Thursday, April 2, 2020

COVID-19 – Rumors, Conspiracy Theories & Fake News
Zach Zachariah, Ph. D., MBA.
Associate Professor Emeritus, Ohio University
April 2, 2020

These or some of the rumors and fake news regarding the origin of the Coronavirus that is being circulated on social media:
1.       The virus has been created by inserting herpes bits into corona RNA.
2.       The Chinese created the virus and spread it to the world to create chaos.
3.       China spreads the news that the US Army started the Coronavirus
4.       They quickly controlled the epidemic in your country. After all, they already had the antidote.
5.       The coronavirus travelled entire world from Wuhan but it did not reached Beijing and Shanghai.
Here are the facts:
The first report of the outbreak of the current pandemic was confirmed on December 31, 2019 in Wuhan, in the Hubei Province of China and the first death was reported on January 11, 2020.  Bats are the natural reservoir of coronaviruses.  These viruses cannot directly get into humans; there must be an intermediate host (animal or bird). A study by Yang Zhang and colleagues of the University of Michigan, U. S. A. published in the ACS’ Journal of Proteome Research[1], which is quoted in the publication, Science Daily (March 26, 2020) suggested that the host animal is pangolin, which the Chinese eat.  The researchers identified protein sequences in the sick animals' lungs that were 91% identical to the human virus' proteins. Moreover, the receptor-binding domain of the spike protein from the pangolin coronavirus had only five amino acid differences from SARS-CoV-2, compared with 19 differences between the human and bat viral proteins. This evidence points to the pangolin as the most likely intermediate host for the new Coronavirus[2].  Other research laboratories are conducting further studies to understand more about the DNA and protein sequences of the novel-Coronavirus that the W.H.O. has named SARS-CoV-2[3].  We have to remember the fact that it was only in January that the sequence was first identified.
The virus’s genetic makeup reveals that the virus is not a mishmash of known viruses. Anyone hoping to create a virus would need to work with already known viruses and engineer them to have desired properties. SARS-CoV-2 virus has components that differ from those of previously known viruses, so they had to come from an unknown virus or viruses in nature. “Genetic data irrefutably show that SARS-CoV-2 is not derived from any previously used virus backbone,” says Kristian Anderson of the Scripps Research Institute, La Jolla, CA, USA in a study published in Nature[4]. Other independent researchers have confirmed this finding.  These research findings point to the fact that the new Coronavirus was not created by inserting herpes or HIV bits to Corona RNA. There is no evidence that US Army started the Coronavirus either.
So far, in China, the number of people reported to have been infected is 82,691 and 3,321 persons have died.  Of that total, in Hubei Province of which Wuhan is a part, 67,802 people have been infected and 3193 persons have died.  Chinese government might have underreported the numbers.  The government enforced a complete lockdown of the province for over eight weeks, which spared the other major cities from the devastating epidemic.  Even then, 580 persons were infected in Beijing and 516 were infected in Shanghai.  It is preposterous to say that China made the virus to create chaos in the rest of the world allowing the virus to affect so many of its citizens. The Chinese scientists were the first to identify the RNA sequence and then shared it with W.H.O., which made it possible for W.H.O., C.D.C. and other public health agencies to develop the tests to identify the disease and for researchers to work on developing the vaccine. Following the Chinese example, the Indian government has clamped a lock down of the country to contain the pandemic.  The White House Task Force on Tuesday, March 31, 2020 projects that the pandemic will eventually kill 100,000 to 240,000 people in the U.S. alone[5]. Yet, there is no countrywide stay-at-home order and many states have not implemented the social distancing guidelines recommended by the White House. 
Conspiracy theory mongers are always going to come up with wild and exotic theories.  They will continue to post to Facebook, WhatsApp, Twitter and other social media outlets.  Someone from among us will pick it up and post it to a group forum; others will forward it or retweet it, and it will spread just like the Coronavirus.  Take a moment before you forward or retweet and ask a few simple question:  Does it make common sense?  Does it have any factual basis? Am I spreading a fake news?  If the answer is no, please take the mouse or your finger off that post or tweet.
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[1]Protein Structure and Sequence Reanalysis. https://pubs.acs.org/doi/10.1021/acs.jproteome.0c00129#
[2] Missing Link,  in Coronavirus- Science News, https://www.sciencedaily.com/releases/2020/03/200326144342.htm
 [3] Features, Evaluation and Treatment COVID-19, https://www.ncbi.nlm.nih.gov/books/NBK554776/
[4] The proximal origin of SARS-CoV-2, https://www.nature.com/articles/s41591-020-0820-9
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Monday, March 30, 2020



COVID-19 – Is New York a Prelude to Florida and Beyond?

Zach Zachariah, Ph. D., M.B. A.
Associate Professor Emeritus, Ohio University
March 30, 2020
Number of Covid-19 cases in the U. S.:  The United States has now surpassed all other countries in the world including Italy, Spain and China as the number one country with the total number of confirmed Covid-19 cases at 144,410.  That is close to 20% of the total reported cases in the World.  Approximately 1.8% of those infected (2,600) have died.  In the U.S., New York State leads with 60,679 cases, which accounts for 42% of the total number[1]. More than half of the cases (33,500) are in New York City.  Close to a thousand persons have died of Covid-19 in the city alone including a renowned surgeon, a nurse and a police detective. 
The White House coronavirus coordinator estimates that this pandemic could kill 100 to 200,000 Americans[2].  Over 10 million people have to be infected for that many people to die. Initially, the vast majority of cases were in coastal states like Washington, California, New York and New Jersey. More cases are being reported from Michigan, Florida, Illinois, Louisiana and Georgia.  Cook County, of which Chicago is a part, reported 3,445 cases. Detroit (1,542), New Orleans (2,100), and Miami-Dade County (1472) - the number of cases are in parenthesis - have been identified as hotspots where there is a surge in hospitalization resulting in shortages of supplies, staff, personal protective equipment (PPE), ventilators and ICU beds. Houston and Dallas are not far behind. This graphics (Click on graphics to watch the YouTube video) from yesterday’s CNN program[3], is a good illustration of how the number of confirmed Covid-19 cases surged in the different regions of the country. 
https://www.youtube.com/watch?v=EKQ0AasW8yI&t=3s


New York State and New York City Stats: The first reported case of Covid-19 in New York was on March 1, 2020.  On March 6, the number of cases doubled to 44 from the previous day.   
The next day, the number was 89 and Gov. Andrew Cuomo declared a state of emergency. On March 14, the first death was reported and the number of cases reached 524.  On that day, the number of cases in New York City was a mere 464. In another week, the number of cases in New would reach 15,000 and the city would report 8,115.  By March 29, the number of cases for New York State would be 59,648 (a 300% increase) and New York City would report 32,300 cases (242% increase) and 1,543 deaths.  It took 12 days for the number to reach 100 and in the next 10 days, that number reached 10,000.  The growth pattern is still exponential.  (See graph on the right). Although the City is under strict-stay-at-home orders, the peak will not be reached for at least three weeks.  Mayor de Blasio made a grim prediction that half of New York City population (4.2 million) would be infected. New York City is now the epicenter of the Coronavirus crisis, partly because of its population density.  Millions of travelers from all over the world came into the three International airports in the area without being tested or monitored. Many of them would have been asymptomatic carriers of the virus. 

How to flatten the curve?  Without any intervention, the trajectory of the epidemic curve will be exponential with the apex or the big peak happening at some point in time before coming down.  At his point, the hospitals will become overwhelmed and will be unable to provide care to the critically ill patients. 
China, by quarantining the inhabitants of a whole province was able to flatten the curve and shift the peak to a later date, which reduced the burden on the hospitals and the healthcare workers.  The total number of infected cases under each peak is the same except that the protective measure taken would flatten the curve to meet the health care system capacity.  Such a drastic step was not adopted in many other countries.  Instead, countries such South Korea, Singapore, Taiwan, Hong Kong and Iceland ramped up testing of as many people as possible to identify those infected and isolated them for 15-21 days.  Another strategy being implemented by countries like USA and UK is to impose travel restrictions combined with public health interventions (banning sports events and other mass gatherings, asking people to stay and work at home) and individual behavioral changes (keeping safe distance, handwashing) has been found to be effective[4].   We still need data on the number of cases, which in turn requires widespread testing of the population.  The numbers reported in the United States do not show the full picture in many parts of the country, mainly because of the inadequacy of testing.  Watch the video[5] to understand what it means by “flattening the curve” and the importance of social distancing.

Have we flattened the curve?  In almost all the states in the United States, the trajectory of the epidemic curve is exponential. USA Today has an excellent set of charts that compares the number of Covid-19 cases in each state to New York[6]. One notable exception is the state of Washington that reported the first Covid-19 case. The state governor had implemented strict social gathering rules by closing down restaurants and bars, restricting large gatherings and issuing stay-at-home orders. Until March 24, the state had the third-highest levels of Covid-19 cases behind New York and New Jersey.  Today it is number seven in the list of states.  In New York, the number of new cases reported increases only at a slower rate in the last few days.  This trend, if continued in the coming weeks, will indicate that strict measures taken do help flatten the curve. Yesterday, the President extended the federal guidelines on social distancing by a month after suggesting that he will open up the country for business on Easter Sunday.

What about the parts of the country that have not implemented the strict guidelines:  There is still no countrywide order to stay-at-home.  As of today, citizens of 30 states, 82 counties, 18 cities, the District of Columbia and Puerto Rico are being urged to stay home, which leaves out at least 80 million people that are not mandated to observe social distancing[7].   Florida is a case in point.  Today, Gov. Ron DeSantis announced a "Safer At Home" executive order until the middle of April, which encourages people to stay inside and practice social distancing to combat the coronavirus pandemic.  However, this order applies only to the four Counties:  Miami-Dade, Broward, Palm Beach and Monroe.  While Monroe County only has 24 reported cases, Tampa area itself has 116 cases and the governor’s order does not apply there although Hillsborough County has issued a similar order.  Unless the other states, many of them in the South do not institute strict social distancing guidelines, the chances are that they will begin to see spikes in the number of persons infected.

How all these matter to us?   I picked several of the places mentioned because majority of Malayalees, many of them Knananites live and work in these places.  Even in places like Ohio, we have a good number of our own healthcare professionals in he forefront of this epidemic trying to save the affected persons. Vast majority of them are nurses, respiratory therapists, nurse practitioners, pharmacists and doctors. Let us take a moment to thank them. We will soon start hearing reports of our own family and friends being infected and die. I am editing this blog on Sunday, April 5, and yesterday, heard the report of the first death due to Covid-19 of a Knananite in New York City .  For social distancing to work to flatten the curve, each individual should do his/her part to follow the guidelines.  We can help to minimize the spread of Covid-19 by staying at home and maintaining safe distance when going to a store.  Let us pray that all of our near and dear healthcare professionals stay safe and healthy.      

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Sunday, March 29, 2020



COVID-19 – Origin and Spread

Zach Zachariah, Ph. D.
March 29, 2020
What is Covid-19 and its symptoms?  The most recently discovered coronavirus that originated in China causes coronavirus disease COVID-19.[1]  Common cold, influenza, and the new Coronavirus share similar symptoms with some significant differences.   
How did humans contract the virus?  The first report of the outbreak of this pandemic was confirmed on December 31, 2019 in Wuhan, in the Hubei Province of China and one person was confirmed dead on January 11, 2020.  Bats are the natural reservoir of coronaviruses.  These viruses cannot directly get into humans; there must be an intermediate host (animal or bird). The suspected animal is pangolin, which the Chinese eat.[2]  There have been rumors that it was a virus the Chinese or the Americans created in the labs and used as a biological weapon to infect people.  According to the new findings, the virus’s genetic makeup reveals that it is not a mishmash of known viruses[3], which disproves the rumors and certain politically motivated propaganda[4].
Spread of the Virus:  The first confirmed case in the US was in Washington State on January 20, 2020.  The patient was a 35-year old man who returned from Wuhan, China. In a little over two months, there are now 125,000 confirmed cases in the US and 2250 persons have died.  Almost half of the cases are in the New York State. As of yesterday, there are 1,406 confirmed cases in Ohio. Of the total, 370 (approximately 82% are above the age of 50) are in the Cuyahoga County of which Cleveland is the County seat[5].  The Chinese government completely shut down the whole Hubei province, which helped to contain the spread of the disease, yet killing 3,300 persons out of the 81,439 infected.  It prevented to some extent the disease from spreading to other parts of China. It is impossible to shut down the whole New York City or the state and quarantine all inhabitants.  Several states and a number of major cities have ordered people to stay-at-home, and non-essential businesses to close. We can only help to minimize the spread of Covid-19 by staying at home and maintaining a safe distance.  Let us all pray that the healthcare professionals stay safe and healthy. 

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Researchers in China report structure of the novel coronavirus bound to its human target
Adapted from the news item in the Chemical & Engineering News (C&EN)1
The structure shows the first steps of SARS-CoV-2 infection, and could help in drug discovery
March 16, 2020

Chinese researchers have now identified part of the novel cornonavirus (SARS-CoV-2) bound to its target on human cells.  It binds to the angiotensin-converting enzyme (ACE2), an enzyme involved in blood pressure regulation.  Those of us who have high blood pressure, may be taking a a class of drugs called ACE-inhibitors (a common drug is lisinopril).  This discovery could lead to the development of antibodies that will block the interaction.  This knowledge is also used in developing vaccines that could prevent people from contracting the disease in future. 

More details from C&EN: ACE2 is the first in a string of enzymes that convert the hormone angiotensin into its active form. When cleaved by enzymes, angiotensin makes blood vessels contract. The SARS-CoV-2 spike protein has two key elements involved in infecting human cells. A string of amino acids in the S1 subunit directly binds to the protein-cleaving part of ACE2 called the peptidase domain. The S2 subunit of the spike protein helps the virus fuse to the human cell. The new structure shows the first of these two events. “You have attachment, and entry. Blocking either function can prevent entry,” Jason McLellan, a researcher from the University of Texas says, describing how treatments could be designed to stop SARS-CoV-2. “Ideally, you want antibodies that can target both functions.”

The scientists found that the protein-cleaving part of ACE2 binds the spike through polar interactions formed from a bridge-like structure on the enzyme. Both ends of the receptor binding domain stick to ACE2 through hydrogen bonding and van der Waals forces, and in the middle, Zhou describes several amino acids that interact with an asparagine and histidine in ACE2 that may be required for the spike protein-ACE2 interaction to occur.
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novel-Coronavirus (COVID-19) and Social Distancing 

By Zach Zachariah, Ph.D.
March 24, 2020

What is Coronavirus? Coronaviruses are a large family of viruses that are known to cause respiratory infections ranging from the common cold to more severe diseases such as Severe Acute Respiratory Syndrome (SARS). The most recently discovered novel coronavirus causes coronavirus disease COVID-19.[1] Common cold, influenza, and the new Coronavirus share similar symptoms with some significant difference.

Spread of the virus: The first confirmed case in the US was in Washington State on January 20, 2020. The patient was a 35-year old man who returned from Wuhan, China. COVID-19 spreads from person to person in close proximity. Droplets of bodily fluids - such as saliva or mucus - from an infected person are dispersed in the air or on surfaces by coughing or sneezing. These droplets can travel several feet and stay suspended in the air. This is the reason why we have been encouraged to practice “social distancing.” On surface of a desk or chair, they can stay for hours. Frequent wiping and disinfecting surfaces will help to remove the virus.

Reported cases of COVD-19 in the United States: As of today (March 24, 2020), the number of
reported cases in the U. S. is 48,963 (5,229 of them new) and 615 deaths (62 of them new). New York State has the worst epidemic (20,875 total and 157 deaths)[2]. In Ohio, as of Monday, March 23, 2020, there are 442 confirmed cases and 6 deaths. Of that total, 149 are in the Cuyahoga County, where Cleveland is.[3]. The latest number of cases is an increase of 33% from yesterday. Things are bleak and the pandemic is spreading. New York is approaching the numbers Italy had a few weeks ago and will surpass Italy’s numbers soon. Italy now has 63,927 cases and 6,077 deaths; the corresponding numbers for New York are 20,875 and 5,085 respectively.
The infection rate in New York doubles every 3 days. By Wednesday, there will be seventeen states including Ohio and several other locations with stay-at-home orders in effect. The first three cases in Ohio were reported on March 9 and in fourteen days; the number has increased to 442. These are what statisticians call “exponential” increase. India only has a total of 519 identified cases and 10 deaths so far. Yet, the Prime Minister just ordered a complete lock-down of the country with 1.4 billion people for twenty-one days. These numbers in India will escalate and the government wants to mitigate the effect. In the U.S, the President wants the “country opened” by Easter, contradicting the views of health experts and scientists.

Who are the carriers of the virus: Some people infected may be asymptomatic and will not be tested to confirm, yet they can spread the virus to the population who are vulnerable. If we assume just 1% of the population has been infected, of the 1.25 million Cuyahoga County residents, 12,500 would be infected and so far, only 442 have been identified. The rest of them may be among us transmitting the disease. We in turn can be infected and then become carriers.

Measures that can we follow now: Practice social distancing and keep a safe distance of at least six feet. If you are unwell, stay home and watch out for common symptoms: fever, cough and difficulty breathing. Call the healthcare provider before calling 911. Following the guidelines will safeguard the health of each one of us, our family and our colleagues, some of whom are vulnerable with underlying health issues. Watch the video[4] to understand what it means by “flattening the curve” and the importance of social distancing

Disclaimer: I have compiled the data from several sources, some of which are cited below. My opinion expressed here is based on facts, science and my own analysis.

References:
 [1] World Health Organization, https://www.who.int/news-room/q-a-detail/q-a-coronaviruses 
 [2] Worldometer, https://www.worldometers.info/coronavirus/country/us/ 
 [3] Ohio Department of Health, https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/Novel-Coronavirus 
 [4] What This Chart Actually Means for Covid-19, https://youtu.be/fgBla7RepXU
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Tuesday, April 21, 2009

What Recession?

It is true that there are vacant stores in the area around DC where we were staying. The Courtyard Hotel lobby was full most of the time with guests waiting to check in or trying to fill their cups with freshly brewed coffee. We had to wait for 35 minutes to be seated at the co-located restaurant which also had a micro brewery that had some excellent German beer. The bar area was over crowded on that Friday evening. The waitress had too many tables to wait on that after taking our order, she never showed up except to bring the bill. We wanted to ask for a bottle of Tabasco. What type of tip should you give to the waitress when you are treated like that? The next evening we went to Asia Nine, a Thai outfit that advertises as an Asian-Asian Fusion restaurant. The hostess and server were attentive, courteous, and efficient. The restaurant was full and the turnaround time was the minimum. The food was good and they served Thai beer. The guests were going their merry way and they were definitely stimulating the economy. The DC chamber of Commerce estimates that up to a million visitors would come to Washington to attend the Cherry Blossom Festival. The Amtrak train on the way back was full with no vacant seats. People were definitely traveling, spending money, and enjoying themselves; all healthy signs of a recovering economy. Paul Krugman (the Nobel prize winning economist from Princeton) was seen standing near a gate waiting for a New York bound train. Perhaps I should have approached and told him to be less pessimistic and allow some time for the stimulus package to work its way.
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Return Trip

We flagged a taxi and reached the Union Station around 9:30 AM. Once again we had another African immigrant as driver. He was not in a talking mood.So I could not ascertain his nationality.He too was probably an Ethiopian. Not many places serve breakfast at the food court. Again we had a heavy breakfast which will probably serve as our brunch. The train was on time. What a difference a couple of days make. It is sunny and warm today and the country side of Virginia and West Virginia show signs of greenery sprouting from the apparently dry branches and the underside of the trees. There are cows grazing in the meadows in the the small farms around the countryside.
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