Information about the new coronavirus is rapidly accumulating. Today we know almost everything about this virus that is possible except for two important things. How to prevent infection in humans and once the infection happens, how to end it.

As far as the disease called Covid-19 or more often just called the coronavirus infection is concerned, we have learned a few things. This is probably the last time I am going to write about this disease since almost every op-ed writer and all TV hosts have become experts on and are disseminating and dispersing their expert opinions day and night.

The first thing we have learned is that so far there is no cure for this disease. The only medicine sort of approved for treatment in severely sick patients is Remdesivir. And even this medicine has at best a very ‘moderate’ advantage in these patients. Gargling with hot salt water, eating lots of garlic, and reading from holy scriptures are quite useful except in treatment of this disease.

The second thing we know now is that the only way to prevent getting infected is total isolation. Short of that wearing a mask in public and keeping your distance from other people definitely helps. There is a lot of discussion about the use of masks, however.

Think of the mask as a ‘bullet proof’ vest that does not prevent you from getting shot at or being injured if the bullet hits a part of the body not covered by the vest. But the vest does decrease the chance of serious life threatening injury.

The reason masks are effective is because most transmission of this virus occurs through virus laden droplets released by an infected person while sneezing, coughing, talking loudly or even gently and lovingly. So a mask will make it less likely for a person to inhale these vile droplets and get infected.

Another major advantage of wearing a mask is that almost a third of all people infected will have no symptoms and can spread the disease without realising what they are doing. Masks will prevent these people from spreading the infection.

Masks come in all sorts. Commonly used masks are adequate most of the time but must cover both the mouth and the nose. I see pictures of people walking around wearing a mask but having their noses uncovered. That is just stupid.

As far as the special masks that can filter out even the virus are concerned, they are needed for people actually involved in the care of patients already suffering from Covid-19. These masks have to be properly fitted on the face to be effective. Facial hair however makes these masks ineffective. That is an important point that must be emphasised.

The third thing we now know about this disease is that it damages more than just the breathing system. There is evidence that the virus damages lining of blood vessels and can produce blood clots causing strokes and heart attacks as well as kidney damage. In children it is now known to produce, though rarely, artery damage that can be fatal.

Another thing about the virus causing this disease is that the virus has not changed (mutated) too much. This is bad because the intensity of this disease is not getting any less. And it is good because an unchanging virus makes it easier to create an effective vaccine. Unfortunately, no vaccine is going to be available for quite a few months yet.

Then there is something called a ‘cytokine storm’ that occurs in the very sick and can be fatal. This is an extreme immune response by the body against the infection. This extreme response can best be described as a final maximal attempt at fighting the infection where the response is almost equally harmful to the human body. This condition has been effectively treated with medicines that suppress the body’s immune response.

Think of the mask as a ‘bullet proof’ vest that does not prevent you from getting shot at or being injured if the bullet hits a part of the body not covered by the vest. But the vest does decrease the chance of serious injury.

Another thing that we have learned is that the virus is not that easily caught from surfaces that we might touch when we are out and about. What that means is that the virus does not survive all that long and in sufficient strength on surfaces contaminated by an infected person. No, that does not mean that we should stop washing our hands when we get back home from a trip to the store or the bank.

One question about the pandemic remains unanswered. Why is there such a variation in the mortality from this disease in different countries? Mortality ranges from below one percent to as high as ten percent.

For the low mortality, a few reasons are offered. In some countries like Pakistan, for instance, the average age is around twenty three years. So there are just not enough older people for this virus to kill. Or else again in countries like ours, many people are dying from this disease but are never counted. And in places where large-scale testing has occurred, the total number of infected people is much larger so the mortality seems lower.

And it is also pretty obvious that the virus is here to stay until such time that an effective vaccine is available and enough people are vaccinated (around sixty percent) to create herd immunity. And as I have said above, an effective vaccine is still out there somewhere in the future. Unfortunately, hot weather does not seem to affect the spread of this virus.

One last thing we have learned from the experience of different countries is that there is no single way to prevent the spread of this disease. Lockdowns, isolation, social distancing all help but nothing is totally effective. The important thing is that the healthcare system should not get overwhelmed. And making sure that that does not happen is an expensive proposition.

There has been much criticism of the Pakistani authorities, especially the prime minister for not supporting a more drastic lockdown to prevent the spread of this disease. The PM has held that the economic consequences of a full lockdown will have a major negative impact on the economic well-being of the lowest economic strata of the population. And that death from hunger is as bad, if not worse, than death from this disease.

Even though I believe that the PM is entirely sincere in his sympathy for the poor people and their problems, after seeing what is happening in the United States right now, I can well imagine that the PM was perhaps a trifle more worried about what the hungry poor might do if pushed too hard.

Rioting, looting and public unrest in the US is not just because of police brutality. More than thirty million US citizens have lost their jobs in the last two months and many of them belong to minority communities. All these unemployed young men and women have nothing to do except protest and some among them to go on a looting spree.

A mob on the rampage in Lahore, looting expensive stores, burning cars, ransacking homes of the rich in Gulberg, Defence and in cantonment areas probably worried the PM as much if not more than any deaths from hunger.

The writer has served as professor and chairman at the department of cardiac surgery, King Edward Medical University