In consultation with a range of scientists and engineers, Vijay Prashad offers a guide to the virus and some possible antidotes.
By Vijay Prashad
Tricontinental: Institute for Social Research
The coronavirus continues its contagious march across the planet: almost 425,000 known deaths and over 7.6 million people infected. Recently, in the Bay of Bengal, Cyclone Amphan made its fierce landing, its immense energy tearing a corridor through Bangladesh and India (Odisha and West Bengal). [And the U.S. is in turmoil over racial injustice.] If you do not feel for humanity in this period, you have forgotten to be human.
At Tricontinental: Institute for Social Research, we continue with our studies on CoronaShock, which illuminate why the capitalist order has spluttered before this pandemic, while the socialist sections have recovered much faster.
In 2005, the former International Monetary Fund economist Kenneth Rogoff wrote, “The next great battle between socialism and capitalism will be waged over human health and life expectancy.” Our assessment is that one of the reasons for the advances in the socialist parts of the world, despite their economic poverty, is that they take science seriously. For that reason, in consultation with a range of scientists and engineers, we have produced Red Alert #7 to explain the virus and antidotes to it.
Virus & Bacteria
Virus and bacteria are two major kinds of microbes infecting humans. Bacteria are one of the oldest living organisms and have all of the necessary components to live and reproduce. Only a small number of bacteria cause human disease; many of them are good bacteria. Some are even necessary for our survival.
Viruses are not defined as fully living organisms, as they cannot reproduce by themselves. They are a small bit of genetic material contained in a protein envelope. They are also generally much smaller than bacteria.
Viruses are genetic parasites that need other living cells to reproduce themselves. When they invade the cells of their host, they hijack the cell’s biochemical machinery to make a very large number of copies of themselves. These copies are then released from the cell, sometimes killing it in the process, then infecting other cells and repeating the cycle.
Bacteria are easier to kill, as they have their own distinct chemical processes that drugs can attack, and they reproduce more slowly than viruses. We have a whole host of medicines, from the older sulfa drugs to other antibiotics, that successfully control bacterial infections in our bodies.
The Novel Coronavirus
SARS-CoV-2 belongs to a family of viruses called coronaviruses that usually infect mammals and birds. There are seven coronaviruses that infect humans, four of which have crossed over earlier. SARS-CoV-2, the virus that causes the disease Covid-19, is one of the coronaviruses; it has spiked projections on its surface, which resemble a crown or corona when studied under a microscope.
The chances of viruses crossing over from other species to human beings increase if these species are in close contact with us. Therefore both factory farming and live markets of animals and birds provide opportunities for such transfers, which are called zoonotic transfers.
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Bats often serve as a major reservoir of these viruses. The crossover from bats to humans can happen directly, or it can happen through other animals acting as intermediate hosts. Cats, monkeys, pangolins, and dogs can also harbor such viruses, and therefore can act as intermediaries between bats and us. Several viruses – such as Ebola, rabies, encephalitis, SARS (now renamed as SARS-CoV-1), Chikungunya, Zika, and Nipah — have jumped from bats to humans in this way.
Apart from bat viruses, some of the other viruses that have caused epidemics in humans come from birds and pigs. The most well-known virus group that is shared by pigs, birds, and us, is made up of the different strains of flu viruses. It was a swine flu or bird flu that was responsible for the 1918 Spanish flu, which probably started in Kansas. It also caused the 2009-2010 pandemic that started in North America, infecting approximately 1.6 million people and killing an estimated 284,000. The deadly H5N1 influenza, which is currently seen to be a major threat, is a combination of swine and avian flu. It spreads through birds and then to the human population through domesticated ducks, poultry or poultry farms.
As viruses do not have the full mechanisms of a living cell, they use those of host cells. Viruses have either DNA or RNA. DNA carries our genetic code, while RNA uses this genetic code to produce the proteins that our body needs. RNA viruses include hepatitis C, Ebola, SARS (both variants), influenza, polio, measles, and HIV, which causes AIDS. The novel coronavirus – or SARS-CoV-2 – is an RNA virus.
SARS-CoV-1 and MERS-CoV-1 both had much higher mortality rates than SARS-CoV-2. In SARS, the infection to fatality rate (people dead out of the total infected) was 11 percent, while in MERS, it was approximately 35 per cent. In comparison, SARS-CoV-2 or Covid-19 deaths are in the region of 1 percent – much less than SARS or MERS. However, this is significantly higher than the flu, which has an infection to fatality rate of less than .1 percent.
SARS-CoV-2 is dangerous, as it is easily passed from one person to another. It is this ability to transmit easily from one infected person to another that leads to a very large number of infections, and therefore to a very high level of total deaths. SARS-CoV-2 affects people over 65 much more seriously. The higher the age group, the more likely they have other risk factors such as heart disease, diabetics, cancer, asthma or other chronic diseases. It is this – among other risk groups, such as those who are immune compromised or have existing respiratory conditions – that is seeing a much higher death rate in the Covid-19 pandemic. This has been compounded in countries with a large presence of nursing homes, where elderly patients with weak immune systems and many chronic diseases live close together, fueling the spread of the infection. But this does not mean that Covid-19 is dangerous only for the elderly.
SAR-CoV-2 has more effectively adapted itself to its human hosts than SARS-CoV-1 and MERS have. When the current version of the Covid-19 virus mutated, either in us or in a yet-unknown intermediate host, it became particularly effective in binding itself to human cells. The spike protein on the surface of SARS-CoV-2 binds to the ACE-2 receptors that lie on the surface of a large number of our cells, from the lungs to our liver, kidneys, and intestinal tract.
The initial infection is most likely to occur through airborne particles carried in droplets released by those infected. Therefore, the initial infection takes place in the nose, throat, or upper respiratory tract. If the body can fight the infection there and defeat it, it may exhibit itself only as a mild throat irritation, dry cough, or mild fever. Quite often, people who are infected do not even show symptoms; they are asymptomatic. But both those who have mild symptoms or are asymptomatic can infect others.
In most people, Covid-19 is not a serious disease. But in a small proportion of cases, the infection travels to the lungs – the lower respiratory tract – triggering pneumonia. The lungs in such patients show a ground glass effect visible in CT scans. For older people, it can also be accompanied by secondary bacterial infections.
In some cases, Covid-19 becomes particularly dangerous when it causes the immune system to overreact and go berserk. This heightened immune response not only attacks the infected cells, but also the healthy cells, creating what is called a cytokine storm and damaging the lungs even further. It is the cytokine storm triggered by the flu of 1918-20 that caused its high mortality. Further, as the SARS-CoV-2 spike protein can bind to other organs in the body by attaching itself to the ACE-2 surface receptor, it also attacks other vital organs and can contribute to multiple organ failures.
Vaccination became the major route to control infectious diseases caused by viruses. While we did use vaccines against bacterial diseases like the plague, and still use them against other diseases such as typhoid, with the discovery of broad-spectrum antibiotic drugs like sulfa drugs, other antibiotic drugs like penicillin, bacterial infections have become easier to control.
Viral infections are fought largely by the body’s disease fighting mechanisms. Our antibodies and T cells fight any external invasion, whether by a bacteria or virus. Vaccines trick the body into creating antibodies in our system to fight against infections of specific viruses. The body’s immune system remembers the invaders introduced by the vaccine and knows how to fight the actual infection when it presents itself. For viral diseases, real herd immunity comes from vaccination, which protects a significant part of the population and thereby breaks the transmission chain.
Research institutions and companies are taking different approaches to vaccines. One set of approaches is to use existing technologies – that is, live, inactive, or parts of the viruses to trigger the creation of antibodies. These vaccines are well-known. The other approach is to use the advances in genetic engineering to create new types of vaccines. Both sets of vaccines are entering clinical trials. Most candidate vaccines fail during the clinical trial phase of vaccine development; they may not develop antibodies, the effect may be too small, or they may even trigger negative responses such as an even more serious infections than would have taken place without the vaccine. Vaccine development can take a minimum of 12 to 18 months.
Vaccines are often developed with full patent protection to make profits for private pharmaceutical companies, even though large amounts of public money are invested for their development. Philanthropic capital – which has floated bodies such as GAVI (The Vaccine Alliance) – claims that it supports public good, but has refused to accept that vaccines should be available without any patent protection. China, on the other hand, has said that it will break the chains of patent protection and offer a vaccine as a public good.
Once a drug works, or a vaccine is developed, duplicating it is within the powers of any scientifically developed country. The “protection” against such developments is in international treaties and geopolitics (such as in the World Trade Organisation’s Trade-Related Intellectual Property Rights or TRIPS).
Existing drugs are being repurposed to fight the SARS-CoV-2 virus. Human trials will teach us if these repurposed medicines are effective. Several drug trials are in progress, such as a set of drugs being tested through the ‘Solidarity Trials’, launched by the World Health Organization and partners.
Armed with a faith in science and medical knowledge, over two thousand Cuban doctors in the Henry Reeve International Contingent of Doctors Specialized in Disasters and Serious Epidemics have traveled across the world to fight the pandemic on the frontlines. The Contingent, formed in 2005, is named after a U.S. soldier who fought in the Cuban Army of Liberation between 1868 and 1878. His internationalist commitment inspires the Cuban medical personnel. The suffocating air of jingoism and racism is not for them; their internationalism and their commitment to science is what confirms our faith in humanity. Code Pink has called for the Cuban medical workers to receive the Nobel Prize for Peace. We hope that this will be the case.
Vijay Prashad, an Indian historian, journalist and commentator, is the executive director of Tricontinental: Institute for Social Research and the chief editor of Left Word Books.
This article is from the Tricontinental: Institute for Social Research.
The views expressed are solely those of the author and may or may not reflect those of Consortium News.
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I wonder where the author got the stats for the IFR. CDC recently revised it to .4%. He was likely using a global figure, but I still think its likely far too high.
Vijay Prashad. I think you wrote a very good article. Succinct and informative, even the part about the Cuban Doctors. Being Humanitarian at such a time as this is a good thing. But empathy towards ones fellow human beings is not in any way a prerequisite for being human, Too many examples of us vs. them exist at all levels. Even in the business of medicine. Forgetting to be human is not the exception, it’s more like going with the flow.
The business of patents lock up knowlege for profit that would benefit all. ‘China, on the other hand, has said that it will break the chains of patent protection and offer a vaccine as a public good.’
China’s actions say everthing. And Cuba’s special group of doctors embody selfless dedication.
I am curious as to why there has not been more protection and frequent testing in nursing homes for the residents and their caregivers. This is where the concentration of energies should have been from the start since they are most at risk of dying if they contract COVID-19. The biggest mistake in Sweden, who avoided the lockdown, was that most of their deaths were in nursing homes (and mainly in the Stockholm area) because of laxness in testing, quarantining, and early treatment for those people. The same could be said for USA, Italy, and other countries with the higher mortality rates. Not doing enough to protect the vulnerable was the biggest sin of the capitalist based health care systems.
Because all these things that look like good will and humanistic behavior are nothing more than maintenance of the work force. The elderly and disabled are not key to that, and are thus neglected.
If any government was evil enough to use the opportunity provided by COVID-19 to run a culling operation ( designed to deplete the population of elderly residents who would generate future pension and health care costs that would require higher future taxes on others) , the resulting COVID infection , mortality , and other public health data would show certain characteristics : a slow decline from peak levels , an extended plateau at high levels but not so high as to crash the health care system ( thus outraging the masses ) , a seeming inability to provide basics like PPE in sufficient quantities , a feebly ineffective response to the crisis in nursing homes , etc.
Perhaps coincidentally , just such characteristics are noted in the data coming out of countries like the US , UK , and Sweden , in sharp contrast to the data from countries like S. Korea , China , Vietnam , etc.
Yeah , probably just a coincidence , though. Don’t lose sleep over it.
USA! USA! USA!
The Vulnerable indeed should have been the focus from the start; one would think by the high mortality rate from flu most years in the aged that we would already have a better protective system in place. However nursing homes are mostly money-making ventures in the US, as with everything else (though arguably keeping the old alive longer should bring bigger profits?)
Covid-19 is only deadly to a small percentage of the population and these people should have been the focus from the start. Locking down the entire population (except for “essential” workers in groceries, pharmacies, and trash removal) already undercut the purpose of a quarantine (and the effects on the economy were easily preventable by just focusing on the Vulnerable– which includes most of our politicians and leaders not coincidentally). The young and healthy are asymptomatic for the most part, less affected than with the flu.
The biggest sin (sending infected patients to nursing homes was flat out murder!) is debatable. I think allowing travel from people “escaping” the virus in the NYC epicenter (and admittedly a natural response and the basis for why Public Health insists on quarantines for easily spread contagions) was a preventable cause of infecting most of the US. Asian countries ignored the WHO and had rigorous travel bans by policy, which is mostly responsible for their low number of deaths there; they eventually added a 14 day quarantine to ANYONE (even their own citizens) entering their countries. Keeping the initial viral entry low buys time not just for hospitals that may otherwise be overwhelmed but allows the fruition of a vaccine, repurposed drugs, and just the experience of what works best in woefully unprepared Western countries. Low viral entry also makes tracing, testing and quarantining of contacts doable.
Profit motive. Why anticipate and waste capital on unexpected contingencies? Convalescent homes are factories of a sort and unfortunately they are necessary in the modern age. . Have you ever visited one of those facilities. Some patients are there to recover for a short time from various maladies but many are there to die. If they have families well, they are expendable, as are for instance elderly black males with ore-existing conditions. These are the two largest groups of victims from Covid-19 in the USA. They are among the least valued and most underfunded members of our society. These unfortunate deaths will not stop “loved Ones”/relatives from seeking damages for pain and suffering through legal means once the pandemic is brought under control. Lawyers should do well. This is not meant to criticize anyone . This is an ugly thing. Mirrors sometimes are that way. I remember my father once saying to me , “Nobody wants to hear the truth about themselves”. In that case he was using indirect logic to hold a mirror up to my face. I miss him.
A nice introduction and much better than some that have appeared on this very site. There is so much we still do not know about covid-19. The World Health Organization has made it clear from the start that they would brook no dissent from scientists or physicians and have had to walk back their own misinformation: they initially said there was no human-to-human transmission and no need for travel bans (Asian countries took the more conservative approach, banning travel from infected countries, which served them well); they said masks were un-necessary, and have totally reversed that tune (even if only a minimal protection, again standard in Asian countries); they stated that there was no evidence that antibodies to SARS-CoV-2 were protective (which flew in the face of companies trying to isolate such antibodies for therapy, as well as a major point of vaccine development); recently they stated that asymptomatic patients did not spread the virus, which was immediately corrected by a number of physicians (some noting that often patients are most infectious before their symptoms appear and even mild symptoms can be associated are associated with insidious spread.)
Our knowledge of coronaviruses, which cause 15-25% of common colds, is limited and what is true for one (such as the more deadly SARS and MERS) may not be true for SARS-CoV-2. We do know that it spreads very easily in the aged (median age of death is 80 years old) and infirm (particularly those with cardiovascular issues) and probably in most individuals contacted. We know that children do not get very sick with covid-19, and don’t seem to spread the virus much; there is a rare Kawasaki response similar to undefined and easily treatable seasonal viruses seen in Asia. We know that young healthy people are largely spared the worse effects; the USS Theodore Roosevelt, with over 4800 crew members, had a 60% infection rate (by serology testing) with less than 50 hospitalized and only one death (and epileptic who may have hit his head on falling). For older and infirm people, the virus can be hellacious, we don’t know why, and the standard of care in the US for deadly respiratory infections was far below that in Asian countries, and physicians have learned much over the months, “proning”, judicious use of steroids to tamp down the immune system (as noted in the article, cytokine storm is a major cause of death) and heparin to prevent clotting and embolisms, has become standard for this disease. The proper use (still mostly trial and error) of other drugs such as remdesavir can help some patients but are not cures, although the proper combinations of therapy should reduce death rates. Covid-19 should be a wakeup call for Public Health in the West.