Li Wenliang, Corona virus patient is dead. Long live, Li Wenling, the medical doctor and whistle blower of the Corona Virus.

Li Wenliang, Corona virus patient is dead. Long live, Li Wenling, the medical doctor and whistle blower of the Corona Virus.

What a travesty of justice it is that Dr Li Wenliang, who is primarily responsible for raising an alarm against a possible outbreak of a new virus, whose symptoms ‘resembled the deadly SARS virus pandemic of 2003’ in the Wuhan region, succumbed to the very disease, on the 6th of February. His mortal remains may have been buried but his contributions in raising an alarm against the Corona virus will remain eternally etched in the annals of history and the global health community will remain grateful to Dr Li for his exemplary services in combating the Corona virus outbreak.

Li Wenliang, aged 34, the Corona virus whistle blower doctor, was among the first to raise concerns - on December 30 - about the possible spread of a new virus, in the city of Wuhan. An ophthalmologist by profession, Dr Li had posted a social message in a chat group for his fellow Doctors about his experience of attending to a series of patients with flu-like symptoms that resembled SARS at his hospital. He had  urged his group members (mostly doctors) to wear protective clothing, while at work, to protect themselves from a possible virus attack. As luck would have it Dr Li’s message went viral. He thus became the whistleblower in the case of reporting the virus epidemic, which later came to be known as the  novel Corona virus (nCoV), which the world is now talking about. Until then the Chinese authorities had concealed the spread of this virus in Wuhan, from the public and also from the international community.

On 30 December, much before the world came to know of the Corona virus, Dr Li sent a message to his fellow doctors, in their social chat group, warning them to wear protective clothing to avoid SARS like infection, which he suspected had struck the city of Wuhan. Fortunately for the world and unfortunately for Doctor Li, his message became viral and just four days later, Dr Li was summoned by the Chinese authorities - who had hidden the news of patients reporting in various hospitals in Wuhan with flu like symptoms to the Public - and was asked to sign a letter in which he admitted to “making false comments" that had "severely disturbed the social order". He was one of eight people who the Chinese police  accused for "spreading rumours". Fortunately the Supreme Court of China intervened and the Chinese health officials realised the seriousness of the issue and very soon admitted to the presence of nCoV epidemic in the city of Wuhan. The local authorities, later, apologised to Dr Li for accusing him of making false comments, rumour mongering and for disturbing the social order in the city and for the unwanted treatment meted out to him. 

Subsequently, Dr Li while operating a woman with glaucoma, without realising that she too was a coronavirus victim, appears to have been infected by the Corona virus. In his Weibo post, Dr Li  described how on 10 January, 2020, he started exhibiting symptoms like coughing and fever which are indicative of the Corona virus. Dr Li was admitted in hospital on the 13th January and was officially diagnosed with the coronavirus on 30 January and within the next week, that is on 6 February, Dr Li was declared dead by the local hospital authorities in Wuhan. Thus ending a bright future of an young Doctor who was the first to publicly post about the attack of this virus in the city of Wuhan.

Scientists and health authorities around the world are now racing to arrest and halt the spread of the Corona Virus, which emerged in the Chinese city of Wuhan some time in December 2019 and has now become a global epidemic. The virus, known as 2019 novel Corona Virus (nCoV), about which I had written earlier in my blog on the 24th of January, causes serious respiratory illness and has so far infected more than 28000 people in China and has taken away the lives of nearly 600 people including most unfortunately Dr Li Wenling the whistle blower of this virus. In the modern connected world in which hundreds of thousands of passengers travel every day from one city to another and from one country to another, including the epicentre - Wuhan - in thousands of airlines, it is no wonder that the nCoV has spread so rapidly, more so since there appeared to be some delay on the part of the Chinese authorities in reporting it in time. The virus has now spread to other countries making the calamity a global epidemic. WHO and international community have joined hands with China in the endeavour to stop the Corona virus menace as early as possible. As things stand today the virus has spread its tentacles beyond the borders of China to 29 other countries including India where three cases have already been confirmed and some more cases have been screened and few people have been isolated/quarantined for further assessment. 

The nCoV originated in a food market in the Chinese city of Wuhan consequently the city was locked down with travel into and out of the city restricted ever since January 23. The Chinese authorities have shown remarkable importance to this issue and are making all possible efforts, including building new hospitals in unbelievable record time, to contain this deadly virus. Among the people stranded in the epicentre of the virus were several Indian students and visitors. Based on the appeal of the stranded Indians, the Indian Government has already flown two special Indian airlines - jumbo Boeing -  and have airlifted more than 600 plus Indians back to India from the locked down city of Wuhan, with support from the Chinese authorities.

Although the virus has taken a pandemic proportion,  it is not the time for blame game to finger point the Chinese or others for the global spread of the virus, which in the modern connected world is an absolute certainty. Moreover, the Chinese authorities are doing an extraordinary job in combating this global pandemic by taking all possible timely actions. It is therefore hoped that the efforts taken by the Chinese authorities, with support from international community, is likely to impact the arrest of the virus very soon. Experts believe that timely collective efforts of the global community, led by the Chinese, in arresting the spread of the virus will start kicking in and in the best case scenario, the virus will only infect few more people. However there are also others who feel that it may be too early to pass judgement, whether efforts to sanitise places and quarantine people, including advocating use of widespread face masks, will at all have their effect that will start arresting the rapid spread of the virus. Scientists have also suggested that the incubation period for the Corona virus (up to 14 days) is relatively longer than most other viruses and therefore the control measures must keep this in mind before deciding on the measures to arrest the spread of this virus. There are also pessimists who believe that the virus has got out of hand in China, spread too far, too quickly to really be contained. Some of them going to the extremes of predicting a worst case scenario, often referring to the Spanish Flu epidemic a century ago, which killed an estimated 12 million people including some 5 millions in India, and believe that (based on a prediction model) some 190,000 people have already been infected in Wuhan, and that it may be just a matter of time that this number could increase exponentially and spread globally. Whatever be the situation, optimistic or pessimistic, one thing is for sure, we all must be better informed to effectively tackle this infectious disease and play our small role in supporting the global health workers in combating this issue.

Just a week back, on 30th, January, the World Health Organization (WHO) had declared this outbreak a ‘public health emergency of international concern’ - an alarm it reserves for events that pose a risk to multiple countries and which requires a coordinated international response. The pace at which the virus is spreading has caught the attention of health workers across the globe, who are unitedly trying to contain this pandemic. Unfortunately, notwithstanding the extraordinary developments in our understanding of diseases, crucial  biological information about the Corona virus and how it spreads are yet to be understood completely. Medical experts are addressing this issue keeping in mind our previous experiences of best- and worst-case scenarios of earlier virus epidemics and what scientists already know.

Based on past experience health workers, with support from scientists, have managed to control certain viruses that cause diseases like chicken pox and influenza, which are endemic in many countries including India, through vaccination and confining people at home when they are ill. One big question is, whether the coronavirus will become endemic and is here to stay? If efforts to contain it fail, there is a high chance that it will become endemic. This could mean that like the chickenpox and influenza, which are caused by a virus, the Corona virus may also continue to circulate every year and lead to some deaths making it necessary for development of a vaccine for the Corona virus. If the virus can be spread by people who are infected but don’t have symptoms, it will be more difficult to control its spread, making it more likely that the virus will become endemic. In which case we are possibly looking at a virus that’s going to be with us for a long time and therefore scientists must work towards developing a vaccine for this virus. Although it is now fairly well established that the Spanish Flu - a global Outbreak - a century ago (1908), had affected close to 50 million people with an estimated 10 to 15 million deaths including an estimated 5 million deaths in India, the current era of medical advances and so also the economic conditions of the people with much better cleanliness and sanitation, we are better prepared to address outbreaks. Take for example the Severe Acute Respiratory Syndrome (SARS). There was a global outbreak of this virus in 2002–03, which also emanated from. Hina but was very effectively addressed by the global community and once the outbreaks in hospitals were brought under control, SARS was contained and now there is hardly any evidence to suggest that the SARS virus is still circulating in humans. So we can be optimistic and we must trust our authorities and must avoid panic and spread of rumours about the Corona virus, which will make it more difficult for the health workers to address this issue. Looking at the way the Chinese and the global community are addressing this issue with WHO putting in their might, and also considering the fact that the control measures are effective, and the virus transmission has started showing signs of slowing down, which means that each infected person infects no more than one other person, the nCoV outbreak will very soon fizzle out. 

There are however some worries about the possible mutation of the virus. Some researchers are concerned that as the China coronavirus spreads, the pathogen could mutate so it can spread more efficiently, or become more likely to cause disease in young people. Currently, the virus has caused severe illness, and death, mainly in older people, particularly those with pre-existing conditions such as diabetes and heart disease. Although Dr Li died of this virus at age 34 it is still not clear whether he had any pre-existing health conditions.

The escalating outbreak has prompted a flurry of research activity on the coronavirus, which emerged in humans in December and is new to science. Researchers have shared dozens of genetic sequences from strains of the new Corona virus and a steady supply of those sequences will reveal genetic changes as the outbreak progresses, which will help in the future development of an effective vaccine against this virus. As of 30 January, at least 54 English-language papers on the coronavirus have been published.  More than 30 papers are on preprint servers, and a handful have also appeared in peer-reviewed journals, like The Lancet and the Journal of Medical Virology. There will also be papers published in other languages including Chinese, which will help in better understanding this virus for an early vaccine development for arresting this virus. There are also some studies which have focused  on the virus’s structure or genetic make-up — information that could be used to identify drug targets or develop a vaccine. Researchers have also published genomic data on the virus on online platforms such as GenBank, which will go a long way in helping scientists and pharmacists to develop drugs for this disease to help patients suffering from this disease. Interestingly enough although most media are talking about this virus outbreak, it is seen from the statistics that the proportion of infected people who die with Corona virus attack is relatively very small in comparison with earlier virus attacks like the SARS. With some 590 deaths so far out of nearly 28000 plus infections, the new coronavirus has a death rate of 2%. This is significantly lower than SARS, which killed around 10% of the people it infected. There is currently no effective drugs against the Corona virus. Two HIV drugs thought to target a protein that helps coronaviruses to replicate are being tested as a treatment. Scientists have also identified other existing medications that target this function, and several international research groups are working on a vaccine for the Corona virus. Hopefully as statistics and data suggest the spread of the virus seems to have slowed down a bit and sooner than later it will completely be removed from human society. 

The most worrying part now is how one can and must control spread of this virus in towns and villages particularly in south East Asian countries and the African countries, which do not have adequate health safety measures in place nor do they have the resources that the Chinese authorities had at their disposal. Addressing the press and declaring a global health emergency, the WHO’s director-general, Tedros Adhanom Ghebreyesus, said his main concern was that the outbreak could spread to countries with fragile health systems. If the virus spreads throughout the world, the number of deaths could be substantial. The current death rate of 2%, while not as high as for SARS,it is still quite high for an infectious disease.

Let us hope that the global efforts on all fronts will effectively take on this virus and defeat it at the earliest.