My name is Swati Madankumar and I am a rising junior majoring in Medicine, Literature, and Society. On April 10, 2020, I submitted this article/essay for the spring issue of the Barnard Bulletin, Barnard’s monthly magazine. [As of publication date, the Spring Barnard Bulletin has not been released.]


Scratching the Surface: The Origins and Outlook of the Silent Killer
It happened almost in slow motion. Wuhan, China fell under the international limelight in January, but Wuhan felt too far away for us to believe we should pay a little more attention. A small minority of people on campus wore masks throughout February and the first half of March, but not enough for most to think that they were the ones doing it right. But on March 7th, Governor Andrew Cuomo declared New York to be in a state of emergency. Westchester became New York’s epicenter, then Manhattan and Elmhurt in Queens. Now, daily death tolls are staggering and the only way to really feel grounded in what’s happening outside a state of quarantine. But there are so many questions. What is coronavirus and where exactly did it come from? Why is a nation with supposedly one of the best healthcare systems and scientific capacities being brought to its knees? How have the nation’s priorities come into view as the pandemic shifts and exposes them? What is on the horizon? These are issues that are discussed repeatedly on the news, especially during New York’s Cuomo’s daily briefing, but that I, and I’m sure many others, don’t feel adequately knowledgeable about.
The COVID-19 outbreak wasn’t too surprising, says coronavirus expert Professor Simon Anthony from Columbia’s very own School of Public Health. Seven coronaviruses have been identified in humans and as coming from animals over the years, four of which regressed into customary seasonal flu or cold and three of which mutated into life-threatening respiratory diseases and human health disasters: SARS, MERS, and SARS-Cov-2. Certain regions of the world are deemed ‘hotspots’ for coronaviruses, likely due to their abundance of bats that carry the virus. According to the Guardian, the stock story is that SARS-Cov-2 came from the pangolin, an animal that resembles an armadillo and is housed at the Huanan Seafood Market in Wuhan. It’s highly valued for the supposed medicinal properties of its scales, but its trade is actually illegal. Yet, scientists seem to say that it first came from bats, then went to the pangolin, before jumping onto humans. The uncertainty arises from 1) the fact that different variants of the virus have been found between pangolins and humans, suggesting mutation and 2) whether the first true case of the virus arose from exposure to the market in Wuhan.
The US has adopted war-like measures against the virus: travel bans, trade bans, requisitioning industries to make personal protective equipment, and instituting drastic quarantine and social isolation measures, drawing upon lessons learned from the influenza pandemic in 1918. Yet, the casualties of the virus don’t match the preparedness of the nation to fight it. The reason, according to the Washington Post: delay. The government first heard about the outbreak in China on January 3rd, but it took two months for productive agreement and coordination between the government and agencies like the CDC, Department of Health and Human Services, NIH, and FDA to make use of funding to develop tests that healthcare professionals could use to isolate and identify the infected as well as know how to most efficiently channel existing resources. Also contributing to this lapse was China’s denial of human-to-human transmission of the virus and withholding of samples of the virus that the US could use to make diagnostic tests. As a result, the situation in countries like China and Italy became the reality for the United States.
The scary thing about SARS-Cov-2, and what distinguishes it from more recent outbreaks, is that it is novel– no one has immunity to it. The current serologic testing for SARS-Cov-2 looks for antibodies in blood plasma, which are only created by one’s immune system 5-10 days after one has acquired the virus, but not even necessarily had symptoms. It can provide a whole host of information pertaining to degree and duration of immunity post-COVID-19 as well as how to harness the response of the immune system to the virus therapeutically. In the meanwhile, Harvard Medical School reports that there is a swath of antiviral treatments and other drugs being tested against SARS-Cov-2–chloroquine, hydroxychloroquine, remdesivir, which worked against SARS and MERS, and high-dose Vitamin C– although none have been solidly confirmed and clinically recommended.
So where are we in the oft-cited ‘curve’ of the outbreak? It’s difficult to say, as the virus hit different states at different times, the measures in each state are different, and hospital records may not be complete. According to the New York Times, New York and New Jersey have had more deaths than in the rest of the US altogether and New York has had more positive test results than any other country outside the US. Yet, the curve of infection in New York is flattening. Regardless, the availability of personal protective equipment and testing, adherence to the civic duty of self-quarantining and socially distancing, as well as the accuracy of the messages that are being transmitted to the public on high-profile platforms will dictate the course of this disease in America, besides the things we can’t control: the seasonality of the virus and our immunity to it. Even if all these boxes are checked, disease director Dr. Anthony Fauci says it could be four weeks to three months for the pandemic to be contained, according to the Atlantic. As long as the outbreak is occurring, disparities in sickness, the hit the economy is taking, and mental health problems will exist.
This killer virus operates quickly and silently– which has shockingly caused it to be associated with more deaths despite a lower fatality rate than SARS and MERS– and sadly thrives on what normally makes us healthier: human connection. While for many of us, this presents a relatively harmless opportunity to rediscover new passions and foster a greater appreciation for what has been withdrawn so fast and dramatically from us, it is important to know how and why we are in this situation and how we may be able to climb out of it.
Sources consulted: Harvard Medical School, Columbia Mailman School of Public Health, The Atlantic, The Guardian, CNN, The Washington Post, Scientific American
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