The Coronavirus infection has been with us since December 2019. 

Since then we have understood a lot about the Virus, it's strain, how it spreads, basic methods to keep ourselves safe (social distance, face mask, frequent hand washing), basic therapeutic management etc.

There are many many questions still left unanswered though.

What are the uncertainties or our gap in knowledge regarding this terrible infection?

I will tackle some of them.

1. If the disease is mild in young adults and children, why are so many dying because of it?

It was understood right at the beginning of the pandemic that the elderly, those with pre-existing diseases like diabetes, uncontrolled hypertension, heart disease and those with compromised immune functions developed a more serious form of the disease and fatality was much higher among them. The obese are among the most at risk. 

But it is also true that many otherwise healthy young persons and children have succumbed to the disease.

What is the reason for that? 

Is it the Virus which is of a more virulent form, or was it a very strong viral load that entered the body which overwhelmed the young body's immune mechanism?

Or is it a Host factor - some genetic predisposition to developing a serious form of the illness - is it related to the number of ACE-2 receptors? 

We do not know.

2. Why do some individuals spread the disease to many and some do not spread it at all?

We know of 'Superspreaders' as well as ' Superspreader events' - like the Church in South Korea, the Markaz in Delhi, the Gurudwara in Nanded and many others. A single location or event caused a multitude of infections.

Is it related to the fact that the virus spreads insidiously within indoor, closed environments and does not spread so much in outdoor events?

Are Superspreaders those who have a large viral load and so pass it on to others?

We are not certain.

3. Does Hydroxychloroquine work?

No drug in recent times has courted as much controversy as the touted off label benefits of this common drug used to treat Malaria and some Auto Immune disorders.

The For and Against Armies are aggressively pitted against each other.

Usually drug usage is obfuscated by Industry driven smart and aggressive strategies. Combine this, in this instance, with the highest level political rhetoric - Is it a surprise then that the true worth or worthlessness of this drug remains a mystery? 

4. Questions about the Vaccine ?

  • When, if at all, be a safe and effective vaccine against the Coronavirus be available?
  • Will we need two doses of the same vaccine or will we need to take two different vaccines which will boost our immunity enough to keep us safe?
  • Will we need to take the vaccine every year? If the antibodies produced by the disease itself have been seen to wear off in a few months what assurance do we have that the vaccine will offer better protection?
  • Will the vaccine carry a biological 'marker' that can be scanned  at transit points like airports and terminals etc so that we carry a 'safety passport' which permits unhindered access without the mandated quarantine requirements?

There are no clear answers as of now.

Though a medical article musk seek to inform; sometimes it is equally important for us to share the depth of our ignorance about this devastating disease.

Our best defense continues to be to remain a minimum of 2 metres from others, wear a face mask while in public, and wash hands frequently with soap and water.