COVID19–8 Lessons from Wuhan, China to Elmhurst, USA
Hope India and others learn and avoid a new epicenter
This article is written along with DR. V. KRISHNAMURTHY, M.D. Internal Medicine, Visakhapatnam, India, a physician with several decades of experience in medical practice at different levels.
Elmhurst, New York, USA, emerged as a new epicenter for COVID19.
How come the USA the superpower is unable to handle COVID19? Why are there more deaths every day in your city? What’s going on? Is not the USA a clean, neat, hygienic country? If the USA is not able to control, can India control if it enters the next phase of the pandemic?
Their genuine concern is primarily about my family and me, at a broader sense why America failed in stopping the virus.
What can be learned from the rapidly growing infection and deaths as a consequence in the USA, in particular, New York City? These are some of the questions on the minds of people around the world and, in particular, India, with a 1.3 billion population.
I am an immigrant from India living in New York City, 11 miles away from the Epicenter of the Epicenter, Elmhurst, for the past 32 years. I am a molecular biologist with working experience in the vaccine industry. So I started checking the data and details available to me in the ‘stay at home ‘ situation and presenting the following points.
1. Strict Measure to suppress the virus is a must!
China, which was the first epicenter for COVID19, has successfully controlled using suppression spread of the virus very effectively. The details of the operations to suppress are narrated by Dr. Zhang Nanshan, the Chinese Academy of Engineering. But the USA failed to suppress as the measures were not strict enough.
Comparison of China, USA & India Confirmed Cases progression
CHINA
The USA
India
The Hammer and Dance model presented by Mr. Tomas Pueyo to control COVID19 has presented all the details. India is doing well until an international congregation of religious group Tablighi Jamaat members from several countries met at New Delhi and spread all over India knowingly or unknowingly when they were stuck in India. Now the Indian cases are increasing at least 10% a day and racing.
2. Public awareness of the virus is essential.
This is people’s war on the virus. Governments can guide but can not fight directly. People have to fight. Viruses have been attacking humans, and humans have been surviving in the process of natural evolution. COVID19, also known as SARS-CoV-2, is the seventh coronavirus known to infect humans. In 4 months from its place of origin, China. It is spread to 183 countries and regions as of today. How is it doing this kind of harm to humans? It is a spherical virus with a 90-nanometer diameter. It is approximately 16 million times smaller than man. A virus is not a living entity. It is an infectious agent that replicates only inside the living cells of humans, as shown in the picture below.
Virus Life Cycle in Human cell
For an explanation of the infection, production of millions of COVID19s by human cells, and the problems it causes, please watch this video presented by the Center for Disease Control( CDC).
A person with active COVID 19 infection can give live COVID 19 virus particles through breath, talking, cough, and sneeze. Sneez can give the highest number fo the disease-causing virus approximately a million per sneeze. The disease-causing virus particles will be in the droplets of the fluids coming out from the nose and or mouth. Therefore, maintaining a 6 feet distance from one another is essential. If you do not get the droplets, you can not be a host to the virus and carry it alive forwards. COVID19 patients shed virus for a prolonged period after symptoms end, including in stool. It can be at least eight days. It may not survive beyond some time. Proper hygiene and Social distance is the right measure to stop the virus.
3. Unconfirmed reports must not be used for decision making
Besides, there are hypotheses people hope that India is better protected due to T.B. vaccination, higher temperatures, and higher summer temperatures can reduce the transmission; a specific micro RNA in Indian may protect from COVID19. There is very little data to predict the virulence of the COVID19 virus strain in India. But as we know from the available data, the hospitalization and death % should be taken seriously.
4. Fear should be avoided
At present, there are 1.70 million confirmed cases in the world. This scares many people more than the needed caution. As the testing goes up, COVID19 positive case number goes up. From the analysis of 44,672 Chinese data, we know that not all of them are patients and need hospitalization. Only some 20% of all the positives required hospitalization, and some need critical care. The same trend is seen with a much larger data set from the USA and New York City. However, the trend in India is taking a different path. As of today ( 11th April 2020, India has 8,006 cases and 249 deaths only. Statistical analysts predict 1/8th — 1/10 of death rate in Tropical countries compared to the other countries.
Administration and people of Bhilwara, Rajasthan, India demonstrated that India can fight a ‘hotbed’ and control COVID. This gives hope that without ‘harsh methods’ countries can control the virus.
5. Medical Measures — Prophylactic and Treatment
There are many sincere suggestions for preventing, prophylactic, form various parts of the world based on the traditional or Folk or Indigenous medical practices — Ayurveda, Homeopathy, Unani, Siddha, Chinese Traditional medicine and others from different parts of the world. Steam inhalation, adequate warm water consumption, and gargling to keep the upper respiratory tract clean and healthy are the most useful and accessible. The most used medicines so far are Hydroxy Chloroquine ( 400 MG BID), Anti parasitic drug IVERMECTIN from Australia, Favipiravir. Steroids, oxygen, blood transfusion, the serum of recovered patients are also used as needed. Vitamin A, C & D, and Zinc supplements are also suggested as a general immune system boosting agents. All other medical management needed for upper and lower respiratory treatments are being used. A lot of data from different clinical observations and reviews of many doctors and intensivists and from the postmortem examination pictures of COVID-19 victims in the USA and Europe is being published every day. It is prudent to watch the information put out regularly by the CDC, USA, Harvard Medical School, and discuss it with your physician if you need to know more.
6. Politics can kill more people than the virus.
President Trump tweeted to impose Quarantine on the New York Metro area as it became ‘hot spot for Carona virus, on 28th March 2020. But due to pollical opposition and legality and logistics of such a maneuver, he backtracked. In the following week, there are 196,200 new cases in the USA that may have resulted in a few thousand deaths.
President Donald Trump, on Monday, said 3M would produce 55.5 million masks per month for health workers in the U.S., ending a days-long conflict between the White House and the mask manufacturer over Trump’s use of the Defense Production Act forcing 3M to prioritize domestic orders.
7. The Near Future is Critical
The USA situation can be a useful guide for India. Three weeks back on 15th March 2020, The USA had 4,600 confirmed cases, just like today in India 4,908.
Total projected U.S. deaths from COVID-19 are projected to climb steeply in the coming weeks and reach 93,531 by 4th August, according to the Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington. The estimate, which includes a wide range of uncertainty, was cited today by Dr. Deborah Birx, the White House coronavirus response coordinator.
“There will be a lot of death,” President Trump declared on 4th April 2020.
“If a county has detected only one case of COVID-19, there is a 51%
the chance that there is already a growing outbreak underway,” the researchers state. “COVID-19 is likely spreading in 72% of all counties in the U.S., containing 94% of the national population.”
Probability of ongoing COVID-19 outbreaks for the 3142 counties in the United States. The chance of an unseen outbreak in a county without any reported cases is 9%. A single reported case suggests that community transmission is likely.
“Proactive social distancing, even before two cases are confirmed, is prudent,” concluded the researchers, Emily Javan, Dr. Spencer Fox, and Dr. Lauren Ancel Meyers. “Although not entirely surprising, these risk estimates provide evidence for policymakers who are still weighing if, when, and how aggressively to enact social distancing measures.”
8. “ CATCH me NOT’ game between Man and Virus!
The pandemic is a CATCH me NOT game between man and virus. At early stages in a child’s life, having a catch is a good way to evaluate and improve the child’s physical coordination. Here in this nature’s big game, the virus wants to be caught. The one who gets the virus is helpless but to throw, but through carefully so that no one can catch! Nature wants all the 7.7 billion people to play the game. For a disease with no specific treatment, two things are important the individual immunity and nutritional status of the patient. The weak who can not sustain will be lost. Those who Catch but withstand will win!
