Where is the covid-19?

14 04 2020

The message is clear

Officially there have been 3 deaths due to the covid-19 (the causative virus is called SARS-COV-2) in Zimbabwe. Nobody really believes that – testing is sketchy at best but the point remains; the deluge has not arrived and nobody really knows why.

South Africa has a much more robust medical service than Zimbabwe and it’s top medics are also puzzled by the lack of a tsunami of covid-19. Their containment policy has been much more rigorously applied than Zimbabwe’s and testing has been widespread. Nobody is prepared to say that this has worked just yet, and planning for widespread infection goes on regardless.

Meanwhile in Zimbabwe we are taking precautions on a number of levels. I don’t do the shopping even when it’s not restricted but Marianne tells me that all the shops she goes to, which is just the food markets and pharmacists, have hand sterilizer for customers and it’s not always optional to use it. At the doctors’ practice I use it’s prominently displayed (picture above) and although its use wasn’t being enforced I’m pretty sure that someone would have called me out if I’d avoided it. It’s a sensible precaution along with the advice to social distance.

Having left the doctor with a script for my asthma control I went to a local pharmacy. On the way I passed by a noisy crowd outside the side entrance of a local supermarket. They were queuing for mealie meal (maize meal), the local staple food. It was a scrum of pushing and shoving – social distancing was the last thing on a hungry person’s mind!

There’s much we don’t know about this virus. The mode of transmission is assumed to be mainly by droplets and aerosols from infected people coughing or sneezing and to a lesser extent contact with contaminated surfaces. We don’t know if it will follow the seasonal pattern of the common ‘flu – there are indications from outbreaks in the southern hemisphere which is now coming out of summer that it won’t be.  This could be bad news for Zimbabwe or good news. We are just going into our winter which is characteristically cool and dry. We tend to be an outdoor economy and work in well-ventilated office spaces as there is no real need for heating or cooling, so virus transmission by aerosols is likely to be low. Indeed a study in the online journal PLoSCurrents indicates that influenza in the tropics is much more sporadic (not seasonal) in nature and the most usual mode of transmission is by contact not aerosols which are sensitive to temperature and humidity. Not good news for Zimbabweans for whom social distancing is an alien concept.

“There really is nothing else that can prevent this virus from spreading in the population outside of public health interventions like social distancing. It’s the lack of immunity in the population that is making people so susceptible.” (Andrew Pekosz, Professor of Microbiology and Immunology at Johns Hopkins University, USA.)

There is of course the possibility that the lock-down has been effective in preventing the covid-19 from really getting going. I don’t think that really is the case. While the roads are relatively quiet they are not as quiet as in South Africa – I have yet to encounter a road block. A friend in the USA who’s daughter is a doctor working in Liberia has commented that they covid-19 hasn’t really taken hold there either. Whatever the cause I see a real issue here if it doesn’t take hold like expected; the general population will become contemptuous of the warnings and let down their already low guard for the next time.

“Public health measures can only succeed if there is a high degree of social solidarity, which requires trust in public health agencies and their leaders.” (Mark A. Rothstein is the Herbert F. Boehl Chair of Law and Medicine and Director of the Institute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine and a Hastings Center Fellow.)

And there will be a next time. It could take the form of another novel virus or a resurgence of the covid-19. The virus that caused the 1918 influenza pandemic that killed around 17 – 50  million people took 3 years to abate, so we should expect the covid-19 to be around for some time and a possible resurgence in the northern hemisphere winter is a real possibility. There’s also a possibility of a resurgence at the end of lock-down – a problem that South Korea may already be experiencing.

The tuberculosis vaccine, BCG, is mandatory for children in Zimbabwe and other African countries. There has been speculation that it could explain apparent anomalies in the spread of the covid-19 as it may confer resistance to other viruses. My friends in the medical profession are sceptical that it will be of much use to my generation as the vaccine is thought to be effective for a maximum of 20 years though that is hugely variable depending on, among other things, geographical location.  Trials are underway though it will be several months before the results emerge.

World UV intensity map

We have plenty of sunshine in Zimbabwe and are heading into the sunniest time of year; winter. It’s long been known that patients exposed to sunshine and fresh air recover quicker. UV light, which is also in abundance here due to our altitude and latitude, is an important sterilant and vitamin D generator which is also important for the immune system.  This all sounds like we should have an easier time of the pandemic, should it arrive, though I think this is far from a certainty. I am not taking chances and as an asthma sufferer I am high risk so will continue to take my medication. And wait.


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3 responses

18 04 2020
Dennis Hoines

You may wish to listen to A presentaton by Dr Jackie StoneMBChB (cum laude) (UCT), BSc (Med) Hons, (Medical Biochemistry) (UCT)MRCP (UK), D Av Med (UK), FRACGP (Aus), FACAsM (Aus)31st March 2020 who is based in Zimbabwe and has remarkable success in treating the Wuhan China Virus.

https://email.mweb.co.za/service/home/~/?auth=co&loc=en_GB&id=88356&part=2

17 06 2020
tuppit260

Worth considering that Brazil on a similar latitude in the southern hemisphere isn’t faring very well against the virus! What haven’t they done? What is different there?

17 06 2020
gonexc

They were very slow on the lock down. Also have much bigger cities and slums. Suspect obesity is more of an issue there.

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