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Coronavirus Q&A

The most recent Questions and Answers about Covid-19
During Spanish Flu, apparently no vaccines were available for it and millions died before it abruptly 'ended' on its own. Does that mean that if we don't develop a COVID vaccine, that it will eventually 'end' on its own too?
It's not killing enough people fast enough to end on its own.

There were two major strains of the Spanish Flu. Both were pretty virulent but the second strain, the one that erupted in the fall of 1918, was far more deadly. Both shared its basic traits: it spread for a short time, gave symptoms to everyone, and progressed very quickly. The latter strain could kill you within a few hours of showing symptoms.

As a result, it was easier to isolate. People with symptoms could quarantine themselves and once they were dead and buried, transmission stopped. Spanish Flu also killed more indiscriminately across age groups, including a high death rate among children.

With COVID-19, people are infectious for a week before showing any symptoms, half of those infected show no symptoms at all, and it kills 2–4% of the people it infects. It's nowhere as easy to detect it, isolate it, or halt its progression.

This coronavirus is ideally suited to kill a larger number of people over a longer time.

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For those who are in the medical and retail/service industries - what has this whole thing been like for you, personally? How many cases of COVID-19 have you had to deal with?
I'm a health care professional in the UK. Our general medical ward was closed and I now work in a covid-19 ward. Every 12 hour shift is frightening. We worry that the ppe that our Public Health organisation say is adequate is actually adequate. A few weeks ago they were saying a surgical mask would not offer protection from covid-19 yet now it is our recommended ppe along with gloves, a plastic apron and eye protection. I have sent my young children away to live with family in lockdown as I don't want to bring anything home to them, especially my asthmatic son. That breaks my heart, FaceTime is not enough. Our government is telling us that ppe is a precious resource and to use it wisely. Apparently NHS staff are not considered a precious resource.

The teams I have worked with have all been supportive and kind to each other but you can see the fear in everyone's eyes. The majority of the general public are showing lots of support and love to NHS staff. We are just doing our jobs, hoping that the majority of our poor patients can get better and go home. This situation is lousy and we can only pray that we come out of this pandemic unscathed. Every day on the nurse's forums I frequent there are reports of more HCPs dying. Stay safe people!

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Why are there low coronavirus cases in African countries, even for those doing plenty of tests like South Africa?
We've received a lot of submissions here, with widely ranging answers.

Here's my best roundup:

  • South Africa has also apparently mobilized some 28,000 healthcare workers to do house checks in vulnerable communities. This kind of proactive screening can help curb spread.
  • We still don't know exactly what effect humidity and heat have on the virus, if any. But they may be helping to some appreciable degree. (What I've read has suggested not so much. But lots more data still forthcoming, likely soon.)
  • As for the rest of Africa (a continent 3x the size of Europe, with astonishing geographic, demographic, and political diversity), it's hard to make many generalizations. But one fair one seems to be that most African nations aren't doing enough testing for us to have a very accurate sense of spread. The country with the next-most tests done seems to be Egypt, who were at 25,000 as of five days ago (6% positive rate). But they've taken softer containment measures than SA, and are more likely to see a big jump in coming weeks. Ghana was also pretty close, with 26,346 tested as of April 10th (1.5% positive). They seem to be contract tracing quite aggressively, which is good. Most other African countries have done 10,000 or fewer tests from what I can tell, though that's hard to confirm.
All said, it seems like:

  • Africa is too diverse for most generalizations.
  • Some African countries will fare well (in a relative sense, at least) thanks to aggressive testing/tracing regimes.
  • Weather and partial immunity may help many Africans. But we don't yet have any substantial reason to believe these effects, if real, will change much.
  • Africa contains some poor countries/regions with limited healthcare systems. Those are vulnerable traits. This is especially true for areas without strong sanitary infrastructure. Thankfully there's been some amazing work done there in recent years.
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If they expect the COVID-19 to stop at the end of cold weather, then why and how has it spread to Texas?
Many viruses, including coronaviruses, become less durable in warmer, drier conditions, and for this and other reasons, become somewhat less infectious in the summertime. For ordinary diseases like the cold and influenza, this is enough to cause a reduction in the total number of cases during the summer—but these diseases to not magically go away. The reason we face different flu strains each year is not because last year's strain is gone, it's because flu continually evolves, and newer strains gradually displace the old ones as we develop immunity.

Again, colds and flu do not "go away" in the summer, they just become less of a problem.

We don't know if SARS-COV-2 will "become less of the problem" in warm weather. So far it doesn't look like it, as it seems to be growing throughout the world regardless of local season or climate (the southern hemisphere is entering winter as the northern enters summer, and equatorial regions are warmer, and sometimes drier, then temperate regions).

But even assuming that SARS-COV-2 does become less transmissible like many other viruses, that won't be the end of the pandemic. This virus is so infectious to begin with that as with social distancing, the most we can hope for from warmer weather is a further slow to its spread.

And that's a good thing, because this pandemic will only end one of two ways. Either we will develop and deploy an effective vaccine (in a year or so if we're lucky) or the virus will run out of new people to infect. If the later happens too quickly—because everyone who could be infected already has been—the result will be millions of dead and millions more debilitated or (in places like the US, buried under crippling medical debt.)

Neither God nor nature is going to swoop in like the last act in War of the Worlds and save us. Only our science can do that.

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