You have heard of the coronavirus. You see the news of new infections and deaths popping up all over the world. You heard that there were 12 cases in Nigeria. You also heard that someone had died somewhere in Ekiti.
At work, everyone is talking about the virus. You listen. You contribute. But still it appears so very far away from your reality. You refuse to allow the paranoia set in. As far as you are concerned, you are educated, you are young, you will take the advertised precautions but you will not allow it ruin your daily routine.
There is a vague feeling of apprehension, but not fear, so you soldier on because there is also hope. Hope that it will all blow over soon. After all, they said, it doesn’t affect black people. They also said Africa is too hot for the virus. They also said something about chloroquine being the magic drug for it.
You know chloroquine. You took it as a drug. Although it itched you, piriton helped. You reason, worse case, I will rather the itch than succumb to the virus.
So you are confident.
You call a friend and arrange to meet for lunch. It’s really hot and the humidity makes it even worse. So you choose a place with air-conditioning and good service. It is high brow. So less crowd. You reason that this should be safer as you remind yourself to practise social distancing.
You have dedicated yourself to take all reasonable precautions: You use hand sanitizer, sit a good distance from other customers, and try to avoid touching your face, though that last part is hard.
Even as you sit there and stare at the people lining up to be served at the food counter, none of them obeying the social distancing advice. Most of them touching their faces after touching the food counter. One of them actually coughing. No one else [taking precautions to maintain a safe distance] even though none of them is wearing masks.
You feel a tinge of concern. But you sit there and wait for your friend who has been caught in traffic because a part of you suspects that this whole thing might be overblown.
Finally, your friend comes in. She is flustered. And apologetic. You stand up and you hug. And then when you separate. You crack a joke.
“Ahhh, see me that should be practising social distancing o. No touching.”
“Haba, where will I carry corona from na? Me that I have used hand sanitizer sotay I have nearly rubbed off all the colours from my hands.”
You both laugh. And wanting to get the meal started. You both walk over to the counter and order for food. You are both laughing and talking as they dish it out. You do not see one of the servers clean the sweat from her face with the back of her hand and then hold the plate upon which your food is being served.
You do not notice so many other oddities that are normalities in Nigeria. So you both go back to your table to eat. You sit down. And as you eat, all you talk about is the virus and the panic.
You blame the President for having not addressed the nation. You blame him for not closing the borders in time. You blame China for lying about the virus in the beginning. You blame Trump for being Trump and complicating matters. You blame this and you blame that.
But you feel somewhat safe after all you had used the hand sanitizer again just before you started eating.
What you don’t know is that ten days ago, your friend’s father was a guest of his business partner at another high brow restaurant in the same city. Where he caught the coronavirus.
He caught it from a hug and then a handshake he had exchanged from the wife of a banker who had recently returned from the United Kingdom and had disobeyed the fourteen days self-isolation request of the government. This wife was asymptomatic and therefore was not coughing or running a temperature, but had unconsciously licked her finger after eating her pounded yam and efo riro with cutleries, when she realized a soup stain, a short while before she shook your friend’s father.
Three days after that, your friend’s father coughed into his hand before opening the door of their home to welcome your friend who had come visiting.
As you both sat there eating and talking about the virus, neither of you knew that the saliva of COVID-19 patients, who are those infected by the Coronavirus can harbor half a trillion virus particles per teaspoon, and once they cough, it aerosolizes it into a diffuse mist.
So even your friend did not realize that as she walked through the door that had been open by her father, who had coughed earlier into his hand, the breath she took actually sucked in about 32,456 virus particles, which immediately settled onto the lining of her mouth and throat. You both had no idea that these viruses have been multiplying inside her body ever since.
And as she talked with you on the table, the passage of her breath over the moist lining of her upper throat creates tiny droplets of virus-laden mucus that waft invisibly into the air over your table. Some settle on the food on your plate, some drift onto your fingers, others are drawn into your nasal sinus or settle into your throat.
By the time you extend your hand to shake good-bye and hug her, your body is carrying 43,654 virus particles. By the time you’re done shaking hands, that number is up to 312,405.
One of the droplets gets drawn into the branching passages of your lungs and settles on the warm, wet surface, depositing virus particles into the mucus coating the tissue.
Each particle is round and very small; if you magnified a human hair so that it was as wide as a football field, the virus particle would be four inches across.
The outer membrane of the virus consists of an oily layer embedded with jagged protein molecules called spike proteins. These stick out like the protrusions on a knobby ball chew toy.
In the middle of the virus particle is a coiled strand of RNA, the virus’s genetic material. The payload. As the virus drifts through the lung’s mucus, it bumps into one of the cells that line the surface. The cell is considerably larger than the virus; on the football-field scale, it’s 26 feet across. A billion years of evolution have equipped it to resist attackers. But it also has a vulnerability — a backdoor.
Protruding from its surface is a chunk of protein called angiotensin converting enzyme 2, or ACE2 receptor. Normally, this molecule plays a role in modulating hormone activity within the body. Today, it’s going to serve as an anchor for the coronavirus.
As the spike protein bumps up against the surface of the lung cell, its shape matches that of the ACE2 so closely that it sticks to it like adhesive. The membrane of the virus then fuses with the membrane of the cell, spilling the RNA contents into the interior of the lung cell.
The virus is in.
The viral RNA gets busy. The cell has its own genetic material, DNA, that produces copied fragments of itself in RNA form. These are continuously copied and sent into the main body of the cell, where they provide instructions for how to make the proteins that carry out all the functions of the cell.
It’s like Father Christmas’es workshop, where the elves are dutifully packaging out the toys on his instructions. These toys are complexes of RNA and protein called ribosomes. As soon as the viral RNA encounters a ribosome, that ribosome begins reading it and building viral proteins. These proteins then help the viral RNA to copy itself, and these copies then hijack more of the cell’s ribosomes. Other viral proteins block the cell from fighting back.
Soon the cell’s normal business is completely overwhelmed by the demands of the viral RNA, as its energy and machinery are occupied with building the components of countless replica viruses.
As they are churned out, these components are transferred on a kind of cellular conveyor belt toward the surface of the cell. The virus membrane and spike proteins wrap around RNA strands, and a new particle is ready. These collect in internal bubbles, called vesicles, that move to the surface, burst open, and release new virus particles into your body by the tens and hundreds of thousands.
Meanwhile, spike proteins that haven’t been incorporated into new viruses embed themselves directly into the host cell’s membrane so that it latches onto the surface of an adjacent cell, like a pirate ship lashing itself to a helpless merchantman. The two cells then fuse, and a whole host of viral RNA swarms over into the new host cell.
All up and down your lungs, throat, and mouth, the scene is repeated over and over as cell after cell is penetrated and hijacked. Assuming the virus behaves like its relative, SARS, each generation of infection takes about a day and can multiply the virus a millionfold. The replicated viruses spill out into the mucus, invade the bloodstream, and pour through the digestive system.
You don’t feel any of this.
In fact, you still feel totally fine. You are on the phone. You are chatting on WhatsApp. You are scrolling through Instagram. You are reading tweets and responding. You try to watch stuff on Netflix. Some you like. Some you don’t.
As far as you know, you are going about your daily activities in the best way you can while listening to all kind of tales of Coronavirus and trying to get over bothered by it.
If you have any complaint at all, it’s boredom.
You’ve been a dutiful citizen, staying at home as much as you can, while avoiding unnecessary travels, so much so that even when you have to go to work, you practice social distancing.
Apart from when you meet up with close friends and family members. Like your cousin. Who calls you and says she needs to talk. You drive over to her estate. It is gated and in an exclusive part of town.
She is at home with her husband, who is actually the reason she has called you, owing to the fact that they are having issues. But since she doesn’t want to talk in his presence, she says you both should take a walk around the beautiful, well-landscaped estate.
Before you guys go out. She dorns a face mask. You laugh at her.
“Ahhh, you own paranoia pass my own o.”
She smiles from behind it as she responds in her muffled voice.
“The fear of Corona is the beginning of wisdom. I have three children to stay alive for.”
You both walk around the estate talking. You advise her. She feels happier.
When you get back to the house, you tell her you don’t want to come back into the house and will instead leave because you were so irritated by the actions of her husband. So she gives you a warm hug as you say good-bye, and you tell her it was great to see her, and you leave feeling deflated and dreading marriage the more.
What your cousin who has removed the mask inside her house and is going about the rest of her day feeling safe doesn’t know is that an hour before you came to her house, you went to the bathroom and forgot to wash your hands afterwards.
And because you didn’t, you didn’t get rid of the microscopic shit that had broken through the toilet paper as you wiped your butt. She doesn’t know that you left that microscopic shit on her hand when you were consoling her.
She has no idea that the microscopic shit you unconsciously gifted her contains 893,405 coronavirus particles. And forty-seven seconds after she had gotten into her home, after you left, she had scratched an itch at the base of her nose after she took off her face mask and just before she washed and sanitized her hands.
In that moment, 9,404 viral particles will transfer to her face. And make their way into her nose.
In five days, an ambulance will take her to one of the ultra-expensive hospitals in the city, just because she can afford it, if she couldn’t she would have been taken to the general hospitals or the teaching hospitals where help would come when she hopefully would have been diagnosed to be surviving from COVID 19 as a result of being infected by the coronavirus.
An infection you caused, without your knowledge.
Because unknown to you, you are a carrier, but it is taken longer for you to show symptoms. And since your cousin is asthmatic, her symptoms appeared faster.
You hear of her sickness. And you begin to worry. You call your other friend to tell her about your cousin. Your friend is not ill. So you are relieved. But your friend tells you that her father is gravely ill. And it is Coronavirus. She tells you that she is self-isolating. And your worry returns.
Your cousin’s husband calls you and tells you that you have to self-isolate, just like he and the children are doing because you had come in contact with your cousin. You tell him you will do it. And you do.
You shut your doors, knowing that you have enough food and resources for 14 days. You begin to pray like you have never prayed before. You promise God all sorts of things, if only He will ensure you don’t come down with COVID 19.
And as you pray. Your infected cells spew out virus particles until they burn themselves out and expire. As fragments of disintegrated cells spread through your bloodstream, your immune system finally senses that something is wrong. White blood cells detect the fragments of dead cells and release chemicals called cytokines that serve as an alarm signal, activating other parts of the immune system to swing into action.
When responding immune cells identify a cell that has become infected, they attack and destroy it. Within your body, a microscopic battle, like the warfront in the North East against Boko Haram is raging. Your immune system is leveling its Big Berthas on both the enemy trenches and its own troops.
As the carnage mounts, your body’s temperature rises and the infected area becomes inflamed.
Two days later, sitting down to lunch, you realize that the thought of eating makes you feel nauseated. You lie down and sleep for a few hours. When you wake up, you realize that you’ve only gotten worse. Your chest feels tight, and you’ve got a dry cough that just won’t stop.
You wonder: “Is this what contracting coronavirus feels like?”
You check Google again for the umpteenth time. Symptoms. You see that high temperature is one of it. You crosscheck with the list of symptoms that your cousin’s husband had dictated to you. It is there.
“Call the helpline if temperature rises above 37.2 degrees.”
You rummage through your medicine cabinet in vain and ultimately find the thermometer that had been delivered to you by the dispatch rider from the government agency in charge of the Coronavirus response. You hold it under your tongue for a minute and then read the result: 39 degrees.
“Oh my God!”
You crawl back into bed. Instead of calling the helpline that your cousin’s husband had given you. You tell yourself that it might just be the regular flu, and even if worse comes to worst, you’re young(-ish) and otherwise healthy. You’re not in the high-risk group.
You’re right, of course, in a sense.
For most people infected with the coronavirus, that’s as far as it goes. With bed rest, they get better. But for reasons scientists don’t understand, about 20 per cent of people get severely ill.
Sadly. Despite your relative youth, you’re one of them.
After four days of raging fever and feeling sore all over, you realize that you’re sicker than you’ve ever been in your life. You’ve got a dry cough that shakes you so hard that your back hurts.
Fighting for breath, still holding out for hope, instead of calling the helpline, you order an Uber and head to a private hospital. It is one of your companies hospitals and you are covered by their insurance. And as you journey in the Uber, you leave 376,345,090 virus particles smeared on various surfaces of the car and another 323,443,865 floating in aerosols in the air.
At the hospital, you’re examined and sent to an isolation ward. As doctors wait for the results of a test for the coronavirus, they administer a CT scan of your lungs, which reveals tell-tale “ground-glass opacities.”
These are fuzzy spots caused by fluid accumulating where the immune-system battle is the most intense. Not only have you got COVID-19, but it’s led to a kind of intense and dangerous pneumonia called acute-respiratory-distress syndrome, or ARDS.
But you are not alone.
There is already an influx of people infected with the COVID 19 sufferers. The cases are increasing rapidly by the hour. Panic has spread around the country.
And while they admit you, since all the regular beds are already occupied by the many COVID-19 sufferers, you’re given a cot in a room alongside five other patients.
Doctors put you on an intravenous drip to supply your body with nutrients and fluids as well as antiviral medicine. They tell you that it is the same treatment that was administered to the Italian who was the first index case and he recovered. They tell you that it has worked for others. They also tell you that Chloroquine trials are ongoing and if approval comes through, they will administer it.
Inspite of the intense itch that would come, you are hopeful.
Your family rush over to the hospital when they get the news. They cannot see you. Because within a day of your arrival, your condition deteriorates. The doctors change the treatment regimen. Somehow what worked for others is not working for you. You throw up for several days and start to hallucinate.
They give you chloroquine upon the insistence of your family, who are saddened by the death of your cousin from COVID 19. Anything to help you. It does not.
Your heart rate slows to 50 beats a minute. When a coronavirus patient in the next room dies, doctors take the ventilator he was using and put you on it. By the time the nurse threads the endotracheal tube down your throat, you’re only half-conscious of the sensation of it snaking deeper and deeper toward your lungs.
You just lie there as she places tape over your mouth to keep the tube in place. In that state, you vaguely hear that your friend’s father has recovered. You hear that your friend is still not displaying any symptoms. You hear the pleas of your family begging you to fight the disease. It comes from far off. In the voice of the nurses who flock around you. Fighting to keep you alive.
You’re crashing.
Your immune system has flung itself into a “cytokine storm” — an overdrive of such intensity that it is no longer fighting just the viral infection but the body’s own cells as well. White blood cells storm your lungs, destroying tissue. Fluid fills the tiny alveolar sacs that normally let the blood absorb oxygen.
Effectively, you’re drowning.
Even with the ventilator pumping oxygen-enriched air into your lungs. That’s not the worst of it. The intensity of the immune response is such that under its onslaught, organs throughout the body are shutting down, a process known as multiple-organ-dysfunction syndrome, or MODS. When your liver fails, it is unable to process toxins out of your blood, so your doctors rush to hook you up to a round-the-clock dialysis machine. Starved of oxygen, your brain cells begin to expire.
You’re fluttering on the edge between life and death.
Now that you’ve slipped into MODS, your odds are 50-50 or worse. Owing to the fact that the pandemic has stretched the nation and hospital’s resources past the breaking point, your outlook is even bleaker. Lying on your cot, you half-hear as the doctors hook you up to an extracorporeal-membrane-oxygenation (ECMO) machine. This will take over the work of your heart and lungs and hopefully keep you alive until your body can find its way back to equilibrium. And then, you are flooded with an overwhelming sense of calm. You sense that you have reached the nadir of your struggle. The worst of the danger is over.
With the viral attack beaten, your body’s immune system will pull back, and you’ll begin the slow, painstaking journey to full recovery. Some weeks from now, the doctors will remove the tube from your throat and wheel away the ventilator. Your appetite will come back, and the ashen colour of your skin will change back to its rosy mahogany.
In the morning you’ll step out into the fresh air and order an Uber to take you home. And later still, you’ll meet the guy who will become your husband, and you’ll have three children, two of whom will have children of their own, who will visit you in your palatial mansion somewhere in the city, after they have left the house to marry people of their choice and bless you with grandchildren.
That’s what your mind is telling itself, anyway, as the last cells of your cerebral cortex burst in starburst waves, like the glowing algae in a midnight lagoon. In the isolation ward, your EKG goes to a steady tone.
The doctors take away the ventilator and give it to a patient who arrived that morning. In the official records of the COVID-19 pandemic in Nigeria, you’ll be recorded as Victim No. 592.
Lagos
Jude Idada
March 21, 2020
NB. This story is my adaptation of an article by Jeff Wise: ‘How the Coronavirus Could Take Over Your Body (Before You Ever Feel It)’ in the Intelligencer. On March 18, 2020.
This piece was originally published here on Facebook. (Kindly note that the title was added by Punocracy.)
