Covid-19 Scientific Communication

In one of the most critical moments of the history of our Republic at economic, social and health level as a citizen of Reggio Calabria, as a citizen of Italy and as a citizen of Europe, I feel obliged to contribute by sharing my studies and scientific researches with my contacts. I will try to be supportive through a scientific communication aimed at fighting against misinformation and fake news that are spreading out harmfully.

- Antonino Napoleone

𝟏. 𝐂𝐨𝐯𝐢𝐝-𝟏𝟗: asymptomatic cases and incubation period.

The first case of COVID-19 (Coronavirus disease – 2019) was reported by Chinese authorities to WHO on 31 December 2019 from a patient affected by viral pneumonia in Wuhan, China. To date, March 21, 2020, exactly one month from the first Italian case detected in Lombardia, 47,021 cases are registered in Italy, 284,566 cases worldwide distributed in 166 countries. This led the WHO to the decision on 11 March 2020 to announce the COVID-19 outbreak a pandemic. Recent large-scale studies show that 5% of cases positive for the virus develop critical symptoms, 14% develop severe symptoms, while 81% show mild symptoms. In the latter category, there is not always or not completely need to run a diagnostic test, which could mean that the number of infected people can be “n” times higher than official epidemiological data. These do not include asymptomatic and pre-symptomatic cases. Even though they do not present any significant symptoms, they represent a widespread and unsuspecting source of infection. This makes the pandemic management and containment a real challenge. Hence the WHO recommendations to increase as much as possible the identification and diagnosis of suspected cases or symptomatic contacts of confirmed cases. The incubation period is on average of 5-7 days with a maximum of 14 or even 17 days until the development of mild to severe symptoms highly influenced by factors such as gender, age, pre-existence of chronic pathological conditions (diabetes, chronic respiratory diseases, cardio-cerebrovascular diseases). The stringent containment measures adopted by the Italian government on 11 March 2020 and taken as a model in different times and ways by the other European governments aim to limit the spread of the virus, limiting contact between asymptomatic cases, pre-symptomatic cases and the categories most at risk mentioned above. Staying at home, closing schools and universities, canceling social events, cutting flights and train/bus travels, suspending the Schengen agreement, intensifying hygiene measures are all aimed at saving lives and avoiding saturating hospitals already on the verge of collapse in the most affected areas. We are the cradle of Western civilization, beauty and culture, Europe and the world will look at us and admire us when we will soon rise again. Please respect the rules together and share and have faith in medical sciences rather than the media, we all need to work together to stop all of this.

Antonino Napoleone

References :

1. https://systems.jhu.edu/
2. https://doi.org/10.1186/s13578-020-00404-4
3. https://doi.org/10.1002/jmv.25776
4. World Health Organization (2020, March).
5. https://doi.org/10.1017/ice.2020.81
6. DPCM dell’11 Marzo 2020

2. Covid-19: Persistence of the virus in the environment and on surfaces.


To date, March 23, 2020, there are 372,563 cases registered worldwide distributed in 168 countries, 63,927 only in Italy, of which 50,418 are currently active. This new human coronavirus has been named Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) to distinguish it from other previously known forms of human coronavirus. Human-to-human transmission is mainly transmitted by respiratory droplets of saliva or by self-inoculation in the eyes, nose or mouth due to contact with contaminated surfaces. Investigations carried out by several studies on human coronaviruses, such as SARS-CoV-2, reveal that these viruses are able to persist on surfaces such as metal, glass or plastic for up to 9 days, but can be easily inactivated in few seconds by common disinfection procedures based on products containing 70% ethanol (like common hand sanitizers), 0.5% hydrogen peroxide and 0.1% sodium hypochlorite (bleach). There are different factors that influence the persistence of the virus in environments or surfaces, and among these, it has been seen that high temperatures (between 30°C and 40°C) drastically reduce the persistence of the virus in environments compared to lower temperatures (4°C) and that factors such as high humidity instead increase it. A recent study published in the New England Journal of Medicine analyzed the stability of SARS-CoV-2 at room temperature (21°C) and 40% relative humidity under five different environmental conditions (air, plastic, steel, copper, and cardboard). It was found that the virus can remain in the air for about 3 hours with minimal reduction of the viral load. No virus presence was detected on copper and cardboard surfaces after 8 and 24 hours respectively. In contrast, the active virus was detected after 72 hours on plastic surfaces and after 48 hours on steel surfaces, although the viral load was significantly reduced over time. Of course, there are several factors to be taken into accounts such as the source of the virus (symptomatic patients, asymptomatic patients) and the environmental contexts of daily life. The restrictions applied aim to limit the places of social interactions, but at the same time, they are concentrated on supermarkets, pharmacies, and groceries. This virus is not transmitted by contact, so intensifying procedures for disinfection and sanitization of public and private environments as well as good hand hygiene when outside the home, are key strategies to reduce drastically the spread and the presence of SARS-Cov-2 in cities. Simple strategies, but incredibly effective. Share and have faith in medical sciences rather than the media, we all need to work together to stop all of this. 

 

Antonino Napoleone
Domenico Gangemi
Giuseppe Scarlata

References:
1. https://systems.jhu.edu/
2. https://doi.org/10.1016/j.jhin.2020.01.022
3. http://jamanetwork.com/article.aspx?doi=10.1001/jama.2020.3227
4. https://www.nejm.org/doi/full/10.1056/NEJMc2004973

3. Covid-19: Was the virus truly created in the laboratory?

To date, 28 March 2020, 652,079 cases of Coronavirus Disease-19 (Covid-19) are registered worldwide, of which 92,472 only in Italy, that dramatically reaches 10,023 victims since the beginning of the pandemic. The new Severe Acute Respiratory Syndrome Human Coronavirus (SARS-Cov-2) first emerged in Wuhan, China, in December 2019, and it spread to 177 countries around the world in less than 5 months, destabilizing the daily life of millions of people and alarming the public opinion shocked by the exponential increase in the number of infections and by the increase in the number of victims. SARS-Cov-2 is the seventh known coronavirus able to infect humans, preceded by the well-known SARS-CoV and MERS-CoV, and the lesser-known HKU1, NL63, OC43, and 229E. The Wuhan Institute of Virology, founded in 1956 in collaboration with the Chinese Academy of Sciences, represents a worldwide Centre of excellence for the study of human and animal coronaviruses and it has recently been at the middle of a media storm for the presumed bio-engineering of SARS-CoV-2, where the deliberate or accidental spread in the environment would have resulted. The techniques for engineering a microorganism are well established in scientific practice and these are, for example, the basis for the development of many drugs and vaccines in use. These are generally performed starting from the genome (DNA or RNA) of already known and isolated microorganisms, to which experimental modifications are then applied. If SARS-CoV-2 had been created in the laboratory, it would have been easy to identify the laboratory techniques used by scientists to manipulate the virus genome. Furthermore, SARS-CoV-2 is unlikely to have been created in the laboratory for several scientifically proven reasons. Researchers from several countries around the world (including Italy) have isolated the virus, sequenced and analyzed the genome and universally concluded that SARS-CoV-2 originated in nature. According to the renowned journal Nature, the plausible scenario that would explain the virus origin would be the natural selection of the virus in an animal host before transmission in humans. In fact, the SARS-CoV-2 sequence recently published in Lancet shares a high similarity (96%) with the bat coronavirus sequence. Another high similarity was found with the pangolin coronavirus sequence from which SARS-CoV-2 could have jumped species boundaries acquiring mutations that would have increased its virulence in humans.

The similarity with other human coronaviruses such as SARS-CoV and MERS-CoV are 79% and 50% respectively. For instance, if the viral genome of two Covid-19 patients were sequenced, the similarity of these two sequences would be over 99%, so the higher this similarity, the more likely there is a close relationship and/or derivation. The same principle is applicable to the direct connection of the human genome with that of the chimpanzee with 98% similarity, from which the common evolutionary process has been deduced. Where does the idea of connecting the genome of SARS-CoV-2 with that of bats come from? This was discovered by the Chinese scientist Shi Zhengli at the Wuhan Institute of Virology, who has been studying for years the characteristics of these viruses in bats and the possible risk of animal-human transmission. In the midst of a health emergency of this magnitude, it is conceivable that everyone wonders where the viral agent causing the current pandemic originated. The studies mentioned have refuted the widespread theories of manipulation and creation of SARS-CoV-2 in the laboratory, although further researches are needed to fully explain its high contagiousness as well as the mechanisms of animal-human transmission. Share and have faith in medical sciences rather than the media, we all need to work together to stop all of this. 

Antonino Napoleone
Domenico Gangemi
Giuseppe Scarlata

With the IT contribute of Antonino Barreca

Link to the previous articles:

References:

1.     https://doi.org/10.1038/s41591-020-0820-9 

2.     https://coronavirus.jhu.edu/map.html

3.     https://doi.org/10.1016/S0140-6736(20)30251-8

4.     https://doi.org/10.1002/jmv.25700

5.     https://doi.org/10.1080/22221751.2020.1738279 

6.     https://doi.org/10.1016/j.jaut.2020.102434 

7.     https://www.mdpi.com/1999-4915/11/3/210

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