Modest improvements in treatment could make a big difference.
https://www.economist.com/briefing/2020/03/12/understanding-sars-cov-2-and-the-drugs-that-might-lessen-its-power?fsrc=scn/fb/te/bl/ed/anatomyofakillerunderstandingsarscov2andthedrugsthatmightlessenitspowerbriefing
But interconnectedness may be its downfall, too. Scientists around the world are focusing their attention on its genome and the 27 proteins that it is known to produce, seeking to deepen their understanding and find ways to stop it in its tracks. The resulting plethora of activity has resulted in the posting of over 300 papers on Medrxiv, a repository for medical-research work that has not yet been formally peer-reviewed and published, since February 1st, and the depositing of hundreds of genome sequences in public databases. (For more coverage of covid-19 see our coronavirus hub.)
Even if a drug were only able to reduce mortality or sickness by a modest amount, it could make a great difference to the course of the disease. As Wuhan learned, and parts of Italy are now learning, treating the severely ill in numbers for which no hospitals were designed puts an unbearable burden on health systems. As Jeremy Farrar, the director of the Wellcome Trust, which funds research, puts it: “If you had a drug which reduced your time in hospital from 20 days to 15 days, that’s huge.”
Little noticed by doctors, let alone the public, until the outbreak of sars (severe acute respiratory syndrome) that began in Guangdong in 2002, the coronavirus family was first recognised by science in the 1960s. Its members got their name because, under the early electron microscopes of the period, their shape seemed reminiscent of a monarch’s crown. (It is actually, modern methods show, more like that of an old-fashioned naval mine.) There are now more than 40 recognised members of the family, infecting a range of mammals and birds, including blackbirds, bats and cats. Veterinary virologists know them well because of the diseases they cause in pigs, cattle and poultry.
Virologists who concentrate on human disease used to pay less attention. Although two long-established coronaviruses cause between 15% and 30% of the symptoms referred to as “the common cold”, they did not cause serious diseases in people. Then, in 2002, the virus now known as sars-cov jumped from a horseshoe bat to a person (possibly by way of some intermediary). The subsequent outbreak went on to kill almost 800 people around the world.
Some of the studies which followed that outbreak highlighted the fact that related coronaviruses could easily follow sars-cov across the species barrier into humans. Unfortunately, this risk did not lead to the development of specific drugs aimed at such viruses. When SARS-CoV-2—similarly named because of its very similar genome—duly arrived, there were no dedicated anti-coronavirus drugs around to meet it.
A SARS-CoV-2 virus particle, known technically as a virion, is about 90 nanometres (billionths of a metre) across—around a millionth the volume of the sort of cells it infects in the human lung. It contains four different proteins and a strand of rna—a molecule which, like dna, can store genetic information as a sequence of chemical letters called nucleotides. In this case, that information includes how to make all the other proteins that the virus needs in order to make copies of itself, but which it does not carry along from cell to cell.
The outer proteins sit athwart a membrane provided by the cell in which the virion was created. This membrane, made of lipids, breaks up when it encounters soap and water, which is why hand-washing is such a valuable barrier to infection.
The most prominent protein, the one which gives the virions their crown- or mine-like appearance by standing proud of the membrane, is called spike. Two other proteins, envelope protein and membrane protein, sit in the membrane between these spikes, providing structural integrity. Inside the membrane a fourth protein, nucleocapsid, acts as a scaffold around which the virus wraps the 29,900nucleotides of rna which make up its genome.
First contact between a virion and a cell is made by the spike protein. There is a region on this protein that fits hand-in-glove with ace2, a protein found on the surface of some human cells, particularly those in the respiratory tract.
ace2 has a role in controlling blood pressure, and preliminary data from a hospital in Wuhan suggest that high blood pressure increases the risks of someone who has contracted the illness dying of it (so do diabetes and heart disease). Whether this has anything to do with the fact that the virus’s entry point is linked to blood-pressure regulation remains to be seen.
Once a virion has attached itself to an ace2 molecule, it bends a second protein on the exterior of the cell to its will. This is tmprss2, a protease. Proteases exist to cleave other proteins asunder, and the virus depends on tmprss2 obligingly cutting open the spike protein, exposing a stump called a fusion peptide. This lets the virion into the cell, where it is soon able to open up and release its rna (see diagram).
Coronaviruses have genomes bigger than those seen in any other rna viruses—about three times longer than hiv’s, twice as long as the influenza virus’s, and half as long again as the Ebola virus’s. At one end are the genes for the four structural proteins and eight genes for small “accessory” proteins that seem to inhibit the host’s defences (see diagram). Together these account for just a third of the genome. The rest is the province of a complex gene called replicase. Cells have no interest in making rna copies of rna molecules, and so they have no machinery for the task that the virus can hijack. This means the virus has to bring the genes with which to make its own. The replicase gene creates two big “polyproteins” that cut themselves up into 15, or just possibly 16, short “non-structural proteins” (nsps). These make up the machinery for copying and proofreading the genome—though some of them may have other roles, too.
Once the cell is making both structural proteins and rna, it is time to start churning out new virions. Some of the rna molecules get wrapped up with copies of the nucleocapsid proteins. They are then provided with bits of membrane which are rich in the three outer proteins. The envelope and membrane proteins play a large role in this assembly process, which takes place in a cellular workshop called the Golgi apparatus. A cell may make between 100 and 1,000 virions in this way, according to Stanley Perlman of the University of Iowa. Most of them are capable of taking over a new cell—either nearby or in another body—and starting the process off again.
Not all the rna that has been created ends up packed into virions; leftovers escape into wider circulation. The coronavirus tests now in use pick up and amplify SARS-CoV-2-specific rna sequences found in the sputum of infected patients.
Because a viral genome has no room for free riders, it is a fair bet that all of the proteins that SARS-CoV-2 makes when it gets into a cell are of vital importance. That makes each of them a potential target for drug designers. In the grip of a pandemic, though, the emphasis is on the targets that might be hit by drugs already at hand.
The obvious target is the replicase system. Because uninfected cells do not make rna copies of rna molecules, drugs which mess that process up can be lethal to the virus while not necessarily interfering with the normal functioning of the body. Similar thinking led to the first generation of anti-hiv drugs, which targeted the process that the virus uses to transcribe its rna genome into dna—another thing that healthy cells just do not do.
Like those first hiv drugs, some of the most promising SARS-CoV-2 treatments are molecules known as “nucleotide analogues”. They look like the letters of which rna or dna sequences are made up; but when a virus tries to use them for that purpose they mess things up in various ways.
The nucleotide-analogue drug that has gained the most attention for fighting SARS-CoV-2 is remdesivir. It was originally developed by Gilead Sciences, an American biotechnology firm, for use against Ebola fever. That work got as far as indicating that the drug was safe in humans, but because antibody therapy proved a better way of treating Ebola, remdesivir was put to one side. Laboratory tests, though, showed that it worked against a range of other rna-based viruses, including sars-cov, and the same tests now show that it can block the replication of SARS-CoV-2, too.
There are now various trials of remdesivir’s efficacy in covid-19 patients. Gilead is organising two in Asia that will, together, involve 1,000 infected people. They are expected to yield results in mid- to late-April. Other nucleotide analogues are also under investigation. When they screened seven drugs approved for other purposes for evidence of activity against SARS-CoV-2, a group of researchers at the State Key Laboratory of Virology in Wuhan saw some potential in ribavirin, an antiviral drug used in the treatment of, among other things, hepatitis c, that is already on the list of essential medicines promulgated by the World Health Organisation (who).
Nucleotide analogues are not the only antiviral drugs. The second generation of anti-hiv drugs were the “protease inhibitors” which, used along with the original nucleotide analogues, revolutionised the treatment of the disease. They targeted an enzyme with which hiv cuts big proteins into smaller ones, rather as one of SARS-CoV-2’s nsps cuts its big polyproteins into more little nsps. Though the two viral enzymes do a similar job, they are not remotely related—hiv and SARS-CoV-2 have about as much in common as a human and a satsuma. Nevertheless, when Kaletra, a mixture of two protease inhibitors, ritonavir and lopinavir, was tried in sars patients in 2003 it seemed to offer some benefit.
Another drug which was developed to deal with other rna-based viruses—in particular, influenza—is Favipiravir (favilavir). It appears to interfere with one of the nsps involved in making new rna. But existing drugs that might have an effect on SARS-CoV-2 are not limited to those originally designed as antivirals. Chloroquine, a drug mostly used against malaria, was shown in the 2000s to have some effect on sars-cov; in cell-culture studies it both reduces the virus’s ability to get into cells and its ability to reproduce once inside them, possibly by altering the acidity of the Golgi apparatus. Camostat mesylate, which is used in cancer treatment, blocks the action of proteases similar to tmprss2, the protein in the cell membrane that activates the spike protein.
Not all drugs need to target the virus. Some could work by helping the immune system. Interferons promote a widespread antiviral reaction in infected cells which includes shutting down protein production and switching on rna-destroying enzymes, both of which stop viral replication. Studies on the original sars virus suggested that interferons might be a useful tool for stopping its progress, probably best used in conjunction with other drugs
Conversely, parts of the immune system are too active in covid-19. The virus kills not by destroying cells until none are left, but by overstimulating the immune system’s inflammatory response. Part of that response is mediated by a molecule called interleukin-6—one of a number of immune-system modulators that biotechnology has targeted because of their roles in autoimmune disease.
Actemra (tocilizumab) is an antibody that targets the interleukin-6 receptors on cell surfaces, gumming them up so that the interleukin-6 can no longer get to them. It was developed for use in rheumatoid arthritis. China has just approved it for use against covid-19. There are anecdotal reports of it being associated with clinical improvements in Italy.
While many trials are under way in China, the decline in the case rate there means that setting up new trials is now difficult. In Italy, where the epidemic is raging, organising trials is a luxury the health system cannot afford. So scientists are dashing to set up protocols for further clinical trials in countries expecting a rush of new cases. Dr Farrar said on March 9th that Britain must have its trials programme agreed within the week.
International trials are also a high priority. Soumya Swaminathan, chief scientist at the who, says that it is trying to finalise a “master protocol” for trials to which many countries could contribute. By pooling patients from around the world, using standardised criteria such as whom to include and how to measure outcomes, it should be possible to create trials of thousands of patients. Working on such a large scale makes it possible to pick up small, but still significant, benefits. Some treatments, for example, might help younger patients but not older ones; since younger patients are less common, such an effect could easily be missed in a small trial.
The caseload of the pandemic is hard to predict, and it might be that even a useful drug is not suitable in all cases. But there are already concerns that, should one of the promising drugs prove to be useful, supplies will not be adequate. To address these, the who has had discussions with manufacturers about whether they would be able to produce drugs in large enough quantities. Generic drug makers have assured the organisation that they can scale up to millions of doses of ritonavir and lopinavir while still supplying the hiv-positive patients who rely on the drugs. Gilead, meanwhile, has enough remdesivir to support clinical trials and, thus far, compassionate use. The firm says it is working to make more available “as rapidly as possible”, even in the absence of evidence that it works safely.
In the lab, SARS-CoV-2 will continue being dissected and mulled over. Details of its tricksiness will be puzzled out, and the best bits of proteins to turn into vaccines argued over. But that is all for tomorrow. For today doctors can only hope that a combination of new understanding and not-so-new drugs will do some good. ■
Dig deeper:
This article appeared in the Briefing section of the print edition under the headline "Anatomy of a killer".
Local residents queue to fill buckets and containers with water at a communal tap in Empompini in Cowdray Park, Bulawayo, Zimbabwe, on Saturday, Aug. 3, 2019. (Photo: Cynthia R Matonhodze/Bloomberg/Getty Images) Less
We have a transport crisis in Zimbabwe.
The other option for public transport users is tiny cars (second-hand Honda Fits imported from Japan), that operate as pirate taxis and ferry at least six passengers per trip instead of the 3-4 passengers they were designed for. Daring operators add two more passengers in the car boot to increase their load per trip to eight or nine passengers. In these little taxis, people sit on each other, cough on each other, sneeze into each other’s faces, touch each other and sweat on each other.
We have a water crisis in Zimbabwe.
The majority of Zimbabweans in both rural and urban areas have no access to running water. We fetch water from rivers, boreholes and wherever else we can. In cities, people can go for days without water. The excuses by the government for failure to provide adequate water and sanitation services vary from shortage of chemicals, to lack of damning infrastructure, to drought. Lack of access to clean water cost thousands of Zimbabweans their lives during the cholera outbreak of 2018.
We have an unemployment crisis in Zimbabwe.
Independent statisticians have put it at above 90%. Many Zimbabweans have resorted to vending and various forms of self-employment in the informal sector. We have markets that house in the same vicinity: hardware hubs, carpentry workshops, car washes and vegetable markets … our towns and cities seem to have long abandoned town planning as wherever you go, there is someone selling something on the pavements, in street corners and in flea markets.
These areas are overcrowded and have no “real” infrastructure, so many have no toilets and no running water. Food, clothes, car parts and whatever you can think of, are sold wherever, whenever by whoever.
At a personal level, Zimbabweans cannot do much to prevent contracting or spreading Covid-19. There is no chance that people will social distance while jostling for mealie-meal or in overcrowded buses. There is no chance that we can correctly, constantly and consistently wash our hands under running water. There is no chance, unless literally at gunpoint, that Zimbabweans living from hand to mouth, will stay at home.
What will we eat?
At a national level, the situation is just as hopeless.
We have a production crisis in Zimbabwe.
As a country, we produce very little. Most of our groceries and clothes are imported. The closing of borders to Malayitshas and cross border traders will plunge the country into a serious shortage of basic commodities, from toiletries to food.
A lockdown will also be difficult to enforce as very few Zimbabweans have the capacity to buy food supplies for 21 days. Unless households are given food, it will be impractical to have a lockdown. People have to be able to leave the house every morning to hustle for money to buy food. Whatever most vendors make per day is for that night’s and the next day’s meals.
We have a health crisis in Zimbabwe.
Zimbabwean doctors have been complaining about the incapacitation of hospitals for years now. In 2019, they went on strike for months explaining that because they were not earning decent salaries, they could not even afford to transport themselves to and from work, and to feed themselves and their families.
Central to their grievances, was the state of the hospitals and lack of equipment. The doctors explained that our hospitals are dilapidated and unequipped for the core business of treating patients. They said there were no surgical gloves in hospitals, no disinfectants, no drugs – nothing basically to help them do their jobs of treating the sick. They said they were frustrated and tired of going to work to preside over senseless, and preventable deaths due to hospitals’ incapacitation.
In response to their grievances, the government fired doctors en masse.
Using the Zimbabwe ‘health system’: Real life experiences
In January 2020r, I took my cousin to our local hospital and they refused to treat her because she did not have the $140 consultation fee. Her mother is a teacher and at the time earned $1,000, an amount that could only buy her a combination of 30 loaves of bread at $15 each ($450), 10kg of mealie-meal at $150 and 5kg of meat. There was no chance she would have $140 lying around for emergencies such as this one. We sourced the money and paid, only to be told there was no doctor available and she would have to return the next day, despite her case being an emergency.
This was how dire the situation was for hospitals, health personnel and patients prior to Covid-19 landing in Zimbabwe. Now that we are faced with the possibility of an outbreak, what chance does Zimbabwe have?
We have already heard that doctors and nurses have gone on strike until they are given adequate personal protective equipment (PPE) to deal with the virus. Wilkins Infectious Diseases hospital, Harare’s isolation centre was shut down, reportedly for renovations, on 27 March 2020. It is clear that our health sector is at present unable to handle the looming Covid-19 outbreak.
On 20 March 2020, I posted this thread on twitter :
#Sigh. So Gwanda hospital has people exhibiting #Covid_19 symptoms,
Spoke to some,
Who said they’ve been investigated & cleared,
I’m like wow!
So fast?
Turns out no tests done,
There are no test kits at the hospital,
Investigation was verbal
#ZanuPfMustGo
They don’t even at the very least,
Have soaps for hand washing in the bathrooms.
They have face masks thou,
But that’s hardly enough.
There are kids with pneumonia,
Nurses says there’s a pneumonia “outbreak”.
#ZanuPfMustGo”
An hour after I posted the tweets about the suspicious cases, the Minister of Health was on national TV announcing Zimbabwe’s first (official) Covid-19 positive patient.
We have a propaganda crisis in Zimbabwe.
This has led to trust issues between the people and the state. We have no idea what part of the news reported by state media is factual and what part is misinformation? Up to that point, the government had been insisting that we had no positive cases yet in the country. A declaration many found to be suspicious considering the fact that by 20 March 2020, nearly 100 people had already tested positive in neighbouring South Africa.
Also, a Chinese woman exhibiting Covid-19 symptoms died on her way to Wilkins Hospital, but authorities insisted she had not died of Covid-19. A British tourist to the Victoria Falls, who had fallen ill while still in Zimbabwe, had tested positive once he got back to England. Namibia had also announced that someone who had tested positive in Namibia had come from Zimbabwe two days before. Add the fact that we were still letting people from all over the world come in and out of the country at will, and it was puzzling how we had got to be so lucky. Many thought the government of Zimbabwe was not being honest.
The next morning, Nelson Chamisa, leader of the opposition MDC, announced on his Twitter page that two more people had tested positive for the virus. Government was then forced to make a statement, but they claimed only one more person had tested positive and the other patient’s results were inconclusive.
It became apparent to many that the government was withholding information.
The death of Zororo Makamba
On 23 March 2020, we were shocked to hear of the death of Zororo Makamba, a 30-year-old pro-government journalist and son of James Makamba, a businessman and a former Zanu-PF member of parliament. He had succumbed to Covid-19. One wonders at what point the government discovered he was positive and why they had not informed the nation. Had Nelson Chamisa not spilled the beans, would they have told us?
How many more people have died or recovered from the virus that the government is hiding?
Zororo is said to have landed at the Robert Mugabe International airport from New York on 10 March. He is alleged to have recorded a high fever upon entry. Airport staff wanted to detain him, but Zororo allegedly called someone who apparently then instructed airport officials not to quarantine him and he was allowed to leave the airport, unleashing Covid-19 on an unsuspecting public.
He had several meetings over the next few days, including with someone from the office of the president and cabinet as well as someone from the ministry of finance. Speculation is high that he was chasing payment for his propaganda videos. He was also seen at Pablos nightclub, a high-end club in Borrowdale where the country’s rich kids (read Zanu-PF kids) party.
I posted this on Twitter after Zororo’s death:
Expects us to believe,
To accept,
That from the 10th of March when Zororo landed in Harare,
Going through customs,
On the drive home,
Reunions with loved ones,
Before he fell sick,
During his illness,
Until his death,
He didn’t infect anyone?
#ZanuPfMustGo”
Even after interacting with many people from the day he landed, the government is mum on who else was infected by Zororo, or at least suspected to have been infected. Since his death, three more people have tested positive, but the nation is yet to be given details on the new infections.
It is said Covid-19 is more infectious than the flu. In other countries, it is spreading like a wildfire. We have heard of South Korea’s “patient 31”, whose case explains just how infectious this virus is, but the government of Zimbabwe expects the nation to believe that Zororo, who was allowed to roam around freely despite exhibiting symptoms, did not infect other people.
Zororo’s brother told the nation that staff at Wilkins Hospital were afraid of being around Zororo. He alleges that they would leave him unattended for hours and Zororo would call home telling them he was not being attended to. They were helpless because they were not allowed into the hospital. He says the doctor in charge switched off his phone.
According to Zororo’s brother, Wilkins Hospital has no ventilators and even after they sourced one privately, the hospital failed to use it as there were no compatible electrical sockets in the hospital. The family apparently called the president to intervene, but even that could not save Zororo.
One wonders if one so monied and well connected could not get treatment, do ordinary Zimbabweans have a chance?
We have a corruption crisis in Zimbabwe.
The story of Zororo Makamba is a sad, but illuminating tale. It is appalling that we are led by people who, as a “favour” can allow someone exhibiting one of the most telling symptoms of Covid-19 to avoid quarantine. It illuminates the dangerous privilege, corruption, negligence, abuse of power, elite capture of institutions, failure and collapse of health institutions, the gap between the rich and the poor, and the absolute lack of readiness by Zimbabwe to deal with Covid-19 or any other crisis for that matter – much the same way the government failed to deal with Cyclone Idai, drought, cholera and typhoid before. It exposes the extent to which the government of the day is unsuitable to rule.
We have a leadership crisis in Zimbabwe.
Covid-19 is exposing the failure of Zimbabwe as a state and the disaster that is Emmerson Mnangagwa. The current leaders are insensitive and completely detached from the suffering of the masses. In a clear display of cluelessness, instead of coming up with a context specific message, the president copied and pasted the general “how to prevent coronavirus” message on his Twitter feed.
He advised us to practice social distancing. Does he know, or care about the mealie-meal shortage and transport situations?
He advised washing of hand. Does he know we have no water?
He says people must stay at home, but he then immediately got on a flight to Namibia.
How does he expect this to work when we survive on odd jobs and vending? The president must first address these pertinent issues and tailor a strategy to curb Covid-19 that takes those issues into consideration.
Wilkins Hospital reportedly asked the government for $6.7-million to get the hospital ready for Covid-19, but they were apparently only allocated a mere $100,000.
During that time, Mnangagwa flew to Namibia (for the presidential inauguration), on a hired private jet that flew from Dubai to Harare to take him on the hour-long trip to Namibia. How does one explain such gross extravagance at a time when the nation is facing an outbreak our hospitals cannot handle? Around that time, Mthuli Ncube, Mnangagwa’s Minister of Finance, was also gallivanting in Europe where pictures of him shaking people’s hands were taken. Was he quarantined upon return?
A day after the shipment of donations from Jack Ma landed in Zimbabwe, pictures of Mnangagwa holding a meeting of people wearing Zanu-PF regalia and face masks circulated on social media? Where did they get the masks? At a time when doctors and nurses have no personal protective equipment, they saw it fit to waste the scarce masks on themselves.
What a shame.
We have a marginalisation crisis in Zimbabwe.
Covid-19 is also exposing the extent to which the Zanu-PF government has been marginalising many parts of the country – most rural areas and all of Matebeleland since 1980. As it is, the government is in a panic and trying to refurbish Wilkins Hospital, and accused of getting an elitist Covid-19 centre ready for the ruling political elite.
What about the rest of the country?
The whole of Matebeleland province only has Thorngrove Hospital, a rundown infectious diseases hospital that has no capacity to handle any illness. So where is the rest of Zimbabwe going to go if the virus spreads? We cannot all go to Harare.
We have a political crisis in Zimbabwe.
Because the government is guilty of neglecting their mandate to provide public goods, they are going out of their way to hide information about the extent of infections in Zimbabwe. In their 40 years of power, Zimbabwe has failed to build hospitals and clinics, or to maintain the hospitals built by the Rhodesians. They let the health systems completely crumble and if Covid-19 hits Zimbabwe as badly as we fear, it will be entirely their fault. Millions of people are going to suffer and thousands risk dying unnecessarily because of the state of our health sector.
Because of all these crises, Zimbabwe is an unfolding disaster. The government, which has misgoverned the country for decades, has neither capacity nor desire to deliver on matters of national and public interest. They just do not care.
My only prayer is that geographical and environmental factors like our weather, the age of people concentrated in the cities and sheer luck will protect us. This is a terrible, frightening and also infuriating situation. We have no reason to be experiencing this uncertainty. Covid-19 may be a natural disaster, but if it spreads in Zimbabwe, its effects will be entirely man-made.
God save Zimbabwe. MC
Thandekile Moyo is a writer and human rights defender from Zimbabwe. For the past four years, she has been using print, digital and social media (Twitter: @mamoxn) to expose human rights abuses, bad governance and corruption. Moyo holds an Honours degree in Geography and Environmental Studies from the Midlands State University in Zimbabwe.
Prudential today announced a cash payout to its customers, should they unfortunately be diagnosed with Covid-19.
In a statement, the life insurance firm said the pay-out is intended to help their family manage expenses while they are in recovery.
In addition, the firm said, if a customer is admitted to a hospital with Covid-19, Prudential will provide a daily allowance at no extra cost to the client.
“Covid -19 is impacting everyone and all aspects of our lives. In times of uncertainty, it is important that an insurer deliver on its promises. For nearly two centuries, Prudential has been standing up for clients and communities in good times and bad, and we stand with Uganda in this challenging time”, said Arjun Mallik, managing director, Prudential East Africa.
He said the Covid 19 cover is applicable to all Prudential clients with a Pru Edusave or Prudential medical card, with in-force policies (up to date premiums). New clients who join within the next 45 days, will also be covered under this scheme. Tests need to be conducted from ‘Ministry of Health’ approved testing centres’’ Arjun added.
Kaddunabi Lubega, CEO, Insurance Regulatory Authority said the gesture was a true exhibition of the ability of life insurance to help protect Ugandans in uncertain times and, as a regulator of the insurance sector.
“I commend Prudential Uganda for continuing to cover their clients during this pandemic and providing an extra service to Ugandans at no extra cost.”.
Rome (CNN)Medical student Chiara Bonini, 26, had barely finished her final exam, before the young doctor was headed for the front line of Italy's coronavirus pandemic.
A sign alerts people to the closure of a beach, due to Covid-19, in Lisfannon, north Ireland, on March 28, 2020. PHOTO | PAUL FAITH | AFP
If you were of schoolgoing age in 1939 when World War II broke out, you would be a longevous octogenarian in 2020.
And now for the third time in history we are engaged in worldwide warfare. This round against the invisible scourge, aka the Great Social Leveller that is Covid-19.
So for the under-87s among us, the essay question today is: Compare and contrast WW II and WW III.
First, the good news. Although we have become home-based refugees, I would suggest the daily commute from bedroom to living room (now converted into a joint office/classroom) is not quite the same as fleeing for your life to escape an armed front.
In fact, a lucky few among us may still be providing value over a Zoom video call and getting paid for it.
In the world of winners, Safaricom has transcended to a league of its own – as we endeavour to maintain our status as social animals.
Regrettably, similar to WW II, the ratio between winners and losers will be one to many.
AGGRESSIVE CAMPAIGN
The rose as the gift that says ‘I love you’ appears to have been replaced by hand sanitiser and thousands of workers are now unemployed in Kenya’s flower farms.
Your favourite barber has no customers due to difficulties in plying their trade as per the recommended social-distancing guidelines.
If you work at KQ, you likely had a pay cut. If you work at a hotel, you can anticipate unpaid leave, in the best case.
The big unknowns here are: how long will this last? Will I live or die? (likely at less than three per cent mortality, the answer is yes, especially if we can #FlattenTheCurve).. but can we subsist on significantly lower or zero income?
To solve for “t”, time, let’s recall that from its first case in early December 2019, it has taken China just over three months of aggressive actions to reverse the build-up of new infections.
Note that this is a country that can track every one of its 1.4 billion citizens as soon as they step out of their front door through an extensive CCTV network utilising Artificial Intelligence and facial recognition.
For the Chinese, tracking an errant populace disobeying a lockdown becomes a more scientific exercise than the Italian mayors' ranting and swearing accompanied by Mafiosi-style threats to their constituents on broadcast TV.
COURSE OF ACTION
Ergo, it will likely take the world a substantially longer time to delay disease spread with the accompanying economic collateral damage.
In the case of World War II, it started off with a seemingly contained altercation between Germany and Poland.
This grew to encompass the whole world, with both the Allies and Axis thinking they would decimate the other within a matter of weeks. It lasted 312 weeks.
Learning from the above, stocking up, if you can, is a logical course of action.
Now the caveat to this is unless you are a professional Doomsday hoarder, it is unlikely you will have bought enough for a multi-year siege.
And a couple of tips here: remember toilet paper is not a necessity to live; secondly, don’t forget crops grow in cities, too, so if things become dire - no unpaved ground is sacrosanct!
This is war and we need to adopt a ‘war economy’ approach on a global scale.
GLOBAL TEAMWORK
During World War II, the US government brought together private companies to ramp up production of ships, tanks, bombers.
At present, the world does not have enough armaments against ‘the coronavirus’ - such as testing kits, ventilators, drugs, masks and so on.
The heavy lifting required is akin to the Marshall Plan provided to Western Europe in the post WWII era.
In Britain, Her Majesty’s Chancellor of the Exchequer has literally provided a blank cheque to ensure markets do not collapse and businesses avoid bankruptcies.
As we brace ourselves for the next several months, every country will need to dip into its national piggy-bank, to ensure families can secure their daily ugali na sukuma and buy recession-proof school shoes when the time comes.
Lest we forget, though, this is a universal threat that requires everyone to act.
It’s about fighting this shoulder to shoulder on the beaches of Normandy; it’s not about preserving short-term liberties for countries, corporations and citizens; it’s about survival for the long-term.
The author is the Managing Partner of C.Suite Africa; adema.sangale@csuiteafr.com
