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Silver Lining to this Dark Cloud

If you watch TV news, you cannot help but get worried about all the negativity surrounding COVID-19.  However, there are many positive aspects that we should take solace in and be thankful for. 

1.  COVID-19 is not as contagious as other disease the world has dealt with.  When a person gets infected with COVID-19, they are likely to infect somewhere between 2-4 other people. This statistic is called R0, pronounced ‘R-naught.’  This gives some idea of how contagious the disease is.  

Measles, on the other hand, has an R0 of 30 which means that it is more than ten times as contagious as COVID-19.  We have struggled with measles for aeons and we still do not have any known drugs that can help this. It took us ages to develop a vaccine for measles, yet the world survived in spite of not having a vaccine or any known treatment.  

2.  COVID-19 does not cause as many deaths as other diseases we have dealt with.  COVID-19 has a Case Fatality Rate (CFR) of 1.4% which means that if 1000 people get infected, about 14 are likely to die.  Compare this to small pox that has a Case Fatality Rate of 30%!  While COVID-19 is nothing to mess with, it could be a lot worse.  Small Pox has been causing problems for many years, until a vaccine was developed by Edward Jenner.   He used the fact that Cox Pox causes a mild infection but increases immunity to Small Pox. 

3.  Vaccine are already being tried on humans for COVID-19.  It might take a few months for this vaccine to be available widely and will likely be given to health care workers first.   But once this vaccine is developed, this pandemic will come to a dead halt given the immunity that people will have.  The virus will not be able to spread from person to person so will die away or become very infrequent.   

4.  Since many people are surviving the disease, their antibodies can be used to fight the disease.  Every time we successfully fight a viral infection, our body learns to produce antibodies that can bind to a virus particle and help clear it before it can cause another infection.  These antibodies can be purified from people who have recovered from COVID-19 by a process called ‘apheresis’ where blood is taken from the body, the anti-viral antibodies are removed and blood put back in the person who it was taken from.  The purified antibodies are then infused into a person who is struggling against the disease to help that person fight the disease more effectively.  This process is called giving passive immunity.  Apharesis was used in the SARS outbreak of 2002 and the MERS outbreak of 2012 and more recently against Ebola.  It helped people who were admitted with severe sickness get better faster and be out of the hospital earlier.  

Such antibodies can also be developed outside of the human body. Regeneron is a company that is developing two such antibodies and hopes to have them available by Fall.  It states that these antibodies might be used for treatment but might also help with prevention.  

5.  We already have medications that might help.  We still do not have any medications that help against measles but there are at least three drugs that have been shown to have some efficacy against this virus.  We cannot rely on these yet as there are no double blind controlled trials showing they really help.  We used to think blood letting helped people until testing showed that it actually hurt people so we have to do a rigorous trial to show what works.  Some of the drugs are anti-malarial drugs, anti-arthritis drugs but some are anti-virals.  Isn’t it wonderful that all the work we have done against HIV is helping us against this pandemic as well?  We should all be happy that we have at least some medications that might be useful for critically sick patients in the hospital.  Some might be helpful to prevent infection in close contacts with the sick.  

6.  Genome of virus was determine and disclosed for entire scientific community.  Within a few weeks of the virus having been discovered and reported, the Chinese authorities were able to sequence the virus and provided the world the entire sequence.  They could have kept this a secret but they did not.  Also, if they had been an impoverished country, they would have had trouble sequencing the genome.  Therefore, it is fortunate that this was information was successfully researched and shared.  Just a few decades ago, we did not know what DNA was and we did not have any way to sequence it. It is amazing that we have this ability and it is available as far away as China!    

7.  Social media has already been very helpful.  Dr. Li Wenliang from China noticed this unusual virus making patients get sick at an alarming rate so he got on social media and advised the world to take precautions.  He was reprimanded and accused of crying wolf but he was vindicated even as he succumbed to the illness.  If he had not disclosed this news, perhaps the information might not have been disseminated as fast as it did.  Therefore, even social media in the hands of a compunctious, young doctor helped the world fight against this disease. 

8.  Our electronic connections will help us going forward.  Until there is a vaccine and better treatment, we all need to distance ourselves from each other, a little.  However, we now have so many modes of electronic communication that this will be a breeze.  Smart organizations will find a way to function well in spite of quarantines and this might improve the way we all work together. 

While this pandemic has caused a lot of problems, there are many opportunities that will present themselves to those who are ready to see them. 

9.  We need to keep a positive outlook.  As mentioned earlier, the world has gone through much worse even when it had much less that it does today.  We will overcome this and will be better prepared for worse pandemics that might present themselves in the future.  

We need to think positively and help each through this difficult time and not be negative.  The world will get through this and already is doing so in great measure.  The important thing is to have a positive outlook and not let anything get you down!

When I go to sleep, I am thankful for all the things the world has like instant communication, medications, vaccines and knowledge. I am thankful for the people who developed these vaccines and some of whom died developing it. I am thankful to the Chinese doctor who with his dying breaths informed the world of this virus on social media. I am thankful to all the people who are heeding warnings and trying their best to be smart.  And then I drift off to sleep thinking positive thoughts and wake up with a positive mindset. I suggest we all do this…

Dr. Nitin Bawa, MD, MBA is a board certified, Internal Medicine Physician who has been practicing in Destin, Florida for the last fifteen years.  

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