by Mansoureh Tajik for The Saker Blog

Bismillah-ir-Rahman-ir-Rahim, “In the Name of God, the Most Gracious, the Most Merciful.”

Novel Corona virus, nicknamed 2019-nCoV, is the latest global celebrity puffed up and propped to exact fear in some, to divert attention from others, to settle a few economic and political scores among adversaries, and to make a few bucks selling diverse prophylaxes along the way. Mainstream and alternative media, social network bazaars, and idea salesmen, too, have been busy haggling and peddling creative theories and analyses from varieties of angles that deal with this latest celebrity. The vendees, as well, have had their own colorful twists and takes to contribute. One wonders how much more currency could be milked out of a tiny nucleotide during whatever time is left of this winter season. Not much, I suppose. Spring and summer have their own fashions and trends.

Meanwhile, it is a good habit to remind ourselves of important truths and core values even if the excuse is nothing but a minuscule virus. I would like to use the essay before you as a reminder of some things that are paramount to life on this earth by discussing two different aspects of this “pathogenoid”, or “weaponoid”, or “whatever-elseoid” anyone prefers to label that is commensurate with his/her already established mindset. The first aspect is the biological, individual and public health components of the narratives surrounding the virus (and others like it), and the second is the psycho-social and political aspects related to Iran and the Iranian people.

First the biological and health aspect. In general, all living and non-living agents, be they natural or anthropogenic in origin, must be able to interact biologically with human body systems in order to have the potential to produce diseases and be classified as toxins and/or pathogens. In addition, the right internal conditions (inside human body systems) and external conditions (environment) must be provided for long enough time duration for those toxins and pathogens to produce diseases and/or biological death.

With that framework in mind, let us put nCoV and its colleagues in their proper and reasonable place. The most complex, the deadliest, and the scariest pathogens that are created by human beings anytime and anywhere on earth as bioweapons or as anything else are not, cannot be, and will never be anything but clumsy, crude, synthetic, and cheap imitations of what exists already in an all-encompassing natural/biological systems. Full stop. Therefore, neither our current celebrity virus, nCoV, nor any other fabricated and engineered pathogen for that matter, can enjoy an exceptionally more perilous status than what is allowed by laws of nature. By the same token, human beings, as part of this natural biological system, are already endowed with numerous and diverse natural defense mechanisms to deal with whatever potentially novel and/or antiquated pathogenic agents are thrown at them both at the individual level and the population level until whenever.

For those of us who genuinely believe in God that whenever is ultimately and in truth rooted in the fact that God Almighty, our Creator, has created us and these natural systems in a purposeful and rather fool-proof way for a specific period of time until I-Sa’ata, the Hour. [1] For others into whose calculus God’s Will and plan for humanity do not enter, I present examples of scientific evidence as mental toys with which they could play until whenever.

nCoV is an influenza virus. Like all viruses, it is not a living being and does not have the cellular structure to survive and propagate. It needs specific bacteria or live human and/or animal cells into which to inject its genetic material and in essences hijack them to replicate itself and propagate. On most surfaces, coronaviruses can maintain their infectivity from 2 hours to 9 days[2] depending on temperature and relative humidity of the environment, surface type, and other factors. These viruses are single-stranded RNA (ssRNA) type and are the type most vulnerable to sunlight. Exposure to direct sunlight (depending on location and duration) could effectively cause structural and functional inactivation of these viruses in a relatively short period of time and render them harmless and/or induce dramatic reduction in their infectivity or harmfulness.[3,4,5,6]

Here, I would like to open a paragraph-long parenthesis and remind people of some key points that might be useful as good health practices anyway. Sit, walk, play, pray, work, type, eat, and rest under the sunlight wherever you are and whatever the season to harvest the benefits of sun.[7] It is the best natural viricide free and available to rich and poor. Basic hygiene, proper and adequate hand washing habits are good. However, excessive hand washing and use of chemical disinfectants and antiseptic solutions are not healthy (unless you are in a hospital operating room). Doing so strips the skin from its natural flora and good bacteria that actually fight harmful viruses and other pathogens and one might end up with a host of chronic skin disorders. Also, these chemicals get into the wastewater systems and come right back to our breakfast, lunch, and dinner tables through water and food cycles. Reduced and regulated hand-to-mouth movements (i.e. refraining from non-stop munching and drinking in between main meals) are both a good health habit and a good preventive measure. Strengthening the immune system, anti-inflammatory nutrition, and healthy lifestyle are extremely helpful in warding off viral infections and acquiring immunity. As for the rest, do your best and put yourself in God’s Hand and do not worry too much. When your time is up, your time is up. For those who do not believe in God, put yourselves in all else’s hand and hope that a few more miles is still left in that which you call <i>me.</i> Close parenthesis.

In terms of epidemic dangers of nCoV and to put it in a proper perspective, it would be helpful to look at some general statistics for other influenza epidemics first. According to US Center for Disease Control and Prevention (CDC), there have been from 140,000 to 810,000 hospitalizations due to seasonal influenza and from 12,000 to 61,000 deaths each year since 2010.”[8] A quick calculation of fatalities based on deaths over number of hospital admissions due to seasonal influenza yields the following results from 2010 to 2018:

2010-2011 – 37,000 deaths/290,000 hospitalized >12.8%

2011-2012 – 12,000 deaths/140,000 hospitalized > 8.8%

2012-2013 – 43,000 deaths/570,000 hospitalized >7.5%

2013-2014 – 38,000 deaths/350,000 hospitalized >10.9%

2014-2015 – 51,000 deaths/590,000 hospitalized >8.6%

2015-2016 – 23,000 deaths/280,000 hospitalized >8.2%

2016-2017 – 38,000 deaths/497,000 hospitalized >7.6%

2017-2018 – 61,000 deaths/810,000 hospitalized >7.5%

(Note: Use of hospital admissions as denominators are better than estimated total number of people contracting the flu. One reason is that the former provides a more accurate and systematic estimate of morbidity and mortality but the latter relies on estimates and extrapolations using indirect data, surrogates, proxies, recall methods, and more for data collection.)

A systematic and comprehensive worldwide and/or country-based data collection, analysis, and publication regarding nCoV-2019 cases does not exist so that we could have a solid comparison with annual seasonal flu mortality rates in the US and elsewhere. However, searching reliable publications that are made available online so far, we could get some sense for a reasonable range for mortality rates reported for this virus. Case fatality rates range from 2.08% (362 deaths out of 17,391 confirmed cases reported to WHO)[9], to 3.36% reported by the Chinese government and 4.3% reported for severe cases. These rates are still much lower than that of another two widely contagious zoonotic coronavirus diseases, SARS (with 9.6% infection mortality rate) and MERS (with 35% infection mortality rate).[10,11]

In Iran, the latest report from the Center for Public Relation of the Ministry of Health, by noon on Saturday, Feb. 29, there were 593 confirmed cases of which 43 had died.[12] This put the rate at about 7.3% mortality. On Sunday, the number of confirmed cases 978 and the number of dead were at 54[13] (5.5%). Both these rates appear to be much higher than any other rates reported anywhere else in the world. There is no valid evidence showing why the mortality rate for the Iranian population would be so different with the global rate. I suspect the number of deaths reported for nCoV in Iran is an overestimation. My suspicion is based on public proclamations by some ministry of health officials and informal statements made by specific hospital staff. For example, one hospital (in Qom) in particular (based on personal communication) prepared its first few death reports based on high probability and suspicion of nCoV infection rather than definitive diagnoses two days after the patients had died and prior to any confirmed Corona cases in Iran.

Ali Rabi’ee, the spokesperson for the government, in a note clarifying issues related to the closure of various schools and universities also responded to questions regarding statistical discrepancies that exist between Iran’s and global mortality rates as follows: “The denominator for Iran does not include cases who contracted the virus but were not in critical condition.” And regarding conflicting reports by one of the members of the parliament, he said, “He was stating the total number of deaths that included non-corona related deaths as well.”[14]

As the nCoV kits produced in Iran increase, the kits arriving from China get distributed widely, and the quality control of tests and reports become more systematic and accurate, then we could take another look at the rates and get a more realistic and correct assessment of definitive cases and mortality rates for Iran.

Nevertheless, based on the information we have so far, both locally and globally, about the infectivity and mortality rates associated with this virus, it just seems the response to the threats and dangers of this virus is disproportionately above and beyond what this epidemic warrants. It is not difficult to see why the US and the West are inflating this epidemic and maximally exploiting it but China’s and Iran’s internal measures and responses seem oddly over-exaggerated and disproportionate. That is unless they have used this as a drill, or a practice run, for a sudden hazard response at nation-wide population level in order to prepare for a much greater biological hazard they are anticipating to come. This is just a guess and I have no evidence to support it.

In terms of response, multiple measures are taken in Iran. All universities and schools are closed and television channels are conducting video classes and lessons for all elementary, middle, and high school grad levels. Regular announcements encourage people to stay at home, restrict their travels to a minimum, and postpone any sort of gathering (be it weddings or funerals). Normally, this month is the busiest month in Iran since it is right before the Iranian New Year (the first day of spring). Unlike China which seemed to have had a more military style public health approach with forced quarantines and travel restrictions, Iran’s approach has been based on voluntary restrictions, individual and family self-regulation of movements and travels, health education, and public mobilization. Still, the usual hustle and bustle for this time of the year is not felt.

One can find a range of reactions from the people here. Some are fearful and crowd-shy; some are indifferent and shrug their shoulders and carry on with their work as usual; many students are happy with no school and no midterms; and some exchange jokes and information via social media. While we weather this latest storm, I will end this piece with a transcript of a direct message by Novel Corona Virus to the People of Iran that is translated just for you and posted below:

 “Iranian People, Salaam. I hope you are not scared by the fact that I am introducing myself to you. I am Corona. I was busy traveling and making my way through different countries and getting them involved. Then I thought why not pay you a visit as well while I’m at it. But, to tell you the truth, I am regretting my decision. I did not know I would be wreaking such havoc on you. The way you have treated me, I thought I was Plague, Cholera, or Ebola. I searched the net and discovered that all this time, I had not killed but a couple of thousands all over the world. Do you know how much more death is caused by regular influenza compared to me?! World Health Organization estimates an annual death between 290,000 to 650,000. Am I more dangerous than that?! In all fairness, I do not say you shouldn’t take precautions but let me be frank with you, if you continue like this, 2000 of you will die just out of sheer panic. Besides, you produce 40 to 50 dead people every day with your traffic accidents. I should be the one to fear you not the other way around. Now, I, the Corona, have come and will extract a low percentage of death from you like all other places. Death is an inevitable truth and just end. I and automobiles (Pride) are just tools and means. Then, why so much self-harm and stress?! Is that your habit?! Do you enjoy doing that?! Why do you act in a way that I, the Corona itself, feel compelled to calm you down? Urgh.”[15]


References

[1] «وَأَنَّ السَّاعَةَ آتِيَةٌ لَّا رَيْبَ فِيهَا وَأَنَّ اللَّهَ يَبْعَثُ مَن فِي الْقُبُورِ» “And indeed that the Hour is coming – no doubt about it – and that Allah will resurrect anyone who is in the graves.” Holy Quran, Chapter 22 (I-hajj), Verse 7.

[2] Kampf G et al., Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents, Journal of Hospital Infection, https://doi.org/10.1016/j.jhin.2020.01.02. https://www.journalofhospitalinfection.com/article/S0195-6701(20)30046-3/pdf

[3]Nelson KL et al (2018). “Sunlight-mediated inactivation of health-relevant microorganisms in water: a review of mechanisms and modeling approaches.” Environmental Sciences Processes Impacts, No 20, Pages 1089–1122. Available online at: https://pubs.rsc.org/en/content/articlepdf/2018/em/c8em00047f

[4] Lytle CD & Sagripanti JL (2005). “Predicted Inactivation of Viruses of Relevance to Biodefense by Solar Radiation.” Journal of Virology, 79(22):14244–14252. doi:10.1128/JVI.79.22.14244–14252.2005

[5] Chun-Chieh Tseng & Chih-Shan Li (2007). “Inactivation of Virus-Containing Aerosols by Ultraviolet Germicidal Irradiation.” Aerosol Science and Technology, 39:12, 1136-1142, DOI: 10.1080/02786820500428575.

[6] Schuit M et al (2020). “The Influence of Simulated Sunlight on the Inactivation of Influenza Virus in Aerosols.” The Journal of Infectious Diseases, Volume 221(3):372–378, https://doi.org/10.1093/infdis/jiz582

[7] Mead MN (2008). “Benefits of Sunlight: A Bright Spot for Human Health.” Environmental Health Perspective, 116(4):A161-167. Available online at: https://ehp.niehs.nih.gov/doi/pdf/10.1289/ehp.116-a160.

[8] CDC -Center for Disease Control and Prevention (2020). “Estimated Range of Annual Burden of Flu United States, 2010-11 through 2017-18 Influenza Seasons.” Available online at: https://www.cdc.gov/flu/about/burden/index.html

[9] Zumla A et al (2020). “Reducing mortality from 2019-nCoV: host-directed therapies should be an option.” The Lancet, Vol 395, Pages e35-36. Available online at: https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930305-6

[10] Sun P et al (2020). “Clinical characteristics of 50466 patients with 2019-nCoV infection.” MedRxiv, BMJ Yale, doi: https://doi.org/10.1101/2020.02.18.20024539.

[11] Kaiyuan Sun, Jenny Chen, & Cécile Viboud (2020). “Early epidemiological analysis of the coronavirus disease 2019 outbreak based on crowd sourced data: a population-level observational study.” Lancet Digital Health 2020. Published Online February 20, 2020 https://doi.org/10.1016/S2589-7500(20)30026-1

[12] Mehrnews, “The Announcement for Newest Statistics for Corona in Iran/593 got infected.” Online Mehr News Agency, Health Section, 10th Esfand, 1398, @13:24. News Code: 4865337.

[13] Mehrnews, “New Statistics for Corona in Iran was announced.” Online Mehr News Agency, Health Section, 11th Esfand, 1398, @14:23. News Code: 4866827.

[14] Mehrnews, “The Government’s Spokesperson’s Explanations regarding Rohani’s Statements regarding Corona.” Online Mehr News Agency, Politics Section, 10th Esfand, 1398, @12:05. News Code: 4865746.

[15] Corona, “Take precautions but don’t over-react.” Transcription from Farsi, Video available online at: https://www.aparat.com/v/xEfgk

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