Coping with Coronavirus

IT WAS REALLY inevitable that the number of people infected from the novel coronavirus eventually rose in India. And so far, at the time of going to press, at least 30 people have tested positive. This includes the first three who recovered from the infection in February in Kerala.

Most of the recent cases involve people who have been in India for over a week or more before their test results came out. And as health officials now start tracing the route and places of stay of these infected individuals—for instance, the group of 15 Italian vacationers and their local Indian driver who were travelling across Rajasthan’s tourist sites—more cases will no doubt show up. Some will potentially even slip their net.
But as alarming as this new spike in cases seem—and it is admittedly worrisome because it comes at a time when self-sustaining clusters of this virus now seem to be forming in Europe, the Middle East and the US—30 is still a very small figure given the size of the country.

And so while alarm bells ring across India, powered by WhatsApp groups and dodgy YouTube videos, as people don masks (mostly pointless), stay at home and refrain from visiting public spaces, cast suspicious gazes at sneezing co-passengers in trains and buses and shy away perhaps even from the upcoming Holi, it is worthwhile to remember that the virus is really not as dangerous as it is made out to be. It kills, according to current estimates, about two of every 100 infected individuals. Even within its own family of coronaviruses, Covid-19, as it is formally called, is not particularly dangerous. The 2003 severe acute respiratory syndrome (SARS) outbreak in comparison killed around 10 in every 100, and the Middle East respiratory syndrome (MERS), around 35. Covid-19’s 2 per cent death rate will probably drop even further over time since in the beginning of the outbreaks the initial identified cases tend to be severe, which makes the mortality rate seem higher than it is.

Now that some time has passed since the first cases of the infection were reported, we know from studies conducted in China that even among those who die from Covid-19, the majority tend to be people who are old or whose immune systems are compromised because of other longstanding health issues. One study, for instance, found that while the general mortality rate is a little over 2 per cent, when it comes to people who are aged between 70 and 80 years, 8 per cent of them die. This shoots up to almost 15 per cent when the infected person is 80 or older. For a majority of the infected, it will probably be a matter of a few sniffles, some mild fever and cough, before they recover fully as though they were suffering from just the common cold.

Even if a full-on outbreak does occur in India, the number of deaths will still be smaller than that of people who die from measles, diarrhoea or antibiotic resistance every year.

Covid-19 does not spread through the air. So there go our masks (if you are trying to protect yourself from an infection). Most commonly used masks, let alone this particular viral infection, cannot filter out small particles that transmit infectious agents. They come with their own hazards since many tend to wear their masks incorrectly and constantly touch their faces to correct it, thereby increasing the risk of infection.
How Covid-19 really spreads through is via ‘respiratory droplets’ which gets released when an infected person speaks, coughs or sneezes. Since these respiratory droplets are heavy, you are unlikely to even catch it directly from an infected individual unless you stand close enough (within 6 ft) for droplets to reach you.

The majority of the infections, as scientists reporting this virus have explained, is actually occurring through people touching contaminated surfaces. When an individual touches a surface that has been contaminated by respiratory droplets from infected people—for instance, doorknobs, lift buttons or handrailings—and the person then goes on to touch their mouths, noses or eyes, they invariably infect themselves. So the best bet is still to wash one’s hands constantly and carefully. What is not known, however, is how long the viruses in these droplets can survive on surfaces, leading some to surmise that the virus will perhaps not thrive in India given the country’s hot weather. Masks can be beneficial when used by those already suffering from this coronavirus or some other respiratory ailment, since it will help contain droplets containing any type of virus when they cough or sneeze.

There have been some raised eyebrows over the new spike in cases in India since there are already travel restrictions in place and screenings at airports. The response has been to point that these new cases are of people who travelled to India not from China but other places such as Italy or Dubai. The Government has responded to these new cases by now ordering mandatory screenings of all passengers arriving at airports and suspending visas of travellers from several more affected countries.

What is done at airports are thermal screenings, where they look for spikes in the body temperature of individuals. In reality, it is quite possible to slip through these screenings. With this particular virus, the infected go through a fairly long asymptomatic phase where they may have no fever or exhibit any other symptom. Some have reported that there have been cases where infected individuals in asymptomatic phases have even passed on the virus to others. The medical journal Lancet reported the case of a 10-year-old infected boy who developed no symptoms, even though others in the child’s family fell ill. In Macau, for instance, there is a report of a 15-year-old resident of Wuhan, who tested positive for the coronavirus despite having no fever or cough.

Could such infected people without symptoms not slip through the thermal screenings at airport or, in the case of a fever, just pop an antibiotic to suppress it?

It is likely that the numbers of those infected will further rise in India. The poor infection control in our hospitals, where often two or more patients share a bed, and the absence of a strong healthcare system, especially in smaller cities and towns, mean that if an outbreak occurs, the infections could spread. It could possibly even lead to a few deaths.

But eventually the spread will decrease in India and elsewhere. As we develop immunity, either through infection or through vaccination whenever that is ready, Covid-19’s footsteps will halt. One good example to turn to is the 1918 Spanish flu pandemic which is believed to have gone on to infect around 500 million people worldwide then. One of the main reasons why its spread halted is because those who survived it had developed immunity and the virus didn’t hop as easily as it did at the beginning.

Another likelihood is that the virus will continue to circulate but it will become part of a bouquet of seasonal but mostly harmless diseases such as the flu or common cold. We will sniffle a bit, maybe cough and run a high temperature for a few days, but eventually get over it.

So till we wait with trembling knees for that immunity cover, it is a good idea, as more cases shore up, to not cast suspicious gazes on all human beings, to not give into WhatsApp forwards and to not spit, but to wash our hands slowly and carefully, and if a cough does arise to our mouths, to develop some coughing etiquette and do our business into handkerchiefs or the crooks of our elbows.

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