Coronavirus COVID 19

Keywords:  corona virus, coronavirus, covid, covid-19

Introduction

The novel coronavirus spreading the COVID 19 disease first appeared in Wuhan, China, in 2019 and quickly spread around the world.  The infectious disease is a new form of a previous severe acute respiratory syndrome coronavirus (SARS) and has led to nationwide lockdowns from the East to the West.  This paper will discuss the signs and symptoms of COVID 19, the cause of the virus, prevention and management strategies currently being employed to help contain and stop the spread of what is now a pandemic, the epidemiology of the disease, and how it has impacted society and culture.

Signs and Symptoms

One of the more mysterious characteristics of COVID 19 is that one can be a carrier of the coronavirus and yet be completely asymptomatic (Chen et al., 2020).  Those who do exhibit signs of infection tend to have flu-like symptoms, especially if the person is already suffering from prior health issues.  Symptoms can range from fever to cough to breathing difficulties, muscle pain, headache, confusion, loss of energy, sore throat, chest pain, and even nausea (Chen et al., 2020).  Pneumonia can quickly develop in patients if not treated right away.

However, because cases of the virus are still being studied, there is no clear cut analysis of what symptoms are readily linked with COVID 19.  Some who present experience chest pain and palpitations.  Others have shortness of breath.  Still others show no signs of infection or symptoms at all and would not even be clinically diagnosed as having COVID 19 for that reason—though they are still being counted as infected persons by most media outlets (National Academies of Sciences, Engineering, and Medicine, 2015).  By far the most common symptoms are fever, cough and fatigue, and it is as of yet unclear what percentage of the population may carry the virus without ever showing symptoms at all.

Cause

Speculation persists about where the virus came from—whether from an infected bat sold and consumed at a Chinese wet market in Wuhan, China, or from a bioweapons lab in Wuhan, China, near the wet market where the virus was first alleged to have been contracted by human from animal species.  There is still no confirmation one way or another on the matter, and Chinese leaders have speculated that the outbreak was a bioweapons attack from the US in an effort to curb the One Belt One Road Initiative that China has been attempting to implement (Myers, 2020).  The fact is that no nation wants to own up to having a hand in the formulation or development of any biological weapon that might have been deliberately or inadvertently unleashed on the global public—even though numerous nations are engaged in the development of such biological weapons.  If the virus came from an animal to human transmission, China has shown itself unwilling to accept blame for not acting quickly enough to stop the spread, and the World Health Organization has essentially acquitted China of any wrongdoing or negligence on that front—much to chagrin of President Trump.

Aside from the question of where the virus came from, what is still debated, too, is how the virus spreads.  It is believed that the primary method of transmission is small droplets that contain a high viral load and that are transmitted from coughing, sneezing or talking to others.  Some have speculated that the virus can be airborne and transmitted simply from breathing the same air as those who are infected.  This speculation was largely born from the fact that so many passengers on cruise ships contracted the virus over a short period of time.

It has also been speculated that the virus penetrates the angiotensin-converting enzyme 2 (ACE2) receptor and thus takes control of the host through the lungs where the ACE2 receptors are most abundant.  The reason for the seriousness of the spread in China has been that Asians have twice as many ACE2 receptors in their body as white people.  The reaction in the West was somewhat muted at first, but as media-inspired fear spread, governors across the US have been locking down states.  Still, it is unclear how the virus spreads, or what it really is doing, whether it is essentially a more severe form of the flu and only has mild symptoms for most people in the US or whether it is as deadly and contagious as the media makes it out to be.  Though lockdowns have been applied for all non-essential services, one of the more perplexing characteristics of this disease is why it can be so quick to infect people at work, church, playgrounds and parks and yet seems to have no infectious capabilities at the grocery store where everyone in the community is still shopping.

Prevention

Prevention of the spread of COVID 19 is still being debated and there are presently two camps with regards to prevention:  those who view the virus as a credible threat and those who view it as an issue that has been blow out of proportion by the media and by politicians.  The first camp believes that total lockdown, social distancing of 6 feet, and the shutdown of all non-essential businesses, along with the wearing of face masks when doing business at essential places of business will help to prevent the spread.  There are, however, problems with this camp’s arguments—the first being that the virus has likely already made the rounds among the entire community since people were permitted to fly in and out of China for more than a month after the first infection was reported in Wuhan.  That means this highly contagious virus that spreads like wildfire had an entire month to spread around the world before anyone lifted a finger anywhere to implement preventive measures.  In short, the virus has likely already been contracted by everyone, at least in theory.

Another problem with the argument of the first camp is that the wearing of face masks will do nothing to actually prevent the spread of the virus if it can be spread airborne because the virus itself is so small:  it would be like a 6 ft tall man walking through a 60 ft high door—the virus could penetrate the pores of the mask with ease.  Thus, the mask is more a social placebo than anything and really provides no medical or scientific security if the virus is really as contagious and infectious as people have been led to believe.

Social distancing is also unlikely to have any positive preventive effect on the mitigation of the spread of the virus as the virus has been found to be able to live on surfaces for weeks (Oliver, 2020).  The prevention strategies are having a fundamentally disastrous impact on the national and global economies, however, and it could be a case of the “cure” being worse than the disease if the quarantine measures are not lifted soon for states.

Management

Managing the pandemic has not been an easy job by any measure and few people have escaped criticism.  China has been criticized for mismanaging the outbreak and failing to communicate to the rest of the world what it was seeing at the local level.  The World Health Organization has been criticized for failing to address the severity of the spread of the disease and for delaying what was clearly a pandemic in the making.  President Trump has been criticized for being slow to close the US borders and for failing to cut all flights to China, Italy and other parts of the world.  And yet on the opposite end of the spectrum are those who believe the whole virus pandemic story is largely incredible and fantastic and they see it as nothing more than a highly mismanaged case of the flu.

For one thing, the skeptics look at the death rate of those who have been put on ventilators and claim that the virus is not what is killing people but rather the mismanagement of patients’ health by health care providers—and the ventilator is being viewed as a big problem because of the fact that four out of five people placed on a ventilator end up dying from bacterial infection (Kekatos, 2020).  Are their better ways to manage the spread of the disease?  Considering the fact that this is a novel coronavirus and fear is spreading as quickly as the virus itself, it should not be surprising to find so much confusion with regards to what the world is actually facing.  So whether a person is dying from COVID 19 or from health complications that arise due to the type of treatment they are receiving from health care workers, or from some other issue is still as of yet unknown.

However, the criticism has not stopped.  Mayor de Blasio and Governor Cuomo of New York have both been criticized for not moving quickly enough to address the outbreak and their statements about keeping the state and city open, people continuing to ride subways being important and so on are now seeming like bad management tactics as the death toll continues to rise.  On the other hand, the fact that there is so much lack of transparency about what people are actually dying from is another issue that has made skeptics think twice about this virus.  At the top of that list is Elon Musk who has stated on Twitter that it is important to distinguish between people who die from coronavirus and people who die with coronavirus—his point being that just because a person has COVID 19 does not mean it is the primary reason for death.  EMS workers have also raised issues about death causes in their line of work by posting stories on social media about doctors marking down the cause of death in people as being COVID 19 when there were no tests done and no indications that this was the reason for the death.  However, hospitals are being reimbursed for every COVID 19 death they have by the federal government so there may be a conflict of interest in terms of what the actual number of deaths being reported is.  All of this plays into how the media portrays the epidemiology of the virus and how actual doctors and researchers describe the epidemiology of the virus.

Epidemiology

Because randomized testing of the public at large has not been conducted in the US it is impossible to fully understand the epidemiology of the disease and anyone purporting to understand it is simply engaging in pure and unbridled speculation.  Epidemiology cannot be known without the randomized testing of a significantly sized sample population in order for validity and generalizeability to be obtained in the research.  Epidemiology focuses on the incidence, distribution, and possible control of diseases—and if it is not known what percentage of the population has actually already contracted the virus and been unaffected by it, it is impossible to know what the mortality rate actually is.  Every outlet purporting to know the death rate is simply speculating based on numbers of tested persons—but the public at large has not been tested and it is quite likely that a vast number of the public has already been infected with the disease, suffered mild symptoms, and has moved on.

Nonetheless, there has been a great deal of discussion about antibodies, immunities, and vaccinations in the past few weeks in the US, with Bill Gates appearing predominantly on cable talk shows to plug his work within the vaccination industry and the need for developing a way to monitor who has been vaccinated and who has not.  The problem with all of this is that vaccinations of the flu difficult because of the tendency for the flu to mutate over time.  Another problem is that vaccinations are suspected by a signification percentage of the population who view them as unhealthy.  Third, there is a problem regarding the issue of consent, particularly as the “my body, my choice” mantra runs both ways.

Society and Culture

Inevitably, the discussion of the COVID 19 pandemic must arrive at the impact on society and culture as there is a clear break between those who believe the effect of the virus is being overblown in the US and those who believe everyone should continue to socially distance for at least another six months if not for the rest of their lives.  The fear is palpable with some and non-existent in others.  Protests have broken out in several states and people who have been put out of work by government mandated state-wide quarantines are now facing the prospect of going out of business.  The governor of Michigan is now facing social unrest as are other governors in other states.  Florida, feeling the pressure from the tourism industry, has opened up its beaches once more, but media outlets are reporting on social media outrage at people flocking to Florida beaches for some much needed relief as though going to the beach were the same as deliberately killing all Americans.  There is an obvious divide, therefore, between those who think the virus is a real threat to one and all and those who think the virus is simply the latest iteration of the flu and nothing more.

Already, however, one is hearing talk about how people should no longer shake hands or be near to one another, how families should stay six feet apart from one another as though this were the new normal in America.  It is a very anti-social policy that policy-makers are talking about, which could greatly undermine the social fabric of America and destroy the economy in turn.  Bars, restaurants, retail shops, churches, parks and playgrounds, libraries and schools all depend upon people being willing to socialize, to come together as a community—and if that is not allowed the very foundation for society ceases to exist as people essentially cease being social.

Thus, the question has to be asked:  at what cost should Americans be willing to sacrifice themselves to stave off the effects of an unknown disease that may or may not be killing as many people as is reported in the media?  One of the big problems in this debate is the fact that there are so many unknowns and so much speculation.  It is rampant speculation that allows for so much guessing and the media plays a big part in fueling the fear and paranoia about what might happen with regards to this virus should people fail to abide by social distancing guidelines.  Yet, these guidelines were not even implemented until March 2020, a full three months after the virus had already been spreading around the world, giving more weight to the argument that the virus has likely already run its course and that everyone who is going to contract it likely already has.  The lack of evidence one way or another, however, does not allow for a conclusive answer to be given.