The reality of the coronavirus pandemic is that the virus has irrefutably returned to create further human catastrophes. However, in most parts of the transcontinental planes, it is not winter as yet. The return of the virus certainly reflects vengefulness of this disastrous biological threat to humanity, as the incidence rate of infection is rapidly creeping up and swiftly climbing to catch the level seen during the summer after a transient ebb during the onset of autumn.
What happens when the full impact of winter is upon us with all the variables favouring the growth, spread, and infectivity of respiratory viruses? This winter there is the potential for exponential rise in both incidence and fatality. However, my aim is not to create negativity and panic, but to advise against complacency.
Environmental humidity plays an important role in the spread of Covid-19 infection. The infectivity and the spread of SARS-COV-2 is not so much season dependent but the influence of environmental humidity on the pandemic, is by far, of much greater importance. Humidity plays a vital role in our ability to resist Covid-19.
In summer, humidity is likely to be high, so winter respiratory bugs like flu, Covid, and others are likely to show less potency. However, high humidity in summer may result in increased rainfall that would reduce humidity and increase the incidence of Covid infection. In winter, on the other hand, the dry weather of reduced humidity makes nasal cilia less effective and reduces the ability of the cilia to clear nasal passage of viruses like Covid, allowing the virus to gain access to human cells and multiply.
The variables of humid weather, rain, dryness, all explain why Covid-19 has aggressively and successfully spread both in tropical and temperate climates at the start of the pandemic, and is the principal cause for humanity to be on high alert in winter months.
At this moment in time, two opposing opinion statements capture all the percipience related to the Covid pandemic: The “Great Barrington Declaration” and the “John Snow Memorandum.” The statements are being actively promoted by two opposing groups of scientists. However, a degree of political motivation is obvious, and it is rapidly being appreciated that where politics related to Covid infection have been better participated and regulated by scientific experts, the outcome of the pandemic has exceeded expectation.
The great Barrington Declaration was initiated by three renowned scientists from Oxford, Harvard, and Stanford universities. They believe that the present lockdown policy is having disastrous consequences on short and long-term public health, as well as on the global economy. These, they advocate, can be avoided if instead of lockdown, vulnerable people are selectively protected and non-vulnerable are allowed to carry on life as normal. This “focus protection,” they believe, would cause infection in young and healthy people and after a certain period, the immunity gained through natural infection would result in “herd immunity” that eventually would protect the entire society, vulnerable or not.
The president of the UK’s Academy of Medical Sciences regards such proposals as unethical and simply not feasible.
The Barrington Declaration is being opposed by equally renowned experts, scientists, physicians, epidemiologists, mathematicians, and public health experts, and their statement John Snow Memorandum has been published in Lancet. As I mentioned last week, these opponents postulate that immunity gained through natural infection is transient, unable to provide lasting protection, re-infection in the same individuals is not unheard of, and therefore herd immunity is a phenomenon not achievable by natural infection without the support of an effective and safe vaccine.
This memorandum has been signed for solidarity by eminent scientists across the world.
At the beginning of the pandemic, I had discussed the pros and cons of herd immunity against Covid from natural infection in the absence of a safe and effective vaccine. My overall impression and conclusion, given all the scientific evidence available at the time, was that herd immunity without a vaccine would cause an unacceptable number of deaths, and was the least possible way to move forward against a SARS-COV-2 virus.
This seems to be the view of the advocates of the John Snow Memorandum. The most interesting observation, however, comes from Richard Horton, the editor-in-chief of Lancet, who states that the policy of herd immunity adopted by Sweden has not materialized, causing severely disproportionate death in the care homes and in the immigrant population, much more frequent outbreaks in the hospital, and many cases of multisystem inflammatory syndromes in children.
Many Swedish scientists believe that an unacceptably high number of Swedish citizens needlessly died from a policy that was not analyzed properly before implementation. The complexity and despair observed in the ineffective tackling of the pandemic, Horton believes, stems from the failure of the scientific community not considering political decision-making more seriously as a core part of public health. Richard Horton critiques scientists for their failure to take a serious role in political decision-making -- that is leading to unacceptable and adverse outcomes.
Today I would like to end Surgeon’s Note with a definitive optimistic message that despite all the uncertainty in vaccine development, the front-runner, Oxford vaccine, continues its phase III trial as the death of a volunteer in Brazil was not related to the vaccine and the vaccine has been scientifically proven to be effective in combating SARS-COV-2 virus in humans.
Research led by Professor David Matthews, from Bristol’s School of Cellular and Molecular Medicine, concludes that the Oxford coronavirus vaccine functions comprehensively in the human body after inoculation, and builds strong immunity to coronavirus, preventing the disease and not merely lessening the severity of infections.
Raqibul Mohammad Anwar is Specialist Surgeon, Global Health Policy and Planning Expert, and Retired Colonel, Royal Army Medical Corps, UK Armed Forces.