Benin COVID-19: “Individuals who are asymptomatic can pass on the disease to others” according to Thierry Adoukonou
The 2nd edition of “Questions for the Experts”, a report by the African School of Economics (ASE), tackles the issue of African remedies for Covid-19 and non-medical alternative solutions circulated on the internet. Professor Thierry Adoukonou, Director of the Public Health and Epidemiology School (ENATSE) at the University of Parakou provides an expert opinion on these matters.
ASE: What do you think, Professor Adoukonou, about the remedies developed in Africa (Covid-Organics, Apivirine, MSK, etc.) for COVID-19?
Professor Adoukonou: First, I would like us to agree on a minimum understanding that there is a difference between medicine and remedy, on the one hand, and between treatment and solution on the other. According to the Larousse dictionary, a “drug” is a substance or preparation administered to treat or prevent a disease, or to correct, restore or modify organic functions. Medical science requires certain steps to be taken and evidence to be provided before using a drug for a defined disease. Giving a substance to an individual whose health improves is not scientific proof. It is also worth noting that in all clinical trials incorporating a placebo (a substance devoid of its own pharmacological effect) a significant percentage of subjects in the placebo (no treatment) group are improved or cured.
Testimonies are not scientific evidence and science has its own approach. Dogma has no place in science. As of now, and at present, no published scientific data has proven a medication to effectively treat Covid-19. I know that a Senegalese team recently tested Covid-Organics with promising results. But we are waiting for the publication of the results to comment. The same applies for Apivirine, for which we await irrefutable scientific evidence. However we are not saying that these solutions developed in Africa are ineffective either. We emphasize that at the moment we do not have data to confirm their effectiveness and urge extreme caution. Let us recall that an advertising free-for-all could encourage people to be optimistic and to loosen their use of barrier measures. We are in favour of endogenous but scientifically proven solutions.
ASE: In addition to barrier measures, several alternative methods (sleep for 8 hours a day, alcoholic drinks, hot water, etc.) have been proposed to the public. What do you think about this?
Professor Adoukonou: First, let’s remember what a barrier gesture is. I spoke in the first article about the important R0 factor in the spread of an epidemic. In fact, the proportion of subjects affected in a population P is P (1-1 / R0). The larger the R0, the more significant a proportion of the population will be affected. Barrier gestures constitute the set of measures to keep the R0 as low as possible. Indeed, if we can reduce the potential number of subjects that can be infected by a contaminated subject (even asymptomatic) we will reduce the infection. For instance, in France before the containment and barrier measures, the R0 was around 2 and 3. But after the containment and barrier gestures, this rate is close to 1 or even less than 1. This is what allows a regression or even a flattening of the epidemic curve.
These actions are aimed at reducing the spread. A subject is essentially contaminated by contact and around the face. We touch our faces ten times a day, and wearing masks and avoiding touching our faces with dirty hands can reduce the spread. That is why ensuring a minimum physical distance of 1m between people, wearing masks and washing hands are the most effective measures to reduce the R0 and minimize the spread. Furthermore, like any viral infection, a good immune system is essential in the fight. Any measures to strengthen our immunity could help us, if not to avoid the disease, at least minimize the risk of severe forms. It has also been demonstrated that having adequate sleep can strengthen our immunity, but alcohol abuse weakens it. Everyone knows that hot drinks provide a feeling of well-being. As a matter of fact, when you have an influenza-like illness, hot drinks can cause a feeling of well-being but this has no effect on the virus itself. The use of alcohol is strongly discouraged as it may weaken the immune system and do people more harm than good.
ASE: We often hear about a healthy carrier of Coronavirus. Are these carriers a risk of contamination for those around them?
Professor Adoukonou: Only less than 20% of carriers of the coronavirus will present symptoms. This is what makes the fight against this illness even more difficult. These asymptomatic subjects can emit viruses into the environment, and they are the most dangerous and the most likely to contaminate others. It should also be remembered that the virus can live in the human body for several weeks. Indeed, humans can spread the virus for 3 to 4 weeks on average. The ability to contaminate drops after two weeks but is not null. In addition, a subject who is contaminated, treated, and declared cured can be infected again, although these cases are rare. It is therefore necessary to adopt barrier gestures everywhere because no one knows who is infected. This is evidenced by the increase in cases when routine screening is generalized. Most of these people have no symptoms but obviously are contagious. These healthy carriers are likely the greatest danger because symptomatic carriers are isolated and treated.
ASE: What advice do you have for readers to better overcome this health crisis?
Professor Adoukonou: Adversely to the pessimistic forecasts for Africa, we think that by following barrier measures, Africa should be able to survive it without necessarily engaging in general containment. So my advice would be…
To the authorities:
- Structure the response;
- Support researchers in clinical trials on endogenous solutions;
- Multiply the screening tests and isolate the positive subjects until they test negative;
To the population:
- Wash hands regularly with soap and water;
- Avoid to touching the face;
- Wear masks correctly and properly;
- Observe the 1m physical distancing;
- Avoid gatherings;
- At the slightest symptom, isolate yourself and call the toll-free numbers;
- Trust only information from official sources;
- Avoid self-medication because it is not effective and can even be dangerous.
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