This can be an interesting article..

https://jamanetwork.com/journals/jama/fullarticle/2759815

Hi all,

The global COVID-19 outbreak / pandemic could have several different endings. The best-case scenario may be COVID-19 spontaneously fading out as was the case with SARS in 2003. Or it may continue to sporadically pop up over many years with the occasional outbreak as MERS has done. Or, more worryingly, it may follow a more sinister path such as the 1918 Spanish influenza and take root in populations worldwide, resulting in a heavy toll in morbidity and mortality over decades to come. The initial signs are worrying – early estimates put its reproductive number at 3.11 with a case fatality rate around 3%, not too dissimilar to the 1918 pandemic flu strain. We have to wait and see, as it appears.

Have a look at these literature:

Mills C.E., Robins J.M., Lipsitch M. Transmissibility of 1918 pandemic influenza. Nature. 2004 Dec;432(7019):904–906.

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Read J.M., Bridgen J.R., Cummings D.A., Ho A., Jewell C.P. Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions. medRxiv. 2020 Jan 1

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Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., Zhang L., Fan G., Xu J., Gu X., Cheng Z. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Jan 24;395:497–506.

Hi

Please check the following work. I believe it will help you.

https://www.ncbi.nlm.nih.gov/m/pubmed/25093995

Regards

@ Abhishek you have prompt up a very important question and discuss. I totally agree with @ M. R. Mozafari. It is likely that there bay be change in the virulence of the virus looking into the morbidity and mortality across regions and countries. In Africa for example where health services are not optimal and have few or no ventilators in some quarters you can see that the type of manifestation clinically of the virus does not appear to be same with that of china, Europe and America. We have very few or no patients on ventilators people suffer mild disease and recover.

Regarding herd immunity: This is an issue that has many side of the coin. Being an RNA virus with probable different strain with varying virulence will herd immunity be optimal? Even vaccine may not be optimal because of varying mutation. I think in my opinion we are out for a very long ride with this unfortunate virus with varying epidemics here or there. Just like HIV! Malaria we may have to cope to continue existence with COVID-19.

Thank you Talha Bin Emran M. R. Mozafari , Md. Sazal Miah , Abubakar Abubakar Panti for your time. Indeed the scenario may have many future revelations of which some will be costlier than others.

But the issue highlighted at the start of the discussion focused on possible dilution of potential virulence to the point of being non-fatal through multitudinous mutatation within a very genetically diverse and immunologically challenging population mass as that of India.

Spanish flu outbreak happened at the time of World War I and affected mostly the European countries with possible origin from the United States of America. At that time none of these regions were even close to the gene pool diversity of India (you can find people of almost every part of world in India).

More importantly, the once thought to be among the deadliest virus, the causal agent of 1918 Spanish flu has been found to be no more aggressive than other similar strains of Influenza A and chiefly super-infections by bacteria had caused most of the fatality in combination with undernourishment and lack of hygiene. Today, the scenario worldwide is not similar while the infection may appear to be. One very crucial aspect should not be ignored that 1918 flu first spread in the trenches and army hospitals, implying it ravaged the immune system of otherwise fitter and healthier young adults which must have aided the strain to easily sweep through the rest of the lesser immune populations. Here with SARS-CoV-2 the case is not similar.

Any thoughts shall be highly appreciated.

Abhishek Mukherjee

Virulence would be increased, as we don't have much data related to it's new strains. Even it's been a long time, nobody found out it's vaccine's preparation method yet, so you can imagine what would be the consequences in case of more lethal strains. In case of herd immunity some researchers concluded that, people will be gained acquired immunity upto 67% (as they assuming that), so, in case of secondary infection, what will be the future of old ones or those who have weak immune system? Then we have to prepare ourselves to lose huge population or our loved ones. Isn't it? What will be the exact fatality rate? I don't think so, phenomenon of herd immunity would work in a beneficial way.

Sana Arshad - your version of the situation could be a possibility, but, how many millions do we see dying of common cold nowadays? of course the millions in hundreds of billions will inevitably perish, making the rest more immune. I guess, What doesn't kill you makes you stronger. The old and the weary could also succumb to comorbidities; even presently among the total number of deaths there must have been a significant percentage who had comorbidity, but for some reason the net number of deaths actually brought about solely by COVID19 is not yet published.

Unpopular as it may sound, it is and always has been the way with natural selection. Respectfully, Your answer was sort of a forceful submission of the negative but it hardly touched upon my original point of discussion. I did recommend your answer for it touched on a possible scenario, in spite of its foregone nature.

India had contracted the disease from both China and Europe, through people returning from these countries along with the uninvited submicroscopic hitchhiker, the two original strains, which were thought to be more lethal but after three months the percentage of fatality compared to the confirmed cases is among the lowest in the world. What does it say? That India was privileged enough to receive milder versions of the viral strain which has been wreaking havoc all over the world or it became milder through repeated mutations among a far diversified gene pool than it had previously encountered anywhere and is starting to lose the edge. Of course the latter possibility would be most welcome.

Any comments to shed light on the issue from anyone will be greatly appreciated.

Regards,

Dr. Abhishek Mukherjee

I too agree with Dr M R Mozafari coment that the covid may loose its virulance and it may not be longer a pandemic...even i think the less hygein in asian countries compare europian countries shown different level of its pandemic nature..

Agree with Dr. M. R. Mozafari