These are tough times. We are all anxious about the possibility of dying from COVID-19. Even though we are not in the worst affected age group. Even though we are, at least those reading this, well off. That’s the difference between the haves and the have-nots, ie between those who have a bank account and can afford to sit down comfortably on their property, physically distance themselves from others and criticise those who cannot afford to stay at home or live in cramped quarters with elderly relatives.
So even though our sugar is normal, we not too overweight and the blood pressure is satisfactory these days, we still nervous. Those daily press conferences! The warnings from politicians, talking about the “science,” as if they know what science is! The media hype! The social media conspiracies, all making us anxious.
In addition, medical professionals haven’t been overly active in educating the public, have we? When was the last time you heard any private doctor or the Medical Association of T&T say anything about the outbreak?
At the first sign of the outbreak most of us closed shop and disappeared into our homes leaving the field to the dictates of the Ministry of Health. Of course it’s not easy to educate anyone when, halfway through the pandemic we know so little about the science behind COVID-19.
It’s all very uncertain. The problem is that science itself is uncertain. Scientists and competent doctors are comfortable with uncertainty. The public is not. The public demand certainty. But science is seldom definitive. Science is never static. Science changes. As knowledge accrues, through study and repeated experiment after experiment, today’s “fact” becomes tomorrow’s “steups.”
Stomach ulcers were thought to be due to an excess of stomach acid. Read any novel, see at any film published before 1990 and if there is a fat man in it, he always suffered from an ulcer and constantly was on a “diet” or took “anti-acids” or repeatedly sipped that favourite food of corporate dietitians, milk. Today we know that stomach ulcers are caused by a bacteria. The treatment is simple, antibiotics.
Cancer of the neck of the womb is another. I was taught as a medical student that there was some sort of relationship between sex and this malignancy. It was “scientifically” insinuated in the 1960s that too much sex, especially with an uncleaned male member, was the cause of that particular cancer. It was considered infra dig to discuss the cases of cancer of the womb that appeared in Roman Catholic nuns and Moslem and Jewish women. Now we know that a virus causes that particular cancer and there is an effective and risk free vaccine for it.
Despite all the hullabaloo, we know very little about the SARS-CoV-2 virus and its disease COVID-19. First we know that many people with COVID-19 are asymptomatic. Anywhere from 25 to 50 per cent of people with COVID-19 show no symptoms.
Second the common nasopharangeal RT-PCR test, which can establish if you have the virus, has a “well described false-negative result” of up to 30 per cent or 1 in 3. The antibody test, which tells you if you had the virus, up to now has a similar problem with accuracy.
Third we know that apart from more seriously attacking the elderly (over 60); the poor (disguised as race) and people with co-morbidities (see above), the virus thrives indoors. Indoors is where you are at greatest risk of getting the virus. Church groups. Choir practice. Zumba classes. Football stadiums. Concerts. Rum shops. Restaurants. Hospitals. Public transport. Cruise ships. Airplanes. Crowds. This is where you are most likely to pick up the virus. One study in Japan has worked out that you are 19 times more likely to get COVID-19 indoors, as outdoors. That’s because of something called “viral load.”
Viral load is the difference between inhaling hundreds of viruses and thousands of viruses. It’s the difference between being stung by one jep and one hundred jeps. Outside or even in a well ventilated room seems to reduce the concentration of the virus.
Viral load may also explain why children seem to be less contagious than adults. Contrary to local opinion, children appear to be less contagious because, for some unknown reason, they have less virus in their nose and throats. Less virus usually means less illness. That has implications for reopening schools. But the science is not yet complete. All we can do in the meantime is make educated guesses. That’s anxiety provoking.