The most searched questions on the internet in 2020 so far have been around “What is COVID-19?” and “What is coronavirus?” Coronavirus is a newly discovered virus in the family of coronaviruses so called for their crown appearance. Its scientific name is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The universally used name for the disease it causes in humans — COVID-19 — has its root in CoronaVIrusDisease-2019. The first case of human infection was reported in December 2019. In late January 2020, the World Health Organization (WHO) declared COVID-19 a public health emergency of international concern. Less than two months later, WHO declared it a pandemic meaning it was spreading fast throughout the world.
What has brought much attention to COVID-19 is the numbers deaths it has caused in such a short time all over the world, previously not seen by any living person under the age of 100 years. Scientists have equated it to the Spanish flu of 1918- 1920 which caused a lot of death and even then not on such a global scale. In the early period of the pandemic, it was thought that children were immune to the coronavirus and that only the elderly were at risk of dying from it.
Time has however proven us all wrong. Infants, children, young and middle-aged adults have succumbed to the virus. As of May 12th, 2020 more than 4.17million cases of the disease had been confirmed and over 286,000 had died from it – that is the equivalent of 526 airbus 380 planes (the largest passenger airplane) crashing between December 2019 and May 12th, 2020! Interestingly though, “only” 6.7% of all those who have been confirmed with coronavirus have died. Some people do not even fall sick when infected. But we ask, why are some people dying and not others? Most of the people who have been dying live in rich countries with advanced healthcare, how come they are not being saved?
While initially old age was thought to increase the risk for death alone, it is now clearer that the existence of a medical condition that weakens the body increases the risk for death. The presence of these medical conditions means the person has what is called in medicine “an underlying condition” implying that the disease is either mild or is well controlled with treatment. Infection with the coronavirus however, adds stress and strain to the body so that the body now has to struggle to control an extra illness on top of what it already has been dealing with.
If a person is already old, or has more than one underlying disease or even one underlying disease that was not properly controlled, then it is easier for them to lose the battle against the new infection. People with cancer who get COVID-19 are more likely to die no matter what age they are. People with diabetes, high blood pressure, lung and heart disease are at an increased risk of dying. These diseases are common diseases among the elderly and can explain why the excess deaths are seen in that age group. However, there are other underlying medical conditions that could cost one’s life. In the USA for instance where most of the mortality is among younger people than in Europe, it has been established that most of them had one of these underlying medical conditions.
Essential workers in the COVID-19 season with jobs that put them at risk of getting infected with the virus are at a high risk of dying from the disease. You may have read reports of several medical workers dying from COVID-19. It is supposed that stress of working in high-risk jobs for long hours, from worrying about contracting the disease, and being exposed to so much suffering and death daily, weakens their immunity even when they have no underlying medical condition.
What about people with HIV? So far people with HIV responding well to their antiretroviral therapy (ARVs) have not been found to be at an increased risk for death from COVID-19. Could it be because most people with HIV have had their immunity restored by ARVs? Could it be because most HIV in the world is in Africa and there has not been as much COVID-19 on the African continent for the interaction with HIV to be understood? Only time will tell. In the meantime, it is believed that HIV-infected people who are not on ARVs are at a high risk for coronavirus infection and even possibly death.
All HIV-infected people (even those well controlled on ARVs) must be vigilant in ensuring physical distancing, handwashing, minimize contact with their faces, minimize touching public surfaces like door handles, counters in banks, restaurants and shops, use a face mask when outside home and only go out of home when absolutely necessary.
We have been fortunate that COVID-19 in Africa is not yet as high as in the western world. Recent data, though, shows a sharp increase in infection and death. Every one of us is responsible for their own life but also for that of everyone around them. Let us all heed to the warning and #STAYSAFE
Dr. Miriam O. Laker-Oketta
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