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Covid-19 is a paradox. It is getting us to look over there when we should be looking here. The first paradox is that the drivers of the virus are those without symptoms. We need to find them. Why don't they get symptoms? Therein lies the clue to the vaccine. We need to test those who we would not usually test. They establish a chain reaction as detailed in the "Chain Reaction of Covid-19". Understanding the chain reaction is the key to beating the virus. The second paradox is that we have a vaccine but have not used it. The vaccine is to test and isolate the infected from the uninfected. Stay-at-home is no substitute for to test and isolate. The greatest spread is within families. Stay-at-home stops the spread outside the house but not the spread inside. There is a third paradox. The best ventilator is fresh air. A study of the SARS outbreak suggested hospitals with cross-ventilation from open windows may have prevented heath-care workers from being infected. We are locking ourselves inside when we need fresh air. We need to open the windows. The last paradox is the most contentious. As Man has more difficulty breathing, the planet appears to be breathing better. In every other measure other than the measures of Man, the planet appears to have become more sustainable.
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The Paradox of Covid-19
Kim R. Sawyer*
April 14 2020
Academics are supposed to write only after all data has been compiled. Covid-19 is a paradox.
A more complete explanation is given in The Chain Reaction of Covid-19.
Let us summarise
1. Testing those without symptoms
The secret to Covid-19 is that it hides better than other viruses. 95% of current active cases
have mild symptoms or no symptoms at all. The virus has power because it cannot be seen.
The virus depends on the asymptomatic. They are driving the virus. The secret is to find them.
Why don’t they get symptoms? It provides a clue to the vaccine.
Evidence for this is found in large samples, for example a sample of 18,000 in Iceland which
found 1% were infected.
One-half of those infected had no symptoms. We need to identify
the asymptomatic before they transmit the virus to the vulnerable. We are finding clusters too
late. The solution is to find those who spread the virus before they spread, rather than after
they have spread. We need to test those we would not normally test. It is a paradox.
We must move to mass testing but we do not have the resources to test the whole population.
So we need to sample just as we do with opinion polls.There are two types of sampling
(i) Random sampling
(ii) Cluster sampling
We have to identify the possible clusters before they form. Perforce we need to sample
nursing homes, households and population clusters like apartment complexes, but we really
have to sample the socially mobile. They are spreaders because of their mobility. That means
we must sample the young who may be infected but have no symptoms. We need to sample
those who we would not usually sample. It is the key to beating the virus. It is a paradox.
* Associate School of Historical and Philosophical Studies, University of Melbourne.
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2. Isolating the infected from their families
The second paradox of Covid-19 is in the isolation of the infected. One way to represent the
virus is by the symbolic representation
𝑆𝑝𝑟𝑒𝑎𝑑 = 𝑆𝑝𝑟𝑒𝑎𝑑 𝑤𝑖𝑡ℎ𝑖𝑛 ℎ𝑜𝑢𝑠𝑒ℎ𝑜𝑙𝑑𝑠 + 𝑆𝑝𝑟𝑒𝑎𝑑 𝑏𝑒𝑡𝑤𝑒𝑒𝑛 ℎ𝑜𝑢𝑠𝑒ℎ𝑜𝑙𝑑𝑠
Stay-at-home stops the spread between households; but the greatest spread may be within.
In China where Covid-19 began, 75 to 80 percent of all transmission was within families.
We can regulate outside the household but not within where the spread may be greatest.
South Korea solved the problem by isolating the infected away from their families in shelters.
We may further the spread by placing the asymptomatic and the uninfected together at home.
This is the second paradox of Covid-19.
3. More than one curve
We do not know how the virus started. We know it was first identified in Wuhan, and
possibly as early as mid-November.
We presume it was a transmission from a bat to a
pangolin to a human. Patient “0” will be one of the keys to understanding this virus.
Much has been discussed of flattening the exponential curve of the contagion. The curve is
the dominant factor but not the only factor. There is more than one curve even without
different types of intervention. There are two variations
(i) One variation depends on environmental factors like air quality, the spatial
distribution of the population, and cultural factors like how we greet each other.
Thailand is not the same as Italy. We will learn a lot more in years to come.
(ii) Like all viruses, the virus will return with new clusters and new waves. There will be
multiple waves, and not just a once-only. Viruses tend to be cyclical and seasonal.
Covid-19’s closest relatives among seasonal coronaviruses are OC43 and HKU1.
They transmit more efficiently in winter. Lipsitch (2020) expects Covid-19 to be the
For Australia, the main curve may be June to August rather than now.
There will have to be frequent re-testing as new clusters emerge. The incubation period can
be up to fourteen days. Norman Swan
has suggested re-testing three times over six-weeks.
But that is only the first round. Re-testing is necessary to find new clusters. Without a vaccine,
testing and isolating is the only way to prevent the uninfected from becoming infected.
The paradox is test and isolate is the vaccine. We just have failed to use it.
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4. Fresh air
Fresh air is the best ventilator. The testament to that is not from Covid-19, but from SARS.
During the 2003 outbreak of SARS, there was an important example, in Vietnam not China.
Sixty-one patients with SARS were hospitalised in two different hospitals, hospital A and B.
In hospital A, extensive transmission of SARS occurred to healthcare workers and visitors.
Five patients died. In hospital B, there was no transmission to health care workers or visitors.
No patient died in hospital B. There were 108 healthcare workers, and none became infected.
Hospital A was a modern air-conditioned hospital with closed windows. Hospital B had
spacious rooms, high ceilings, ceiling fans and large windows kept open for cross-ventilation.
There were other factors, but the evidence suggests the ventilation may have been important.
This is the evidence emerging in this outbreak. Cruise ships, planes and hospitals are where
the virus spreads, but possibly in apartment complexes where air quality may not be optimal.
The virus spreads easily indoors, not just coughing but through breathing and conversation.
According to the US Centers for Disease Control and Prevention, the virus spreads from
person to person when people are within about 6 feet of each other "through respiratory
droplets produced when an infected person coughs or sneezes but if you're outside, the
breeze will likely disperse it.
Indoors is where the virus spreads. The paradox is we are directing people to stay indoors.
We need to open the windows. We need to walk in the fresh air but not congregate.
5. The final paradox
The last paradox is the most contentious. As Man has more difficulty breathing, the planet
appears to be breathing better. With the lockdown of our civilisation, there have been
examples of better air quality over China, India, Europe, and more generally over the planet.
The Earth is quieter. The Earth is shaking a little bit less.
In every other measure other than
the measures of Man, the planet appears to have become more sustainable.
In The Descent of Man,
I advocated for Man to become a minimiser rather than maximiser;
for Man to co-exist with other species rather than exist for the self-interest of Man. I did not
anticipate or advocate this catastrophe. We are now caged as we have caged other species.
We are afraid as other species have been afraid of us. We are now prisoners of the unknown.
It is as if the universe has signalled to us the karma we have imposed on ourselves.
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The Prisoner
The prisoner of the body,
The incredible nothingness of the nobody,
The line in the floor, the key in the door,
Judged, with nothing but a conscience to implore.
The prisoner of the body,
The incredible nothingness of the nobody,
The being in the chair, the being without repair,
Bound, with nothing but hope and despair.
The prisoner of the body,
The incredible nothingness of the nobody,
The host and the virus, the host and the anti-virus,
Absorbed, with nothing but pride and prejudice.
The prisoner of the mind,
The spirit and its freedom left behind,
The tearing of the soul, the mind under other control,
Subordinated, with nothing but the need to be whole.
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Marc Lipsitch (2020)
Le Dang Ha et al (2004). “Lack of SARS transmission among public hospital workers,
Vietnam,” Emerging Infectious Diseases, 10(2), 265-268.
Sawyer, K.R. (2019b). “The Descent of Man”
Sawyer, K. R. (2013). Poetica.
ResearchGate has not been able to resolve any citations for this publication.
Full-text available
The severe acute respiratory syndrome (SARS) outbreak in Vietnam was amplified by nosocomial spread within hospital A, but no transmission was reported in hospital B, the second of two designated SARS hospitals. Our study documents lack of SARS-associated coronavirus transmission to hospital B workers, despite variable infection control measures and the use of personal protective equipment.