While the U.S. president continues to blame China there are more signs that the outbreak started elsewhere:
Some question why Italy was caught off guard when the virus outbreak was revealed on Feb. 21.
Remuzzi says he is now hearing information about it from general practitioners. "They remember having seen very strange pneumonia, very severe, particularly in old people in December and even November," he says. "This means that the virus was circulating, at least in [the northern region of] Lombardy and before we were aware of this outbreak occurring in China."
The sudden appearance of a new type of coronavirus against which no one had any immunity led to a sudden rise of cases with severe respiratory difficulties. These require up to three weeks of ventilator support and intensive care.
Our healthcare systems are not capable of working under such an onslaught. If they get overwhelmed other cases which require intensive care will fall by the wayside. The number of unnecessary deaths will then start to explode.
The only possible way to avoid such an outcome is to minimize contacts between humans to stop the mass infection wave.
When the first wave exploded in Wuhan city the authorities ordered a complete lockdown of the city and of Hubei province. That happened on January 23. Twelve days later, on February 4, the number of new cases in Wuhan started to decline. The Lombardy region in Italy ordered a lockdown on March 9. Twelve days later Italy reported its first decline of new cases.
While the hospitals in Wuhan as well as in Lombardy were for a while overwhelmed the further outbreak has been slowed if not stopped.
(Wuhan is notorious for air pollution but Lombardy is not. The theory that air pollution has contributed to the high number of severe cases in both regions is thus not confirmed.)
Lockdowns have been ordered in several European nations and in several U.S. states. Boeing and other companies have shut down their production facilities in Washington state. Many people are now unemployed. The situations in various states look dire.
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But the lockdowns work and they will limit the rise of the current wave.
The question is now when to lift a lockdown. While twelve days are sufficient to stop an explosive rise in new cases they are likely not sufficient to stop the wave. Another two weeks of lockdown is probably required. After that the restrictions will have to be lifted in several steps to keep the number of new cases manageable.
It may well be necessary to prevent mass events from happening for several more months. Some travel restrictions are also likely to be kept in place. People will be able to get back to work but large meetings should be avoided. Using masks should become a social requirement (see below).
Instead of locking down whole populations one will have to find and lock down clusters.
The health care system needs a new branch that can take care of Covid-19 cases without the danger of infecting other patients. China established local fever clinics where people with flu or Covid symptoms can get tested. Those who have Covid must then be isolated for two weeks to prevent further infections. Their contacts must be actively traced. People who have come into near contact with an acute infected person are part of the cluster and must also be tested and isolated. Those who are put into isolation must be paid. Otherwise some will avoid it and will continue to spread the virus and disease.
These measures can be intensified or relaxed as needed. Their purpose is to keep the number of severe cases manageable. If the system works well we might even be able to eradicate the virus.
We now have tests for the antibodies people develop while they have the disease. Mass production has started. These tests will allow us to identify those who are no longer in danger when they handle a Covid patient.
There are signs that children often have carried the disease but were little affected by it. The antibody tests will show how many of them are already immune. The larger their number the better for the rest of us. Mass testing also seems to show that there are a quite large number of asymptomatic cases among grownups who nonetheless infect others. We should find some measures to prevent that.
A current paper published in Lancet argues that everyone should wear a mask:
Evidence that face masks can provide effective protection against respiratory infections in the community is scarce, as acknowledged in recommendations from the UK and Germany.
However, face masks are widely used by medical workers as part of droplet precautions when caring for patients with respiratory infections. It would be reasonable to suggest vulnerable individuals avoid crowded areas and use surgical face masks rationally when exposed to high-risk areas. As evidence suggests COVID-19 could be transmitted before symptom onset, community transmission might be reduced if everyone, including people who have been infected but are asymptomatic and contagious, wear face masks.
Wearing a mask helps with protecting oneself but even more importantly helps to protect others. One might be carrying and spreading the disease without knowing it. We all release fine droplets when we speak, sneeze or cough. Masks prevent one's droplets from spreading out.
The viruses are quite small and could slip through the pores of a mask. But the droplets they are carried with are larger and are less likely to come through. There are also suggestions that one virus alone is less likely to do harm and that a significant load of viruses is required to start the disease.
There are some cultural consideration that support the call for everyone to wear a mask:
The contrast between face mask use as hygienic practice (ie, in many Asian countries) or as something only people who are unwell do (ie, in European and North American countries) has induced stigmatisation and racial aggravations, for which further public education is needed. One advantage of universal use of face masks is that it prevents discrimination of individuals who wear masks when unwell because everybody is wearing a mask.
There is currently a shortage of professional masks and those that are still available are needed in our hospitals.
But one can also use a scarf, sew oneself a mask or make one's own masks from household items. None will be as good as a professional masks but all will help to keep the number of cases down.
Viruses do not like heat. Soap breaks them apart. One can clean a mask by heating it in an oven at 70°C (160°F) or by washing it with soap.
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Previous Moon of Alabama posts on the issue:
- The Coronavirus – No Need To Panic – Jan 25 2020
- Novel Coronavirus Defies Conspiracy Theories As Data Shows Its Coming Decline – Feb 1 2020
- The Epidemic Recedes – Number Of New Coronavirus Cases In Decline – Feb 8 2020
- Coronavirus – Statistical Change Causes Confusion – New Case Count Continues To Decline – Feb 13 2020
- Coronavirus – The Decline Of New Cases Continues – Economic Ripples Begin To Emerge – Feb 21 2020
- As Virus Spreads Over The Planet Governments Are Slow To React – Feb 27 2020
- Coronavirus – Its Time To Press Your Government To React Faster – Feb 29 2020
- Coronavirus – Bad Preparation And Propaganda Increase The Onsetting Panic – Mar 6 2020
- Why Is The Coronavirus More Dangerous Than The Flu? – Mar 9 2020
- Coronavirus – The Hidden Cases – Why We Must Shut Everything Down And Do It Now – Mar 11 2020
- News-Nugget About The Coronavirus Pandemic – Mar 13 2020
- The Pandemic Will Cause A Global Depression – We Need Demand Side Measures To Counter It – Mar 16 2020
- Coronavirus – A Lockdown Is Not Enough – Mar 17 2020
- False Claims About The Novel Coronavirus And How To Debunk Them – Mar 19 2020
- Congress Grifters Profit From Crisis – Mar 20 2020
- Coronavirus – On Western Government Failures And Possible Therapies – Mar 21 2020
- Coronavirus – How To Lift Lockdowns And Why We Should All Wear Masks – Mar 23 2020