The Three Kings
Prior to December 31, 2019, the running theme in preparation for the coming year seemed to be one of fatalism. All over social media, people yapped about how they were not going to make New Year’s resolutions for 2020. Their reasoning had been that these resolutions never worked; or rather, they never were able to adhere to these stipulations. The past seems to always repeat itself, so why bother?
I did go to church on that 31st night. Oh! that night, Father was a philosopher. He espoused a new complicated reading into the birth of Christ and the Three Wise Men’s Journey towards the Star of Bethlehem. It was so complicated that after a few minutes, I drifted off in thought. We did pray fervently that night, right through to dawn.
We prayed for self, family, for country, and the world. But somewhere in China, a disease was brewing unbeknownst to us. It is easy to blame this now pandemic on my inattentiveness to the sermon and prayer session that 31st night. But in this article I attempt to redeem myself—you see, I am not to blame. Neither is God.
History repeats itself—in fact, it is the lack of cognisance to this fact, that makes it all the more true. This coronavirus is not the first; there have been six preceding it. It is not the first fatal human coronavirus either; there have been two of such preceding it. And with each, the world has had to scramble through—yes, scramble through—for our understanding of each of these cases have been half-baked.
Researchers have laboured in the past to get a grasp of each outbreak of coronavirus; but never achieving full certainty, never arriving at a vaccine, only to be introduced to a whole new kind. We know, in more general terms, the cause of coronaviruses: they are zoonotic diseases; they transmit from animals to humans. Of this we are sure, and that is about where our certainty ends.
The Three Crown-like Viruses
The virus affects animals and humans. As early as the 1930s, the first animal coronavirus was recorded. A decade later, two more were found. In 1960, the first human coronavirus was discovered. This was to be treated with far less severity than done presently, for these earliest cases of coronaviruses manifested merely in common colds. In 1968, the virus earned the name corona, meaning ‘crown’ or ‘halo’ due to the appearance of the virus.
In February, 2003, coronavirus donned a much thorny crown, and shocked the world with fatality. The virus was found to be responsible for severe acute respiratory syndrome, and from thence, we derived the name of the first fatal coronavirus—SARS-CoV, an abbreviation. Its origin: the Guangdong Province of China; specifically, the nation’s live-animal markets. For months, SARS baffled the world; infected more than 8,000 people worldwide; made claim of over 800 lives—the mortality rate was thus pegged at around 10 percent.
It took the imposition of strict quarantines and immense control measures over the live-markets in South East Asia to curb the virus. And a vaccine for this virus, till date, eludes us.
The world saw two other coronaviruses: HCoV-HKUI and HCoV-NL63 after the SARS pandemic. These two were however dwarfs, compared to SARS.
In 2012, yet another fatal coronavirus erupted, proving more deadly than SARS-CoV in terms of mortality rate—about 35 percent, it stands. It is the Middle East Respiratory Syndrome (MERS-CoV).
The first instance of the diseases was reported in Saudi Arabia. Though the disease has been highly concentrated in the Middle East, it did spread to France, Tunisia, USA, South Korea (which happened to record the highest cases and fatalities outside the Middle East). Like SARS before it, no vaccines for MERS has been developed; what we have now are periodic outbreaks of the disease in some parts of the world—as of December 2019, there has been 2468 reported cases with 858 deaths.
So then, there has been three fatal coronaviruses in the past two decades alone: SARS, MERS, and our burden now, COVID-19.
- Journey to COVID-19
And now, back to the latter part of 2019: the world was presented with yet another novel coronavirus. Novel—that word has an almost comic undertone, for SARS and MERS, had each been informally called novel coronaviruses in their time. The International Committee on Taxonomy of Viruses caught the absurdity of this and quickly provided a name to replace 2019-nCoV (2019 new coronavirus)—SARS-CoV-2, they named it, due to its similarities with the SARS pandemic of 2003. WHO announced, to avoid confusions with the 2003 SARS, that the official name would be COVID-19, so here we are.
On 31st December, China was reckoning peculiar cases of pneumonic patients. On Jan 1, the Wuhan wet market, suspected to be the source, was closed down. On Jan 5, the Wuhan Municipal Health Committee announced that this new case, was not in fact influenza, neither was it SARS or MERS.
On Jan 8, the world got word from the Chinese CDC that this new case was, as suspected, a novel coronavirus. Two days later, China reported its first fatality. On Jan 13, Thailand reported its first case—it had been a traveler from Wuhan.
Japan found one traveler—who too had been in Wuhan—positive for the virus on January 16. In January 18-20, there had been a third death, with 15 health officials in Wuhan infected with the coronavirus. Within the next 3 days, there had been 18 deaths in China. Need I bother stipulating the recent numbers, since they change so rapidly?
A field of uncertainties and the reoccurring Bat
The attribute of coronaviruses, since the outbreak of SARS, has been quite frankly: uncertainty. Each step of the way, researchers have been presented with more probabilities, and less convictions. Animal vectors, responsible for spreading the diseases from animals to humans, have not been conclusively arrived on, in each of these three fatal coronavirus cases. What we have had is conjecture.
For SARS, civet cats and bats, especially have been the suspected zoonotic origins. In the case of MERS, bats and camels have been narrowed down on as the most probable causes. Now with COVID-19, similar challenges ensue: snakes (originally suspected), then civet cats, pangolins, and presently, bats have been shortlisted as suspected causative agents.
Researchers have been faced with the challenge, in all three cases, of developing animal models for the viruses, so as to understand their pathogeneses; thus hasten the vaccine development process. In all these three coronaviruses, there have been cases of asymptomatic individuals, this makes it harder to contain the virus; thus the recourse to national mandatory isolation strategies employed by some governments are well-placed.
These measures, though effective, are—through no fault of these governments, per se—resorted to relatively later in the diseases’ spread. The incubation periods of patients of these three viruses vary. MERS takes around 2 to 14 days for symptoms to start; COVID-19, 5 to 14 days. This makes these coronaviruses even more dangerous, for one may be contagious even before symptoms set in, and they may move about—for lack of symptoms, not quarantined—spreading the disease further.
The modes of transmission of the diseases has also been one major headache for researchers—again in all three cases. How do these viruses spread? Are they purely through animal-to-human transmissions, or human-to-human transmissions too? Are the animal vectors proposed, capable of infecting humans directly or do they do so via intermediate vectors.
All these past coronaviruses, though similar in their manifestations—their symptoms are indeed similar—each require their own study (though knowledge transfer is imperative).
These are just a few of the challenges presented to researchers.
A long, ongoing search for the Messiah
Control measures, not groundbreaking vaccine developments, have been the mode of curbing these past two viruses. What this presents is the reality that our chances, as a human race, are only as good as the inherent fatality or otherwise of these past, present, and future coronaviruses—yes, future coronaviruses.
The object of this brief history into coronaviruses, is to make us all prophets. You cannot help but foresee another outbreak. The aim of this brief history is to also make clear this fact: whenever these novel viruses erupt, we are presented with the scenario of chasing the wind—we go about on a treasure hunt, going to unknown places, scouting for clues; we are presented with a jigsaw puzzle, with pieces hidden.
And as we painstakingly study these new outbreaks, they, by nature being fluid in their transmission, replicate, multiply, move swiftly, that by the time we have the tiniest sufficient working theory, the disease has claimed a fair number of lives. So then what is our best bet? Is it not prevention?
The silver lining in this all seems to be the advancement the human race has had in science. Science should help place us in a better position to prepare for, and effectively fight such outbreaks. But science’s doing may just be its own undoing, for it has also placed viruses in a better position to spread more quickly from one national border into another, then another, then eventually the whole world, in less the time that it took outbreaks of centuries past.
The world has a wealth of information from which to tap, especially from the two prior coronaviruses: SARS and MERS, and even the other four non-fatal coronaviruses (HCOV-229E, -0C43, -NL63 and -HKU1). But what is the world to do when these information are themselves filled with pot-holes; and this new case of the virus, though sharing similarities with these past ones, presents its own peculiarities.
The battle, actively, against highly pathogenic human coronaviruses has been two decades now. We need to contain ourselves if we are going to win this war. We need to find ways of culling our human contacts with animals like bats who are hosts to such large number of deadly viruses. A dismissive, the-past-seems-to-always-repeat-itself-so-why-bother? attitude towards these viruses would leave us all for dead. The world needs staunch preventive solutions.
An Introduction to ‘Prevention’
I reiterate: of one thing we are sure, coronaviruses are zoonotic diseases—they transmit, primarily, from animals-to-humans. And in the past century, two of the three fatal viruses have had their origins in China—specifically their wet markets. And did Christ Himself not say, “…if your hand—even your stronger hand—were to sin, cut it off and throw it away. It is better for you to lose one part of your body than for your whole body to be thrown into hell.”?
In another article we would decipher if we can effectively use this argument against these identified coronavirus sources—and if we should at all. We will spread our research further into other zoonotic diseases—and in that, we will find that this advocacy for a prevention of animal-to-human transmissions is not a clarion call targeted at China only, but us all. We would also have to make an inquiry into the international law implications on communicable diseases—perhaps the law can save us all from history constantly repeating itself.
It seems we are all (researchers especially) like the Three Wise Men. The difference is that while they looked ahead, following a star in the bid to find the Messiah; we have to look behind, into our past to arrive at redemption. Had I been more attentive on that 31st December night, I may have been able to construct a much more sophisticated juxtaposition than this—perhaps.
>>> the author is co-founder, Blarney Stone Inc. (BSI Africa), an organisation that specialises in the creation of policy-initiating programmes aimed at spurring our country and continent toward economic and socio-economic development www.blarneystoneinc.com. She can be reached on [email protected]