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Letters Covid-19: UK cases of delta variant

Infection with SARS-CoV-2 is not the same as covid-19

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1896 (Published 02 August 2021) Cite this as: BMJ 2021;374:n1896

Rapid Response:

COVID-19 Pandemic: A persisting pervading devastating unprecedented 21st century scourge; the imperative to protect, project and promote the immutability of the factuality of science to the rescue

As a 21st Century Unprecedented Scourge, the ‘COVID-19 Pandemic’ remains bothersome as a ‘Persisting Pervading and Devastating Global Public Health Challenge’! The role of ‘COVID-19 Infodemic Pandemic’ in stoking the ‘Persisting Pervading Devastating Scourge’ has been exposed previously [1,2]! Also compounding and confounding the ‘COVID-19 Infodemic Pandemic’ is the avalanche of ‘COVID-19 Research Outpourings’ which possibly defied ‘Robust Research and Data Governance Principles’ and have been disposed as ‘COVID-19 Research Wastes’[3-10]! The ‘COVID-19 Pandemic’ is STRICTLY about SCIENCE, INFECTION and PUBLIC HEALTH and the IMMUTABILITY of the FACTUALITY of the ‘Core Concepts’ MUST be PROTECTED, PROJECTED and PROMOTED. Hence the recent ‘Publication’ in the BMJ is quite INSTRUCTIVE, BOTHERSOME and INTERESTING[11]!

Generically, any ‘Comprehensive Objective Discourse’ on INFECTION disposes the ‘Causative Agent’, the ‘Modes of Transmission’, the ‘Vector’ or ‘Intermediary Agent’ if any, the ‘Susceptibility and Vulnerability’, the ‘Disease’, the ‘Disease Possibilities’ (Asymptomatic and Symptomatic), the ‘Disease Severity (Mild, Moderate and Severe)’, the ‘Hospitalizations and Critical Care’ in ‘Intensive Care Units’ as indicated, the ‘Lethality’, the ‘Postmortem Possibilities’, the ‘Public Health and Social Measures (PHSM)’ and the ‘Infection and Prevention (IPC) Measures’ deployable for the ‘Holistic Infection Control’! All these are predicated on verifiably available SCIENCE and FACTS of the INFECTION! How do these apply to the ‘COVID-19 Pandemic’?

For the ‘COVID-19 Pandemic’, the relevant information has largely been ‘Work in Progress’ with ‘Specifics in a Flux’ keeping pace with the increasingly ‘Dynamically Rapidly Transmuting COVID-19 Pandemic Information/ Specifics’! However, some extant FACTS can be disposed herewith! The ‘SARS-CoV-2’ is the ‘Causative Agent’ of the ‘Disease’ (‘COVID-19)! The ‘Modes of Transmission’ include, among unfolding others: ‘Air-borne’/ ‘Aerosols’, ‘Person-Person Close Contact’, ‘Person-Surfaces Contact’ etc! There are documented ‘Asymptomatic Transmissions’ and ‘Pre-Symptomatic Transmissions’. While ALL are ‘Susceptible’, there are persons with particular ‘Vulnerabilities’: Those 60 years and above and those with ‘Pre-Existing Morbidities’ etc! Those infected with ‘SARS-CoV-2’ may be ‘Asymptomatic’ or ‘Symptomatic’ and those with the ‘COVID-19’ may be ‘Mild’, ‘Moderate’ and ‘Severe’! Those with ‘Moderate to Severe Disease’ may be ‘Hospitalized’ and require ‘Critical Care Gadgets and Systemic Support’ in ‘Intensive Care Units’!! For those who succumbed to ‘COVID-19 (Lethal Cases)’, there are ‘Postmortem Findings’ suggesting some aspects of the ‘Pathology’ of the ‘Disease’: ‘Inflammatory Lesions’, ‘Coagulation Disorders’ etc as seen in, for example, ‘Microvascular COVID-19 Lung vessels Obstructive Thromboinflammatory Syndrome (MicroCLOTS)’ with ‘Vascular Inflammations’ and ‘Microthromboses’ in the ‘Multi-Systemic Afflictions’ of COVID-19[12]!

The index ‘Communication’ in the BMJ disposes a new ‘Concept for Conversation’: ‘Infection with ‘SARS-CoV-2’ is not the same as ‘COVID-19’’[11]! It posits that ‘Positive COVID-19 Tests’ are, in fact, also erroneously regarded as ‘COVID-19 Cases’ and firmly disposes further that ‘COVID-19’ refers to ONLY ‘Severe Immunological Consequences of SARS-CoV-2 Infections’ with the ‘Development of Hypoxia, Biochemical and Immunological Indicators’!! This defies the known SCIENTIFIC FACT that ‘INFECTION’ with ‘SARS-CoV-2’ is the cause of ‘COVID-19’ which has protean ‘Possibilities’ in ‘Outcomes’: ‘Asymptomatic and Symptomatic Infections’, ‘Mild, Moderate and Severe COVID-19’ with a plethora/ spectrum of ‘Complications’ which may include, among several still unfolding others: ‘Severe Immunological Consequences’ now touted as the ONLY basis for the ‘Diagnosis’ of ‘COVID-19’!!! This MUST be ‘Nipped in the Bud’ before more irredeemable damage is done to the SCIENCE of ‘COVID-19’!!!

The contributions of ‘COVID-19 Infodemic Pandemic’ and ‘COVID-19 Research Wastes’ to the failing ‘Global Fight’ against the ‘COVID-19 Pandemic’ have been highlighted earlier in this ‘Communication’! The undermining of the IMMUTABILITY of the FACTUALITY of the SCIENCE of the ‘COVID-19 Pandemic’ MUST be actively resisted by SCIENTISTS before we do more irredeemable damage to the ‘Global COVID-19 Pandemic Control’!! The FACTS of the SCIENCE are SACRED and should be disposed as such; to do otherwise is to animate stoking the ‘COVID-19 Infodemic Pandemic’ and poke ‘Programmatic Holes’ in the ‘Global COVID-19 Pandemic Control’!

The implication of ‘Vaccine Hesitancy’ for the ‘Global COVID-19 Pandemic Control’ is now all too obvious and its ‘Determinants’, including the ‘COVID-19 Vaccines 2nd Dose Uncertainties’ and ‘Vaccine Booster Dose Controversies’, have been exposed and explored previously[13-33]! We cannot, as SCIENTISTS, begin to ‘Stoke’ and ‘Further Entertain’ dispositions that challenge and undermine the SCIENCE of the ‘COVID-19 Pandemic’! Our ‘Communications’ MUST be CONSISTENT, SCIENTIFIC and FACTUAL! We will be enlarging the ‘Determinants’ that animate ‘COVID-19 Pandemic Denialism’ and ‘COVID-19 Vaccine Hesitancy’ and the worrisome Persisting, Pervading and Devastating Unprecedented 21st Century Scourge if we do otherwise!

This modest ‘Communication’ is contributed to invite SCIENTISTS, as an imperative, to PROJECT, PROTECT and PROMOTE the IMMUTABILITY of the FACTUALITY of the SCIENCE of the ‘COVID-19 Pandemic’ if the ‘Global Pandemic Control’ is to be ASSURED as a taken and given for the ‘Universal Good of Our Common Humanity’!

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Professor Charles Osayande Eregie,
MBBS, FWACP, FMCPaed, FRCPCH (UK), Cert. ORT (Oxford), MSc (Religious Education),
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria.
Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria.
UNICEF-Trained BFHI Master Trainer,
ICDC-Trained in Code Implementation,
*Technical Expert/ Consultant on the FMOH-UNICEF-NAFDAC Code Implementation Project in Nigeria.
*No Competing Interests.

Competing interests: No competing interests

23 August 2021
CHARLES OSAYANDE EREGIE
MEDICAL DOCTOR
Professor of Child Health and Consultant Paediatrician and Neonatologist, University of Benin and University of Benin Teaching Hospital, Benin City, Nigeria.
Institute of Child Health, College of Medical Sciences, University of Benin, PMB 1154, Benin City, Nigeria