No cure for Covid-19, but you can recover

By Saturday, the latest figures for Covid-19 pandemic in Nigeria are up: 1,095 confirmed, 32 dead and 208 discharged.

The last part is proving to be some contradiction for many people: how do you say 208 have recovered and been discharged from hospital for a disease that is said to have no cure?

Coronavirus is a respiratory virus, and most viruses of this kind are self-limiting. It means they have a finite period in your body before they wear themselves out, or your immune system contains them. When that happens, you recover.

For a person, that means your immune chews up the virus so it is no longer able to infect new cells. For a community, that means the virus is unable to find new people to infect.

Treatment in this case has two aims: one is to relieve symptoms and make you comfortable; two is to keep you alive by supporting the organs the virus has attacked [in this case, your lungs, which is why oxygen and ventilators are needed].

The treatment is not a cure. For one, self-limiting viral illnesses resolve on their own, like the cold and catarrh you have nearly every year. The cough medicines you take only ease the chesty cough, and help you expel phlegm easier. They don’t attack the virus behind the cold.

Your immune system produces antibodies that do that, and once that mother of all battles is won, you bounce back. And your body becomes stronger for another battle should the virus return.

And then again, because viruses mutate rapidly to fit into every new environment, it is difficult to spend years developing a medicine to target them. By the time you get the medicine, they may have mutated into a form that’s resistant to the wonder drug.

Hence the best treatment is prevention—social distancing, hygiene and modifications to break the chain of transmission. The other is vaccination to teach your immune system to recognise and fight the virus when it comes around again.

But if you do get infected, you can be treated in a way that’s called “supportive treatment”. It is different from “definitive treatment”.

Say you have typhoid fever. Your doctor gives you antibiotics that directly target and kill the Salmonella typhii bacteria responsible for the typhoid. Once the bacteria is eliminated, your body’s “mechanic’s garage” takes over, repairing the damage done and you recover. That’s definitive treatment.

In supportive treatment, as is the case for Lassa fever, Ebola and Covid-19, treatment does not eliminate the virus but relieves the symptoms and supports the organs already damaged while waiting for your immune system to contain the virus.

So, you get cough syrup to suppress cough, paracetamol to cool fevers, painkillers to suppress pain.

Because coronavirus attacks the lungs, oxygenators help raise the oxygen levels in your blood and ventilators take over the breathing function of your lungs, while waiting for your immune system to return from the battlefield.

When the immune system returns, having won the war by containing the virus, and you are still alive through supportive treatment, you have recovered.

But if the damage done by the virus is too much and the supportive treatment is not able to keep you alive to see the end of the battle between your immune and the virus, then it is RIP.

This battle can last two to six weeks depending on, among other things, the health of your immune system, which is why that is your greatest arsenal against Covid-19.

The other things include age, sex differences in immune response, gaps in immune system, race, the dose of the virus entering the body, the strain of the virus, the presence of pre-existing conditions (like diabetes, hypertension, heart disease, cancer) and many other unknowns. They all factor into why the disease is mild for some and deadly for others.

The severity is classed into different forms based on how the virus attacks the respiratory system.

Asymptomatic—you get infected but show no symptoms and end up being a mere carrier spreading the infection to others.

Mild—you get the virus but have just regular upper respiratory tract infection—sneezing, mild fever, cough—and recover with or without supportive treatment.

Moderate—you get lower respiratory tract infection, with pneumonia and need some supportive treatment but you may not be sick enough to need oxygen therapy.

Severe—you get up to pneumonia and get so sick you need oxygen.

Critical—it is so bad you develop acute respiratory distress syndrome; your lungs fail and you need a ventilator to mechanically breathe—and a full array of intensive care unit, without which you may not survive.

Yes, there is no cure, and yes, it is your immune system that clears the virus and relieves the symptoms.

And yes, if all this care is provided, even without a definitive cure for coronavirus disease, you can still pull through to recovery.