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Mitigating Covid-19 Infections

Just some information, a few observations and a paradox concerning the rates of Covid-19 (novel Coronavirus) infections in different countries and people of different ages. I have a degree in Microbiology and a PhD. in Medicine but I am no expert here - I am just asking questions on Saturday 28th March 2020. My last job was in a rich-country Immunology department but I have spent a few years travelling in poorer countries and The Brazilian President quipped that Covid-19 is a rich-person's disease. I wonder if simple additional mitigation measures might already be available? Possible ideas might be: staying warm, exercising outside, catching a related less dangerous virus first, stop smoking, boosting old peoples immune systems etc.

Background knowledge of SARS-CoV-2 and the Covid-19 Pandemic

To see the paradox, one must first collect the data and understand or model the expected rates of infection, sickness, reporting biases and deaths. Here is some background data:

As Douglas Adams and the UK Government might say: Don't panic, keep calm and carry on. We do not need to just sit indoors and wait for a vaccine, that might be the worst thing to do ! Realise that this is natural, normal and we will all die anyway and it used to be much worse when half of all children would die under the age of five in the UK in the late Victorian era with poor overcrowded housing so there is no need to destroy the global economy or buy a year's supply of toilet roll so wake up, smell the flowers and count your blessings but know this is not directly an economic threat to any country - even the weakest. The UK created the greatest empire that the World has ever known when those children were dying from those forgotten simple infections and retirees losing a few years off their pensions and annuity payments only helps rich economies. Also, this is not an intelligent alien invasion, instead the virus is a dumb, stupid accident that doesn't want to kill you or anyone else: it is just a bunch of chemicals that can reproduce and spread if you give it a home to trash. So, in perspective, the current novel Coronavirus is a mild, sub-clinical infection in most people and it is possible to avoid infection - this virus is full of weaknesses (others might be much worse). Only government reactions to the virus can cause any serious economic damage. The dead and the nearly dead are the most vulnerable people in any society and deserve respect and love but not at the cost of the productive, creative, happy living people.

Avoiding the virus

From basic physics and chemistry, the novel Coronavirus, SARS-CoV-2, can be destroyed or rendered non-infective outside your body by: It can also be mechanically filtered out of the air by full NBC gas masks and normally needs to be taken to one's eyes, nose or mouth on grubby finger. If you are outside exercising alone in sunshine in fresh air, you cannot catch the virus. Exercise will also increase production of mucus in your lungs and then your lungs and trachea will wash yourself and little whipping cilia will push the cleaning mucus up and out of your lungs where you can spit it into a tissue. It may be that almost no one who cycles for a living ever catches the serious version of this disease ? It would be good to get the data? People who work in crowded air-conditioned offices or homes are asking for infection. However, even in Singapore which almost worships the air-condioner in daytime has managed to supress Covid-19. Indeed, we need a success to know what works and what is the minimum necessary for mitigation. Singapore has been a success but they only trace people who have been close with the infected person for over 10 minutes. In this BBC article, Coronavirus: The detectives racing to contain the virus in Singapore Getting angry with a family walking in a park or sat on a sunny beach with a sea breeze is a crazy over-reaction or worse ? 'There was no interest in someone I had brushed shoulders with even if it was someone that I knew. They were looking for people I had spent some amount of time with.' Officials were looking for close contacts, typically someone who spent more than 30 minutes with the infected person, within a 2m space.

Avoiding serious infection

Each of us normally has an awesome immune system better than all pharmaceutical companies put together with standard constant immune responses and an adaptive immune system that can identify and optimise antibodies in less than two weeks normally. The point is that everyone is absolutely fine normally but if one is old, immunocomprised or recently was infected by an influenza virus, then, in those special cases one becomes vulnerable. Even vulnerable people are not normally killed by the virus but some with pre-existing heart conditions or diabetes are especially vulnerable. I would guess that the location of the original site of infection matters and the dose definitely matters. Covid-19 seems to be two different diseases: a mild upper respiraory tract infection for most people and a deadly pneumonia for old people with pre-existing medical conditions. Infective doses matter - especially with gut infections - so getting a faceful of virus deep into ones lungs like a certain Chinese opthamologist probably got from a patient, is probably the worst thing to avoid. The old original bat coronavirus is 96% identical with SARS-CoV-2 at the protein level but may never have infected or spread between humans despite thousands or years or bats and humans sharing caves, getting eaten and even sweeping up bat poo regularly for use as fertiliser even today. I would imagine that just like Jenner published how infection with Cowpox virus protects against Smallpox infections, other Coronavirus infections might protect against Covid-19.

Treatments after infection

Most people do not need any medicine or treatments of any kind but there are some being developed.

Paradox of the Poor Countries

World map showing a green band over Europe and North America show where easiest for Covid-19 to spread

From metereological data, it appears that the virus spreads most easily in cool temperate humid climates like those shown in the green band in the map above. The large wide red band are areas which are too hot or dry to favour the spread of the virus. Maybe there is something about the climate or the relative poverty of people in Cambodia, Thailand, Vietnam and even the Philippines which helps protect the locals despite strong connections to both China and The USA which were the two most badly affected countries at different times ? Vietnam had many early infections but the disease has not spread much. Vietnamese people are smart, disciplined and their government controls everything but the people are still poor. Cambodia even allowed a cruise ship to dock when it had been refused by every other country out of fear of infection and the president himself even went down to the dock area to wave as the passengers disembarked. Only a single passenger was ever found to be infected and only after they had already left Cambodia and travelled through Kuala Lumpur ? The Philippines is a remarkably beautiful country made up of over 7000 islands with many surrounded by calm turquoise waters, beautiful corals, iridescent giant clams, tropical fish and brightly coloured sponges and even lavender and pink starfish! The local people are unusually friendly, kind, sociable, fun-loving and speak English so it is a great country to visit as a tourist and the Chinese and Americans visit in the millions. I also recently spent a few months there exploring the natural beauty and trying to let people know how cheap solar power has become recently: cheaper than any other electricity in the Philippines.

Unfortunately, The Philippines is not all Paradise because there are problems with corruption, pollution, congestion, poverty, poor planning, electricity production and reliability, and also with healthcare. Vaccination is a wonderful cheap safe way to protect people against infectious diseases but in The Philippines, the live attenuated Polio vaccine can pass through a vaccinated child and emerge as live infectious Polio virus into polluted rivers and water sources which then infect other vulnerable Philippinos with a full Polio disease. Better sewage treatment should prevent this completely. So the Philippines should be both rich and beautiful but is not currently and it is facing a special threat from the novel Coronavirus that causes the Covid-19 disease. It might appear surprising and paradoxical that The Philippines which struggles to prevent diseases that almost every other country on the Earth can manage is now apparently not being swamped by Covid-19 cases when it has millions of potentially infected Chinese visitors and relatively poor health infrastructure?

Chinese in The Philippines Links


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