The anomalies of living with Coronavirus

The Anomalies of living with Coronavirus 

The Coronavirus has brought out the best and the worst in society,perhaps in our lifetimes.

During this unsettling time, it has become my drive to write blogs to provide my readers,  a respite of enthusiasm or escapism, as well as "random research" of a   "lock down world" in disarray.

It has no doubt been a public nightmare in many ways. Some terrible things have happened, Draconian laws accompanied by over zealous approach at enforcement powers by the Police as well as others, with public as well as global governments not at all prepared for Personal Protective Equipment (PPE), Antibody Tests and Ventilators. 

It was a known fact that Governments around the world have not enforced hygiene over decades. But most of all, there has been no reserve capacity of Intensive Care Unit Beds. All the available ICU units had been fully occupied worldwide with Care occupants prior to the outbreak of this virus in December 2019.  It was a calamity waiting to happen. 

The real cause of this virus turning from a epidemic to a pandemic is because of too little, to late action taken by world governments over years,if not decades.

Result was understandable panic by the public. Public judgement of law enforcement has thus been harsh on Governments for over reaching, in fact overreaction, with lockdowns, restrictive in some cases, on social contacts and generally knee jerk reaction. There was no balanced approach all the while, and no coordinated action by health authorities worldwide. Can you blame globalisation or do you blame populism for concerted action to control the spread?

Some will maintain it was unavoidable, others will rightly state it was unpreparedness. 

                                                         

Public sentiment trampled 
                                                   

Public or even private mourning during lockdown was forbidden. It has hardly been openly allowed to be expressed, perhaps as a mark of respect to the dead, but more as a strange way, of a show of support for the bereaved, in crisis situations.

We can only comprehend the exact number of dead due to the Coronavirus pandemic as an a number statistic, with exact condition of cases calibrated and measured in a variety of ways, by each country, according to its own standards. 

John Hopkins Research team too, has quoted these figures of people with Coronavirus, according to statistics compiled by Governments around the world, as people counted "as dead". There is no detailed  medical history record of the cause of their individual condition, prior to death, perhaps, as it has become an impossible and thankless task for governments.

Nobody really knows the exact numbers attributed to coronavirus and/or due to natural causes, other than these official statistics. Rather, no one has been able to assess, who has succumbed as a direct result of the contagion of this pandemic or partly due to natural causes of death. Perhaps,it has been easy to lump one figure as the number dead and attribute it to this pandemic at this difficult time. The anomaly is that it has become a "statistic rather than a condition".

The World Health Organisation to date has not authenticated a verifiable figure,perhaps, due to the vagaries of identification information. 

As Longfellow stated: "the dead have been left to bury the dead".

In many countries the only form of internment is cremation, with families not attending final rites or saying fond farewells. It all appears very strange, with some countries requesting families to say goodbyes to loved ones by SMS messages relayed to patients in hospitals, before entering ICU's. Some day in history, there may be monuments erected for these dead like the monument in Vienna, for the Black Death of 1347 to 1351. Some day, a century later,historians will write epitaphs in commemoration. 

The anomalies of life under lockdown in Britain and abroad

The UK now has been in lockdown for almost a week in a bid to tackle this pandemic. At least 19,522, the authorities say, have tested positive for Coronavirus with 1,228 people confirmed to have died to date, some 90 days of pandemic outbreak. Experts warn it could be months before life returns to normal.

Whilst there is a virtual lockdown worldwide, there is no general consensus about "anti-body tests" or what action needs to be enforced to combat it on a worldwide scale other than WHO advice on "Tests,Tests and Tests".                  

              

                             
In Belarus,the government has dismissed the pandemic as a conspiracy,with life going on as normal. In Sweden, on the other hand,there are no constraints of segregation or movement or containment. In refugee camps around the world, people have no choice but continue living as normal in cramped conditions,with a scarcity of food and water, as compensation.

Compare this to the 1.4 billion population of China,with confirmed cases of coronavirus deaths officially declared as 83,000 to date (30 March 2020). There is fakenews, even conjecture that the death rate is 40 times this figure.The anomaly is that there is no way of authentication or verification. Only the Space Satellites have shown towns and cities in China deserted during the period of quarantine over months with air quality less polluted by the shutdown of factories and travel.

At a cursory reckoning, it appears to be minuscule in relation to deaths recorded per head of population in the two main European counties, of Italy or Spain. We are told that Italy has a population of 50 million with infections surging past 100,000 and 11,591 deaths and Spain has 46 million with 85,195 infections and 7,340 deaths. 

We know the health system of these two European Member countries have been crumbling under the weight of caring for so many desperately ill patients,infirm all at once. The number of Intensive Care Units in both these nations were never expected to cope with the outbreak of this virus. Care Homes in these countries were not required to state the cause of death of inmates.

Financial assistance from the EU has been lacking over years.  As a show of solidarity, a minuscule  number of Coronavirus patients from Italy and France have been recently  transferred by air ambulance to be cared for at German hospital ICU's. 

In the UK 20,000 former NHS staff have volunteered to go back to work and some will perform support roles, such as changing beds, at the newly turned Excel Exhibition Centre now called Nightingale Health Care Emergency in East London and at similar makeshift centres nationwide, 

A breathing aid, called Continued Positive Airway Pressure Machine (CAPM) to deliver oxygen to the lungs without the need of a Ventilator or for a patient to be sedated,has been developed by a team of researchers from Mercedes Formula 1 Team and University College London. They hope to produce up to 1000 such machines a day. The CAPM would help keep Coronavirus patients out of the limited number of 25,000 Hospital ICU beds in UK. 

The cost of dying

The curbs of life and death in this time of Coronavirus is unaccountable.
                                                         

At this time digging deep within our psyche to focus on our immediate access to our human instinct of survival is the key. 

Creating the environment that brings each one of us inner peace and serenity can lead us to mental,emotional and spiritual wellbeing. 

Whilst we individually mourn the dead, and do all in our power to constrain our governments to deliver solutions sensitively at this time of crisis, let our creative side of our humanity shine.

Victor Cherubim 

What happened to the first patient with Coronavirus at Jinyintan Public Hospital,Wuhan

Inside the epicentre of the deadly Coronavirus

Back in 8 December 2019 the first confirmed case diagnosed as Coronavirus (COVID-19) epidemic was noticed at the Public Hospital in Jinyintan,Wuhan, a sub district of  Jianghan in Hubei Province in China.

A man aged 55 was admitted to this hospital complaining of difficulty in breathing having high temperature and not responding to medication.

The doctors treating him did notice that he was not responding to the normal treatment  as was put in Intensive Care,while further tests were being done.

Stages of illness

The reports emanating from Jinyintan ICU Hospital Consultants now give us a picture of the stages of his severe condition.

Based on the data from Jinyintan Hospital, they reveal that a particular strain of virus similar to SARS was detected in the pathogen tests.  

At first his prognosis was pneumonia, which caused the inflammation of his lungs.

Due to his immune system overreacting to the virus,the chemical signals which caused the inflammation of his lungs also caused collateral damage throughout his body.

How it was doing this,they were at first unable to know. But it now appears,they were able to trace that the virus had travelled through his mouth,down the windpipe through the tiny tubes in both his lungs and eventually ended up in the tiny air sacks.

They came to know that this virus had triggered an imbalance in the immune response causing too much inflammation. 

This was where oxygen moved into the bloodstream and carbon dioxide moved out. 

In this condition the tiny sacs started to fill in with fluid (water) and eventually caused him shortness of breath and difficult breathing. 

He was then put on a tubular ventilator by the ICU Consultant to help him with assisted breathing.

The ICU Consultants at Jinyintan Hospital now state that this stage affects some 14 % of patients and around 6% of cases generally become critically ill. 
                                   

Inside an ICU

In the case of the first Corona virus (COVID-19) patient they treated at Jinyintan in December 2019, his body was starting to fail and there was a real chance of imminent death. 

They knew at this point that his immune system was now spiralling out of control and was causing damage throughout his body. 

It then lead to septic shock as his blood pressure dropped to dangerously low levels and his organs stopped working properly. 

To avoid acute respiratory distress syndrome caused by widespread inflammation in both his lungs and to stop the body getting enough oxygen it needed to survive,the Consultants at this stage put him on a highly invasive procedure called ECMO or extra-corporeal membrane oxygenation.

This is an artificial living which takes the blood out  of his body through thick tubes, oxygenates it outside and pumps it back into the body.

This procedure did at first manage to clean his infected lungs,
                                               

The ICU and ECMO Consultants at this stage after some time noticed that this did not stop the kidneys from cleaning the blood and the damage to the lining of the patient's intestines had caused multi-organ failure.

At this stage they had to take an ethical decision as to whether to keep him ventilated in the ICU to keep his keep his organs in the body alive or to treat him as clinically dead and switch off his life support. 

This is a life or death clinical decision which was difficult to make. To avoid more pain and suffering to the patient he was under continuous sedation. 

At this point the patient's next of kin were informed of his fatal condition and asked to give their consent to turn off the ventilator, thus giving him hours and minutes to be able to breathe without life support. 

He was pronounced dead as all his organs had collapsed and his body was taken to the mortuary in the hospital.   

Report on first death of patient of Coronavirus at Jinyintan Hospital, Wuhan was in late December 2019.   
                                              

While the first patient to recover from the new deadly virus was 23 year old man,Mr.Huang, a worker in a train station in early January 2020.

Victor Cherubim                                  

Getting back to life again

Everyone’s mind is on the development of a vaccine to control the spread of the pandemic.

Did you know we do not have to produce a vaccine to monitor any recurrence of the pandemic?

Research epidemiologists in France maintain that the simplest and easiest way of identifying the presence of this rogue and clever virus, is for humans to be as clever as the virus itself.

Environmental surveillance

The suggestion is that sample tests can be made of the bacteria found in the effluent sewage water of towns and cities and you can easily monitor if the strain of COVID-19 is still present and in circulation. This is more like a litmus test if the virus is still around.

Researchers have demonstrated the potential value of sewage water system monitoring for studying the trends in the circulation and for recurrence of COVID-19.

                                               

Pathogens present in the sewage have been studied by microbiologists and waste water screening is a well recognised surveillance tool.

This could become part of the UK Government’s battle plan to track and trace as well as check recurrence of this pandemic as restrictions are being slowly released.

When we are uncertain about what to do, we look to the behaviour of others to guide us. They provide us with a signal as it were about our choice of action. This is called herd immunity. The Government having tried both suppression and mitigation policies is slowly but surely wanting to get the economy back to work again, but not immediately.

Suppression policies

All around the world suppression of the virus has been the preferred option to mitigation because they deal directly with people’s fears and government’s care of the threat to human lives.

Mitigation policies address the fear of infection of the virus. But as populations are getting weary of permanent lockdown, the UK and other governments have this week opened up schools and released the strain of staying at home. But they are still cautious

not to open the flood gates too soon.

Pent up emotion, pent up demand

What we are seeing in the United States after George Floyd and the ripples it has caused in many other countries, governments are wanting to cool things down, especially with the prevalent heat wave in Europe and across the U.S.

The first thing that comes to mind for an ordinary man is the desperate need to visit the Barber Shop without any further delay, and the same for a woman, to go to her hairdresser.

Hair has got desperate, it has overgrown, beyond recognition. The barbers and hairdressers have been closed/shut for over ten weeks. Beauty has gone out of the window; maintenance rather than pampering is screaming for attention.

As many have lost their sense of taste and smell with the viral infection, people around the nation are at long last wondering when they can hope to look presentable?

Many people feel guilty to break the code of social distancing, but no one has dared to question in Parliament when we will get back to life again?

Victor Cherubim