When the pandemic with the virus SarsCoV2 started we were bombarded with information. We stayed in quarantine and tried to figure out what had happened to us. In order to provide useful information for my patients, I started to write some texts for my private blog. It slowly became a tour through medical theory and practice, finally arriving at the principles of naturopathy. I decided to publish the English concepts of these articles as they provide an impression on how we are able to think through the complexity of this pandemic and of medicine in general.
Today’s official discussion concerns mainly social distancing and wearing masks. This is somehow a bankruptcy of medical science. Medicine and medical science have much more to offer than that. This is what these texts are also about.
Now, half a year later, some of the information is a bit outdated. The content is not. Going through all the details it becomes clear that one thing is terribly lacking in today’s discussion about the Covid-19 pandemic: the health aspect.
2.10.20
The Coronavirus and the Everyday Life in the Quarantine
The life with the Coronavirus responsible for the disease Covid-19 is our new reality. This virus will stay with us. This is where most scientists agree. Different countries have chosen different measures to face this pandemic. They follow different strategies and it is important to understand why this is so. Some countries have imposed severe restrictions to the freedom of their citizens, others rely on intensive testing with less social restriction. Some countries want to keep infection rates as low as possible until a vaccination or treatment is available, other countries want to allow a certain amount of infections such that the disease spreads slowly through the society. This strategy failed in Spain where casualties soared but worked somehow in Germany and other countries.
Quite early Greece has introduced strict social distancing with a slow number of casualties until now.[1] However, to keep infection rates low, it is necessary to keep restrictions for many months,[2] actually until a major part of the population is vaccinated. According to specialists, a vaccination of a wider part of the society will not available until Spring/Summer 2021. Only a few scientists see a quicker positive development[3] or hope that warm weather will lead to a reduction of infections. In the latter case the infections will abate, but they will come back in winter. Some tools how such developments are modelled can be found here.
Strong social distancing and even a lockdown for a long time will have a severe impact on the somatic and psychological health of the people and it will destroy social structures.
Many exit strategies for the lockdown are discussed, like allowing only the young to move freely or relying on those who went through the disease. It does not make any sense to restrict the movement of the ever-growing amount of people who have antibodies. They might even be precious in all professions where a contact with ill people is necessary. A British model proposes to loosen social restrictions for a week every month, such that people get somehow infected, but the numbers don’t get too high. [4] However this stop-and-go method seems to be too problematic from a medical and organizational point of view.
There will be a lot of discussion about the right strategy as they involve difficult ethical decisions. The problem with the Covid-19 pandemic is not only the number of people who will die from the virus.
The more severe consequences will be the impact of the quarantine and the solitude like anxiety, fear, violence. There will be problems from the death of loved ones. There will be many financial problems and social difficulties. Such indirect consequences onto the health of all of us are not obvious and will appear by time. For example, after the earthquake in Japan with the destruction of the Fukushima power plant, the Japanese government closed all nuclear power plants. The resulting rise in electricity prices led to less home heating during cold weather, causing an estimate of 1,280 deaths from 2011-2014.[5] The Covid pandemic will have many more and more severe consequences concerning all parts of our life. And the consequences will be life changing and many will die from these consequences, too.
Why this text?
The main Covid-19 topic currently discussed in Greece is how not to get infected. For this topic, enough information is available. From the point of view of naturopathy and of family medicine in general there are many other important topics, like how to improve the immune system, how to go through the disease, how to encounter the somatic and psychological consequences of an eventual disease. The texts in this blog have the aim to shed some light on some less discussed aspects of health and disease, aspects that might help to have a better understanding of Covid-19 and to find individual strategies to cope best with this situation.
What is a viral disease?
Experience tells that many people have difficulties to understand what a viral disease is. Viruses are strange creatures. They are not alive but behave like intelligent beings. I call them zombie-pirates. They capture living cells of humans, animals or even bacteria and force these cells to replicate the viral material.
The SarsCoV2 virus resembles in many respects the flu virus. Therefore this pandemic is often compared with the yearly flu pandemic and especially with the disastrous pandemic of the Spanish Flu.
Covid-19 is a viral infection of middle danger if we compare its lethality with other viral diseases
Spanish Flu 1-2%
Common Flu 0,015%
Measelse 0,066%
Ebola 50-90%
SARS 30%
MERS 10%
COVID-19 Italy & Iran 5%, South Korea & Germany 0,5%
Such numbers are always doubtful. If we take the lethality of the common flu, we mostly read numbers around 0,1%. But how to calculate such a number without knowing how many people are infected each year?
There are estimates that in Greece each year 5%-15% of the general population will be infected with the flu virus.[6] With yearly deaths ranging between 100-160 people, there would be a much lower lethality in Greece. But in the end, all these are speculations.
We have the same problem with Covid-19. In countries where many people are tested the number of severe cases is low. If only people with severe symptoms are tested, as in Italy, the rate of problematic cases is necessarily higher. The question is how many asymptomatic people are around for every positive tested person? 10? 100? More? The answer is: we do not know. Therefore, all these numbers are to be seen cautiously. However, when numbers like 500.000 possible deaths in Greece are published in the press (attributed to Konstantinos Daskalakis)[7] they are far too high.
Severe developments and the lethality of a disease are not a constant. Many factors influence whether a disease becomes more or less severe.
When we had an outbreak of measles in Europe a few years ago, the lethality ranged from 0,066% in Italy (4.487 cases, 3 deaths in from 1.1. 2017 until 13.9.17) and 0,38% in Romania (9.226 cases, 35 deaths from 2016 until 15.9.17).[8] In Germany there were no official numbers, but the rate was still lower. This difference cannot be explained by undetected numbers. It has to do with other factors like the medical system, nutrition, the way of life and with the functioning of the immune system in general.
All these topics will be discussed in the next articles.
2.4.20
[1] https://www.ethnos.gr/ellada/96861_koronoios-g20-fos-sto-toynel-gia-italia-ispania-i-ofthalmapati-pinakes-grafimata
[2]Ferguson NM, Laydon D, Nedjati Gilani G et al. (2020): Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand, , Medical Research Council (MRC) 16-Mar-2020 https://spiral.imperial.ac.uk:8443/bitstream/10044/1/77482/5/Imperial%20College%20COVID19%20NPI%20modelling%2016-03-2020.pdf
[3] https://www.cretalive.gr/ellada/polytehneio-kritis-problepsi-tis-exelixis-ton-kroysmaton-toy-koronoioy-stin-ellada
[4] Ferguson NM, Laydon D, Nedjati Gilani G et al. (2020): Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand, , Medical Research Council (MRC) 16-Mar-2020 https://spiral.imperial.ac.uk:8443/bitstream/10044/1/77482/5/Imperial%20College%20COVID19%20NPI%20modelling%2016-03-2020.pdf
[5] GREG IP, DANNY DOUGHERTY AND ANTHONY DEBARROS (2020): The Trade‑Off Between Economy and Health, The Wall Street Journal 21.3.20
[6] Εβδομαδιαία Έκθεση: Επιδημιολογικής Επιτήρησης της Γρίπης, Eβδομάδα 6/2019
[7] https://www.ethnos.gr/ellada/97512_daskalakis-den-lambaname-metra-tha-eihame-eos-kai-500000-thymata-stin-ellada
[8] European Centre for Disease Prevention and Control
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