 2019. Therefore, for Dr. Jefferson, “The explanation could only be that these agents don’t come or go anywhere. They are always here and something ignites them, maybe human density or environmental conditions, and this is what we should look for…There is quite a lot of evidence of huge amounts of the virus in sewage all over the place, and an increasing amount of evidence there is faecal transmission…There is a high concentration where sewage is 4°C, which is the ideal temperature for it to be stabled and presumably activated. And meatpacking plants are often at 4°C. These outbreaks need to be investigated properly.”

To be sure, an earlier report published in The Lancet had challenged the Wuhan Seafood market theory due to “No epidemiological link was found between the first patient and later cases,” The data revealed that in total, 13 of the 41 cases had no link to the marketplace. Daniel Lucey, an infectious disease specialist at Georgetown University who saw the findings as significant, also explained that the incubation interval could account for the absence of linkage. While commenting The Lancet paper, Kristian Andersen, an evolutionary biologist at the Scripps Research Institute who has analyzed sequences of 2019-nCoV offered an explanation on virus origin. He stressed the point that the 1 December timing of the first confirmed case was “an interesting tidbit…The scenario of somebody being infected outside the market and then later bringing it to the market is one of the three scenarios we have considered that is still consistent with the data,” consistent with available data. The other two scenarios attribute virus origin to a group of infected animals or a single animal that came into that marketplace. Andersen’s analysis of 27 available genomes of 2019-nCoV affirmed a “most recent common ancestor “as of October 1, 2019.
 
This assertion has indicated a research direction. Dr. Jefferson and his colleague, Professor Carl Heneghan, CEBM director, called for an investigation into dynamics of virus survival in environments such as food factories and meatpacking plants. For them, it could lead to knowledge of new transmission routes, such as the sewerage system or shared lavatory facilities. Altogether, nothing specifically new in this assertion as the virus has been found in the fecal substance.

So far, we are trapped in the mystery of COVID-19, until science truly liberates us from the pedestal of prehistory that we are presently ensconced in. For sure, the times call for vigilance and we shall overcome someday.
Akhaine is a professor of Political Science at the Lagos State University.


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