Suggestions By: Dr. M.K. Boateng – March 20, 2020
For days I have been wondering how come this virus is able to infect the masses so quickly and with impunity leading to global pandemic. I then questioned if indeed the transmission is just via human to human contact alone or there is much more other alternative which is robust, easily and faster route of transmission.
As much as the former is generally agreed as one important route of transmission, I rather considered the alternative route of transmission as an area public health officials should really focused on. Thus my scientific understanding is beginning to indicate that this viral can be transmitted through aerosol suspensions but not just human to human contacts alone or on surfaces alone rather the route of transmission via the atmosphere/open spaces is much faster than that of human to human contacts.
As I was contemplating on the aerosol/airborne transmissions, I looked for current studies to support my view and I found out from recent work by the National Institute of Health (NIH) in Hamilton that the virus can remain stable in the air for about 3 hours and on plastic and stainless steel for about three days. My interest and concern here is on transmission through the atmosphere/open space but the NIH’s work was done within a controlled room but not in an open space hence, my question here are:
1. How long can the virus remain in the atmosphere/open space?
2. How far can the virus travel in the atmosphere/open space from point of release?
3. Does the virus able to multiple after they are released from host cells?
4. What mechanism allows the virus to retain stability?
5. How and why the virus has an affinity to bind to steel and plastic including cardboard surfaces which is likely mode of transmission?
I am very much convinced as indicated by NIH’s work that the virus is able to remain very stable for a long time in the atmosphere/open space and factors in the atmosphere such as wind, air, pressures etc are contributing carriers/transporters inducing the very high rate of transmissions resulting in this pandemic. It is well known that many infected patients just don’t know how and where they got infected therefore from the above deductions, it is possible such patients may have inhaled virus atmospheric aerosols at locations far away from where the virus was first discharged. Highly affected nations such as China and Italy are doing lockdowns, and in my view, such measures support the fact that the virus may have been saturated in the atmosphere which maybe localised saturation or blowing around from one place to the other by natural transporters/carriers such as wind etc. This therefore would imply that any person or persons walking around such areas would be susceptible to inhalation of this viral aerosols/particles and does not necessarily mean one has to touch infected surfaces or be around infected persons alone rather one can easily be infected through normal and natural involuntary breathing in the area or atmosphere where virus is saturated. From the above, I am more than convinced that the faster rate of transmission/infections is due to airborne/atmospheric/open space saturation of viral load because possibly the virus is able to travel to far distances through the atmosphere blown by air/wind due to the fact that they can remain stable and viable for a long time.
It must be added that the virus ability to be stable and viable for a long time outside the host may suggest why it can take up to 14 days or more before symptoms are presented in some individuals and in some infected host can remain asymptomatic for longer and in my view one of the reasons could be that virus remain stable in the host for some time and only begin to utilise host cells after stability begin to reduced or depleted whereas outside the host it may die after surviving beyond certain period as cellular products to keep it viable and stable would be exhausted. Hence, it appears virus has a novel mechanism to survive longer both outside and inside the host. There are a few factors I would like to consider on viral novel behaviour but will leave it to my next write up and will now focus on urgent recommendations and actions i would like the public health officials to focus on.
1. It is great to do social distancing but two areas officials need to consider are our cultural and religious beliefs. Thus, about 99% persons in this country have been brought up to believe and rely on the supernatural more than addressing and solving physical needs and problems using the God given mind, hence we have tend to be living in a religious economy rather than knowledge based economy so my point is that such beliefs would end up spreading the infections more than anywhere else as many would ignore the precautional advise and rather decide on trusting and believing that their God will protect them because they have prayed. Just like before the virus entered Ghana I heard a well-known bishop saying he has arrested the virus and it cannot come to Ghana, but when it eventually arrived in Ghana this same bishop now saying no weapon that rises against him shall prosper. This is exactly my point that we refused to use wisdom and knowledge to live on this beautiful place that God has given us and rather drag God into providing us everything including expecting God to come and clean our dirty environment which we knowingly and ignorantly caused by ourselves.
I therefore recommend that govt should let the NCCE and the media to educate the whole masses that yes they can pray and trust their spirit sources but they must strictly abide and adhere to the precautional directives provided.
2. Critically I recommend that there should be an urgent “herd prevention” or “mass community prevention” just like what in immunology is called “herd immunity” whereby a number of people within a community where there is an outbreak are treated or vaccinated as a results prevents others to be infected or reduce transmission. In the present case, “herd prevention” or “mass community prevention” would be disinfecting the whole of Accra/Tema and Kumasi where transmission is currently known using drones or helicopters and disinfect from the air like a shower by flying at a low altitude and release the disinfectants which would surely destroy any airborne stable and viable viral saturations as a result would clearly reduce the super spread and many would be protected from infectivity.
This can be done in the nights with a night lockdown during the exercise. It is good some market places are been disinfected but the spread goes beyond market places the whole system must be treated/disinfected.
If using a drone or helicopters or even small planes are not available, fogging machines could be used for this purpose although product particles may not travel far upwards to space but it may help greatly. If such advice is considered then I would suggest hydrogen peroxide disinfectant be used as it is much safer since this would be used in the communities.
This is a suggestion hence it is up to the responsible authorities to device the approach to undertake this exercise.
3. It would be useful for a lockdown just after the disinfecting exercise for the minimum viral incubation period/days and during this period good number of all those infected with symptoms could be known and isolated. And this could be carried on if we’ll planned and more isolation can be established if it is well controlled and done well.
4. If recommendation 3 is not possible then recommendation 2 must be repeated weekly by spraying from the air or into the air in affected cities such as Accra/Tema and Kumasi and this can be extended to all regional capitals and possibly district capitals too. In otherwise must be done base on case by case.
I am convinced as we keep disinfecting towns and cities particularly from the space/air we should be able to overcome this problem as we need to find solution to resolve and overcome this mess in our own innovative way. As this approach hopefully and relatively reduces the incidences, health officials would then be able to manage and control the number and therefore community acquired infection may be almost or completely eliminated.
5. We must start nose masking as clearly this virus appears to transmit faster through aerosols. So as we do social distancing, we should also do atmospheric or open space distancing by way of wearing nose mask.
6. I would recommend that passenger numbers should be reduced per taxi, trotro or buses/coaches and passenger should sit in some distances apart to reduce direct contacts and spread. The govt can find a way to reimburse the transport owners for the lost income. This is sacrifice time.
7. How long must we always wait for every solution to our problems to be imported?
This is the time all these Scientists in Ghana and other African countries must rise up to the occasion to be counted and find solution to this problem. We cannot just only focus on testing, we must also and critically focus on treatment and cure. As other Scientists in America, China and Europe are busily locked up in finding vaccines, faster and robust test kits, treatment etc, what are the Ghanaian and African scientists doing? All I hear some of them saying on TVs, radios etc is testing, using sanitizers, etc but not any pragmatic solution. We have loads of natural plants of which many are anti-inflammatory and antiviral medicines where some of these medicines are known and otherwise, and all that is required is serious and committed study and we could find solution to this problem because there is no problem on this earth without a solution we just ve to be serious in our thinking with a desire to contribute to the peace and harmony of our existence. We just can’t go to school to PhD levels yet contribute nothing to our national development and survival apart from just talk talk talk, attend conferences and do one or two research and publish plenty articles without having any meaningful impact on society. We have become so pompous with no humility because we are professors, doctors, master’s degree holders, PhDs, politicians yet contribute nothing and I mean nothing to such an overwhelming naturally resource endowed nation and continent, and we are not even ashamed with our ignorance and can’t see how we have been messing Ghana and our continent and we keep passing our skillful wastefulness to generations. See how this pandemic has exposed us all? And in the mix of this crisis we are sitting there waiting for the West to ve sleeplessness to find a solution for us. Why can’t we find our own solution so we can also give to the west?
I would recommend that the govt immediately form a scientific group from noguchi, all the universities to involve molecular biologists, geneticists, virologists, general microbiologists, pulmonary/respiratory experts, cardiologists, histopathologists, Cytopathologists, clinical pharmacologists, Centre for plant medicine Scientists, immunopathologists, zoonologists (to help in any zoonotic transfers), meteorologists (will help to identify viral movements in an open spaces including distances viral travels via wind controls etc). Now this group will be funded and task to find an immediate treatment for the infection and at the long term a vaccine if possible. There is no excuse to say the virus is not known and it’s new. The virus genome is known and it’s available that is why it has been named covid 19. The virus is in Ghana and your PCR is able to diagnose it and you have samples of the infected patients which you can isolate for further studies.
In my conclusion I would say we can’t just go to sleep and pray that God will come and eradicate the problem. In the first place God created the virus and he was aware and still aware of this pandemic and I believe he is watching and expecting us to go deep inside us as a multicellular and intelligent beings to find solution to overcome this unicellular virus. He has given some people this skill here in Africa yet these people are letting us down.
Finally, apart from the fact that this virus may have gone natural mutation as a result has become very potently harmful, we should also not loose sight that this could be a bioterrorism tbus a laboratory manipulated biological weapon dumped on us or a genuine laboratory viral manipulation that unintentionally got lose and end up in the population and now affecting us all. We should be open minded because the type and rate of infectivity is extremely questionable compared to other epidemics and rarely pandemics that occurred in the past.
There should be efforts to disinfect Accra/Tema and Kumasi from the open space. This can be extended to the regional capitals and possibly district capitals.
Nose mask must be worn from now onwards.
Lockdown for 14 days would help and if this has to be done then we would need prior notice for everyone to prepare. If lockdown is impossible then the disinfection must be done weekly or in every 5 days for about two months.
Considering the results from NIH’s work, it would be important for healthcare professionals should show keen interest in disinfecting plastics, and steel materials quite often to prevent spread and nosocomial infections as the results show the virus has the affinity to bind of plastic and steel surfaces for longer and as it is known, our hospitals have a lot of plastic and steel structures including hospital beds.
I would also advise that we look for sanitizers that contains moisturisers/skin nourishers such us vitamin E etc because there is a potential skin damage due to the overuse of the alcohol hence a sanitizer without moisturisers/skin nourishers must be avoided or must be minimally used. Or if there is no option then rub your hands with melted shea butter 5 minutes after using the sanitizers.
We don’t even know if mosquitoes can be used as carriers to transmit or this virus can enter the gastrointestinal space and excreted through feaces where flies that feeds on the feaces could transmit by dropping on foods just like the mode of transmission of cholera to humans, hence, our Scientists over here must get to work immediately to assess all these parameters as it is possible this virus could mutate in our African climate and may cause even worse problem or otherwise.
The above is just for now and all should contribute to overcome this problem and we must learn from this to now get serious to build our nation and continent by ourselves provided we stop the insatiable desire for power, jealousy, selfishness, abuse of power, religious dependency, backward and unproductive and unprogressive cultural beliefs etc.
Let’s get to serious and meaningful work. Let’s save our ourselves. Let’s future generation come to know there was a pandemic and the solution that conquered it came from Ghana/Africa