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Human behaviour is complex; the case of HIV/AIDS …and other communicable diseases

In the 1980s, the International Union Against Tuberculosis and the World Health Organization developed a system of taking anti-Tuberculosis treatment called “Directly Observed Treatment”. This system, later systematized into what is now called “DOTS” (Directly Observed Treatment- Short Course), transformed the approach to treatment of TB and assured very high cure rates and treatment success rates.


What motivated this approach? The problem was that it was very difficult to get TB patients to take their 18 months treatment to completion. Many patients defaulted, i.e., they either disappeared, took their treatment irregularly, or simply collected the tablets monthly to please health workers but did not actually take the tablets. The result was that very few TB patients were treated to completion and cured.


When I took over the National Tuberculosis Programme in Botswana in 1979 that was exactly the situation. Very few patients were finishing treatment and getting cured, so many patients became chronic or died of TB.  This was despite attempts by Government and its partners to address the situation. By the time I took the programme over, it was run by a WHO Medical Officer and had district TB coordinators from the USA Peace Corps and from the Netherlands.  However, the situation did not improve to a significant degree as patients did not just change their habits.


This problem was prevalent in TB programmes around the world. Solutions had to be found. The first thing achieved was the discovery of new drugs that cut down treatment to six months. Research had been going on for some time to develop new drugs which would be more powerful and would reduce treatment time. It was reckoned that this would improve treatment compliance.

So, by the close of the 1970s new drugs had been developed that would reduce treatment time to six months. However, while shortening treatment did improve compliance significantly and reduced defaulter rates, thus improving cure rates, it was still not enough. Hence the move to “directly observed treatment”,  which meant that the patient had to be supervised by the health worker for every dose taken.

In other words, on a daily basis the patient had to be observed actually taking treatment by the health worker or a designated person. This dramatically improved cure rates in Tuberculosis and many countries that adopted this approach started to make noticeable impact on their TB rates.


Here in Botswana we adopted the Short Course Chemotherapy of 6 months in 1985, the first country in Africa to do so outside those like Tanzania and Malawi that were pilot projects for DOTS under the IUAT and WHO programme. It should be noted that these new drugs were much more expensive than the old drugs, and few African countries could afford them without aid. Botswana went ahead and introduced the new drugs, implementing Short Course Chemotherapy and also adopting directly observed treatment as this was a condition of moving to the new drugs.

This paid dividends. TB notification rates started to decline in the mid-1980s, but unfortunately started to rise steeply in the early 1990s because of the impact of the HIV epidemic. Botswana experienced a three-fold increase in TB notification rates because of HIV; other countries in Southern Africa experienced up to five-fold increases.


The above introduction on TB is meant to illustrate how complex human behaviour is. The world has experienced many major epidemics and pandemics since history started. For example, a third of the population of Europe was decimated by the Plague (Pasteurella pestis) epidemic of the 14th century. Since it was before the discovery of micro-organisms and their role in disease causation, all sorts of groups of people were victimized and blamed as the cause.

Plague is transmitted by fleas from certain species of rats. Europe also experienced epidemics of Cholera in the 19th century that resulted in very high mortality rates. It was during one of these epidemics in London that the role of water in the transmission of Cholera was discovered and demonstrated.

This has since become a classic case study for study of investigative Epidemiology. In 1917-18 there was a major pandemic of influenza that resulted in very high mortality rates around the world. I am quoting these examples to illustrate that the human race has always faced major epidemics or pandemics caused by micro-organisms and many of them were self-limiting because their causation was not even known or understood.

There are always emerging diseases. Luckily, in the last two or so centuries medical knowledge has advanced so much that the causes of these emerging diseases, almost invariably micro-organisms, are always discovered and control measures put in place. In the last half century or so, medical science has advanced more than in all previous history.


Most major epidemics and pandemics in history were caused by acute illnesses. In the modern era what facilitates control of such diseases is i) having a good knowledge of their incubation period, ii) the disease having easily recognizable signs and symptoms, iii) the disease having a high manifestation rate, i.e., infected people showing signs and symptoms so making diagnosis of cases easy and iv) the mode of transmission of the disease being well known.

These factors facilitate control measures based on diagnosis, surveillance and containment, including quarantine when necessary. In the modern era, the discovery of microscopic organisms as causes of disease (19th century) and the discovery of antibiotics were also great milestones in the control of epidemics. The former also led to the development of vaccines for many diseases, while the latter made virtually all bacterial diseases curable. Viral diseases, such as influenza and HIV/AIDS are still largely not curable by antibiotics.


The most challenging pandemic in the modern era has been the HIV/AIDS pandemic. For several reasons its control has not been easy. Firstly, the factors listed above are not operative in HIV/AIDS; i) the incubation period is very long and variable, sometimes being as long as five or more years; ii) the signs and symptoms of HIV related illness are highly variable as it is a syndrome that manifests differently in different individuals because the illness results from suppression of immunity; and iii) many infected people carry the virus and are infectious for many years without having any recognizable signs or symptoms. While the mode of transmission is known, it is a mode that people do not want to talk about because it carries a moral stigma.

This is transmission through sexual intercourse. As a result those infected are not keen to be known because they are afraid that they will be regarded as immoral, sexually permissive or promiscuous. This stigma results in many HIV infected individuals not knowing their status but remaining sexually active and transmitting the virus to their partners.


It is now more than thirty years since AIDS and the virus that causes it-HIV- were discovered and described. In Botswana after the first infected individuals were diagnosed in 1985 the pandemic has now been active for about 30 years. Yet despite the amount of information that has been churned out here and in other countries, new infections continue to occur at a high rate, especially in Africa, and more especially in Southern Africa, which remains the epicentre of the epidemic.


In Public Health we have always been taught that Knowledge should lead to change in Attitude and subsequently to change in Practice (K-A-P). But we have also been taught that things do not always work out that way. HIV/AIDS has clearly demonstrated that people do not necessarily use the knowledge they have gained to change their attitudes and practices for the better. Factors that result in people not using knowledge are many and complex, and being not a behavioural scientist I cannot say much about the subject.


What we have seen in Botswana is that failure of people to change attitudes and practices in relation to HIV/AIDS has resulted in extensive blame game. And as usual the press and others have had a feast laying the blame on Government. I would like to argue here that while the Government response may not have been perfect, especially in the early days when knowledge about the disease was rather sparse anyway, the response has strengthened considerably with time, but the response of the sexually active population has been very far from optimal.


From the very early period of the HIV epidemic in Botswana, the Government, initially led by the Ministry of Health, faithfully followed WHO and other international guidelines in putting its response in place. The very first strategic response was put out in the 1980s and was revised every three to four years as recommended.

The bulk of the strategy related to transmitting information to the public. At a technical level the response to the HIV epidemic was therefore sound in Botswana from the beginning. The political response, and response from the traditional and other leadership, as well as civil society however lacked behind. This obviously did cause some problems in the delay. However, we have to accept that information on the transmission of the virus, information that the individual needed to change his/her behaviour was available from the beginning of the epidemic.


The Health Sector initially ran the HIV response in Botswana, but in line with international trends and recommendations, by the early 1990s the response was made multisectoral as HIV/AIDS was recognized as a development as opposed to a health problem. The National AIDS Council was created and other sectors were drawn into the response.


Botswana and other countries of the extreme Southern tip of the continent (SACU) had the advantage that their epidemic was late, when countries in Central and East Africa had already borne the epidemic for some years. So after the diagnosis of the first sero-positive cases, as we watched the virus spread, we were able to predict what would happen and warn the leadership and the public in general. By the end of the 1980s the Ministry of Health was issuing warnings about the impending large number of cases and deaths. Unfortunately the leadership and the public did not respond in a commensurate manner.

So, when the illness and deaths hit the country from the middle 1990s, it was virtually the ‘we told you so’ phenomenon from the health sector. We had mistakenly thought that the experiences of Central and East Africa would make the people of the country more receptive to the messages and warnings of the Health Sector.  Unfortunately that was not the case. Many seminars and workshops were run for leadership at all levels and for the public without much impact on behavioural change. The media and other routes were also saturated with messages without impact.


Read part two next weekend

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The Corona Coronation (Part 10)

9th July 2020

Ever heard of a 666-type beast known as Fort Detrick?

Located in the US state of Maryland, about 80 km removed from Washington DC, Fort Detrick houses the US army’s top virus research laboratory. It has been identified as “home to the US Army Medical Research and Materiel Command, with its bio-defense agency, the US Army Medical Research Institute of Infectious Diseases, and  also hosts the National Cancer Institute-Frederick and the National Interagency Confederation for Biological Research and National Interagency Biodefense Campus”.

The 490-hectare campus researches the world’s deadliest pathogens, including Anthrax (in 1944, the Roosevelt administration ordered 1 million anthrax bombs from Fort Detrick), Ebola, smallpox, and … you guessed right: coronaviruses.  The facility, which carries out paid research projects for government agencies (including the CIA), universities and drug companies most of whom owned by the highly sinister military-industrial complex, employs 900 people.

Between 1945 and 1969, the sprawling complex (which has since become the US’s ”bio-defence centre” to put it mildly) was the hub of the US biological weapons programme. It was at Fort Detrick that Project MK Ultra, a top-secret CIA quest to subject   the human mind to routine robotic manipulation, a monstrosity the CIA openly owned up to in a congressional inquisition in 1975, was carried out.  In the consequent experiments, the guinea pigs comprised not only of people of the forgotten corner of America – inmates, prostitutes and the homeless but also prisoners of war and even regular US servicemen.

These unwitting participants underwent up to a 20-year-long ordeal of barbarous experiments involving psychoactive drugs (such as LSD), forced electroshocks, physical and sexual abuses, as well as a myriad of other torments. The experiments not only violated international law, but also the CIA’s own charter which forbids domestic activities. Over 180 doctors and researchers took part in these horrendous experiments and this in a country which touts itself as the most civilised on the globe!

Was the coronavirus actually manufactured at Fort Detrick (like HIV as I shall demonstrate at the appropriate time) and simply tactfully patented to other equally cacodemonic places such as the Wuhan Institute of Virology in China?

THE FORT DETRICK SCIENTISTS’ PROPHECY WAS WELL-INFORMED

 

About two years before the term novel coronavirus became a familiar feature in day-to-day banter, two scientist cryptically served advance warning of its imminence. They were Allison Totura and Sina Bavari, both researchers at Fort Detrick.

The two scientists talked of “novel highly pathogenic coronaviruses that may emerge from animal reservoir hosts”, adding, “These coronaviruses may have the potential to cause devastating pandemics due to unique features in virus biology including rapid viral replication, broad host range, cross-species transmission, person-to-person transmission, and lack of herd immunity in human populations  Associated with novel respiratory syndromes, they move from person-to-person via close contact and can result in high morbidity and mortality caused by the progression to acute respiratory distress syndrome (ARDS).”

All the above constitute some of the documented attributes and characteristics of the virus presently on the loose – the propagator of Covid-19. A recent clinical review of Covid-19 in The Economist seemed to bear out this prognostication when it said, “It is ARDS that sees people rushed to intensive-care units and put on ventilators”. As if sounding forth a veritable prophecy, the two scientists besought governments to start working on counter-measures there and then that could be “effective against such a virus”.

Well, it was not by sheer happenstance that Tortura and Bavari turned out to have been so incredibly and ominously prescient. They had it on good authority, having witnessed at ringside what the virus was capable of in the context of their own laboratory.  The gory scenario they painted for us came not from secondary sources but from the proverbial horse’s mouth folks.

CDC’S RECKLESS ADMISSION

In March this year, Robert Redfield, the US  Director for the Centre for Disease Control and Prevention (CDC),  told the House of Representatives’ Oversight Committee that it had transpired that some members of the American populace  who were certified as having died of influenza  turned out to have harboured the novel coronavirus per posthumous analysis of their tissue.

Redfield was not pressed to elaborate but the message was loud and clear – Covid-19 had been doing the rounds in the US much earlier than it was generally supposed and that the extent to which it was mistaken for flu was by far much more commonplace than was openly admitted. An outspoken Chinese diplomat, Zhao Lijian, seized on this rather casual revelation and insisted that the US disclose further information, exercise transparency on coronavirus cases and provide an explanation to the public.

But that was not all the beef Zhao had with the US. He further charged that the coronavirus was possibly transplanted to China by the US: whether inadvertently or by deliberate design he did not say.  Zhao pointed to the Military World Games of October 2019, in which US army representatives took part, as the context in which the coronavirus irrupted into China. Did the allegation ring hollow or there was a ring of truth to it?

THE BENASSIE FACTOR

The Military World Games, an Olympic-style spectrum of competitive action, are held every four years. The 2019 episode took place in Wuhan, China. The 7th such, the games ran from October 18 to October 27.  The US contingent comprised of 17 teams of over 280 athletes, plus an innumerable other staff members. Altogether, over 9000 athletes from 110 countries were on hand to showcase their athletic mettle in more than 27 sports. All NATO countries were present, with Africa on its part represented by 30 countries who included Botswana, Egypt, Kenya, Zambia, and Zimbabwe.

Besides the singular number of participants, the event notched up a whole array of firsts. One report spelt them out thus: “The first time the games were staged outside of military bases, the first time the games were all held in the same city, the first time an Athletes’ Village was constructed, the first time TV and VR systems were powered by 5G telecom technology, and the first use of all-round volunteer services for each delegation.”

Now, here is the clincher: the location of the guest house for the US team was located in the immediate neighbourhood of the Wuhan Seafood Market, the place the Chinese authorities to this day contend was the diffusion point of the coronavirus. But there is more: according to some reports, the person who allegedly but unwittingly transmitted the virus to the people milling about the market – Patient Zero of Covid-19 – was one Maatie Benassie.

Benassie, 52, is a security officer of Sergeant First Class rank at the Fort Belvoir military base in Virginia and took part in the 50-mile cycling road race in the same competitions. In the final lap, she was accidentally knocked down by a fellow contestant and sustained a fractured rib and a concussion though she soldiered on and completed the race with the agonising adversity.  Inevitably, she saw a bit of time in a local health facility.   According to information dug up by George Webb, an investigative journalist based in Washington DC,     Benassie would later test positive for Covid-19 at the Fort Belvoir Community Hospital.

Incidentally, Benassie apparently passed on the virus to other US soldiers at the games, who were hospitalised right there in China before they were airlifted back to the US. The US government straightaway prohibited the publicising of details on the matter under the time-honoured excuse of “national security interests”, which raised eyebrows as a matter-of-course. As if that was not fishy enough, the US out of the blue tightened Chinese visas to the US at the conclusion of the games.

The rest, as they say, is history: two months later, Covid-19 had taken hold on China territory.  “From that date onwards,” said one report, “one to five new cases were reported each day. By December 15, the total number of infections stood at 27 — the first double-digit daily rise was reported on December 17 — and by December 20, the total number of confirmed cases had reached 60.”

TWO CURIOUS RESEARCH HALTINGS

Is it a coincidence that all the US soldiers who fell ill at the Wuhan games did their preparatory training at the Fort Belvoir military base, only a 15-minutes’  drive from Fort Detrick?

That Fort Detrick is a plain-sight perpetrator of pathogenic evils is evidenced by a number of highly suspicious happenings concerning it. Remember the 2001 anthrax mailing attacks on government and media houses which killed five people right on US territory? The two principal suspects who puzzlingly were never charged, worked as microbiologists at Fort Detrick. Of the two, Bruce Ivins, who was the more culpable, died in 2008 of “suicide”. For “suicide”, read “elimination”, probably because he was in the process of spilling the beans and therefore cast the US government in a stigmatically diabolical light. Indeed, the following year, all research projects at Fort Detrick were suspended on grounds that the institute was “storing pathogens not listed   in its database”. The real truth was likely much more reprehensible.

In 2014, there was a mini local pandemic in the US which killed thousands of people and which the mainstream media were not gutsy enough to report. It arose following the weaponisation at Fort Detrick of the H7N9 virus, prompting the Obama administration to at once declare a moratorium on the research and withdraw funding.

The Trump administration, however, which has a pathological fixation on undoing practically all the good Obama did, reinstated the research under new rigorous guidelines in 2017. But since old habits die hard, the new guidelines were flouted at will, leading to another shutdown of the whole research gamut at the institute in August 2019.  This, nonetheless, was not wholesale as other areas of research, such as experiments to make bird flu more transmissible and which had begun in 2012, proceeded apace. As one commentator pointedly wondered aloud, was it really necessary to study how to make H5N1, which causes a type of bird flu with an eye-popping mortality rate, more transmissible?

Consistent with its character, the CDC was not prepared to furnish particulars upon issuing the cease and desist order, citing “national security reasons”. Could the real reason have been the manufacture of the novel coronavirus courtesy of a tip-off by the more scrupulous scientists?

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Masisi faces ultimate test of his presidency

9th July 2020

President Mokgweetsi Masisi may have breathed a huge sigh of relief when he emerged victorious in last year’s 2019 general elections, but the ultimate test of his presidency has only just begun.

From COVID-19 pandemic effects; disenchanted unemployed youth, deteriorating diplomatic relations with neighbouring South Africa as well as emerging instability within the ruling party — Masisi has a lot to resolve in the next few years.

Last week we started an unwanted cold war with Botswana’s main trade partner, South Africa, in what we consider an ill-conceived move. Never, in the history of this country has Botswana shown South Africa a cold shoulder – particularly since the fall of the apartheid regime.

It is without a doubt that our country’s survival depends on having good relations with South Africa. As the Chairperson of African National Congress (ANC), Gwede Mantashe once said, a good relationship between Botswana and South Africa is not optional but necessary.

No matter how aggrieved we feel, we should never engage in a diplomatic war — with due respect to other neighbours— with South Africa. We will never gain anything from starting a diplomatic war with South Africa.

In fact, doing so will imperil our economy, given that majority of businesses in the retail sector and services sector are South African companies.

Former cabinet minister and Phakalane Estates proprietor, David Magang once opined that Botswana’s poor manufacturing sector and importation of more than 80 percent of the foodstuffs from South Africa, effectively renders Botswana a neo-colony of the former.

Magang’s statement may look demeaning, but that is the truth, and all sorts of examples can be produced to support that. Perhaps it is time to realise that as a nation, we are not independent enough to behave the way we do. And for God’s sake, we are a landlocked country!

Recently, the effects of COVID-19 have exposed the fragility of our economy; the devastating pleas of the unemployed and the uncertainty of the future. Botswana’s two mainstay source of income; diamonds and tourism have been hit hard. Going forward, there is a need to chart a new pathway, and surely it is not an easy task.

The ground is becoming fertile for uprisings that are not desirable in any country. That the government has not responded positively to the rising unemployment challenge is the truth, and very soon as a nation we will wake up to this reality.

The magnitude of the problem is so serious that citizens are running out of patience. The government on the other hand has not done much to instil confidence by assuring the populace that there is a plan.

The general feeling is that, not much will change, hence some sections of the society, will try to use other means to ensure that their demands are taken into consideration. Botswana might have enjoyed peace and stability in the past, but there is guarantee that, under the current circumstances, the status quo will be maintained.

It is evident that, increasingly, indigenous citizens are becoming resentful of naturalised and other foreign nationals. Many believe naturalised citizens, especially those of Indian origin, are the major beneficiaries in the economy, while the rest of the society is side-lined.

The resentfulness is likely to intensify going forward. We needed not to be heading in this direction. We needed not to be racist in our approach but when the pleas of the large section of the society are ignored, this is bound to happen.

It is should be the intention of every government that seeks to strive on non-racialism to ensure that there is shared prosperity. Share prosperity is the only way to make people of different races in one society to embrace each other, however, we have failed in this respect.

Masisi’s task goes beyond just delivering jobs and building a nation that we all desire, but he also has an immediate task of achieving stability within his own party. The matter is so serious that, there are threats of defection by a number of MPs, and if he does not arrest this, his government may collapse before completing the five year mandate.

The problems extend to the party itself, where Masisi found himself at war with his Secretary General, Mpho Balopi. The war is not just the fight for Central Committee position, but forms part of the succession plan.

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The Corona Coronation (Part 9)

29th June 2020
Michael Mellaham

If we are to go by what I can term as conventional wisdom, the coronavirus arose in China’s Hubei province in the city of Wuhan. According to the WHO, the Chinese government filed the country’s first confirmed Covid-19 case with the international health regulator on December 8, 2019, with the first case outside of China’s boarders reported in Thailand on January 13, 2020.

We now know, however, courtesy of a paper in The Lancet that was authored by doctors from Wuhan’s Jinhintan Hospital, that the first such case was logged on December 1. We have also come to learn that in point of fact, the first patient, the so-called Patient Zero, may have presented with the as yet unfathomed Covid-9 symptoms in a public health facility on November 17. This is according to a report in the South China Morning Post, which claims to have seen classified medical government reports.

The Post report says nine cases of Covid-19 sufferers, aged between 39 and 79, were attended to during the month of November alone and that a total of 266 people officially had the disease by December 31st. Clearly, the disease had been sedately circulating for some time before it exploded towards the end of the year considering that a great number of people do not present symptoms at all.

Yet the fact the disease was first announced in China and even laboratory-spawned in that country does not necessarily mean China was its veritable place of origin. It almost certainly had multiple origins and may have occurred much earlier in other places on the globe.

AMERICA’S FLU ILLNESS TSUNAMI

Unbeknownst to much of the world, Covid-19 struck in Europe and the USA about the same time it did so in China, if not much earlier, it has now emerged. This is not tabloid hogwash or simply idle gossip folks: it was reported by the highly estimable news outlets such as NBC News and The New York Times. Even Newsweek, which along with Time magazine constitute America’s leading two weekly political magazines, was adamant that the coronavirus outbreak must have occurred as early as September 2019 and that Wuhan was possibly not its birthplace as such. For some reason (or is it for partisan reasons?), the globally renowned broadcast media networks like CNN, BBC, and Sky News have chosen to self-gag on the matter.

If there’s one disease which is so notoriously recurrent and even death-dealing in the US, it is influenza – commonly referred to as the flu or common cold. Here in Africa, flu is no much of a big deal: it is so mild I personally do not know – nor have ever heard of – a single one person who died of flu. In the US, flu is some menace. For instance, in the 2017-18 season, over 61,000 deaths were linked to flu, and in the 2018-19 season, 34,200 succumbed to the disease. Every year, 10 percent of the US population, or 32 million people, contract flu, though only about 100,000 end up being hospitalised anyway.

In the US, the flu season ordinarily runs from October to May, straddling three of the country’s four-season set, namely fall (September to November), winter (December to February), and spring (March to May). The disease is particularly widespread in 16 states. Last year, the winter flu season began atypically early and with a big bang that had never been seen in 15 years according to a December 6, 2019 report by Associated Press (AP), a wire news agency. By the beginning of December or thereabouts, 1.7 million flu illnesses, 16,000 hospitalisations, and 900 flu-related deaths had taken place.

The Centre for Disease Control & Prevention (CDC) put the number of people already dead from flu-related illnesses as of mid-March 2019 at between 29,000 and 59,000. This was in addition to the misery of hundreds of thousands of flu-related hospitalisations and millions of medical visits for flu symptoms that have raged in the course of the season. Some hospitals in New Orleans have reported the busiest patient traffic ever at their emergency departments.

Health authorities in Louisiana, which was the first to be impinged, said flu-like illnesses began to rocket in the month of October. Said the AP report: “There are different types of flu viruses, and the one causing illnesses in most parts of the country is a surprise.” Dave Osthus, a flu statistician at the Los Alamos National Laboratory, was quoted as saying, “This could be a precursor to something pretty bad. But we don’t know what that is.”
Well, maybe we can venture an answer to the conundrum: the flu situation was exacerbated by the coronavirus.

THE CASE OF A NEW JERSEY MAYOR

The story of Michael Mellaham, the mayor of the New Jersey city of Belleville, has been widely reported in the Western world, albeit in the comparatively fringe media houses primarily lest the finger of indictment shift from China to the US. Sometime in November last year, Mellaham came down with an ailment that presented with Covid-19-like symptoms such as aches, high fevers, chills, and a sore throat, the latter of which went on for a full month.
Right at the onset of his diseased condition, Mellaham went to see his doctor, who told him not to worry as it was little more than flu and would peter out in a matter of days. The illness lingered for much longer though he at long last fought it off. It was the sickest he had ever been in his adult life.

In April this year, Mellaham took a Covid-19 test and he was found not with Covid-19 per se but its antibodies, which crystal-clearly evinced he had the disease at some stage in the recent past. This is what he told China Global Television Network (CGTN) in May: “We’re told that they (people with Covid-19-like symptoms) don’t have the flu. They just have bronchitis. They just have a bad cough or it’s a bad cold. I think that we just weren’t expecting Covid-19 then, so therefore the doctors didn’t know what to call it or what to expect.”

Of the credibility of the test he took, known as IgM (Immunoglobulin M Test), the first antibody a body makes when it fights a new infection, Mellaham said, “The IgM is the more recent antibody, which would have shown that that antibody is more recent in my system, that my body more recently fought the coronavirus.”

The first publicly admitted case of coronavirus-triggered morbidity in the US was announced in January this year and involved a Californian who had recently returned from Wuhan, but as Mellaham pointedly put it, “that doesn’t mean it wasn’t here (on US soil) before that”.

SUDDENLY “MANY PIXELS”

On May 7, 2020, The New York Times reported of two men aged 57 and 69 who died in their homes in Santa Clara, California, on February 6 and 17 respectively, and this was 23 days before the US announced its first Covid-19 fatality in Kirkland, Washington, on February 29. Their demise was attributed to flu post-mortem but it later emerged that they had been victims of the novel coronavirus. Since they had never travelled outside their community for years, they must have contracted the disease within the locality.

The Santa Clara county’s chief medical office Sarah Cody said the deaths of the two was probably the tip of the iceberg of unknown size. Dr Jeffrey Smith, the Santa Clara county executive, he too a medical doctor, opined that the coronavirus must have been spreading in California unrecognised for a long time now.

Indeed, if we take stock of the fact that passengers on board the Grand Princess cruise ship, which departed California on February 11, developed Covid-19 whilst on board, the odds certainly are that Covid-19 hit much earlier in the US than it hit the headlines. As Cody pointedly put it, “We had so few pixels you could hardly pick out the image. Suddenly, we have so many pixels all of sudden that we now realise we didn’t know what we were looking for.”

THE FRENCH CONNECTION

In Europe, a radiology research team at the Albert Schweitzer Hospital in Colma, France, has traced the first Covid-19 case in that country to November 16, 2019 according to reports by NBC News and The New York Times. The researchers came to this finding after examining 2500 chest X-rays taken from November 1, 2019 to April 30 this year.

French authorities declared the first Covid-19 case on January 24 having detected it in three nationals who had recently been to China, though it has now transpired that whilst one finger was point to China, four were point back at France itself.

It came to light last month that a sample taken from a French patient with pneumonia on December 27 subsequently tested positive for the coronavirus. “There’s no doubt for us it was already there in December,” Dr Yves Cohen, head of intensive care at the Avicenne and Jean Verdier hospitals in the northern suburbs of Paris, told The New York Times on May 4 this year. “It is quite possible that there were isolated cases that led to transmission chains that died down.”

Weighing in on the matter too, Michel Schmitt, who led the Albert Schweitzer Hospital research, said, “The testimonies are really rich; they show that people felt that something strange was going on, but they were not in a capacity to raise the alarm.”

THE CAMBRIDGE AND UCL FINDINGS

Meanwhile, two independent research projects by two of Britain’s premier institutions of learning have turned up evidence that Covid-19 was in Europe as early as the third quarter of 2019.  Following a study to understand the historical processes that led to the Covid-19 pandemic, the University of Cambridge found that the coronavirus outbreak appears to have started between September 13 and December 7 in 2019.

The University College London’s Genetics Institute (UCL) analysed genomes from the Covid-19 virus in over 7,500 people and deduced that the pandemic must have started between October 6 and December 11 in 2019.
The UCL team analysed virus genomes, using published sequences from over 7,500 people with Covid-19 across the globe. Their report, titled HYPERLINK “https://www.sciencedirect.com/science/article/pii/S1567134820301829” \l “s0045” \t “_blank” Emergence of Genomic Diversity and Recurrent Mutations in SARS-CoV-2, was published in the May 6, 2020 edition of the journal Infection, Genetics and Evolution.

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