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. Today, The UK has announced over 1000 deaths whilst Vietnam's health ministry says there have been a total of 174 confirmed cases but zero deaths. I wonder if simple additional mitigation measures might already be available? Possible ideas might be: turning off air-conditioning, riding a bicycle to work, staying warm, exercising and living outside, catching a related less dangerous virus first, stopping smoking, boosting old peoples immune systems etc. but I have no data to test these ideas. Understanding why young people are not dying from this virus would be great and might be transferrable easily. People who have had Covid-19 and recovered can work in hospitals and supermarkets protecting others. If we just had a cheap reliable test, everyone could take it on one day and then there would be nowhere for the virus to hide and everyone would stop panicking chasing ghosts that they cannot see.
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 does not want to kill you or anyone else: it is just a bunch of chemicals that can reproduce and spread if you give them a nice home to invade and 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 particular 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. If six hundred thousand people normally die each year in the UK, I wonder why we are aiming to keep deaths amongst the sickest, nearest-to-death people in the UK below twenty thousand just so they can die from the even nastier dementia and or cancer which are the two commonest causes of death in the UK? The total overall cost of the cure must be less than the cost of the infection or why bother ?
In the north-eastern Italian city of Rimini a man aged 101, identified publicly as only "Mr P", was released from hospital on Thursday after being admitted last week and testing positive for Covid-19.Spain and Italy are rich countries with good pensions, weather, family structures and healthcare so they kept many old people alive, healthy and happy longer than most countries ever could but nature still cares more about genes and DNA more than individuals who are supposed to die so this virus is having a shocking effect there.
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 respiratory 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 heroic Chinese ophthalmologist probably got from a patient, is probably the worst thing, the one 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 today, sweeping up bat poo regularly for transport to market and sale as fertiliser. 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. Some people will always be genetically resistant to infection but they might be in a minority.
Most people do not need any medicine or treatments of any kind but there are some being developedand the UK death rate is estimated to be well be 0.5% and should fall as treatments are discovered but testing has been unclear so far. Each recovered patient can donate or sell their blood plasma which should contain antibodies to fight infections in the plasma recipient. Each recovered patient can have their immune system memory cells read to discover which antibodies were being made and these can be copied and manufactured.
Everyone expects that the virus will not be important next year so all the direct economic effects of government responses will be finished by then.
From meteorological 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 which cover Europe and North America. The large wide red band covers 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 with basic healthcare. 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 then only after they had already left Cambodia and travelled through Kuala Lumpur in Malaysia? These countries are generally not well run but looking at the rates of death from Covid-19, they appear to be doing astonishingly well. However, Vietnam is trying a full lockdown now as a single infected airline pilot in a bar was unlucky enough to give the disease to 13 others in District 2 in Saigon. Is it just warm sunny weather enouraging an outdoor life in the fresh air? Are they not testing or actively hiding results - maybe slightly but I think it is also a real effect - the virus is not spreading so well there ? Thailand is a well-run middle-income country that also has low levels of death from Covid-19. It certainly seems that Indians can be infected easily and it is just relative isolation that protected them initially. The UK has been slow to get both antigen and antibody testing scaled up and health workers are very worried about ineffective protective clothing but we do have good researchers and the virus is a static target.
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 definitely not all Paradise because there are problems with corruption, pollution, congestion, poverty, poor town 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, normal standard 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 yet being swamped by Covid-19 cases when it has millions of potentially infected Chinese visitors, relatively poor health infrastructure, cronyism and coruption ?
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