What we know about the ugly SARS-CoV-2 virus is that it is among a group of coronaviruses that causes diseases in animals and birds, and respiratory tract infections in humans. These infections tend to be mild, but in rarer forms such as the Middle East respiratory syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) they can be fatal. The current outbreak declared by the World Health Organization (WHO) is caused by SARS-CoV-2 which has a close genetic similarity to bat coronaviruses and are thought to have been its likely origin.
The wild tornado in the body: how the infection starts and kills
COVID-19 seems to be spread in a similar way to cold and flu bugs; through droplets being left on surfaces after a person coughs or sneezes, which are then touched by other people and spread further. The Coronavirus (SARS-CoV-2 / CoVID-19) is currently killing thousands of people every hour globally and clinicians and pathologists are still trying to fully understand how it inflicts such damage as it tears through the human body. Although it well know that the lungs are ground zero (i.e. the main point of impact), the virus can extend to many other organs including the heart and blood vessels, kidneys, guts and brain. « Its ferocity is breathtaking and humbling », said Krumholz a cardiologist from Yale university.
The infection begins when an infected subject expels virus-laden droplets and another person inhales them, the SARS-CoV-2 coronavirus then enters the nose and throat and finds a comfortable home in the lining of the nose according to scientists from the Wellcome Sanger Institute. This region is lined with cell-surface receptor known as ACE2 (i.e. Angiotensin-converting enzyme 2) which are present throughout the body to help regulate blood pressure but it also marks tissues vulnerable to infection. The virus requires this receptor to enter a cell, and once inside it hijacks the cell’s machinery, multiplies itself and takes over new cells. During the period where the virus is multiplying itself, an infected person may shed copious amounts of it, especially during the first week. There may not be any symptoms at this point, or the victim may develop a fever, dry cough, sore throat, loss of smell and taste, or head and body aches. If the immune system does not destroy the virus at this early stage, then it moves down the windpipe and starts to wreck havoc in the lungs where it can become deadly.
The thinner, distant branches of the lungs respiratory tree end in tiny air sacs called alveoli [alveolus (single], each lined by a single layer of cells that are also rich in ACE2 receptors, the very same receptors that allows the virus to penetrate. When we are in good health oxygen crosses the alveoli into the capillaries, which are tiny blood vessels that lie beside the air sacs (alveoli), this oxygen is then transported to the other regions of our body. But, when the immune system is stressed and fighting ardently against the virus, the battle disrupts the oxygen transfer. The front-line white blood cells release inflammatory molecules called chemokines, which in turn create more immune cells that target and destroy virus-infected cells. When these infected cells are destroyed by the chemokines, they leave a stew of fluid and dead cells – pus – behind. This process is the scenario that takes places in pneumonia and the corresponding symptoms are: coughing; fever; and fast, shallow breathing. In some cases, we find COVID-19 patients who recover, sometimes simply with oxygen breathed in through nasal prongs.
However, in other unfortunate scenarios, patients often deteriorate suddenly to develop a condition referred to as acute respiratory distress syndrome (ARDS), where they struggle to breathe as the oxygen levels in their blood falls abruptly. On x-rays and computed tomography scans, the lungs of these patients are shown to be riddled with white opacities where instead healthy dark space [i.e. air] should be. These cases end up on ventilators and many die. Autopsies have shown their alveoli (air sacs) stuffed with fluid, white blood cells, mucus and the detritus of destroyed lung cells.
Some clinicians are suspecting the driving force that leads to severely ill patients’ downhill trajectory and death to be a disastrous overreaction of their own body’s immune system, a reaction referred to as a « cytokine storm« , which viral infections are known to trigger. Cytokines are chemical signaling molecules that guide a healthy immune response, however, in a cytokine storm, the level of cytokines rise beyond the level of what is needed, and hence this excessive rush [i.e. storm] of immune cells also start to attack and destroy healthy tissues – these individuals’ blood vessels leak, blood pressure drops, blood clots form, and catastrophic organ failure can follow.
Some studies (Chen et al., 2020) have demonstrated elevated levels of these inflammation-inducing cytokines (Huang et al., 2020) in the blood of hospitalised COVID-19 patients. Jamie Garfield, a pulmonologist who treats COVID-19 patients at the Temple University Hospital argues that the real morbidity and mortality of this disease is probably driven by this out of proportion inflammatory response of the human immune system to the virus. However, other medical professionals are not convinced. “There seems to have been a quick move to associate COVID-19 with these hyperinflammatory states. I haven’t really seen convincing data that that is the case,” said Joseph Levitt, a pulmonary critical care physician at the Stanford University School of Medicine. Levitt is also worried that efforts to develop several drugs to dampen the cytokine response could actually cause harm by suppressing the immune response that our body needs to fight off the virus.
We find different views among the academic community on this new virus. Others are viewing it from a completely different perspective, and are focusing on the heart and blood vessels, that they believe is playing a significant role in the rapid deterioration of some patients.
Tearing the heart
All the classic symptoms of a heart attack was observed in a 53-year-old Italian woman in Brescia along with signs in her electrocardiogram and high levels of blood marker suggesting damaged cardiac muscles. Further tests revealed cardiac swelling and scarring, and a left-ventricle – which is usually the powerhouse chamber of a human heart – so weak that only one-third of the normal amount of blood could be pumped. When doctors injected dye in her coronary arteries to look for what they believed to be a blockage that is usually associated with heart attacks, they found nothing. The next test carried out revealed that the culprit was in fact COVID-19.
It is still a mystery to academics how the virus attacks the heart and blood vessels but many preprints and scientific papers attest that such damage is common. A JAMA cardiology paper observed damages to the heart in nearly 20% of COVID-19 patients (Shi et al., 2020) out of 416 hospitalised patients in Wuhan, China. Another Wuhan study revealed that 44% of 36 patients admitted in ICU had arrhythmias, i.e. irregular heart beats (Wang et al., 2020).
What has been discovered, is that the disruption extends to blood itself. Among 184 COVID-19 patients in a Dutch ICU, 38% had blood that clotted abnormally, and about one-third already had clots (Klok et al., 2020). Blood clots are very dangerous since they can break apart and end up landing in the lungs, blocking vital arteries – a condition known as pulmonary embolism, which has killed many COVID-19 patients. Blood clots from arteries can also end up in the brain, causing stroke. Many COVID-19 patients have dramatically high levels of D-dimer, a byproduct of blood clots. Hence, it is very likely that blood clots have a major role in the disease severity and mortality with the COVID-19 pandemic.
Infection may also lead to the constriction of blood vessels. There are reports emerging of ischemia [i.e. an inadequate blood supply to an organ or part of the body, especially the heart muscles] in the fingers and toes – reduction in blood flow can cause swollen, painful digits and eventually tissue death. Blood vessels carry oxygen to various parts of our body, and when they become constricted problems will logically arise. In the lungs, the constriction of blood vessels may explain the reports of a very perplexing phenomenon seen in patients with pneumonia caused by COVID-19: some patients although having extremely low blood-oxygen levels are not gasping for breath. Since we are still uncovering the depths of the virus, one explanation may be that at some stages of the disease, the virus modifies the delicate balance of hormones that regulate blood pressure and constricts the blood vessels going to the lungs. Logically, constricted blood vessels will lead to oxygen uptake being impeded – this may be the cause of low blood-oxygen levels rather than clogged alveoli (air sacks) as explained above.
It is very important to take note that if COVID-19 targets blood vessels, it may explain why patients with pre-existing damage to those vessels, such as those with diabetes and high blood pressure, face a higher risk of serious disease. The recent data from the Centers for Disease Control and Prevention (CDC) on hospitalised patients in 14 US states found that bout one-third had chronic lung disease and nearly as many had diabetes and half had pre-existing high blood pressure (Garg et al., 2020). It has also been observed that there is a very low number of cases suffering from asthma and other respiratory diseases. The risk factors seem to be vascular: diabetes, obesity, age and hypertension. Academics are still in the dark regarding the causes of cardiovascular damage. Since the lining of the heart and blood vessels are rich in ACE2 receptors just like in the nose and the alveoli, it is possible that the virus may be directly targeting and attacking them. Another possibility for cardiovascular damage could be the lack of oxygen caused by a combination of factors: lack of oxygen, chaos in the lungs and damages to blood vessels. A cytokine storm unleashed by the immune system itself could also be responsible for damages to the heart as it does for other organs. COVID-19 is a new virus and the academic community do not have all the answers to these questions: who is most vulnerable? Why some patients are hardly affected while others are hit so severely? Why does it develop so rapidly and why it is so hard for some patients to recover?
Destruction in multiple zones
While there is worldwide tension regarding the shortage of ventilators for failing lungs, less attention has been given to dialysis machines. Jennifer Frontera, a neurologist from New York University’s Langone Medical Center who has treated thousands of COVID-19 patients pointed out that if patients are not dying from lung failure, they are dying from renal failure. Hence, her hospital is developing dialysis protocols with different machines to support additional patients. As usual, the ACE2 receptors, a favoured penetrating site for the virus, is abundantly present in kidneys. Going by a preprint, 27% of 85 hospitalised patients in Wuhan had kidney failure (Li et al., 2020). Another report read 59% of nearly 200 hospitalised COVID-19 patients in China’s Hubei and Sichuan provinces had protein in their urine (Diao et al., 2020), and 44% had blood clot; both suggest that kidney damage took place. Patients with acute kidney injury (AKI), were more than five times as likely to die as COVID-19 patients without it, the same Chinese preprint reported.
“The lung is the primary battle zone. But a fraction of the virus possibly attacks the kidney. And as on the real battlefield, if two places are being attacked at the same time, each place gets worse,” says Hongbo Jia, a neuroscientist at the Chinese Academy of Sciences’s Suzhou Institute of Biomedical Engineering and Technology and a co-author of that study.
The electron micrographs from the autopsies of kidneys revealed viral particles (Diao et al., 2020), suggesting a direct viral attack. However, the kidney injury may also be a collateral damage caused by ventilators – that heighten the risk of kidney damage – as do some antiviral compounds such as remdesivir [which is being used experimentally in COVID-19 patients]. The immune system’s cytokine storms may also severely reduce blood flow to the kidney and often causing fatal damage. Diabetes can also increase the chances of kidney injury. Hence people with chronic kidney diseases are at a higher risk for acute kidney injury.
Combo hits to the brain
Another range of symptoms in COVID-19 patients focus on the brain and the central nervous systems (Mao et al., 2020). Frontera says that neurologists are required to assess 5% to 10% of coronavirus patients at her hospital and believes that it may be a gross underestimate of the number of patients whose brains are struggling since many are sedated and on ventilators. Patients have suffered from brain inflammation, encephalitis (Moriguchi et al., 2020), with seizures and with a sympathetic storm [i.e. a hyper reaction of the sympathetic nervous system that causes seizure-like symptoms and is mostly observed after a traumatic brain injury]. Some COVID-19 patients even lose consciousness for a short amount of time while others suffer strokes. The loss of the sense of smell has also been widely reported. Frontera and others are asking themselves whether in some cases, infection depresses the brain stem reflex that senses oxygen starvation; this may provide an explanation to why despite dangerously low blood oxygen levels, patients are not gasping for air.
The former coronavirus behind the 2003 severe acute respiratory syndrome (SARS) epidemic – a cousin of COVID-19 – could infiltrate neurons and at times caused encephalitis. Since ACE2 receptors are present in the neural cortex and brain stem, the virus could interact with those receptors and penetrate the brain. In a case study in the International Journal of Infectious Diseases, a team of academics from Japan found traces of COVID-19 traces in the cerebrospinal fluid of a patient who developed meningitis and encephalitis, insinuating that COVID-19 can penetrate the central nervous system.
However, other factors could also be damaging the brain, such as a cytokine storm triggered by patients’ immune system itself, leading to swelling, and the blood’s exaggerated tendency to clot could trigger strokes. The collection of neurological data from care patients received is ongoing at a worldwide consortium that now include 50 centers in order to identify the prevalence of neurological complications in hospitalised COVID-19 patients and document how they fare.
The aim of course is to better understand the virus’ impact on the nervous system, including the brain. Sherry Chou, a neurologist speculates about an invasion route for the virus: through the nose, then upward through the olfactory bulb which connects to the brain, which may explain the loss of smell.
To the gut
Diarrhea with blood, vomiting and abdominal pain was reported in early March 2020 from a 71-year-old woman from Michigan who returned from a Nile river cruise. Doctors suspected the common stomach bug, e.g. Salmonella. However, after she developed a cough, nasal swabs revealed that she was positive for COVID-19. Gastrointestinal (GI) infection was diagnosed after a stool sample was positive for viral RNA and an endoscopy revealed signs of colon injury according to a paper in The American Journal of Gastroenterology (AJG) (Click to see).
This case adds to a growing body of evidence suggesting that like the SARS, COVID-19 can infect the lining of the lower digestive tract where, once again, the ACE2 receptors needed for the virus to enter are abundant. As many as 53% of sampled patients’ stool samples have shown to contain viral RNA. The virus’ protein shell was also found in gastric, duodenal and rectal cells in biopsies by a Chinese team who reported it in a paper in Gastroenterology (Xiao et al., 2020). “I think it probably does replicate in the gastrointestinal tract,” said Mary Estes, a virologist at Baylor College of Medicine.
Up to 50% of patients, making up about 20% across studies experience diarrhea. Gastrointestinal Infection (GI) however is not on the CDC’s list of COVID-19 symptoms which could lead to some COVID-19 cases to go undetected. The co-editor of Gastroenterology, Douglas Corley of Kaiser Permanente, Northern California said: “If you mainly have fever and diarrhea, you won’t be tested for COVID.”
So, can COVID-19 be passed on through feces? We do not know if the stool contains active, intact, infectious virus or simply RNA and proteins, there is no evidence to date. Based on experiments with SARS and with the virus that causes Middle East respiratory syndrome, a cousin of COVID-19, the risk from fecal transmission is probably low.
Finally, the virus also affects the eyes as one-third of hospitalised patients develop conjunctivitis – reddish, watery eyes – although it is not clear if the virus directly attacks the eyes (Wu et al., 2020). Some other reports have also suggested liver damage since more than 50% of COVID-19 (Zhang, Shi and Wang, 2020) patients hospitalised in two Chinese centers had elevated levels of enzymes (Fan et al., 2020) which suggest injury to the liver or bile ducts. However, many experts reportedly told Science that direct viral hits are unlikely, stating that other events in a failing body, like drugs or an immune system overdrive, are more likely driving the liver damage.
It is important to note that these findings are just the beginning, and it will take years of serious research to fully understand COVID-19 along with the range of cardiovascular and immune effects it might trigger. We can only hope to find a way to stop this ugly virus in its track through the combined efforts of planet Earth’s scientific force and medical geniuses.
At present, whilst COVID-19 appears to be more contagious than SARS or MERS, the fatality rate is relatively low (around 3%) when compared with MERS (34%) and SARS (10%), with early data suggesting the elderly and those with underlying health conditions are at a higher risk.
In France, if Mentonians are concerned about coronavirus, it is in fact mainly for their elders. « Menton is a town of old people. If the epidemic spreads, they’ll all be dropping like flies. It’s going to be no man’s land, » said Denis, arm in arm with his 88-year-old mother. « I’m not afraid for myself: I know the virus won’t kill me. But I’ve told my mother, ‘you’re not going out of the house any more,’ » explained Véronique, in her fifties, as she folded a tablecloth from her shop in the centre of town.
By advocating the use of chloroquine to treat people suffering from Covid-19, the brave maverick, Professor Didier Raoult became the target of criticism in a very short time. Raoult did, however, receive some support, notably from Jean-Marie Bigard, who recounted one of his telephone conversations with the much-scorned professor. « We talked about how he thanked me for supporting him (…) And then he said something funny to me, saying: ‘All the time I was thinking about this story, I only thought about one thing, and that was your sketch about the bat,’ » the comedian said. Furthermore, even if it is not a miracle cure, a range of other medical professionals claim to have successfully treated a range of COVID-19 sufferers with hydroxychloroquine, while some studies have shown its ability to inhibit the virus in vitro.
While research is focusing on treatments and vaccines, Didier Sicard a professor from Sorbonne University also a specialist in infectious diseases who has a long experience in scientific work on the HIV, argued that researchers should go back on the field and inquire on the animal origin of the epidemic. Professor Sicard noted that the abrupt transformation of primary forests has brought humans closer to bats and hence a reservoir of viruses that has not yet been closely studied. While China has only recently, on the 24th of February 2020, immediately and completely banned all traffic and consumption of wild animals, conscious of its dietary culture of eating practically anything that moves, it is important to note that such a legislation exists since 2003 without it being strictly respected by Beijing. Hence, Professor Sicard reasonably argues for an international health court. The former Chair of the Advisory Committee on Ethics from 1999 to 2008 emphasizes the extent to which, in this epidemic, the issue of contact is paramount – everyone must behave like a model.
Sicard also points out that the starting point of this pandemic is an open market in Wuhan where wild animals, snakes, bats, pangolins, preserved in wicker crates, accumulate. In China, these animals are bought for the Rat Festival and are quite expensive and considered as food of choice. In this wild meat market, these animals are obviously touched and handled by the vendors throughout the day, skinned, while they are stained with urine; ticks and mosquitoes also make a kind of cloud around these poor animals by the thousands. These conditions have meant that a few infected animals have inevitably infected other animals within a few days. One can hypothesize that a vendor injured himself or touched contaminated urine before putting his hand to his face. Here we go! What strikes Sicard is the indifference at the starting point of this ugly virus. As if society was only interested in the point of arrival: the vaccine, the treatments, the resuscitation. But for this not to happen again, the starting point should be considered vital. And it’s impressive to see how it’s being neglected. The indifference to wildlife markets around the world is dramatic. It is said that these markets bring in as much money as the drug market. In Mexico, there is such a traffic that customs officers even find pangolins in suitcases.
Jean-Christophe Ruffin, a doctor, diplomat and writer from the Académie Française said: “Now is not the time to burden anyone and sue, it will come. But they’ll have to be done. We’ll have to learn from this. This proves one thing: when we get out of this terrible crisis, as infectious disease specialists say, there will be others. And we can’t be in a situation like that again.”
« It is of course not the first time that animals are at the origin of sanitary crises, in fact they are responsible for the majority of epidemic crises: HIV, H5N1 avian flu, Ebola. These viral diseases always come from a reservoir of animal viruses », Sicard pointed out, and there’s almost no interest in them. It’s the same with dengue fever. “I have a very close relationship with Laos, and when the disease appears, the local people there say, ‘We have to control the mosquitoes’. But in reality, it is during the dry season, when there are only larvae, that a policy of exterminating mosquito larvae should be implemented. But nobody does it because people say ‘oh, there are no mosquitoes, why do you want us to use insecticides? And the Pasteur Institute of Laos is sputtering in vain, asking local people to make the effort before the disease bursts”, Sicard explained to France Culture, saying “It is exactly like the work that’s left to be done on the bats. They are themselves carriers of about 30 coronaviruses! We need to do some work on these animals. »
The latter also added: « Obviously, it is not very easy: going into caves, well protected, taking vipers, pangolins, ants, looking at the viruses they harbour, this is ungrateful work and often despised by laboratories. Researchers say: ‘We prefer to work in the molecular biology laboratory with our cosmonaut hoods. Going into the jungle, bringing in mosquitoes, is dangerous. Yet, these are by far the most important routes. Moreover, we know that these epidemics will start again in the years to come repeatedly if we don’t definitively ban the traffic of wild animals. This should be criminalized as an open-air sale of cocaine. This crime should be punishable by imprisonment. I am also thinking of those battery farms for chicken or pork that are found in China. Every year they give new flu outbreaks from viruses of avian origin. Gathering animals like that is not serious. It is as if veterinary art and human medical art had nothing to do with each other. The origin of the epidemic should be the subject of a major international mobilisation.”
Prof Sicard argued that we need to reconstruct the epidemiological pathway by which bats have tolerated coronaviruses for millions of years, but have also dispersed them. It contaminates other animals.
When bats hang in caves and die, they fall to the ground. Then the snakes, vipers in particular, who love their corpses, eat them. Just like the young bats that fall down and are immediately eaten by these snakes which are therefore probably intermediate hosts for viruses. In addition, there are clouds of mosquitoes and ticks in these caves and we should try to see which insects are also possible transmitters of the virus. Another hypothesis concerns the transmission that occurs when bats go out at night to eat fruit. Bats have an almost automatic reflex; as soon as they swallow, they urinate, explained Sicard. They will therefore contaminate the fruits of these trees and the civets, which love the same fruits, hence contaminating themselves by eating them. The ants participate in the agape and the pangolins – for which the most wonderful food is ants – devour the ants and become infected in their turn. It is this whole chain of contamination that needs to be explored. Probably the most dangerous reservoirs of viruses are snakes, because they are the ones that are constantly feeding on bats, which are themselves carriers of coronaviruses. Snakes could therefore be a permanent host for these viruses, and obviously eating them is not only disgusting but dangerous. But that is exactly what we need to know and check. Researchers should therefore capture bats, but also do the same work on ants, civets, pangolins and try to understand their tolerance to the virus. It’s a bit ungrateful, but essential.
Didier Sicard also elaborated on the relation between the local Eastern Asian population and the bats, saying “What struck me in Laos, where I often go, is that the primary forest is regressing because the Chinese are building stations and trains there. These trains, which cross the jungle without any health precautions, can become the vector of parasitic or viral diseases and carry them through China, Laos, Thailand, Malaysia and even Singapore. The Silk Road, which the Chinese are in the process of completing, may also become the route for the spread of serious diseases. Caves are becoming more and more accessible there. As a result, humans tend to get closer to where the bats live, and bats are also a highly sought-after food source. Humans are now also building fruit tree parks close to these caves because there are no more trees due to deforestation. The inhabitants feel that they can gain territory, like in the Amazon. And so, they are building agricultural areas very close to extremely dangerous virus reservoir areas. I don’t have the answer to all these questions, but I just know that the starting point is not well known. And that it’s totally ignored. It’s being turned into folksy conference speeches. They talk about bats and the curse of the pharaohs.”
Sicard also said that there must be some serious studies about the ability of bats to harbour coronaviruses, saying “but when I go to the Pasteur Institute in Laos which is run by an exceptional man, Paul Brey, this director has the fibre of a Louis Pasteur, he has been passionate for twenty years about transmission issues, but he is extremely lonely. Even the study of mosquitoes, which is fundamental to understanding the transmission of diseases in Laos, is almost abandoned. And Paul Brey keeps telling me that there are about thirty species of coronavirus in bats. So, the scientific effort is not up to the task.” The professor added, “When the French Ministry of Foreign Affairs removes the virologist’s post at the Pasteur Institute, which is a few hundred kilometres from the Chinese border, we are finished. This happened in November 2019. We are going to try to get that post back, but it is still frightening to think that even at the very gates where viral infectious diseases come from, it is hard to put all the effort into it. The Pasteur Institute of Laos is supported very moderately by France, it is supported by the Japanese, the Americans and the Luxembourgers. France contributes to it, but it does not make it a major research tool.”
The role of this Pasteur Institute according to Professor Sicard is to train local researchers, “To carry out epidemiological studies on the existing viruses chikungunya, dengue fever and now coronavirus, to be a place for high-level biological scientific studies in a remote, tropical territory, but with a high-security laboratory. To be as close as possible to where epidemics occur and to have laboratories that are up to the task. It is very difficult for relatively poor countries to have high level scientific equipment. The network of Pasteur Institutes – which exist in several countries – is a structure that the world envies. But institutes like the one in Laos need much more help than they do now. These laboratories are struggling to make ends meet and they are also having difficulty recruiting researchers. Most of them prefer to be in their laboratory at the Pasteur Institute in Paris or in a Sanofi laboratory or at Merieux, but to become an explorer in the jungle, there aren’t many people who do that. But that’s what Louis Pasteur did, he went to see the farmers in the vineyards, he went to see the shepherds and their sheep.
Louis Pasteur would come out of his laboratory. Just like Alexandre Yersin who was in the field in Vietnam when he discovered the plague bacillus. So, entomological research and research on transmitting animals is not up to the challenge. Of course, it exists, but it must account for perhaps 1% of research. Because what fascinates the candidates for the Nobel Prize is to find a treatment or a new virus in molecular biology and not to reconstitute the epidemiological chains. And yet the great infectious discoveries were born this way: the agent of malaria, Plasmodium, was discovered by a Frenchman, Alphonse Laveran, in the field in Tunisia. And this is fundamental research that is carried out on a scale that has been somewhat forgotten.”
Is the study of animal really crucial? Sicard said: “The plague remains an exciting example. The reservoir of the plague are rats. There are populations of rats that are very resistant and that transmit the plague bacillus, but they don’t care. And then there are populations of rats that are very susceptible. All it takes is a few individuals from the susceptible rat population meeting the resistant rat population one day to get infected. The susceptible rats die. At that point, the fleas that feed on the blood of the rats, desperate not to have more live rats, will start biting humans. Reconstructing this very beginning of the chain of transmission makes it possible to act. In places where the plague is still rife, in California, Madagascar, Iran or China, when we see that a few rats start to die, that is exactly the time to intervene: it is extremely dangerous because that is when the fleas will start to want to bite humans. In plague areas, when we see hundreds of dead rats, it is a real bomb. Fortunately, the plague is a disease of the past. There must still be 4,000 or 5,000 cases of plague in the world. That is not a huge number and then the antibiotics are effective. But this is an example, to show that the animal origin is fundamental and always difficult to apprehend. It is nevertheless essential for understanding and makes it possible to put in place prevention policies. Today, if we continue to sell wild animals on a market, we are in a delirious situation. The precautionary principle must be applied.”
While wild animal traffic is prohibited and there is an international convention that monitors all sales, in China this international convention is not respected, declared Sicard, adding “It is clear that if we ask each country to organise itself nationally, nothing will change. China initially put pressure on the WHO not to call it a pandemic. It tried to block it because it is a major contributor to the funding of the WHO.
It would therefore be important for it to be a totally independent health tribunal, like an international war crimes tribunal, with independent inspectors who verify what is happening on the ground. In Laos, in the countryside, there are many markets where wild animals are sold like chickens or rabbits. There is general indifference because it is the local culture. And culture is the most difficult thing to change in a country,” observed Didier Sicard. Indeed, rightly concluded, since culture, which is a mode of behaviour passed down by individual groups to other generations unfortunately is also sometimes constitutive of a range of atrociously bad and unproductive habits [e.g. medical, dietary, physical (health), linguistic, educational, artistic, perceptive, emotional, managerial and political patterns].
« Avant, avec mes amis, on avait peur des Chinois. Maintenant, on voit sur Twitter qu’on a peur de nous, les Italiens ! »
Alicia à franceinfo
Sicard also commented on what struck him on the attitude of the French population, stating, “the gap between a kind of indifferent casualness, hardly any critical look at Italy and China and the brutal discovery of the health disaster. We have gone from recklessness to extreme anxiety and both are equally toxic: recklessness creates contamination and extreme anxiety leads to irrational behaviour. The proof of this is the flight of Parisians, Lyonnais and inhabitants of large cities to their second homes. This seemed to me at first to testify to a very short-sighted vision, as if one could escape, in war, from the arrival of the German armies. And then an extraordinarily individualistic behaviour, in the wrong sense of the word: ‘Save whoever you can, I shut myself up in my countryside and then it’s too bad for the others, I protect myself’. Of course, I imagine that if you can protect the elderly and keep them safe, that’s fine. But when we see young couples or groups of friends who are now saying to each other, we’re going to go on holiday! This is all the more shocking because this epidemic is about something completely different from just saving someone. On the contrary, it’s a question of asking how each can be seen by the other as a role model.”
Professor Didier Raoult also pointed out in 2009, that human civilization is still savage and prehistoric when it comes to a culture of medical hygiene because most of us do not know how to handle viruses due a lack of knowledge and social organisation, i.e. it is a pattern of behaviour that is still not firmly embedded in culture of the non-scientific majority. Raoult even pointed out 11 years ago that if a mutant respiratory virus was to appear we would be facing a considerable disaster, and here we are.
Didier Raoult « On ne sait pas lutter contre la contagion d’un virus respiratoire » | Archive INA (2009)
A similar argument was also recently brought forward by Bill Gates in 2018 who suggested that a new diseases could kill 30 millions in 6 months, while his foundation published a simulation showing an epidemic spreading from China, which is coincidentally now facing a « serious situation » to deal with the accelerating deadly coronavirus epidemic that has put the world on its knees. « In the case of biological threats, that sense of urgency is lacking, » Gates said, adding that countries need to prepare for pandemics in the same serious way they prepare for war; he asserted that a small non-state actor even had the ability to construct a deadly form of smallpox in a laboratory environment. The philanthropist explained in an interview on Virtual TED Interview that if the United States enacts such a strict isolation law, positive results could be seen within the first 20 days. According to Gates, the United States was too late to react. If they had started testing people who might have had the virus as early as February, they could have escaped total isolation. « There are no half measures. It’s not right to say « keep going to restaurants and buying houses, ignore the pile of dead bodies in the corner. It’s irresponsible to tell people not to worry, » said Bill Gates, also adding that the public must, at all costs, maintain the law of isolation for as long as it is necessary to save lives and prevent the situation from becoming similar to that in Wuhan and Northern Italy.
In an essay written on the Oxford Martin School website at the University of Oxford Ian Goldin and co-authored by Robert Muggah, a similar orientation is suggested, i.e. for the world to become more interdependent since our world has become more connected. However, globalisation must be managed efficiently in order to fight systemic risks such as the COVID-19.
We saw how the growing complexities of the global financial system was badly managed by public authorities controlled by politicians, and supposedly financial « experts », people who were supposed to have graduated from the supposed best institutions, simple parvenus turned mechanical thinkers, and what did they do? Together, as a pack of ruthless & cannibalistic great white sharks, they took the whole world into the financial crash in 2008; it is not even the first time in history and nothing tells us that they will not do it again. The full blame can be attributed to the dangerous negligence and overconfidence of this very special and particular breed.
This has led to mediocre, cheap, uncharismatic and atavistic populists politicians without any sophisticated outlook about a connected world to storm to power since the world’s political and economic « elites » were held responsible for the 2008 financial crisis. But we now see how these populists lack the sophistication to lead a new modern and interconnected world as we are living through this crucial phase in human history where civilisation is changing era.
These atavistic minds who grabbed power in the US are following an ancient tradition that does not have its place anymore in our modern world, i.e. blaming foreigners for everything and turning their back to the outside world, and hence also making themselves insignificant among noble world leading societies, i.e. those who together set an example to civilisation and shape the human civilisation of the future. The grotesque US president, Donald Trump spurned scientific thinking about a range of serious issues such as climate change, spread fake news through petty news agencies and twitter ogres and even shunned traditional allies and international institutions such as the World Health Organization and the Paris Climate Agreement, decisions that have not been met with approval by many sensible Americans; for example, Melinda Gates sees Trump’s decision as absurd, and with the evidence of infections rising fast, most extremist nationalist politicians are compelled to recognise the traumatic human and economic costs of COVID-19. Hence, it is also not surprising that in France, a literary, intellectually hungry and constantly evolving nation of voracious and sophisticated book readers & writers, Trump is viewed as one of the greatest disasters of the modern world, compared to the pigs of George Orwell’s « Animal Farm », and has even been paraded as a clown along with Macron in Nice.
« Do me a favor, speed it up, speed it up. », this is what the naive Trump told the National Association of Counties Legislative Conference, because the ignorant, infantile, insensitive and obese politician may believe that if he repeats it a couple of times the vaccine may suddenly appear. A vaccine takes longer to be safe and ready, and most people with some scientific foundation know this. As the American chemist, inventor, musician, professor, entrepreneur and former chancellor of the University of North Carolina, Herbert Holden Thorp wrote for ScienceMag, China has rightfully taken criticism for blocking attempts by scientists to report the truth about the coronavirus, the US under Trump and his circus have been doing the same thing. To inform Fauci and other government scientists that all public comments must be cleared with Pence is bordering on dictatorship and an assault on individual freedom and dignity. It is clearly not a time for a mediocre, disconnected, unsophisticated and atavistic American politician who does not fear ridicule by making an absolute ass of himself through his denial of evolution, climate change and the dangers of cigarette smoking to come around and tell people how to live, what to believe in and shape the public message; this is dangerous to every single person who lives in the US. It is however encouraging to see that Fauci, Francis Collins [director of the U.S. National Insitutes of Health (NIH)], and their colleagues across federal agencies have ignored these instructions and gradually spread the message, because transmission rates and death are not measurements that can be changed with Trump’s will and an extroverted presentation. The Trump administration repeatedly lied, saying that the virus spread in the US was contained, when it was very clear from genomic evidence that community spread was occurring in Washington State and beyond. This kind of distortion during such a deadly pandemic is unacceptable and contributed to the federal government’s slow response. Although the words of the Trump administration have never mattered to or registered in the brain of learned individuals, these words are now clearly a matter of life and death in the US during the pandemic.
Most intellectually cultivated, smart and refined individuals do not expect politicians or mediocre gossip journalists to know much about philosophical discourse, the foundations of scientific reasoning, objectivity, statistics, to be able to read and fully understand a scientific paper, let alone understand brain physiology, the laws of evolution, Newton’s laws of gravity, p-value, logical reasoning or know what legato is; and that is perhaps why most of the finest intellectuals remain in their league and keep their distance from street politicians and the common crowd, because they likely know that it would be like trying to communicate with non-receptive, indifferent and inanimate objects such as pebbles or truffles.
Hence, it is very likely that to most sensible and intellectually cultivated individuals, attempting to have a conversation with those objects would be a waste of time, neuronal activity and calorie; while also having to leave the noble realm of philosophical discourse, their library with names such as Darwin, Voltaire, Balzac, Descartes, Rousseau, Lacan, Satie and Debussy, and sometimes even their piano or violin, to then have to jump into a world of slimy reptilian characters and see weird and untrustworthy faces of brains inferior to their own trying to tell them how to live, and also having to endure mockery of the lowest, most infantile and animalistic kind from some of the vilest and most frustrated peasant-like parvenus in politics with severe inferiority complexes. So these cultured intellectuals keep quiet in the distance and focus on writing books instead.
As a bilingual Franco-British intellectual, in the French world for me, it would be like trying to discuss about « les métaphores artistiques d’Eugène Delacroix, la structure du psychisme, la philosophie du désir, la motivation chez le sujet cartésien, l’héritage voltairien, et la dialectique Lacanienne » with « simplets » [i.e. simple minds] like Bécassine, Nabilla, Bamboula, Darmanin, Hollande, Pompili and Morano in a small village bistrot; and in the Anglo-Saxon sphere with Postman Pat, Nigel Farage, Harry Potter or Mr.Bean in an ancient and derelict pub in England, or Homer Simpson, Forest Gump, Joe Biden and Donald Trump in the US – so, what I mean and what most intellectually superior individuals understand is that it would be useless and unproductive because of the unsynchronised psyches caused by different levels of intellectual cultivation and heritage.
Regarding the degraded and cheap form of politics around the world in the 21st century, people at large need to firmly understand that every time typical, plain and ignorant office workers stack enough money aside to be able to afford quitting their day job in order to join a group of politicians in a movement, it does NOT suddenly transform them into a superior authority that requires everyone to stand in line to listen to everything that comes out of their mouths; they cannot and will never win a noble and sophisticated philosophical debate by insulting and disrespecting intellect and science simply because it does not always conform to their wishes and is often against their disconnected and backward outlook, while also at times being too challenging for most of their average, limited, naive, unproductive, boring and uncreative brains.
So, these simple animalistic minds and parvenus in the media along with those who hold their leash in politics need to seriously understand that no matter how many rotten tomatoes they throw at the wall of reason, these bricks were built on science, philosophy and intellect, and they will NEVER go down; for example, we know for a scientific fact that cigarette smoking is one of the leading causes of lung cancer, and that flesh in a state of decomposition is a breeding place for maggots, no amount of headlines, photo editing or covers will ever change those facts and convince any intellectually cultivated mind otherwise, although that does not seem to stop some cheap, corrupt and deluded journalists from trying – Trump could be a suitable equivalent example. We know some are hired to do so, but they would make their own lives easier and less stressful by knowing the limits of rational possibility, for example, by understanding that covering gold with manure and swine scum will never transform it into those.
During the CoVID-19 pandemic, these haters of intellect and science then insist on something as serious as a vaccine that science cannot provide on demand – as if it was as simple as feeding or mass breeding pigs on a farm. As Holden Thorp also noted, for the past 4 years the obese Trump and his circus have made deep cuts in the scientific budget including cuts to funding for the Centers for Disease Control and Prevention and the NIH. For their selfish political goals, the grotesque administration’s disregard for the science of the Environmental Protection Agency and the National Oceanic and Atmospheric Administration, and the stalled naming of a knowledgeable director for the Office of Science and Technology Policy has caused a lot of harm over 4 years to US residents and the credibility of the US itself on the world scene. Now, with the devastation caused by CoVID-19, Trump suddenly needs the discipline he disrespected and ignored, i.e. science. Yet, to cite Thorp, « the centuries spent elucidating fundamental principles that govern the natural world—evolution, gravity, quantum mechanics—involved laying the groundwork for knowing what we can and cannot do. The ways that scientists accumulate and analyze evidence, apply inductive reasoning, and subject findings to scrutiny by peers have been proven over the years to give rise to robust knowledge. These processes are being applied to the COVID-19 crisis through international collaboration at breakneck, unprecedented speed […] the same concepts that are used to describe nature are used to create new tools. So, asking for a vaccine and distorting the science at the same time are shockingly dissonant.«
The website PubPeer.com allows users to comment on scientific articles in post-publication, but also to report suspicions of breaches of scientific ethics. The site highlighted gaps in several high-profile articles, which in some cases led to retractions and accusations of scientific fraud as noted by the blog RetractionWatch.com, which analyzes retractions of scientific articles and comments on issues related to scientific integrity. PubPeer exists because of the inability of some hard empirical science to sometimes replicate its results and effectively self-correct itself.
A reliable vaccine must have a strong scientific foundation and will have to be manufacturable and safe. To achieve this, it will take some time, and although the top scientists are working as fast as they can to deliver this life changing vaccine, we should not expect a miracle in time-scale [e.g. in 3 weeks]. The business executives from those giant pharmaceutical companies who see life in terms of bank notes, have every thing to gain in getting the vaccine fast but luckily for people, even they also understand that we cannot use magic to get there in a week. However, we can perhaps take a positive note from this tragedy, since a couple of years ago Trump declared his skepticism about vaccines and even tried to launch an antivaccine task, but today crippled with CoVID-19, he suddenly loves vaccines. Herbert Holden Thorp beautifully said it: « If you want something, start treating science and its principles with respect. »
The Centers for Disease Control’s worst-case scenario suggests that about 160 million to 210 million Americans will be infected by December 2020; as many as 21 million will need hospitalisation and between 200,000 and 1.7 million people could die within a year. Harvard University researchers believe that 20% to 60% of the world’s population could become infected, and estimate that 14 million to 42 million people could lose their lives.
As Ian Goldin also suggested, the extent to which excess mortality can be prevented depends on how quickly societies can organise itself medically and culturally to reduce new infections, isolate the sick and manage health services and resources humanly and efficiently, and also on how long relapses can be prevented and contained.
While intelligent campaigns that teach and reshape human cultures on hygienic habits to deal with viruses may help, without a reliable and effective vaccine, COVID-19 will remain as a hugely disruptive force for years, the pandemic will inflict more suffering and damage on poorer and most vulnerable communities within many countries, highlighting the risks associated with rising inequality.
In the US, over 60% of the adult population suffers from chronic disease, around 1 in 8 Americans live below the poverty line, and more than 75% of them live from paycheque to paycheque, and over 44 millions in the US have no health coverage at all; and to make matters even worse, they also constitute the largest culture of obesity and community of fat people on the planet.
Speaking with the Conversation France, Frédéric Altare, the director of the département d’immunologie at the Centre de Recherche en Cancérologie et Immunologie Nantes-Angers confirmed that being overweight is the major comorbidity associated with severe forms of Covid-19, which require admission to resuscitation in hospital. It can be estimated that, in some places, up to 80% of these may be related to obesity and that if we take a national average, obesity certainly accounts for more than half of the proportion of people admitted to intensive care. The fact that obesity creates a bias in favour of worsening the disease is also confirmed by the outbreak of the epidemic in the United States, a culture of hot dogs and big bellies where almost 40% of the population is severely obese. Since we are on the topic of hot dogs, a review of evidence in the British Medical Journal found that all processed meats [e.g. sausages, bacon, ham, and corned beef] are highly carcinogenic, i.e. they cause cancer. Those foods all now appear in the same risk group for cancer (group 1) as asbestos, cigarettes and alcohol (Kmietowicz, 2015).
This association between obesity and severe forms was already well-known for other respiratory infections such as the avian flu. The people at higher risk are those who have passed the morbid obesity milestone. Whether an individual is overweight is assessed using the famous « body mass index« , or BMI [You can check your BMI here], which is the ratio of weight to height squared. A person with a BMI above 25 is considered to be slightly overweight. From 30, we speak of proven overweight with the onset of obesity, at 35 we begin to speak of severe obesity, and from 40 we enter into what is called « morbid » obesity. Morbid, because the people concerned are considered to be at risk of developing pathologies, mainly cardiovascular and atherosclerosis, but also type 2 diabetes, liver diseases, certain forms of cancer.
The challenges are also dramatic in Latin America, Africa and South Asia, where health systems are weaker and governments are less able to respond, risks caused by the failure of politicians such as Bolsonaro and Modi to take the issue seriously enough, argued Ian Goldin of Oxford University and Robert Muggah from the University of Rio de Janeiro.
In poor communities where many individuals share a single room and depend on day to day work to feed themselves, social isolation will be difficult and around the world as individuals lose their income, we should expect rapidly rising homelessness and hunger. In the US, a record of 3.3 million people have already filed for unemployment benefit, and across Europe unemployment is also reaching record levels. Yet, in richer countries some safety nets exist even if they are struggling to organise themselves, but poor countries simply do not have the capacity to ensure that no-one dies of hunger.
All responsible and realistic governments around the world should therefore ensure that all people in need have a basic income to ensure that no-one starves as a result of this crisis. Goldin rightly observes that the COVID-19 pandemic provides a turning point in national and global affairs, it shows our interdependence and also that the general public tends to rely on governments to protect and save them and not the private sector, thus badly organised governments lead to human disasters… a song that most people are already familiar with.
In agreement with my own suggestions, Goldin and Muggah also argue that at a time when faith in democracy is at its lowest point in decades, deteriorating economic conditions will contribute to even more political and social instability. There is already a tremendous trust gap between politicians and citizens. Some politicians are sending mixed signals and citizens are receiving conflicting messages; this reinforces their lack of trust in public authorities controlled by politicians. Due to a shortage of international leadership from the US government, cities, businesses and philanthropies are stepping up.
With the range of serious viral infections that have blighted the world during the last decades, it was only a matter of time for others to appear; most perceptive minds probably knew, but unfortunately these minds are a minority on our planet. « What’s to stop some form of SARS showing up? » Bill Gates asked in 2014, referring to the 2002-2003 epidemic of severe acute respiratory syndrome, caused by another coronavirus. Next, he said, could be « SARS II. » Bill and Melinda Gates established their foundation in 2000 and have always focused on biomedical innovations against disease and ways to deliver them. In 2014, during the Ebola epidemic that killed thousands worldwide, the Foundation was active in helping to stamp out the virus.
Governments should also take notice that the way a society cares for and treats its residents reveals a lot about their philosophy and their values about human life and dignity. As a modern civilisation, free high standard healthcare for all should be one of the priorities for all sophisticated and civilised societies, because people do not go to the hospital for fun, freebies or to collect free candies but end up there in situations of distress. Whether the public hospital has a homeless person, a high-earning lawyer, a student or a child at their doorstep, the quality of medical care should be at the highest standards for all, and societies who want to set an example to the world should certainly start with healthcare, because caring for the population is not spending but investing – a population in good health leads to progress at multiple levels [i.e. physical and brain development, educational achievement, psychological health, professional performance, etc]. Research and medical advancement are sectors that no government should discriminate because it ensures a healthy and progressive society.
Bill Gates in 2016 met Trump in the Manhattan skyscraper where the Trump Organisation is based and wanted to discuss « science and innovation ». Gates who co-chairs Bill and Melinda Gates Foundation – which is focused on infectious disease research and treatments – told Trump before he took office that he ought to make preparedness for the danger posed by viral pandemics a priority of his administration. But, of course, with Trump’s ignorance and lack of sophistication these words probably did not register on his brain who now says that « nobody could have predicted » the CoVID-19 virus » when Bill Gates did warn him. The only horribly stupid question that a scientifically illiterate Trump asked Bill Gates during that meeting was whether there’s « a difference between HIV and HPV ». Gates later recounted: « I was able to explain that those are things that are rarely confused with each other.”
“I feel terrible,” Bill Gates says now. And, “I wish I had done more to call attention to the danger,” even if it is the government’s responsibility to keep itself well informed and protect its population. Gates and his charitable organisation have so far committed more than $300 million to various coronavirus relief efforts, which is about 3 times the contribution of the whole of the US to the World Health Organisation.
The point he made to Trump back then is more or less the same one he’s been stressing for years, including during a much-touted 2015 TED Talk in which he described viruses as posing the “greatest risk of global catastrophe.” “If anything kills over 10 million people over the next few decades, it’s most likely to be a highly infectious virus rather than a war,” Gates said at the time. “Not missiles, but microbes.” As of now the US is the global epicentre of the COVID-19 pandemic with more than 4.5 millions cases confirmed and 87, 000 deaths according to the Johns Hopkins COVID-19 resource center, exceeding the 58,220 lives lost over nearly 2 decades in the Vietnam war.
The Bill & Melinda Gates Foundation have invested $100 million to fight the new coronavirus in China; Twenty million will go to institutions including the World Health Organization (WHO), the American and Chinese Centers for Disease Control and Prevention, and the National Health Commission in China. Twenty million will be allocated to public health authorities in sub-Saharan Africa and Southeast Asia, areas that have been disproportionately affected by recent epidemics including the H1N1 pandemic in 2009. Up to $60 million will be spent on research into vaccines, treatments and diagnostic tools.
Other groups such as the Wellcome Trust, Skoll, the Open Society Foundations, the UN Foundation, and Google.org are also scaling up assistance.
It is clearly not the appeals to atavistic and extremist nationalism and closed borders that will trigger solutions and make the most out of the complexities of our interconnected global civilisation in times of crisis where coming together as one planetary civilisation with a unified economic, scientific and medical force is key to destroying this virus; the solution is not about closing the borders or opening the borders, but to create a strong, safe, reliable and intelligent filtration system that is also flexible, reasonable and humane to people and allows movement in and out that contributes to the multi-layered forms of development of a country and civilisation as a whole (e.g. intellectual, academic, educational, linguistic, literary, cultural, scientific, medical, technological, economic, etc), through the transmission of connaissance (knowledge) and savoir-faire (know-how).
Ian Goldin and Robert Muggah agree on the idea that the spread of COVID-19 must be met with a similarly coordinated international effort to find vaccines, mobilise medical supplies and, when the volcanic dust settles, to ensure that we never again face what could be an even deadlier disease. They write on the University of Oxford’s Oxford Martin School website : « Now is not the time for recriminations: it is the time for action. National and city governments, businesses, and ordinary citizens around the world must do everything they can to flatten the epidemic curve immediately, following the examples set by Singapore, South Korea, Hong Kong, Hangzhou and Taiwan. »
Bill Gates remains optimistic about the crisis, since Covid-19 will allow the world to accumulate experience and prepare for the next pandemic. The modern and forward-thinking philantropist believes that the innovation shown by countries in the northern hemisphere could be of great help to countries in the south that are likely to be affected by the virus in the coming seasons, Gates is convinced that the fight against the virus requires a more realistic count of the number of proven cases, the Microsoft founder will finance the free distribution of testing tests in his city of Seattle. For him, the coronavirus could be the epidemic of the century. In practice, as soon as the tests are available, they will be distributed on demand in Seattle. The aim is that anyone with symptoms will be able to make the diagnosis themselves, by rubbing a cotton stick into the back of their nostrils. The Foundation says it can quickly process thousands of tests every day and deliver results within 48 hours maximum. Positive screenings will be notified to the patients, as well as to public health authorities. Positive patients will then be asked to complete an online questionnaire to detail their recent travels and the people they may have been in contact with. The aim is to better monitor the epidemic and to ensure that potential patients do not travel to hospitals or doctors’ offices.
“You can’t get ‘outside », said Professor Didier Sicard, who also argues for a universal attitude, which comes at a right time to educate world culture on medical hygiene, « We must not consider that we are 30 years old and in good health and that we are not going to be fooled by all this talk. » Everyone must realize that they may be unknowingly contaminating others. The epidemic has passed through people who have returned from China or Italy. Didier Sicard says: « I know the example of an Italian woman who went to Argentina. She attended a wedding and kissed everyone. This woman infected 56 people! Irresponsibility in times of epidemics does immense damage. On the contrary, we have to respect the measures. Like waiting, for example, in front of the supermarket before entering if you see that there are people. »
Surgical face masks have been proven to significantly reduce the detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets, hence surgical masks have the potential to prevent the transmission of human coronaviruses and influenza viruses from symptomatic individuals (Leung et al., 2020). Until antivirals and vaccines are ready, the face mask will become the indispensable and essential accessory for us all at all times, when we are outdoors or in environments frequented by others. Most popular among lay people, the cloth mask is already being widely used and it is re-usable; this accessory will be the key to ease us all out of lockdown and offer some temporary protection to us and the people around us until the vaccine and antivirals are ready. THE MASK IS NOT A MIRACLE PROTECTION, SO INDIVIDUALS MUST REMAIN VIGILANT AND NEVER LOWER THEIR GUARD and are advised to seriously take notice of where their hands and fingers are going and ensure that it does not get in contact with their face [i.e. mouth, eyes, ears], carry a hand-sanitiser with at least 60% alcohol with them at all times and use it properly, maintain a safe distance of about 1 metre minimum from all other individuals at all times, and also stay away from those who are not wearing masks as micro droplets from their breath and mouth may contaminate others.
A study published in the PNAS using highly sensitive laser light scattering showed that micro droplets generated by asymptomatic carriers of COVID-19 during speech can emit thousands of oral fluid droplets per second and these can remain in the stagnant air of confined environments for up to about 15 minutes. This confirms that there is probability that normal speaking causes airborne COVID-19 virus transmission in confined environments (Stadnytskyi, Bax, Bax and Anfinrud, 2020).
People should also not be ashamed about their appearance due to protective measures, nothing is enough for a deadly virus, and I would personally recommend using safety goggles that completely seal the eyes when outdoor in highly frequented public places such as shopping areas. People should also never lose their focus about the possible sources of contamination indoors, such as shoes and clothes worn outside. It may be life-saving to organise a specific routine such as leaving shoes worn outside in a corner, sanitise hands when touching them. Perhaps as soon as one gets home, instantly remove and place all clothes worn outside in a basket far from people in the house, outside in a sheltered place may be convenient for washing then disinfect oneself and shower.
We must NEVER FORGET that there is a deadly virus circulating and any minor slip or even a small reflex [e.g. scratching the eyelids] can mean death. The Académie de Médecine recommends the facial mask for all.
How to maintain your cloth mask
There are many people who do not know that the cloth mask MUST COVER THE NOSE AND THE MOUTH otherwise it would be pointless, hence it is advisable to tell any person not wearing their mask properly to do so; the mask should also not be used for more than 4 hours. Generally, the cloth mask must be washed every time that it has been used, taking into consideration that usage should not exceed 4 hours. Hence, it is obvious that every individual will need to have a few in order to rotate them during the day appropriately. The Association Française de normalisation (Afnor) also advises to wash this protection every time it is dirty or wet or badly positioned on the face. To be worn properly, the mask must cover the nose and the mouth and should not be placed in waiting position on the forehead or around the neck. The Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM) also stated that all mask makers must give details on how to wash and disinfect their masks. Here is a list of some helpful advices for an optimal maintenance:
- Wash at 60 degrees celcius with your usual laundry for at least 30 minutes preferably in the machine, or if not available, by hand
- Dry the mask in the 2 hours that follow the washing in a dryer, or if not available, with a hair dryer
- At the slightest sign of wear (e.g. hole or deformation) the mask must be discarded.
Here are also a few things that you MUST NOT DO:
- Place it in a microwave
- Iron it without washing it
- Use bleach or alcohol
- Dry it in open air
Before the wash
Before the washing process, the Afnor precisely explained in its FAQ that it is not necessary to systematically disinfect the inner tube [i.e. the area that holds the laundry] before washing your masks. However, Afnor recommends to run an empty wash if you have accidentally added a used mask with other clothes during a wash at a temperature lower than 60 degrees celcius. In this case, we must proceed, before the wash, with a cold rince of the inner tube with bleach, or run an empty wash in the machine at 60 degrees celcius or 95 degrees celcius without spin.
During the wash
Masks should be washed with your usual detergent at a temperature of 60°C for at least 30 minutes in the washing machine or, if this is not possible, by hand. The use of fabric softener is not recommended. It is best not to use any product other than your usual detergent, as any other product could degrade the mask fabric. Furthermore, the Afnor specifies that you can wash your masks with sheets or towels, in order to « ensure the mechanical aspect of the wash ».
The Drying Process
The Afnor believes that « the mask should be completely dried within the two hours that follows the washing« . Whenever possible, the mask should therefore be tumble dried after cleaning the filters. Drying in the open air is slower, but it can be an alternative, » we find on the Afnor website.
Can the mask also be blown dry? The option is mentioned in a standard notice for fabric/cloth masks put online by the Direction générale des Enterprises. But Afnor does not recommend this method, because of the « poor control of the temperature level », which can lead to damage to the fabric. If you nevertheless choose this option, for lack of any other solution, it is therefore essential to pay attention to the temperature supported by the mask. The ANSM also recommends, if possible, steam ironing the mask. This can help to complete the drying process, adds the Afnor. Here again, be careful with the temperature so as not to damage the fabric or the elastics.
Whichever option you choose, all layers of the mask must be completely dry. As a final step, before storing it in a clean, airtight package, visually inspect the mask. If you notice any deterioration (wear, deformation, holes, etc.), discard the mask.
If Washing Is Not Possible
It is not recommended to microwave the mask. Steam ironing or hair drying is not a substitute for washing either. Finally, it is absolutely not recommended to use bleach or alcohol to disinfect a mask. Not only can these two products alter the quality of the mask by degrading the fabric, but bleach is also dangerous to your health (with risks of skin irritation or respiratory problems).
The Stop-postillons site, created by doctors, nevertheless gives this advice, if one cannot disinfect one’s mask right away: « keep it in an airtight box (for example a plastic box disinfected with bleach) », then « wait a week ». You can also find a simple method to make your own mask that does not require any additional material except a pair of scissors and a t-shirt.On masks, Didier Sicard declared: « …they are psychological protectors for walkers and not virological protectors. Every French person has to say to themselves: I do everything so that others can’t blame me for anything. We need an attitude where we look for the other’s gaze before our own. That alone will bring efficiency. Masks are obviously protective for doctors and caregivers in an environment where the virus circulates. But when you have people walking down the street wearing masks, it’s paradoxical. They think they’re protecting themselves from others, but there’s a huge gap between the uselessness of masks on the street and the vital usefulness of masks in hospitals. I myself was at the pharmacy on Saturday morning and I showed my doctor’s card to see if I could buy masks. The pharmacist told me there were none left. So, if I needed them to treat a patient, I wouldn’t have been able to go see him, or I might have contaminated him. We have seen too many people walking down the street wearing masks as a kind of panoply. There is a major political drama in this absence of masks.”
Sicard pointed out that masks should be reserved for carers, stating: “To anyone who works around the virus. When you see cashiers at the supermarket who don’t have masks while customers have masks, there is something completely counterproductive. Those who don’t need them have got them, and those who really need them are missing them. This is directly related to individual behaviour. I would never have dared to walk down the street with a mask until the caregivers had masks. It’s something that would have frightened me. It basically shows people’s blindness and ignorance. If you walk around without meeting anyone, there is no point in wearing a mask.”
From an ethical standpoint, the attitude of carers who are now on the front line when they were on strike a few weeks back struck Sicard, who said: “That’s their duty. A doctor is mobilized in his inner self to do his job. Cowards don’t come at the beginning. So, it seems both admirable and normal to me. The suffering of the hospital body, I’ve been seeing it for ten or fifteen years. The number of my colleagues who have told me, you are so lucky to be retired! We suffer, it’s terrible, the hospital has become a business. And I totally agree with what they said: the hospital has been martyred. With purely economic decisions that ignored the interests of patients and doctors. The number of doctors who took early retirement should be measured by explaining that their profession no longer had any interest and that they felt they were spending their time filling in forms and boxes. There has been a real ransacking of the public hospital over the last decade. The last Minister of Health who was still really aware of his role and who respected health care workers was Xavier Bertrand. After that, it was a disaster.”
Sicard also did not think that this broken health system had any repercussions today faced with the current sanitary crisis in France, adding: “All the measures that made the hospital non-functional have temporarily disappeared. The administrators are terrified in their offices and do nothing. The doctors are doing everything. They have regained all their power.
There is a certain happiness for them in finding the job they always wanted to do. The administration has packed up its bags, or more precisely, it is in charge. The balance of power has been reversed: a year ago, doctors were at the orders of the administration; now, it is the administration that is at the orders of the doctors. This is a very interesting phenomenon. Doctors themselves are no longer hindered by being forced to fill the beds with patients who bring in money, which was the principle until then. Now they’re going back to their core business. Which is the fight against death. Deep down, they find the deep DNA of their craft. It’s almost a paradox: there is less distress in the medical profession now at peak activity, than there was six months ago when they were desperate and depressed because they felt that their profession had lost its meaning.”
Sicard seems to rightly observe and believe that the politicians will remember this period and that civilisation is changing era: “I can give you an example for which I’ve been fighting for two years. I won’t name the hospital, but I know a woman who specializes in burn surgery. At the hospital, her department was closed and she didn’t have a position anymore. Nevertheless, she wanted to continue working with children with burns. However, her burn unit was transformed into a plastic surgery unit for buttocks and breasts. Because it brings in a lot of money. But she always tells me that if there was a fire in a school with forty or fifty burned children, we would no longer have the capacity to take them in because we consider that burns are not profitable enough and that it is better to focus on surgery for the stars. »
« This economic vision of medicine, which has been introduced over the last ten years, is an absolute disaster, » declared the experienced medical professional This was of course a public hospital, “In the private sector, institutions do what they want. However, it is not normal for the public sector to destroy an activity that is not profitable – because burns are very expensive and bring in very little money and there is no private activity capable of dealing with them – and to dismiss it in favour of profitable activities. Basically, the public was anguished at the idea that it had to invest heavily in top-of-the-range equipment to match the private sector. The public will never have as much money as the private sector and will never be able to keep up. And by spending money on highly specialized sectors, we end up neglecting the most vulnerable people, be they the elderly, alcoholics or people in precarious situations. The public hospital has ended up forgetting its hospital function, as I have said on several occasions. Ninety per cent of doctors have been aware of this and it has been a terrible suffering for them. Just as it was for nurses and other care workers to do a job that was linked to money.”
Professor Sicard believes that we have no assurance that politicians will change their views on health care, however he thinks that the French will remember and will hold them to account, saying: “President Macron had promised to stop activity-based pricing, the current system of hospital financing. Economists have been pushing the envelope, saying that we would no longer be able to measure the cost of this or that operation. And the head of state gave up. I think that after this crisis, the President of the Republic will modify this activity-based pricing. The hospital will ask to be reimbursed on what it achieves and what it considers its priority. We have to trust the hospital not to treat patients unnecessarily and fill beds as if we were at the club méditerranée. The hospital will regain its true public care function.”
In the UK, at Oxford University, researchers have been working with Oxford University Hospitals NHS Foundation Trust to reduce clinical research activity to allow researchers to prioritise research on COVID-19 and to support the pressing clinical needs of the NHS. The academic community will have to work together with governments, funders and healthcare providers to combat this ugly COVID-19 virus and Oxford has a long history of responding to health emergencies, e.g. during the 2014 Ebola crisis among negro communities in Africa, Oxford scientists lead the way in undertaking human vaccine studies, and Oxford’s strength in research around infectious diseases and international health, alongside its leading work in emergency vaccine development places it in a great position to contribute to better comprehension around the effective control of this horrific epidemic.
The Oxford team has already tested a potential coronavirus vaccine successfully on several animal species. The World Health Organisation (WHO) has reported that over 70 vaccines are being developed globally for the Covid-19. The Oxford team will join 3 other groups of researchers, 2 in the US and 1 in China for the start of human trials. Professor Sarah Gilbert, a vaccinologist at Oxford University said she is « 80 per cent » confident it will be a sucess. Patrick Vallance, the UK’s chief scientific adviser said that it would be « very lucky » if a coronavirus vaccine was available widely within a year.
The Oxford group are among the most advanced viral vaccine group in the world and have been working on vaccine preparedness for several years which means that they should be able to test and evaluate Covid-19 vaccine candidates rapidly. The group have unique unique viral vector delivery and expression systems combined with diverse expertise from basic virology to vaccine production scale-up. The UK has no current vaccine manufacture however, and may have to rely on its Western European neighbours (e.g. France, Belgium and Germany) that have industrial level manufacturing capabilities. The Jenner Institute and Oxford Vaccine Group, could develop a jab that would be ready as early as September, almost a miracle in speed for such a demanding task as people are dying by the thousands every couple of hours globally.
So, we are going to need a technology that allows us to deliver billions of doses over a year. The team at the University of Oxford said that they expect to produce a million doses of their experimental vaccine as early as September; months ahead of the official 12-to-18 month timeline quoted by experts around the world. “Then we’ll move even faster from there, because it’s pretty clear that the world is going to need 100s of millions of doses ideally by the end of the year to end this pandemic and let us out of lockdown safely”, said Professor Adrian Hill, Director of the Jenner Institute, University of Oxford.
The Oxford University team’s experimental product, called « ChAdOx1 nCoV-19 », is a type of immunisation known as a recombinant viral vector vaccine and is just one of at least 70 potential Covid-19 candidate shots under development by biotech and research teams around the world. The vaccine was chosen as the most suitable vaccine technology for the virus as it can generate a strong immune response from one dose, said the team. When asked how they managed to move the usually lengthy process of vaccine approval along so quickly, Professor Sarah Gilbert, who is leading the study, said it was their ongoing research into Disease X – an as yet unknown infectious agent earmarked as a potential pandemic in the making – which allowed them to pivot so quickly to Covid-19.
We should be looking into creating a planetary medical organisation that is minutely planned and efficiently organised around the latest and finest technological advancements. All vaccine researchers and developers worldwide have a responsibility towards mankind to synchronise their knowledge and findings in the development of the ultimate vaccine.
The World Health Organization will also have to prioritise works on the linguistic synchronisation of planet Earth’s medical worlds since this unification of the medical talents and expertise worldwide is of upmost importance for the future of mankind and civilisation. What we mean by linguistic synchronisation is that the whole medical community will need to work in one language as it will speed up development, and will also be one step towards building a united planetary society, even if individuals are free to learn or study other tertiary languages if that is what they desire.
It is also to be noted that with all the difficulties that such a delicate intellectual responsibility and duty involve due to the lack of sophistication, open-mindedness, personality along with the persistent culture of atavism of many rigid, naive, ignorant, infantile and petty little minds, especially in the Anglo-Saxon sphere, reminding me of a comedic post about the 29 things French people love about Britain, but more particularly in the even more savage industrial and mechanical wild west of the US, as a bilingual Franco-British individual with native mastery of French and English, I have always invested my time and energy in the cause of mankind’s evolution and tried my best to act as a cultural bridge between the academic, medical, scientific, intellectual, psychological, philosophical, and psycholinguistic realms of the 2 most widely spoken languages in the so called « developed world » – that sometimes unfortunately still feels like concrete jungles through the savage behaviour, actions and reasoning of the passionless and unsophisticated creatures that are supposed to set an example, inspire, guide a civilisation and create a humane and harmonious society where « le dépassement de soi » is a realistic pursuit and where individuals can grow in multiple ways, truly « live » in the full sense of the term and not simply have a plain and meaningless existence where achievement is purposeless and devoid of sense.
In our times, however, there are still many regions of the world that are linguistically « undeveloped »; where the majority cannot even master simple communication in English, let alone grasp the finesse, artistry, romanticism, emotional sensibility, humane values and depth of the psychical realm of literary French.
Indeed, just like many useless, cheap, uncultivated and frustrated street politicians in France, the great majority of their political counterparts in other parts of the world also fail to do so, unconsciously suffering from a lack of literature, self-cultivation, artistic exposure, self-respect and dignity combined with a constant complexe d’infériorité towards those who are wiser, smarter, nobler in spirit, more intelligent, creative, charismatic and sophisticated than them; I would recommend them to sit down and listen to the university lectures of Prof. Michel Butor [E.g. Les récits philosophiques de Balzac], it may help towards their cultural evolution, but also ease the pain on those forced to endure them, such as their wife and children.
It is time for them to firmly understand that we still have some « adultes surdoués » as Monique de Kermadec » phrases it, or « Overmen » as Friedrich Nietzsche puts it i.e. highly talented and skilled individuals who live and exist out there, especially in the psyches of the French speaking world and heritage [e.g. Napoléon, of whom even the great German Georg Wilhelm Friedrich Hegel himself described seeing as follows: « I have seen the Emperor », he writes « this soul of the world – getting out of the city to go on reconnaissance; it is indeed a marvellous feeling to see such an individual who, concentrated in one point of space, sitting on his horse, stretches out over the world and dominates it. »]; individuals who have the savoir-faire and creative power to manage dozens of governments worldwide, a film/video/music/media production company, a publishing house, who could also give a lesson in professional artistic photography, post-production and presentation, and even train a whole generation of original, sophisticated, witty, poetic, literary and noble writers, and not just in Oscar Wilde’s granular Oxford English, although plain and flat compared to French, but also « la langue Française de Balzac » in all its precise articulations, depth, style and literary artistry.
Logically, to such individuals, running a press/publishing/media business would be a piece of cake, something achievable half-asleep with superior values, style, efficiency and impact than the mass of mediocre newspapers and their usually obese owners and political sympathisers out there; if such a direction was a career choice and goal for those gifted individuals at a particular point of their life – of course!
Besides, my whole life I have questioned my own sanity because I have always felt misunderstood and different from the rest of the crowd and highly sensible and receptive to what most primates around me could not even hear, sense, feel, see, perceive or understand, and also never found anyone in the Anglo-Saxon realm with a mastery of French similar to mine, and nobody in the French realm with a mastery of English as mine, thinking that I could be fake, I then realised that linguistic discourse and speech are not fake, but are very real and alive, as Jacques Lacan also concluded. Luckily, I recently read Monique de Kermadec’s book « L’Adulte Surdoué » and found out that humanity has a minority of individuals out there in the world who also feel misunderstood and are hard to classify, because just like myself, these « weird fools » and misunderstood individuals have an IQ of above 145 [which I only recently found out myself from a small IQ test on the MENSA website that only measured up to 145, which is sufficient for me to know without an exact number since this is a statement of fact not an exercise of arrogance – delivering me from my torment to confirm that the weird ones are not us, but the mediocre majority that surrounds us and cannot follow our discourse or understand our lightning speed judgements because of their lower IQ – valuable things in nature are rare, that is why they are valuable].
Superior individuals with superior intellect will not see these cold-blooded, cannibalistic, reptilian political primates as a model to follow, as an inspiration, as a source of comfort, safety, hope or stability, as a spiritual guide or as an ultimate authority, but instead just see them as a bunch of other disconnected and divisive money-minded politicians and cold bureaucrats passing by, like the thousands of mediocrities who have lived and died before them and who have been responsible for some of the most castastrophic human disasters in history without ever being able to accept their mistakes, while also not having any major positive impact on the world, and who are at this minute rotting in a forgotten grave with maggots sliding through their bones. We could even ask ourselves whether some of them have green blood, and imagine the horror and agony it must be for any woman for whatever reason to have to wake up next to one of those reptilian primates every morning, with its mouth half open drooling on a pillow with its « haleine de boudin ».
And to stress the point that most of the mediocre politicians nowadays cannot be trusted with the heart of the people, the historical and legendary verbal whipping from the great Napoleon himself to the evil, lying, sly, dishonest, disloyal and backstabbing politician, Talleyrand, who was plotting against the emperor with Fouché in 1834, comes to mind; looking at the untrustworthy face and straight in the eyes of the unscrupulous man, the emperor Napoléon said:
« Vous êtes un voleur, un lâche, un homme sans foi. Vous ne croyez pas à Dieu ; vous avez toute votre vie manqué à tous vos devoirs, vous avez trompé, trahi tout le monde […] Tenez, Monsieur, vous n’êtes que de la merde dans un bas de soie. »Nowadays with the adaptive and dynamic technology and skilled software engineers available, we should be creating a sophisticated planetary medical system where the latest findings, empirical studies, analysis and statistics of the medical experts of the whole world are instantly synchronised and available in one place [with instant full-access to all medical journals worldwide], while respecting the personal and non-medical details of patients by a tested and proven system of indexing that does not allow for personal details to be input but only strict medical/scientific details.
We should be focusing on specialised and highly encrypted [an encryption specially devised for this system that is 100% safe so that even if there are hacks and data breaches, the data will never be usable due to the powerful encryption] servers only accessible through highly controlled card systems, only available to the medical departments of hospitals and universities from all around the globe.
Such a system would speed up development for both medical professionals and patients. For example, If a patient suffering from cervical, skin, ovarian, testicular or lung cancer in any part of the world (e.g. Rio de Janeiro, New York, Moscow, Port-Louis, Bombay, Tokyo, Alabama, Berlin, Jerusalem, Ottawa, Cape Town, Zurich, London, Grenoble or Paris) has a CT scan, that scan would be instantly uploaded and classified in the medical database on the specialised and encrypted servers and made available to all medical departments and professionals in the world connected to the system, who would then have the options to add comments or questions, with their involvements being rewarded by points.
The heads of medical faculties at universities could even have the option to use these live data and cases to train medical students, and in doing do, provide a revision to the diagnosis and treatments of patients while also subjecting the cases to constructive criticism and/or new treatments being developed.
A similar scenario could also apply for all diseases and all types of treatment that would be minutely and systematically classified while remaining intuitive to browse, sort by a range of variables and access for medical professionals; the age, blood group, weight, height, sex and other medical details only would be made available on the specialised server, not private non-medical information. Such an advanced system would not only connect the medical community, stamp out medical negligence and raise medical standards, but also provide a massive dataset from which a range of institutions could carry medical research and have a more precise conclusion from statistical tests.
This system with a well organised database could also be used to manage a global blood bank and ensure that it is evenly distributed internationally so that even those with rare blood groups can be treated efficiently when health problems arise;
for example, if the daughter of a motel owner, fried chicken and hot dog seller in Illinois happens to be of a very rare blood type and she finds herself in desperate need of it to remain alive, she could instantly have access to the rare blood which could have been collected from the other side of the globe and extracted from the veins of a locksmith in Amiens, an aborigine in New Zealand, a noodle seller in China, a dwarf circus-performer from an English village, a banker in India, an Eastern European stripper in Las Vegas, a heavy truck driver in Madagascar, a kangaroo keeper in Australia, a potato farmer in Germany, a gay bouncer and bodybuilder in Austria, an old and bald Breton who edits a low class « plouc » newspaper in Northern France, a retired, frustrated, useless and senile politician in Brazil, a peasant with a limited vocabulary and a strong « Marseillais » accent, or a globally known French writer, intellectual, philosopher and creative artist – because such an efficient and sophisticated system would allow for a systematic management of blood banks globally.
That system would also include the profiles of medical professionals accessible between them along with a system of forums, awards, points and chats where any medical department and expert could post messages regarding the recruitment of patients for studies, the latest findings of particular medicines and treatments from the wide range of departments and specialities; and also the top articles from scientific journals made available by different departments – until we work on such a sophisticated system, humanity will continue to suffer from a lack of organisation and management.
A system as sophisticated and organised as that would lead to the world being up-to-date and synchronised medically, with patients also receiving the latest treatments or having the option to travel to different parts of the world for new treatments against deadly diseases or terminal stages that are still in the trial phase and also doctors remaining focused and sharp through the latest updates in their specific fields while also giving them the ability to instantly ask questions on the forum/chat to other experts in their fields right from the operating table if they are unsure or would like some words of support or confirmation.
They may even have a live camera streaming system on their foreheads or face while conducting surgery so that it can be seen by all those connected to the system in private clinics, hospitals and the medical faculties of universities worldwide. Such a system could be regulated by an independent global medical authority that would also deliver certifications to all institutions and professionals who apply for it, patients could also see a particular logo on their treatment locations to see that they are part of such a system; if this is implemented even minor hospitals in small villages will suddenly have the boost and expertise of the top medical experts behind them. This would lead to an instant rise in medical standards worldwide.
In the 21st century with the affordability of powerful multi-core processors, high-definition audiovisual equipment and high speed broadband it is a scenario that is very realistic and not a far-fetch scene from one of the infantile mass produced science-fiction fantasies of the Hollywood industry.
We need to apply the technological ingenuity of mankind appropriately to make the most of our lives in this world and allow our fellow humans to live more and stress less, and not simply focus all that technological prowess into creating brain numbing and absurd entertainment media and other petty devices and apps that lead humanity to a culture of mundane, mediocre, meaningless and useless social blogging and nonsense, where bored and pathetic people share photos of their sandwiches, drinks, breakfast and make-up tips with the world. From an article in the Lancet, Sarah Gilbert said: « WHO is in the process of creating a forum for everyone who is developing COVID-19 vaccines to come together and present their plans and initial findings. It is essential that we all measure immunological responses to the various vaccines in the same way, to ensure comparability and generalisability of our collective findings. Work is continuing at a very fast pace, and I am in no doubt that we will see an unprecedented spirit of collaboration and cooperation, convened by WHO, as we move towards a shared global goal of COVID-19 prevention through vaccination”.
I also take the opportunity to salute all the medical teams and healthcare workers operating all over the world for the courageous task they are undertaking and also express all my gratitude and support to my local NHS GP surgery in West London who have always been there when I needed them and who are still texting their patients to show their concern and support in these difficult times affecting the entire human civilisation.
Steps to prevent infection are vital:
There are many things we can do to protect ourselves and the people we interact with. As with a cold, a flu vaccine won’t protect people from developing COVID-19. The best thing we can do at this point is to follow the same preventive measures as we would against the flu. It is widely known that individual can catch the flu when people sneeze and/or cough on them, or when they touch a dirty doorknob. We should wash our hands thoroughly especially before eating or touching the facial area and cavities and also after using the bathroom, while also avoiding others with flu-like symptoms – these are the best strategies for the time being.
The following preventive actions are also recommended:
- Wash hands with soap and water for at least 20 seconds. Dry them thoroughly with an air dryer or clean towel. If soap isn’t available, use a hand sanitizer with at least 60% alcohol.
- Stay at home if sick.
- Avoid touching nose, eyes, and mouth. Use a tissue to cover a cough or sneeze, then dispose of it in the trash.
- Use a household wipe or spray to disinfect doorknobs, light switches, desks, keyboards, sinks, toilets, cell phones, and other objects and surfaces that are frequently touched.
- It may also be important to create a household plan of action. You should talk with people who need to be included in your plan, plan ways to care for those who might be at greater risk for serious complications, get to know your neighbours, and make sure you and your family have a household plan that includes ways to care for loved ones if they get sick. This includes planning a way to separate a family member who gets sick from those who are healthy, if the need arises.
- Medical professionals recommend that people voluntarily wear cloth face masks in public settings where other social distancing measures are difficult to maintain, including grocery stores and pharmacies, especially if they live in an area of significant community-based transmission. It should be noted that the cloth mask is not meant to protect the wearer from infection. It is instead meant to slow the spread of the virus (if people who have the virus and do not know it wear masks, they help prevent transmitting it unknowingly to others). Health experts advise making face coverings at home from simple materials, and reserving surgical masks and N95 respirators for health care workers and other medical first responders.
While everyone should take precautions, measures may be critical for adults over 65 years old (the risk seems to gradually increase with age starting at age 40, according to the World Health Organization) and those with chronic conditions (such as diabetes, heart disease, and lung disease).
People in these higher risk categories especially should stock up on household items, groceries, medications, and other supplies in case they need to stay home for an extended period of time.
Steps to follow if you become infected and fall ill:
Until now, information available shows that the severity of COVID-19 infection ranges from very mild (sometimes with no reported symptoms at all) to severe to the point of requiring hospitalization. Symptoms can appear anywhere between 2 to 14 days after exposure, and may include:
- Difficulty breathing
Getting in touch with one’s medical provider for advice in the eventuality of experiencing these symptoms, especially if you have been in close contact with a person known to have COVID-19 or live in an area with ongoing spread of the disease is recommended.
Most people will have a mild illness and will usually be able recover at home without medical care. Seek medical attention immediately if you are at home and experience emergency warning signs, including difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse, or bluish lips or face. This list is not final, so consulting your medical provider if other concerning symptoms are noticed is vital.
François Sureau : « Les Français ne sont pas un troupeau de moutons ou une garderie d’enfants »
To conclude, just like Goldin and Muggah, I also believe that the major Western European players, China, Japan and especially France, a world leading and cultivating nation, must set an example for history by stepping up and leading a global effort, forcing the deteriorated and unstable US government and the uncharismatic politicians controlling it into a global response, which includes accelerating vaccine trials and ensuring free distribution to the world once the ultimate vaccine and antivirals are perfected and finalised. Governments and financial institutions around the world will also need to take dramatic action toward massive investments in health, sanitation and basic income and also provide financial support to both struggling employers and employees.
As for potential treatments that have managed to save some lives until the vaccine is finalised, we have some studies suggesting that convalescent plasma [i.e. donated blood from people who have recovered since this donor blood has antibodies to COVID-19] lead to shorter hospital stays and lower mortality for patients who received the treatment while no severe adverse effects were observed (Chen, Xiong, Bao and Shi, 2020). It has also been shown that chloroquine, hydroxychloroquine and tocilizumab have the potential to act as a potential cure in « some » patients but they are not guaranteed to function in all cases of COVID-19. The last substance, TOCILIZUMAB has even recently shown to cure COVID-19 patients with severe underlying medical conditions; it has cured a patient who recently had a kidney transplant (Fontana, et al. 2020), and others with asthma (Schleicher, Lowman and Richards, 2020), systemic sclerosis (Distler, 2020), multiple myeloma (Zhang, et al. 2020) and sickle cell (De Luna, et al. 2020).
Some doctors in France are claiming to have healed patients infected with CoVID-19 through the use of antihistamines, a well-known and easily accessible medication against seasonal allergies, and some patients are claiming that in 24 hours their symptoms disappeared [i.e. blocked nose, runny nose, aches and pains]. Although no empirical studies have been carried out yet, these French doctors are claiming that since antihistamines can reduce inflammation in its early stages it can prevent progression towards dangerous stages. Dr Hélène Rezeau-Frantz prescribed antihistamines to 18 patients who were symptomatic but untested and after a couple of hours they all started feeling better. These doctors are claiming that antihistamines carry no risk of serious adverse effects and genuinely believe that we may be on an interesting trail towards treatment and are asking for serious studies to be carried out on antihistamines.
All these recent advances have been referenced below in the « Références (Études Scientifiques) » section, and academics & medical professionals are kindly urged to read, analyse and continue further research in this direction and the world can also help by spreading this information as far and wide as they can without wasting a single second.
This is a very stressful and testing time for not only the academic community but also to the rest of the human population and until safe solutions are developed to counter COVID-19, as mentioned above, we cannot lower our guards or act recklessly towards this dangerous and deadly virus.
We must NEVER FORGET that there is a deadly virus circulating and any minor slip or even a small reflex [e.g. scratching the eyelids] can mean death. We must follow the barrier moves at all times and be incredibly conscious of our every move and actions while also constantly maintaining a strict clinical hygiene. Those who are not following these protective rules are not only playing with their own life but with those of others and a good suggestion for these dangerous, irresponsible and immature people would be to imagine 288, 212 human corpses stacked in a heap in front of them and ask themselves whether they would like to be part of it, because this is the number of lives the CoVID-19 epidemic has claimed in a few months which includes many highly trained and experienced doctors. We have also heard and read some rumours in the media regarding the impact of weather and climate on the COVID-19 pandemic. What a recent study in Science (Baker et al., 2020) found is that humid climates tend to favour stronger outbreaks, however summer and sunshine will not limit the pandemic growth substantially. The only things that will give us all our life back are effective antivirals and/or a reliable vaccine.
It is also understandable that many people are also eager to get back to resuming their normal lives and having been confined for so long many want to travel or go on holidays, especially confined couples.
However, it is imperative to understand that as long as effective antivirals and vaccines are not finalised, this incredibly dangerous virus will be circulating among human populations. Hence, as matters currently stand the wisest behaviour for the time being is to wait and be patient while also minimising unimportant social interactions and travel and only focus on what is truly important. We should only leave the house for essential and vital reasons such as for work [if impossible to work from home] and for food provisions.
Thanking all my readers, followers and supporters for their kindness, time, loyalty and trust.
Le Boléro de Ravel par l’Orchestre national de France en #confinement #ensembleàlamaison
(FR) Vous trouverez ci-dessous une liste des principaux articles relatifs à la crise COVID-19 en cours. La liste ci-dessous sera continuellement mise à jour comme tous nos articles sur le site. Veuillez visiter ce poste périodiquement pour plus d’informations pendant que nous luttons ensemble contre cet horrible virus en tant qu’une civilisation des créatures les plus intelligentes de la Terre.
(EN) Below is a list of the top articles related to the ongoing COVID-19 crisis. The list below will be continuously updated as all of our posts on the website. Please visit this post periodically for more information as we fight this ugly virus together as a civilisation of the smartest creatures on Earth.
Références (Études Scientifiques) – Cliquez sur les liens
- Ahmed, S., Quadeer, A. and McKay, M., (2020). Preliminary Identification of Potential Vaccine Targets for the COVID-19 Coronavirus (SARS-CoV-2) Based on SARS-CoV Immunological Studies. Viruses, 12(3), p.254.
- Aljofan, M. and Gaipov, A., (2020). COVID-19 Treatment: The Race Against Time. Electronic Journal of General Medicine, 17(6).
- Amuasi, J., Walzer, C., Heymann, D., Carabin, H., Huong, L., Haines, A. and Winkler, A., (2020). Calling for a COVID-19 One Health Research Coalition. The Lancet.
- Asian Pacific Journal of Allergy and Immunology, (2020). Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic.
- Baker, R., Yang, W., Vecchi, G., Metcalf, C. and Grenfell, B., (2020). Susceptible supply limits the role of climate in the early SARS-CoV-2 pandemic. Science, p.eabc2535.
- Bennardo, F., Buffone, C. and Giudice, A., (2020). New therapeutic opportunities for COVID-19 patients with Tocilizumab: Possible correlation of interleukin-6 receptor inhibitors with osteonecrosis of the jaws. Oral Oncology, p.104659.
- Bergin, C., Browne, P., Murray, P., O’Dwyer, M., Conlon, N., Kane, D., Laffey, J., Ní Choitir, C., Adams, R., O’Leary, A., King, F. and Gilvarry, P., (2020). Interim Guidance For The Use Of Tocilizumab In The Management Of Patients Who Have Severe COVID-19 With Suspected Hyperinflammation [V3.0]. The Irish Health Repository.
- Bi, Q., Wu, Y., Mei, S., Ye, C., Zou, X., Zhang, Z., Liu, X., Wei, L., Truelove, S., Zhang, T., Gao, W., Cheng, C., Tang, X., Wu, X., Wu, Y., Sun, B., Huang, S., Sun, Y., Zhang, J., Ma, T., Lessler, J. and Feng, T., (2020). Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study. The Lancet Infectious Diseases,.
- Carsetti, R., Quintarelli, C., Quinti, I., Piano Mortari, E., Zumla, A., Ippolito, G. and Locatelli, F., (2020). The immune system of children: the key to understanding SARS-CoV-2 susceptibility?. The Lancet Child & Adolescent Health,.
- Cellina, M., Orsi, M., Bombaci, F., Sala, M., Marino, P. and Oliva, G., (2020). Favorable changes of CT findings in a patient with COVID-19 pneumonia after treatment with tocilizumab. Diagnostic and Interventional Imaging,.
- Challender, D., Harrop, S. and MacMillan, D., (2015). Understanding markets to conserve trade-threatened species in CITES. Biological Conservation, 187, pp.249-259.
- Chang, R. and Sun, W., (2020). Repositioning Chloroquine as Ideal Antiviral Prophylactic against COVID-19 – Time is Now.
- Chen, L., Liu, H., Liu, W., Liu, J., Liu, K., Shang, J., Deng, Y. and Wei, S., (2020). [Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia]. Chinese Journal of Tuberculosis and Respiratory, 43(0):E005.
- Chen, L., Xiong, J., Bao, L. and Shi, Y., (2020). Convalescent plasma as a potential therapy for COVID-19. The Lancet Infectious Diseases, 20(4), pp.398-400.
- Colson, P., Rolain, J., Lagier, J., Brouqui, P. and Raoult, D., (2020). Chloroquine and hydroxychloroquine as available weapons to fight COVID-19. International Journal of Antimicrobial Agents, p.105932.
- Cortegiani, A., Ingoglia, G., Ippolito, M., Giarratano, A. and Einav, S., (2020). A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. Journal of Critical Care.
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- Le Parisien: Coronavirus : le coup de gueule du président des médecins, contaminé à son tour (19 Mars 2020)
- Le Figaro: Masques: Macron le grand bouffon frustré souhaite «l’indépendance pleine et entière» de la France «d’ici la fin de l’année» (31 Mars 2020)
- Twitter (Nicolas Chung): Bonjour Twitter, je ne fais jamais ça mais nécessité fait loi : une amie médecin en hôpital en IdF cherche imprimantes 3D pour fabriquer les dispositifs d’adaptation pour les masques Decathlon. Merci pour votre aide et vos RT. (1 Avril 2020)
- Oxford University Research: Infectious disease experts provide evidence for a coronavirus mobile app for instant contact tracing (17 Mars 2020)
- Oxford University Research: Coronavirus Researchers at Oxford (18 Mars 2020)
- Clinical Trials Arena: Coronavirus treatment: Vaccines/drugs in the pipeline for COVID-19 (16 Avril 2020)
- l’Opinion: Coronavirus: l’Afrique suit la prescription de chloroquine du Pr Raoult (30 Mars 2020)
- Le Point: Coronavirus : une nouvelle étude de Didier Raoult sur la chloroquine (28 Mars 2020)
- fr: Les malades chroniques traités à la chloroquine sont-ils immunisés contre le coronavirus ? (3 Avril 2020)
- L’internaute: Vaccin et médicaments contre le coronavirus : le point sur les avancées (16 Avril 2020)
- La Libre.be: La Chine commence à tester sur les êtres humains un vaccin « efficace » contre le nouveau coronavirus, a indiqué mercredi le ministère de la Défense à Pékin. Il est développé sous la direction de l’épidémiologiste Chen Wei. Le vaccin a été approuvé après de premiers tests. Il peut désormais être testé sur les êtres humains. Le ministère de la Défense le décrit comme sûr et efficace, et a précisé que les préparations pour sa production en masse sont en cours, rapporte l’agence de presse espagnole Europa Press. (18 Mars 2020)
- Xinhuanews: (COVID-19) La Chine approuve trois vaccins de COVID-19 pour des essais cliniques (14 Avril 2020)
- UK Research and Innovation: Coronavirus: the science explained
- Confédération Suisse: Federal Office of Public Health FOPH: New coronavirus (14 Avril 2020)
- France Inter: « L’État ne va pas pouvoir continuer à soutenir l’économie à ce niveau-là pendant longtemps », selon le Medef (11 Avril 2020)
- France Culture: Youtube: Coronavirus : crise économique ou changement de modèle ? (12 Mars 2020)
- Le Figaro: Coronavirus : Cristiano Ronaldo transformerait ses hôtels en hôpitaux (15 Mars 2020)
- Gala: VIDEO – Didier Raoult : ce surprenant aveu fait à Jean-Marie Bigard (1 Avril 2020)
- Sputnik France: Un pilote de la compagnie aérienne AirAsia a quitté son avion par la fenêtre du cockpit en apprenant que plusieurs passagers pourraient être porteurs du nouveau coronavirus (23 Mars 2020)
- Le Figaro: Aides-soignants, caissiers, camionneurs… Les gilets jaunes sont devenus les «premiers de tranchée» (9 Avril 2020)
- France Bleu: Confinement : qui a gagné ou perdu le plus de population en Auvergne-Rhône-Alpes ? (9 Avril 2020)
- Statista France: Ces produits qu’on s’arrache en plein confinement (8 Avril 2020)
- Oxford University Research: The economic impact of COVID-19 (7 Avril 2020)
- The Conversation France: Conversation avec Frédéric Altare : l’obésité, facteur très aggravant du Covid-19 (2020)
- Science Media Centre: Expert reaction to Times Interview about vaccines with Prof Sarah Gilbert (11 Avril 2020)
- The Lancet: Sarah Gilbert: carving a path towards a COVID-19 vaccine (18 Avril 2020)
- The Telegraph: A vaccine for Covid-19 could be ready by the end of summer (17 Avril 2020)
- France Inter: Coronavirus : voici des sources fiables pour vous informer en évitant les fake news (17 Mars 2020)
- Le Point: Coignard – Covid-19 sur le « Charles de Gaulle » : une allégorie française (20 Avril 2020)
- France Bleu: Coronavirus : les dermatologues alertent sur de nouveaux symptômes cutanés (7 Avril 2020)
- Ouest France: Pour Anne Soupa, journaliste, théologienne et bibliste, le confinement ces dernières semaines a accentué notre inventivité sur la manière d’être présent (28 Avril 2020)
- Paris Match: Edgar Morin, paroles de sage (16 Avril 2020)
- Guardian: Priti Patel has said removing coronavirus restrictions in the UK will not be a binary choice and the government would not give a date for the end of lockdown. The home secretary added that five tests will have to be met before schools can reopen but said giving a date ‘would be irresponsible and get hopes up’, saying: « We want to prevent a second wave of this horrendous virus. To do that we have to ensure that we continue with the measures we have put in place. » (25 Avril 2020)
- YouTube (Telegraph): Priti Patel: « We know people are frustrated but we are not out of danger yet. It is imperative that people continue to follow the rules designed to protect their families, their friends and their loved ones; this will continue to save lives. We all want to return to living our lives as normally and as soon as safely as we can… but the 5 tests we have laid out must be met…» (25 Avril 2020)
- Le Figaro: Hervé Morin: «La reprise des cours aurait pu attendre septembre» (27 Avril 2020)
- RTL: Coronavirus : l’université d’Oxford promet un vaccin pour septembre (28 Avril 2020)
- RFI: Déconfinement en France: Martine Wonner (LaREM) : «Ce plan va être bancal faute de thérapeutique adaptée» (28 Avril 2020)
- Le Point: Déconfinement : ce qui attend les Français le 11 mai (28 Avril 2020)
- Le Point: Masque, visière, gants… Les coiffeurs ainsi que de nombreux commerces, sont autorisés à rouvrir en Suisse, où le déconfinement se fait en plusieurs étapes. (27 Avril 2020)
- Science Daily: Ultraviolet LEDs prove effective in eliminating coronavirus from surfaces and, potentially, air and water (14 Avril 2020)
- Emeral Insight: Only vaccines or drugs will end social distancing (29 Avril 2020)
- France Info: Le coronavirus vaincu par des antihistaminiques ? Certains médecins généralistes français assurent avoir guéri des patients du CoVID-19 avec des antihistaminiques. (7 Mai 2020)
- Our World in Data: Coronavirus Disease (COVID-19) – Statistics and Research
Mis à jour le Mercredi, 27 Mai 2020 | Danny D’Purb | DPURB.com
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