The virus is a mutation of a previously relatively harmless virus, believed to have originated in an animal sold in an illegal live-animal market in the Chinese city of Wuhan, Hubei Province. Live animals of unusual types were sold to cater for the Chinese taste for exotic foodstuffs. Possible suspects for the original host animal include bats and snakes; bats being far more likely. The outbreak spread rapidly during December 2019 but the information was suppressed by the Chinese for some time until it could no longer be concealed from the outside world. One major problem is that it was the Chinese New Year and many Chinese were travelling around China and to other countries. The Chinese government enforced draconian lock-downs in Hubei and various other cities and provinces. The lockdowns prohibited movement from the areas in question, enforced curfews, and in some areas the authorities only allowed named, specific regional representatives to buy food for neighbourhoods.
The Corona Virus.
In common with some other viruses, the corona virus consists of a strand of RNA (ribonucleic acid) surrounded by an envelope of protein. The protein envelope gives the virus its characteristic shape which, because it is something like a spiky crown or coronet gave the virus its name. Viruses reproduce by entering the cells of the host animal and forcing them to produce virus RNA instead of the animal’s RNA which is present in each of its cells. Before it mutated, corona virus caused mild respiratory tract infections such as some cases of the common cold, but also the much more serious SARS infections.
As of the 13th of February, more than 132,500 cases of covid-9 had been confirmed worldwide. There had been 5000+ deaths, most of which occurred in China but Europe is rapidly catching up. More than 123 countries have been affected, with major outbreaks in Central China 80,761 (cases), South Korea (7,513 cases 52 deaths), Italy (17,660 cases 616 deaths), Iran (8042 cases 194 deaths). France (2876 cases, 22 deaths), Germany (3062 cases, ?9? deaths they are not being honest), Spain (4200 cases, 120 deaths), USA (787 cases 19 deaths), Netherlands (265 cases, 3 deaths). On that date there were 798 people in Britain known to have the disease and there had been 11 deaths.
By the 14th of March, cases in Britain had leapt to 1,140 with 21 deaths. The rate of development of infection in the United Kingdom is now exponential.
Rate of development.
At the end of February, Italy had 153 diagnosed cases of coronavirus infection, but by the 11th of March 2020 it had 10,149 cases and the country is now in lockdown. Today we had 8,227 diagnosed cases in the UK and 433 deaths although the authorities believe that there could already be up to 50,000 undetected cases. British epidemiologists believe that we are also on the verge of an exponential rise in cases. Graphs which I am plotting support their belief.
There are at present, an estimated 20,000 British tourists in Italy the other countries who will be coming home as soon as they can arrange transport. It is highly probable that some of them will already be infected with coronavirus. It is expected that the incidence of the disease will peak in a steep curve in the United Kingdom in 10 to 15 weeks, between mid-May and the end of June. The British Government’s policy is to try to flatten the curve giving the Health Service a greater chance to cope with the critical cases.
It is believed that the virus spreads between people in a similar manner to colds and influenza, via respiratory droplets produced during coughing or sneezing. The largest droplets from sneezes can travel between four and six feet in still air conditions. Droplets projected by coughs do not normally travel so far. Live viruses and bacteria from these droplets can remain in the air for as long as 45 minutes, and live viruses can remain on surfaces such as the floor, tables, chairs, door handles, bannister rails, lift buttons and telephones for a few days. For this reason, it is important for the hands to be washed or sterilized after touching potentially contaminated items or surfaces. The handling of paper money could be a particularly significant vector although I understand that on a dry surface the virus survives for only about 48 hours.
The official advice is that there is no evidence that the wearing of a face mask confers any significant protection to a healthy subject, particularly if the wearer has a beard. This is partly because most of the commonly available masks don’t fit properly at the sides, but I also suspect that the authorities do not want the general public to start buying and hoarding masks which are needed elsewhere. Doctors and nurses treating infected patients all wear surgical masks. It is also recommended that anyone infected with the virus should wear a surgical mask to protect others from infection, unless the illness has reached a stage when wearing a mask would adversely affect their breathing.
The time between exposure and symptom onset is typically five days but can range between 2 and 14 days. There appears to be limited evidence that subjects can spread infection before showing any symptoms. Many countries are researching methods for detecting the disease and producing a vaccine, but it is unlikely that an adequate and effective vaccine will be produced in sufficient quantities in less than a year to 18 months. The only palliative treatment which seems to be generally available is paracetamol, which does not cure or prevent the disease but can relieve some of the symptoms.
The hands should be washed thoroughly using soap and warm or hot water as soon as practicable after possible contamination. It is important to ensure that the fingers are washed on all surfaces. The recommendation is that the hands should be washed for 20 seconds which is apparently how long it takes to sing two verses of “Happy birthday to you”. Rinse well in running water and dry, preferably with a paper towel, using the towel to turn off the tap. Unfortunately, certain types of commercial flat air-jet hand dryers can cause aerosol droplets to be produced during the drying process. If possible do not touch the door handle with your bare hands, protecting yourself by using another paper towel.
If it is not possible for you to wash your hands, the next best alternative is to use an antibacterial hand gel which must contain at least 60% alcohol. Contrary to previous incorrect information, alcohol can destroy corona virus, although it does not destroy certain other types of viruses such as norovirus and rhinovirus. This is because corona virus has a protein envelope which can be denatured by the alcohol, whilst the other two types of virus do not.
Most of the 5,000+ fatalities were older patients, 80% of the deaths recorded were over the age of 60, and 75% had pre-existing health conditions including cardiovascular diseases, asthma and diabetes.
In the UK approximately 3% of cases have been fatal. Almost all of the fatalities except one were over the age of 60 and had pre-existing (but undisclosed) health conditions. The apparently high fatality rate conceals the fact that many of the deceased might have died as a result of their health conditions in any case.
Sometimes infected patients show no symptoms; however typical symptoms are normally fever, prolonged coughing fits, fatigue, headaches, shortness of breath, and muscle pains. A limited study seems to show that other symptoms can include loss of appetite and diarrhea. Further development of the disease can sometimes lead to severe pneumonia, acute respiratory distress syndrome, sepsis, septic shock, and possibly death. The normal body temperature is 37° Celsius 98.4°Fahrenheit; a temperature of 39° C. is regarded as diagnostic of a fever, a temperature above 42° C is a high fever and could be very dangerous.
Rate of development.
At the end of April Italy had 153 diagnosed cases of coronavirus infection; by the 11th of March 2020 it had 10,149 cases and the country was in lockdown. On the 13thof March we had 798 diagnosed cases in the UK, the following day we had 1,140 and most British epidemiologists believe that we are also on the verge of an exponential rise in cases. Two graphs which I am plotting tend support their belief.
Reducing the risk of infection when coronavirus becomes endemic in the UK.
The level of precautions needed at any particular time and in any particular area will obviously depend upon the number of cases identified in the area.
Since it appears that some people in the early stages of a coronavirus infection may not realize that they are infected, any situation where you are in close contact with many other people (particularly in a vehicle or indoors) increases your chances of infection.
Travel in an aircraft presents a particular problem because it is an almost totally sealed environment; passengers are rebreathing air that has previously been breathed in and out by many other passengers. When smoking was permitted on aircraft the air was filtered, but on most aircraft now, filtration no longer takes place. So many people have cancelled holidays and air-travel that airlines are now likely to be in serious financial difficulty and it is possible that some of them will go bankrupt.
Travellers on trains, buses and coaches also suffer from danger of infection, but it may be less serious because there is normally better ventilation. Sitting in a crowded room listening to a talk can unfortunately present a significant danger. Sutton Coldfield U3A has now wisely cancelled all talks and meetings until further notice, because most of the 1,600 members are over 60 years of age.
In Italy the advice is that for safety you should stand at least 2 metres away from the next nearest person. Two metres separation distance would not be sufficient to protect you from the respiratory droplets if the other person coughed or sneezed and you were standing downwind.
We have been exhorted not to shake hands when we greet others. Do not consume unwrapped precooked food or fruit from market stalls or other situations where hygiene cannot be guaranteed (this is good advice at any time). Try as much as possible to avoid touching banisters, railings, the handrails on escalators and door handles; particularly with your right hand. If you have to press any buttons, ideally try to do so with the left forefinger knuckle. One study showed that people typically touch their faces about 20 times each hour without really thinking about it. If possible try to get into the habit of using your righthand if you must touch your face to scratch itches etc. Try to keep your left hand as the one which could get contaminated by opening doors and pressing buttons. But of course, wash your hands as soon as you can after any possible contamination. Any bare-hand contact with door handles, handrails, shopping trolleys, baskets, keypads or petrol station filling nozzles should be regarded as possible contamination.
Now that the disease has become endemic in the UK, schools and universities have been closed and all meetings have been banned. Pubs, restaurants, theatres, clubs and nonessential shops have now been closed by the government. Where possible people have been encouraged to work from home. It has now been enacted that all people as well as the older and vulnerable, should undertake “social distancing”.
It is now recommended that all people especially those over 60 years old should voluntarily maroon themselves in their houses and gardens, making most of their social contacts by telephone and the Internet, and possibly venturing out briefly to buy food and medications; although it will be relatively safe for them to get exercise by gardening and by walking in the open air away from other people. For the time being parks have been left open for public access.
Michael Gove, when interviewed on the BBC breakfast programme said that the cultivation of allotments is a permitted form of exercise, but we must strictly follow the guidance on social distancing. Whilst under normal circumstances two metres separation is regarded as safe, this is not necessary the case in the exposed situation of the Walmley Ash Allotments because the respiratory droplets, possibly containing live corona virus, can be carried much greater distances if there is a breeze. If you are carrying on a conversation with another plot holder, I would strongly recommend an interpersonal distance of at least four metres unless you can be sure that you are standing sideways on to the prevailing breeze. When touching locks, gate fastenings or taps it is recommended that you should wear gloves. If this is not possible you should sterilize your hands with antibiotic gel immediately afterwards.
1. There is a claim that a certain miracle mineral supplement called MMS can wipe out Coronavirus. This is complete nonsense, but is no doubt making some fraudster a lot of money.
2. Homemade sanitiser. Some of them use vodka as a source of alcohol. The sanitiser needs to contain at least 60% alcohol. Vodka contains only 40%. Commercial hand sanitiser, besides containing >60% isopropyl, also contains emollients which make it gentler on the skin.
3. Drinkable silver. Some American nut-case claims that colloidal metallic silver kills the virus. This is absolute nonsense!
4. Drinking water every 15 minutes. Obviously the body needs to keep hydrated, but it is not true that drinking large quantities of water will “wash the virus away”.
5. Exposure to the sun and avoiding ice cream. Whilst it is true that health-giving vitamin D can be produced by the skin when exposed to the sun, this does not kill the virus if it is already present in the body. The avoidance of ice cream makes no difference.
6. Eating garlic. There are many posts on the Internet claiming that eating garlic keeps the virus away. There is no truth in this. It used to be believed that eating garlic kept vampires away. If you eat enough so that your breath smells really bad; perhaps it will keep everybody away.
7. Drinking tonic water. There may be some small measure of truth in this. Tonic water contains quinine, and a quinine derivative has been used for the treatment of corona virus infections. Watch this space.
The latest information on COVID 19 can be obtained from the website nhs.111.uk
They give advice such as the following:-
1. Wash your hands with soap and water often, do this for at least 20 seconds.
2. Always wash your hands when you get home or into work.
3. Use alcohol hand sanitiser gel if soap and water are not available.
4. Cover your mouth and nose with a tissue, or your sleeve (not your hands) when you cough or sneeze.
5. Put used tissues in a bin straight away and wash your hands afterwards.
6. Try to avoid close contact with people who are unwell.
7. Do not touch your eyes, nose, mouth or any open wound if your hands are not clean.
If you think you have Coronavirus- do not go to a GP surgery, pharmacy or hospital.
You will need to self-isolate.
1. Stay at home.
2. Do not go to work, school, or any public place.
3. Do not use public transport or taxis.
4. Ask friends, family members or a delivery service to do errands for you.
5. Try to avoid visitors to your home - it is OK for friends, family or delivery drivers to drop off food.
6. You will need to do this for 14 days to help reduce the possible spread of infection.
7. Paracetamol can be taken to relieve some of the symptoms. There is a widespread rumour that ibuprofen is harmful under these circumstances but this appears to be an urban myth.
If your symptoms worsen during home isolation or are no better after seven days, contact NHS111online If you have no Internet access call NHS 111. For a medical emergency dial 999.
To get the latest travel advice, for safety, particularly if you are considering traveling abroad, consult www.gov.uk/guidance You will be given up to date information on the situation and perceived risks at the particular location of interest.
The British government expects the virus to spread in “a significant way” in the next few days and weeks. The epidemic should reach its maximum in about 6 to 12 weeks time. They appear to be preparing for the (hopefully remote) possibility that 80% of the population of the UK will eventually catch the disease, with a worst-case scenario of 500,000 deaths. The most likely scenario is that it will rise to its peak in the next two to three months. It is to be hoped that they are being unduly pessimistic; even in Hubei Province the region of China where it started, only 20% of the population caught the disease. One reason for possible optimism was that the virus was believed to be relatively short-lived in warmer conditions, and as a result the epidemic may become less serious as we go into summer; a bit of global warming could be a very good thing. However, if the virus is short-lived in hot conditions it is hard to understand why it is thriving in Italy, Spain and Iran. It is to be hoped that there will not be another resurgence in autumn and winter. At present there is no evidence that people who have recovered from COVID 19 have acquired future immunity, although this would be the normal assumption. It is an assumption upon which the British government is rightly or wrongly basing its herd immunity policy.
It is intended that this summary will be updated at regular intervals as further information becomes available.
Rodger Ide BSc, CChem, FRSC, CBiol, MRSB. Wednesday, 24th March 2020.