The Dragon’s Breath

The Dragon’s Breath

"The Dragon’s Breath"

 

It is the year 1346 and you are standing on the dockside in Kaffa in the Crimea a prosperous major European trading centre. A two-masted long distance trading Genoese vessel has just docked, returned from its two year journey to the Orient. 

There are rumours of exciting treasures to be had out there, of exquisite blue cloth, beautiful china ornaments, a powder made from dried leaves from which a pleasant and refreshing hot drink may be made, even a white powder that may be burnt and inhaled to make all one’s cares go away. What other unexpected gifts has this far away country got to offer the great countries of Europe you wonder as you idly watch the sailors carry their sacks and bolts of fabric down the gangplanks accompanied, you notice, by the inevitable black ship’s rats.

They were thought harmless at the time but these rats were parasitised by fleas which carried a bacterium, Yersinia Pestis whose DNA has been found in the teeth of skeletons of some of the millions of subsequent Black Death victims. Although some authorities now dispute the animal vector, we know the origin-China, the infectious organism and the the outcome-75-200 million deaths, 30-60% of the population of Europe. We now also know that there were at least two previous Black Death epidemics originating in China that devastated the western World. China seems to have been the source of many pandemics that devastated Europe. 

It is now 2019, you are a South Korean and you are waiting for a relative who is returning from Wuhan province in China. She is your mother who wanted to visit the seafood market, known as  typically picturesque with pangolins, snakes, bats and other animals offered for human consumption - illegally. It was on her bucket list and she now has a sore throat and a dry cough.

Well we all know she wasn’t bringing back the plague but Covid 19, a highly infectious virus and within three months 196 countries would have been infected, half a million people ill and thousands dead.

Covid 19, Corona virus 2019, is a Corona virus shaped like a crown on electron microscopy. Corona viruses were first discovered in the 1960s. SARS and  MERS are well known but of the 200 viruses that cause the common cold some are Corona viruses too. What we know about this current Covid infection is that it doubles its number of victims every 7 days. It, despite all the talk of morgues and previously healthy doctors dying, has a mortality rate overall of about 1%. This is about the same as pandemic flu. Mind you the flu epidemic of 1918/19 killed more victims than the Great War. It is much less harmful to children and as far as we know not harmful to babies in utero.

The mortality is up to about 8% in the elderly with cardiovascular, pulmonary or immune illnesses, but for most people (like the ironically affected Prime Minister, Health Secretary and Chief Medical Officer) it consists of a temperature, myalgia, tiredness, breathlessness and a dry cough. Sometimes a productive cough. As a virus, no antibiotics help but you may have heard that an antimalarial drug, Hydroxychloroquine may have some action against the virus, as may one of the biologic drugs. 

If you have the symptoms of Covid you should assume you have it at the moment and “Self  Isolate” at home for at least 7 days. Others in the house must assume they caught the virus on the last day you had it and stay at home 14 days. Stay well and obviously, if you are on chemotherapy, steroids, or have had treatment for cancer within the last year or so, assume you carry a higher than average risk of contracting the illness and of its complications and talk to your GP or consultant about what to do.

Dr Chris Heath, Chairman,
CANCERactive Medical Board

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