By Dr Jackson Ojera Abusu

President: You! You! COVID-19, why have you made me lockdown my country?

COVID-19:  It is because your people like other people the world over can allow my causative agent, that is, SARS-CoV-2 (Severely Acute Respiratory Syndrome Corona Virus-2) to move from one person to another through simply blowing or sneezing me away from their noses in the mucous, also coughing me out in their sputum/droplets or even when talking their mouth droplets contain me and, therefore, I get transmitted directly onto other nearby people's noses, mouths or eyes or I can land on any object /surface together with mucous and be there waiting to be picked by another person/other people when they touch the mucous droplets - where I hide. By the way, I am one of the seven (07) different strains of coronavirus as listed below:

• 229E (alpha coronavirus)
• NL63 (alpha coronavirus)
• OC43 (beta coronavirus)
• HKU1 (beta coronavirus)
• MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)
• SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS)
• SARS-CoV-2 (the novel or original /new coronavirus that causes coronavirus disease 2019, or COVID-19)

President: So you are just very little, insignificant and microscopic thing that can be blown away in sneezes, cough droplets and even when one is just talking you fly away with droplets from the mouth and you have caused untold suffering to mankind globally, how can we get rid of you? 

COVID-19: You are extremely right. I am just a microscopic thing - actually I am not a living micro-organism but a protein molecule covered by a protective layer of lipid (fat) which when absorbed by the cells of the eyes, nose and throat /buccal mucosa, I change their genetic code (mutation) and convert them into aggressor or multiplier cells and therefore cause one or more of such disease conditions ranging from dry irritating cough, rhinorrhea/runny nose or flue; sore throat; fever and sometimes myalgia/muscle pain, fatigue; headache, vomiting and diarrhoea. When my soldiers (aggressor/multiplier cells) are many and may be overpowering the body in which they are (the fight is easier if immune system/defense mechanism of the body is already weakened by other conditions e.g. HIV, Cancers, Diabetes, Hypertension, etc), then the host (patient) will start experiencing respiratory difficulty /shortness of breath or dyspnea eventually may even result in respiratory failure, multi-organ dysfunction, shock and death. When in the body, not all signs and symptoms may appear; there may be 

• Fever in 88% of cases
• Dry cough in 67%  of cases
• Fatigue in 38% of cases
• Myalgia in 14.9% of cases
• Dyspnea in 18.7% of cases

In any case, once my soldier SARS-CoV-2 gets onto surface of the epithelial cells lining the mucosa of the nose, mouth and eyes, it makes friendship/fuses with a protein molecule called Angiotension Converting Enzyme type 2 (ACE2) and enters the cells where SARS CoV-2 finds freedom to change the genetic code of those cells making them aggressive and multiplying rapidly and the host will produce

• Mild illness in 81% of patients
• Severe illness in 14%  - especially in patients with underlying disease conditions
• Critical Disease in 5 percent (Respiratory failure, shock, multi-organ dysfunction syndrome)
• Overall case fatality rate being 2.3% to 5%

President:  I can see our body soldiers (immune system) can also overcome you in about 81% /majority of cases, but as the President of my country it is one of my fundamental obligations to protect and defend the nation against aggressors and ensure that my people are safe, healthy and productive. If I were not to lockdown the country, I am afraid without disruption in the transmission, you would cause mild illness in about 34 million (81% of 42 million) assuming you really attack everybody since all people are susceptible, about 5.88 million Ugandans may be affected with severe illness while about 2.1 million Ugandans would probably develop critical condition, hence, a big blow to the health workforce and a lot of strain on resources; and yet there could also be deaths, all that still have to drain resources. It is therefore pointless to allow the population continues with routine and make you access almost everybody. In fact, it is my prayer that you be defeated not only from Uganda but globally

COVID-19: Defeating me!! It may be easy only when your people change by listening to what you and Ministry of Health are telling them about the DOs and DON'Ts. Let them not be forced to comply with your directives and yet it is in the best interest of them being alive, healthy and productive. You can only defeat me when you use amongst others the following:

• Hand washing with water and soap and why? This one has dual function: water flashes away the mucous / epithelial cells containing SARS-CoV-2 but that is not enough, some of the molecules remain stuck to the hands, nail beds, in between fingers so the next effect is for soap/detergent to form foam with water. Once formed, the foam CUTS the FAT (lipid layer covering the virus). That is why you have to rub soap with water in your hands for at least 20 seconds to make a foam; don't just rush hand washing). By dissolving the fat layer, the protein molecule disperses and breaks down on its own
• Hand Sanitizers: Alcohol or any mixture with alcohol of at least 70% concentration DISSOLVES ANY FAT, especially the external lipid layer of the virus
• Use of Hot / Warm water and ironing clothes: HEAT melts fat that is why it is so good to use water above 25 degree Celcius for washing hands, clothes and everything, In addition, hot water makes more foam and that makes it even more useful. Ironing clothes similarly confers heat that melts the fat layer of the virus
• Use of Sodium Hypochlorite (Jik): Any mix with 1 part of bleach and 5 parts of water directly dissolves the protein, breaks it down from the inside 
• While it is glued to a porous surface, SARS-CoV-2 is very inert and disintegrates only after 3 hours (fabric and porous); 4 hours (copper and wood); 24 hours (cardboard); 42 hours (metal) and 72 hours (plastic)
• If you shake it or use a feather duster, the virus molecules can float in the air for up to 3 hours and can lodge into your nose

President: Definitely we shall defeat you if my people follow the preventive and control measures even before treatment and or vaccine is found.

COVID-19: You may have also noticed the many unanticipated effects, negative or positive, your curfew and COVID-19 have brought. Kampala City; all urban and peri-urban centres, small or big, have gone silent; traffic jam not in sight anymore in Kampala - actually the city is almost empty with only forces available to enforce Presidential directives;   noise pollution from whatever source gone; Police may be receiving very few crime cases if any; domestic violence on its declining trend; habitual and dependency alcohol consumption remarkably gone down as all bars, hotels /drinking joints are closed; family cohesion and bondage enhanced as a results of all should stay home with the few exceptions camped at factories which are allowed to continue operating; no more socializing /partying with usual friends or getting new acquaintances - social distancing should be at least four (04) metres (looking at everybody else as a "stranger" and possible source of infection); hand washing as the most emphasized precautionary measure to prevent the spread should be accruing more benefits e.g. reducing transmission of diarrhoeal diseases. All these have necessitated a paradigm shift in lifestyles and behaviour to defeat SARS-CoV-2 that causes COVID-19. 

President: I will continue telling my people to stay home; Adhere to Presidential directives and Ministry of Health Guidelines. Truly there should be a paradigm shift in behavior and lifestyles.

The writer is the Director of the State House Health Monitoring Unit