The Dilemmas of the COVID-19 Pandemic

I call it the dilemmas of a pandemic because since its beginning in December last year in Wuhan, China, and to this day, this Pandemic has many unknowns and, as a result, quite a few dilemmas:

1. There was much talk that the virus circulated from wild animals to humans in a food market in Wuhan where wild animals were traded and handled, even bats were accused, but later it turned out that bats were never traded at that market, another wild animal was accused, including wild cats, etc., and the result even today is with big question marks. We still do not know the natural reservoir of this virus even though coronaviruses have been known and studied since the 60s of the last century, even though it has as a predecessor SARS Cov1 which caused a global alarm in 2002 as responsible for severe respiratory failure, but only with a limited number of cases around 8000 and with a mortality of 10%, and then MERS Cov in 2013 or responsible for more than 3000 affected and over 900 victims, or with a mortality of about 30%.

   Even today, there are more conspiracy theories that it was produced or generated in a lab etc. etc.

   Even though we still do not have a confirmed natural reservoir, I strongly believe that the disease is a zoonosis, the virus has passed from the natural reservoir, most likely an animal to humans and has gained the ability to be transmitted from human to human very quickly, even has a very high transmission coefficient. And the place of origin is China.

2. The virus contains RNA, about 75% of its genomic content is similar to SARS, but unlike SARS which affected a very limited number of countries and people, SARS Cov 2 quickly crossed the boundaries of China and today has almost affected most countries of the world with over 2 million affected and over 150 thousand dead. The virus has a relatively large molecular weight, is transmitted through saliva droplets during coughing, sneezing, or talking, but in closed environments especially those hospital settings and through aerosols, the virus can stay in the air for up to 3 hours in these environments. It has a lipid envelope which makes it sensitive to soap, detergents, and alcohol, washing hands with soap and water for about 20 seconds and disinfection with 60% alcohol gel destroys the virus. Lives for several hours on the surface of objects.

   The second dilemma is how stable the viral genome is, whether it will undergo genetic mutations etc., and in this direction, the studies are contradictory.

3. We still do not have an FDA-approved drug as an anti Covid 19 medication, we have many medical alternatives, but not a universally accepted and proven protocol as effective against Covid 19, it seems that all the odds to be positive for Remdesivir, a new antiviral still in the process of clinical trial. We also do not yet have a vaccine and the chances of having it soon are small. The experience gained with the currently used drugs is contradictory.

   And as long as we do not have a treatment protocol and vaccine, the possibility to treat or/and prevent it is impossible. The treatment remains empirical/symptomatic and the rest in the clinical trial phase.

4. What should we do, how to solve the problem? The only possibility is the application of social distancing measures, avoiding contacts, tracking, confirming, and isolating new cases aiming to interrupt the epidemiological chain. How long it will continue, nobody can predict, but with the warming of the weather respiratory viruses generally decrease in transmissibility and the pace of the epidemic falls until it extinguishes, to possibly return again in autumn if by then we do not have a vaccine.