CORONAVIRUS: AN UNSEEN ENEMY THAT HELD OUR WORLD HOSTAGE

CORONAVIRUS: AN UNSEEN ENEMY THAT HELD OUR WORLD HOSTAGE

BY DR ABEL ADEGOKE, FRCGP, PGDip. Cardiology

As many who have read my story will remember, I grew up in a rural town in Nigeria. One of the experiences I had growing up in that town was savouring the special songs that usually accompanied the celebration of various festivals that took place in my town. A line in one of such songs has been playing on my mind recently. It says this: ‘We have never seen this before’.

This aptly describes the Coronavirus pandemic that our world is currently experiencing – The majority of us reading this article have never seen our world in such a panic, a perplexed and perturbed situation like this before – global lockdown, daily report of alarming morbidity and mortality statistics globally, frantic and frenzy governmental responses globally, etc. Our world has been described by various people – politicians, press-people, and scientists, professional and ordinary people, as fighting a serious war of monumental dimension with an unseen enemy.

Since the outbreak of this disease called COVID-19, (short form of Coronavirus Disease 2019), the responses of the world (individually, communally, nationally, and globally) are varied – from the ridiculous, through the interesting, to the expensive. Numerous theories – scientific, prophetic, and conspiracy have been and are being postulated and discussed. No wonder, our situation in the world today is chaotic, confusing, distressing, and frightening.

As a Christian, scientist, medical professional and a leader in healthcare management, I have decided to write this article with one aim in mind; and it is to put everything in perspective. The article will describe the science behind the disease and the reasons why we should give the disease the seriousness it deserves; share the experiences of two of our brothers who have contracted the disease; and share God’s perspective as I experience it. I will be limiting myself to what I know from science. So, don’t worry, I am not going to talk on any prophetic or conspiracy theories; except to mention that the funniest conspiracy theory I read recently was that COVID-19 and the response of the UK government to it, was purely to stop Liverpool Football Club from winning the English Premier League after 30 years of waiting!

Now for the avoidance of confusion and misunderstanding, l will define some of the terminologies I will be using in this article, as they relate to COVID-19:

COVID-19: Coronavirus Disease 2019 (2019 being the year of discovery) SARS-COV-2: Severe Acute Respiratory Syndrome Coronavirus 2

Virus: a sub-microscopic infectious agent (germ) that is capable of infecting any living organism by replicating (multiplying) inside their living cells.

Pandemic: Global outbreak of disease that is infectious (causing severe disease, evidenced by significant morbidity and mortality as it spread easily from person to person worldwide) and due to novel (new) organism to which there is no prior immunity in people.

SCIENCE OF COVID-19

COVID-19 is a zoonotic viral disease – this is an infectious disease caused by a virus called SARS-COV-2 that spreads from a non-human species to humans. There are a number of viruses in nature with this capacity.

World Health Organisation (WHO) declared COVID-19 a pandemic on 11^th March 2020 after it was adjudged to have met the criteria for pandemic as stated in the definition above.

As I am writing this article today, about 3.055 million cases and over 211, 065 deaths have been reported in 185 countries and regions of the world; affecting all the continents of the world albeit, to varying degrees depending on their capacity and capability for testing for COVID-19. In the UK, which is where we live, the total number of confirmed cases is 157,149, and 21,092 people have now died after contracting COVID-19. These are obviously grim statistics.

Now, about the Coronaviruses itself. Human Coronavirus was first identified in the 1960s as an organism responsible for a substantial proportion of upper respiratory tract infections. It is a class of viruses just like we have classes of bacteria, responsible for causing infections. This group of viruses got their name from the crown-like (corona) appearance of their surface projections (the S or Spike protein which is the virus attachment protein that sticks out from the surface of the virus), when viewed under the big microscope called electron microscopes.

Coronaviruses are enveloped, single-stranded, positive-sense RNA viruses (its genome). They have a fat coat, and this is the reason why it is recommended to use soap when you wash your hands because soap dissolves the fat and thus can inactivate/kill the virus. Also, the use of warm water can denature the proteins, expose the genome and thus inactivate the virus.

Coronaviruses as a class are quite common in people and other animals. Coronaviruses produce diseases in non-human species, like pigs, cows, chickens, dogs, and cats. In humans, these viruses are endemic typically causing mild self-limiting respiratory disease like a cold. However, as a group, they are responsible for about 15-30% of respiratory infections each year in people.

The virus, which causes COVID-19, is a new strain of Coronavirus that has just been discovered in human – a result of what we called mutation (a process whereby an organism changes or alters its genetic properties for the purpose of survival). Microorganisms do it all the time because they also want to survive; and that is why we have development of resistance organisms (e.g. MRSA to some antibiotics and resistant malaria parasite to some anti-malaria medications like chloroquine). Viruses survive only in host body. Hosts can be animal or human. They survive once they enter the host body by pretending to be like the body cells and then replicate themselves by taking over the machinery of the cell and making themselves unrecognisable by the normal body defence mechanism. This is why they are very dangerous and difficult to treat. Cancer cells behave similarly to a degree. They cannot survive for long outside the body cells, hence the emphasis we are now placing on good personal hygiene of washing our hands, using sanitisers to kill them and preventing transmission from one person to another by avoiding contact (now called social distancing).

Once they take over the body cells machinery, they lead to destruction of the cells because of the body’s effort at trying to fight them (where two elephants fight, the grass around suffers). This is exactly what leads to the symptoms we have from viral infection. The destruction from COVID-19 organisms are so serious especially in people who have underlying diseases like cancers, diabetes, hypertension, sickle cell disease or anyone with low immunity (ability/capability of the body to resist harmful microorganisms from entering it). It damages the lungs and prevents breathing which leads to death.

As of today, no definitive treatment has been found although research works are actively going on to develop one.

The best/sure way of fighting all viral infections is by vaccination, through which the body is empowered/challenged to produce what we called antibodies (like body soldiers) to fight the viruses and overpower it once it gets into the body but before it can take over or destroy the body cells. The more people vaccinated, the greater the immunity available to the society and the faster we can eradicate (at least limit) the infectivity of the virus. That is why it is extremely important that people be vaccinated. Scientists all over the world are now doing a lot of research works to develop effective and safe vaccines that will help us fight Coronavirus.

What about the disease? COVID-19 as a new disease is still being understood by scientists and medical/healthcare professionals around the world. So many things are still unclear about it. However, what we know are these:

• It is transmitted from person to person.
• Degree of infectivity and seriousness of the symptoms of infection varied from individual to individual – worse in the older people and people with underlying conditions.
• Many people have no or very minimal symptoms when infected but can still spread the virus

– the so-called asymptomatic carriers.

• Common symptoms include fever, cough, myalgia or muscle pain, anosmia or loss of sense of smell, and fatigue.
• Around 20% become more seriously ill, characterized by shortness of breath – largely due to pneumonia, particularly in older people who are likely to have co-morbidities like severe respiratory disease, diabetes, hypertension and other conditions that lead to reduced immunity.
• COVID-19 virus binds well with certain receptors in the body, specifically angiotensin-converting enzyme 2 (ACE2), which is common in the lungs, arteries, heart, kidney, and intestine. So, the virus replicates well in the respiratory epithelium reaching into the lungs.
• It is also thought to infect macrophages and dendritic cells which don’t produce virus but may be important in inducing pro-inflammatory cytokines – which, in large amounts, can create a cytokine storm and cause a lot of damage to the lungs
• Men are affected more than women in about ratio of 70:30. It has been postulated that this is because there are more ACE 2 receptors in men than women.
• Another mechanism of infection is the ability of the virus to bind with a component (haem) of the oxygen carrying haemoglobin leading to different blood abnormalities like clotting abnormalities and poor oxygenation of blood.

Unfortunately, at the moment we do not know enough about this virus and the disease it causes, and in the absence of vaccine to prevent the disease or drugs for treating it, supportive care is all that is being offered to infected people. This is also the reason why governments in different parts of the world are taking more draconian measures like social distancing, self-isolation, shielding, etc. to limit its spread and protect their healthcare facilities from being overwhelmed. It is also the reason why it now appears that our world is held in a hostage situation because of the lockdown around the globe.

REAL PEOPLE’S STORIES

To bring home the reality of COVID-19, I decided to interview two of our brothers – members and leaders in the Overseas Fellowship of Nigerian Christians, (OFNC) who contracted this disease but by the grace of God successfully came through and fully back on their feet. I must add also that my wife and I also had symptoms of the disease for which reason we were knocked off our feet and out of action for almost 4 weeks. Thankfully, God saw us through, healed us, and now back fully on our feet.

Although we were not tested to confirm COVID-19, I have little doubt on clinical ground, that we had it.

Please read the stories as written by our brothers in answers to the questions I asked them:

STORY 1

1. Give a brief introduction of who you are – Age, Gender, Occupation, Branch and post in the OFNC:

✍ I am Emmanuel Olusoji Baikie, aged 62, male, General Practitioner. I am a member of the London Branch (Central). Last served as Area Secretary.

2. We know you have been diagnosed and confirmed to have COVID-19, how do you think you could have contracted this disease?

✍    Most probably via face-to-face patient contact

3. Please describe how you were diagnosis; include your symptoms and a brief narrative of your experience before the diagnosis was confirmed:

✍ It started with flu-like symptoms – severe muscle pain, fever, non-productive cough, low grade fever and headache. I also experienced loss of the sense of taste and smell. Some days into self-isolation, I had the COVID-19 test performed and the result returned positive after a couple of days.

4. If you were admitted into the hospital, please describe your experience and the care you had in the hospital whatever you could recall. If you were not admitted, please give a brief description of your care at home:

✍ I was not admitted to hospital but remained in isolation for two weeks. Following the usual advice for managing viral infections, I maintained adequate fluid intake, took paracetamol around the clock, ginger drinks, high dose vitamin C, and zinc. I had a supply of Zithromax (antibiotics) from my GP for prophylaxis. Though I had lost appetite, I did not reject my meals despite my loss of appetite.

5. Please give a brief description of the severity and nastiness of the disease; please include your emotional feelings/fears/worries, etc. How or what helped you through and especially the role of your faith in this?

✍ Being in isolation meant restricted movement in the house and minimal social interaction with my family. Initially, it did not seem to be hard work but as the days rolled by, isolation became painfully difficult and depressing. Living behind a closed-door felt like being locked in a prison cell. However, this isolation provided the gift of time – to pray, meditate on scriptures and reflect on life in general. I began to appreciate the gift of life more deeply. Looking out of the window from my room which opens into the garden I began to appreciate the beauty of nature – the green lawn, trees, birds, squirrels and flowers. These had always existed but due to the ‘busyness of life, I just hadn’t taken notice of them. I missed the social interaction I was used to especially in church/ fellowship. On the plus side, the period of isolation and the current lockdown has given me the “chance to experience a little how-to live purely from within”, if I may quote from the Carmelite Sister.

“We are very calm and cheerful. Of course, so far, there has been no Mass and Communion; maybe that will come later. Now we have a chance to experience a little how-to live purely from within.” – St Edith Stein, Carmelite Sister, Westerbok Transit Camp, August 1942

The intensity of the symptoms of COVID- 19 varied from one day to another. Severe headache and muscle aches were perhaps the predominant symptoms I experienced.

Cough and fever quickly settled although I had high temperatures on the odd days. Tiredness and weakness were also quite troubling.

Typically, I was not worried at the beginning but eventually, the concerns of those close to me began to affect me. I could no longer fail to acknowledge how serious the situation was and the potential to pass it to other members of my family. Upon this realisation, the prayer circle I drew was widened.

In the midst of human misery, we are admonished to be hopeful. I was sustained by hope and faith in the finished work of the Cross. It is to be acknowledged that the prayer that family, friends and the church offered throughout held me before God’s presence. I found ‘meeting’ via zoom with members of my church, work colleagues and WhatsApp group chats provided a sense of community during the isolation.

6. What was the state of your health prior to you contracting COVID-19? Please describe (if you are comfortable to) any existing health problems you may have had.

✍    Stable

7. Please share any advice or other comments you have for our people and the whole world on this disease that is holding the world to ransom at the moment.

✍ The first piece of advice I would like to give is that Christians should avoid speculative arguments about Coronavirus. Conspiracy theories are unhelpful. It sounds like trivialisation or outright denial when we know friends, colleagues and our patients who have suffered or died from this infection. This is a serious matter.

Please observe the social distancing, hand washing, using sanitizer, etc. Stay safe!

For those of you at the frontline – health and social care professionals, please insist on Personal Protection Equipment (PPEs) for protection at work.

STORY 2

1. Give a brief introduction of who you are – Age, Gender, Occupation, Branch and post in the OFNC:

✍ My name is Odo Akaji, 52, male, Engineer, OFNC Bedford, currently serving as Area Secretary

2. We know you have been diagnosed and confirmed to have COVID-19, how do you think

you could have contracted this disease?

✍ I have no idea how I got the virus but I suspect maybe a train journey into London. The stations were still fairly crowded then.

3. Please describe how you were diagnosis; include your symptoms and a brief narrative of your experience before the diagnosis was confirmed:

✍ I started feeling a bit feverish and lethargic on the Saturday but I did not think too much of it since I like a lie in on a Saturday anyway!

I took a few paracetamols and seemed better on the Sunday and Monday. So much so that I contemplated the 4.8 miles’ farm land walk from Brampton Ash to Desborough on Monday afternoon!

However, the fever came back with a vengeance late Monday evening through to Tuesday evening with my body temperature now quite high. By this time, I had gone through two packs of paracetamol (32 tablets)! It began to dawn on me that I might just have caught the virus.

By 2:00 am on Wednesday, my body was going into spasm and I had started heaving. My wife had seen enough. She called 111 and after speaking to me on the phone, the paramedics came for me at approx. 3:20am. They put me on oxygen, gave me another paracetamol to lower my temperature, which was just under 40^oC. Then ambulance came and took me to Kettering General Hospital at 4:29am.

An X-ray showed I had pneumonia and the swab test returned the next day with a positive result.

4. If you were admitted into the hospital, please describe your experience and the care you had in the hospital whatever you could recall. If you were not admitted, please give a brief description of your care at home:

✍ After the X ray, blood sample and ECG, I was taken into a ward for suspected Covid-19 cases for the night. I started receiving intravenous (i.v.) antibiotic treatment the same day in addition to continuing paracetamol and oxygen. The next day when Covid-19 was confirmed I was moved to a Covid ward. At a point, the concentrated oxygen valve was at 60%. By the third day I started regaining my appetite. The nurses were excellent, doing their regular checks, keeping me appraised of the progress or lack of it and ensuring my comfort at all times.

5. Please give a brief description of the severity and nastiness of the disease; please include your emotional feelings/fears/worries, etc. How or what helped you through and especially the role of your faith in this?

✍ Covid-19 virus is real and nasty. I recall trying to freshen up one morning; I was given some wet wipes having marked myself as an independent. I took the warm wet wipe to clean my face and almost passed out from the effort. I was coughing and gasping for air and it took me a good few minutes to settle – I had the oxygen at 60% strapped to my face all the while.

The 4 steps from the bed to the toilet during the day felt like the end of an unprepared marathon. When the consultant comes around and tell you they are monitoring your oxygen saturation and if there is no improvement the ICU unit is on standby for intubation, which is 50/50, then you begin to think both outside and possibly inside the box, the wooden one.

I count myself very fortunate to belong to the OFNC family.

Within minutes of notifying our National Chairman, he left me a WhatsApp recorded voice message of a scripture reading followed by a prayer, including one in tongues by his wife. Another sister left an encouraging message and ended it with a medley of my favourite songs which meant a lot at the time.

My Branch Executive Committee (BEC) team prayed at 8:00 pm every day until I was discharged.

One of the sisters who is a nurse at the hospital bought me a headphone so I could listen to my favourite songs from YouTube. My three classics were on repeat for most days: “Great is the Lord and most worthy of praise”, “I will be with you” by Maranatha and “Spirit of the Sovereign Lord”.

Sometimes, especially when I could get off the bed and sit up, I used to get emotional and say if not for God it could have been very different.

6. What was the state of your health prior to you contracting COVID-19? Please describe (if you are comfortable to) any existing health problems you may have had.

✍    Very healthy, no known underlying issues!

7. Please share any advice or other comments you have for our people and the whole world on this disease that is holding the world to ransom at the moment.

✍ Advice? Enjoy the conspiracy 5G videos for their entertainment value but still stay safe. Covid-19 virus is very real.

If you are already stricken, then it should not be a death sentence. Cry out to God for mercy, obey your healthcare worker and all will be well.

If you have lost a loved one I pray you know God’s comfort and affliction shall not rise a second time for you.

GOD’S PERSPECTIVE: THE RIGHT PERSPECTIVE

SARS-COV-2 is a novel virus; and the disease it causes, COVID-19 is less well understood. There are so many things we do not know about this disease. Hence, the response of different world governments and leaders (political, healthcare, scientific, economic, etc.) has been characterized by panic, frenzy and fear. It is true really, that we have never seen this before! A Yoruba adage suggested that the phenomenon of ‘we have never seen this before’ always evoke fear; and the greatest fear is the fear of unknown. To be truthful, this disease and the current lockdown situation our world is experiencing are frightening. I would say that to not be afraid in this situation is akin to foolishness.

However, perspective is everything. There is a story in the Bible that I always use when talking about perspective. In Numbers 13, we read about the story of the twelve people Moses sent to spy the land of Canaan as instructed by God. The Bible recorded that all the twelve people went through the land and had same view of what the land and its people were. They all saw and described the fruitfulness of the land as well as the type of people who were the inhabitants of it.

In verse 28, we read that all of the twelve spies agreed that “the people who dwelt in the land are strong; the cities are fortified and very large, and saw descendants of Anak (giants) there”.

Meanwhile, from verse 30 onwards, the perspectives of the spies began to be very different, even though they saw the same things. Some of the spies based their interpretation of what they saw only on the physical reality of what they saw. So, they began to exaggerate the situation out of fear. They saw giants (and truly they saw giants) but the fear of the giants made them to begin to see themselves as grasshoppers. This possibly could still be sensibly explained as they were comparing themselves to the giants. However, it became ridiculous when they began to believe that the giants were seeing them as grasshoppers! This is what fear can do. It distorts, exaggerates, amplifies the reality; and then believes the ridiculous.

Meanwhile, God’s perspective made Caleb and Joshua to give an encouraging report, believing that they “are well able to overcome (the land)” in spite of the fact on the ground. They remembered the promises of God to them, recalled their experiences of the demonstration of His power in their midst in the past, and exercised their faith in the ability of God. Of course, they did not ignore the rules of engaging with the war through which they would overcome the land.

My people, whilst I know that Coronavirus and the disease it causes are serious; and the current situation of our world is heartbreaking and can induce mental health problems, not to talk of all its possible financial sequelae, I have resolved in myself that I will not allow the fear of Coronavirus pandemic to paralyse me. Why? Because I am a child of God.

God has the final verdict on my life, and indeed on His world. There are numerous promises of God in the Bible that I am relying on. Permit me to share a few with you:

1. “My times are in Your (God’s) hands; Deliver me from the hand of my enemies, and from those who persecute me.” Psalms 31:15 NKJV.
2. “God is our refuge and strength, a very present help in times of trouble. Therefore, we will not fear, even though the earth be removed, and though the mountains be carried into the midst of the sea; “ Psalms 46: 1-2 NKJV
3. “Surely He shall deliver you from the snare of the fowler and from the perilous pestilence. He shall cover you with His feathers, and under His wings, you shall take refuge; His truth shall be your shield and buckler. You shall not be afraid of the terror by night, nor of the arrow that flies by day, nor of the pestilence that walks in darkness, nor of the destruction that lays waste at noonday” Psalms 91: 3-6 NKJV.

4. Because you have made the Lord, who is my refuge, even the Most High, your dwelling place, no evil shall befall you, nor shall any plague come near your dwelling.” Psalms 91: 9-10 NKJV
5. “The name of the Lord is a strong tower; the righteous run to it and are safe.” Proverbs 18.10 NKJV

6. “Can a woman forget her nursing child, and not have compassion on the son of her womb? Surely they may forget, yet I will not forget you.” Isaiah 49: 15 NKJV
7. “The eternal God is your refuge, and underneath are the everlasting arms; He will thrust out the enemy from before you, and will say, ‘Destroy!’” Deuteronomy 33: 27 NKJV
8. “Your love for me is so great that you protected me from death and the grave.” Psalms 86:13 CEV

9. “My help comes from the LORD who made the heaven and the earth!”. Psalm 121:2 CEV
10. “…For He Himself has said, I will never leave you nor forsake you.” Hebrews 13: 5

The above scriptures are but a few from the battery of promises of God that are available to anyone who has placed their faith in God through Christ.

The World Health Organization (WHO) in declaring COVID-19 a global pandemic, advised that you should protect yourself by washing your hands frequently, covering your mouth when sneezing or coughing (ideally with a tissue), avoid touching your eyes, nose and mouth and don’t get too close to people who are coughing, sneezing or with a fever, and maintain social distancing. This is excellent expert advice that have been tried and tested; we all must follow it very well. But also as children of God, let us declare like King Jehoshaphat did when he and his nation were faced with a situation that overwhelmed and frightened them: “O our God, won’t you stop them? We are powerless against this mighty army that is about to attack us. We do not know what to do, but we are looking to you for help.” 2 Chronicles 20: 12 NLT. This is how the last phrase of this scripture was rendered in NKJV: “but our eyes are upon you”. And this is my determination. My eyes are fastened firmly on my God. I encourage you to do the same.

Dr Abel Adegoke, FRCGP, PGDip. Cardiology.

A Principal General Practitioner and Primary Care Cardiologist at Hamilton Medical Centre, Birkenhead, Wirral.

He is a member of Wirral COVID-19 Clinical System Coordination Response Team.