There is a period where the infected person shows no symptoms, the person feeling no symptoms is wholly unaware of it and is therefore spreading the virus to other human beings without knowing that he or she is a vector of the viral spread.
Therefore the virus can run through any culture where there are many large group phenomena such as international travel on planes, boats, trains, shared public transport, pubs, clubs, football matches, prisons, care homes, parliaments, apartment blocks, temples of all kinds and large family homes and much else besides.
There is a blind spot among some fit healthy people that I have been feeling into and I will explore what this is in this article. "It can't be all that bad."
The dynamics of close urban living organisation and a silent virus.
In effect an invisible spread before any signs of it happening ever emerge.
Many people will become infected and they will show no symptoms at all. Their immune systems get on top of the virus before it causes any problems. Nobody is any the wiser. Nobody is at fault. We do not know why this is the case. All we have to go on is the experience. What happens.
Fit, healthy people can pretty much shake it off. There are exceptions, of course, and whilst media tend to hype those or minimise them, we are still learning about the disease state as we go and fear is not really useful, whereas caution is.
Stay calm, act responsibly for the whole community.
For the people with strong immune systems the viral infection appears to them to be a not so serious problem. For some it's not. There is no way to predict in advance if one is one of the unlucky few. It is a gamble, a risk.
For people whose immune system is compromised, the issue becomes the disease, COVID19.
The disease is what happens when the virus begins to replicate faster than the body's immune system can cope with, and starts to impact on the body. When the body's immune system response is not robust enough to stall the viral replication which destroys body tissue.
That is what the disease is - the destruction of tissues within the body as the virus takes over cells and then destroys the cell once it has replicated many more copies within the cell, releasing the replicates which seek out new cells and these repeat the cycle, thus destroying enough cells to cause a variety of breakdowns depending upon which tissue is affected, that can then lead towards death : liver, kidney, gut, lungs and heart can all be impacted.
The disease COVID19 is really, really dangerous to a significant percentage of those who have chronic immune compromising health issues, or co-morbidity's.
That is why the Government and NHS has issued instructions to people at risk to shield themselves.
If you can imagine what it is like to live in what is called shielded status, where you cannot be touched by anyone in your immediate family, for months on end, for a year, for a year and a half. A situation where everything that comes to you has to be washed and cleaned, a situation where all your facilities such bath, toilet, clothes washing and handling and all your cooking, if they are shared, must be policed with constant attention to detail every time anyone in your household uses those shared facilities. Imagine being confined to one room. Imagine have to think about every move you might make outside that one room.
Add to that the conflicting narratives that percolate across news media and social media, spreading confusion and uncertainty, and then we can see that there is an extra avoidable element of situational stress loaded onto people who are already dealing with significant stresses not of their own making.
Can you imagine living as an elder in care home that is shielded? The complexity and pressures that are added to those that already exist? What must it be like to be a carer at home?
What must it be like for carers working in large care homes?
In the UK population of people with multiple conditions is about 15 million people. Not all are shielded of course. There are degrees of vulnerability.
In the USA it is about 83 million people.
The existing data from around the world suggests that about 20% of that cohort will, if exposed to the virus, experience severe and critical symptoms of the disease, and about half of those will potentially become fatal. Breakdown of the bodies systems and organs. This is a horrific way to die.
How do we protect those people?
To protect the 10% most at risk we must protect all of those people who could be vulnerable.
Co-morbidity, Disability and Vulnerability within a stressed culture.
The impact of multiple stressors on the human body and psyche that arise from living within a culture where chronic stress and inter-generational trauma patterns remain largely unresolved is well understood in the medical world and not widely understood across the grass roots.
Observe how even media will publish articles that castigate people suffering from obesity: fat shaming is one aspect. Blaming smokers, suggesting they are doing it to themselves and should pay for their treatment, whilst protecting the Tobacco makers, even though we know that smoking involves addiction, The NHS offers treatment for that and other addictions.
There is the all too common negative attitude towards disabled people.
This makes gathering the intention of the population to focus on the needs of the vulnerable more difficult than in ought to be. Nonetheless the majority of people are decent, and will take into consideration the vulnerabilities of their fellow citizens.
To protect the vulnerable, those people with multiple combined health issues, the only proven strategy is to stop them from getting the infection in the first place.
They must not meet the virus.
We do not have a vaccine. There are no medicines that can reliably prevent escalation of the disease or can be used as treatments of the disease. There is evidence that vitamin D and C have offer some degree of immune system boost. There is evidence reducing stress reduces immune system effectiveness, so it stands to reason that reducing stress improves immune response.
SARS was a corona virus pandemic that happened in 2003. It was less infectious than SARSCOV2 but more more lethal, with a case fatality rate of 60%, and because it generated symptoms rapidly it was much easier to trace and close down.
We still have no vaccine for that particular virus. The Governments in countries affected by SARS working with the WHO, informed populations of the threat and what needed to be done, contact tracing, quarantine, treatment in isolation, limiting movement for a period, and they stopped the spread, and in time eradicated the virus from the population. The same procedure was applied in 197-18 epidemic. The process has been learned over a 100 year term, with new learnings since SARS in 2003. In clearest terms we know that suppression of transmission can lead to elimination of transmission, and that cause eradication of a virus that cannot live outside a human body.
We hear talk of a vaccine.
However vaccines are very difficult to make, and even more difficult to test to the degree that they can safely be used across entire populations. Such is the risk that Governments indemnify vaccine makers from litigation and financial compensation that arise when a few cases of vaccination cause severe and lethal reactions.
There are only two strategies that can protect vulnerable people in this situation.
One strategy is to isolate all vulnerable people from the general population, to isolate them from any possible community infection vector. To enclose them behind a virus proof barrier.
That is really, really really difficult, and made much more difficult if you allow the rest of the population to slowly become infected while you wait for a vaccine. Waiting for a vaccine is not a health and safety protocol. Slow spread is not a health and safety protocol.
Those who service the vulnerable must also be isolated from the general population.
If they become exposed, then they must be set away from the vulnerable until they become provably immune, and can then re-introduced to continue their caring work - but they will still have to adopt clean site protocols upon entry into each caring facility as they could still carry the virus in by fomite transmission. Or they must live and work within the isolate environment of the point of care situation.
You have to somehow generate a population of immune people to service the vulnerable to maintain that separation from the virus, and you have to maintain that population in constant state of vigilant surveillance for viral particle presence.
The other way to protect the vulnerable is to stop the spread across the entire population.
That is to say to eliminate the transmission of the virus from within a given population, which leads to eradication of the virus. Stop the spread, spread the love.
This is also difficult, but it is proven. We know it works.
It was proven in SARS and MERS, and in other outbreaks of infectious disease where human to human transmission was the vector of spread. Suppression of the spread of infection, leading to elimination of community transmission and eventual eradication when the virus can find no new human hosts, and it dies out.
The process is complex, yes. It requires a lot of human resources, and a lot of co-ordinated action willingly undertaken by citizens, businesses and state officials. What makes it complicated are political and economic agendas intruding on the Health and Safety requirements.
New Zealand, Vietnam and others are showing that stopping the spread is a viable policy choice, across very different populations and economies.
Economics and Health and Safety.
Governments that have chosen the slow spread approach have all done so for economic and political reasons, not for health and safety or public health reasons.
And there is another dynamic that clouds the judgement of many people in this matter, going back to the start of this article.
Fit, healthy people are to a large degree thinking of and quite rightly concerned with how any of the protocols to stop the spread, social distancing, contact tracing and quarantine of workers, and a general shut down impacts them, their jobs and livelihoods. Because of the media narrative that the disease does not affect fit, healthy people, that many if not most will have no symptoms or will experience very mild symptoms,they are not so much worried about getting the infection and suffering severe symptoms.
Many believe that getting the infection will grant them immunity, and that as such getting the infection is desirable, to get it out of the way. This is understandable. They have not been given the full accurate picture.
Support - in economic terms - to take on the task of stopping the spread in the UK is minimal, and conditional and not well organised, as it was offered in an off the cuff move. This makes it less likely that working folk in the UK will readily consider what it might take to stop the spread - if your livelihood is under threat that is a reasonable feeling to have. They solution is to provide adequate and timely support. That is the job of the State in this kind of situation.
In the UK there is a further complication, that being cuts to public services and the decades long policy of restricting support to disabled and chronically ill people who require state benefit support, as pursued under the policy banner of Austerity.
That the general population has been unwilling or disinterested in confronting this over the past ten or twenty years or so in any meaningful manner is largely a matter of how media refuses to cover the dynamic honestly, how ineffective Parliament has been as a body with oversight that reins in harmful policies, and how the media and right wing politicians have been pursuing narratives that undermine empathy for people who need and deserve support - the attack on the welfare state as a thing that undermines the economy.
The UN report into the mistreatment of low income, unemployed, chronically ill and disabled people in the UK, by Government policy, was barely noticed by the population, and almost totally ignored by the largely right wing media, and robustly denied by Government, without any firm rebuttal - because there was and is no defence of those policies given the harm they have caused.
With regards to SARSCOV2 and COVID19 the Government attitude and it's stance is clearly focused on the economy, rather than on the welfare of the whole population, fit and vulnerable alike. The poverty of 14 million people in the UK is real. The feeling of deprivation amidst a growing population of billionaires whose wealth gains are in inverse proportion to the wealth losses from the low income groups is real.
Ironically, many of the fit and healthy feel as if they are being oppressed by the situation of the shut down. That said most people are adhering to the social distancing measures, and are diligent in their compliance and that is a really wonderful phenomenon - I know that most people are decent people, caring people. That decency is not reflected in the corridors of power, as the PPE scandal and others reveals.
And there is a large degree of confusion and resentment across the divided UK electorate which is largely a consequence of Brexit and the deliberate bipolar adversarial dynamic deployed by it's proponents. So we can see that there's a lot going on here.
Protect the Economy, allow slow spread of the infection.
The confusion of political and economic and ideological perspectives in News media and across social media that filter perceptions of the nature of the threat and we have a perfect storm that creates confusion when what is need is clarity so that the population as a whole understands what is happening and what needs to be done.
Stop The Spread is the only viable policy facing this infectious disease.
Slow the Spread renders the whole population vulnerable. Loss of income is a serious leverage in deflecting attention from the realities of the Governments chosen stance. But we must transcend that and integrate it to resolve this situation.
What we are looking at is a factor that will determine the lethality of this viral infection will be socio-economic - low income population are much more at risk in any situation where an epidemic occurs.
This is born out by the most recent statistics produced by the Office of National Statistics.
Low income is a factor, as much as health and fitness, or lack of it in outcomes during an epidemic.
Universal Basic Income for the duration of a stop the spread policy duration could resolve that issue, and it would put cash flow into the local economies.
Global international general trade must take second place for the duration. Internationally, resources movement must take precedence over personal travel so that areas that are less developed are more effectively supported in stop the spread policy implementation. We need every state to follow the stop the spread protocols. We have to help each other through this.
Tourism and Air travel are luxuries that must wait. Both were major vectors of the global spread of the infection. Nobody is talking of blaming either of these, and nobody should. That said, caution must be the stance, a until we are in control of the pandemic.
The dynamics of power as a factor in the exploitation of the situation.
Bullies will always, always seek to exploit any emerging vulnerability in a family, village, town, organisation, institute or population where they hold degrees of power over others. This is a behavioural dynamic, almost an un-thought about reaction other than they will think about how to maximise the opportunity - they will not have to think about choosing to exploit the vulnerability, that will feel natural, second nature to the bully.
Trump, Johnson et al are clearly part of a bullying dynamic, as are their hard core supporters. Their behaviour reveals this. The hatred poured out at those who are their political opponents, the bile and the misleading narratives with which they project and scapegoat others is well documented.
I think that British Government and their sponsors have made a huge strategic error in allowing and endorsing a slow spread in order to protect the economy. That choice means that the hit to the economy will be much, much worse than if they had chosen the stop the spread policy, because it will mean extended periods of economic disruption as successive waves of opening up and closing down inevitably flow from the slow spread policy towards the fiction of 'herd immunity'.
The hubris and the arrogance of that decision stops them from admitting it, and now they are just bluffing through, which is why the media denial is so intense.
There is still time to stop the spread, but it means we must remove those in Government who refuse to take on that policy, because they have ideological and economic attachments to the slow spread policy and they cannot be trusted to carry through a stop the spread policy. Because they have already caused so much avoidable harm, they must be prevented from causing any more. They must be held accountable, and they must prevented from causing any more harm. The prevention of more harm has to be the primary concern right now.
We must address the issue of acknowledging that the often unspoken origin of distress, disease and ill health across entire populations lies in how power is mediated, and where that observation is avoided, ignored, muted and suppressed - we must confront the deliberate gaslighting focus on what is 'wrong' within the individual, that avoids addressing what is harmful about the culture itself.
That is a serious problem - the resolution of which must come from a widespread, accurate and wholly evidenced understanding of the situation and fuller engagement across the population based on that understanding. Honesty and transparency matter profoundly. Spin causes harm. Lies are wholly unacceptable.
"Do what you love, it's Your Gift to Universe"
Thank you for reading this blog. All we need to do is be really honest, responsive to the evidence we find,and ready to reassess when new evidence emerges. The rest is easy.