Author: Nanadadzie Ghansah

“Blood” Economic Recovery

Cocoa Production, 1957–1983
Sources: K. Ewusi, Statistical Tables on the Economy of Ghana, 1986

It was already evident towards the end of the Nkrumah government that the Ghanaian economy was struggling. The World Bank recommended a devaluation of the Cedi. If Nkrumah planned to, he never got the chance. He was overthrown in 1966. Busia was finally the one who got to order it in 1971. This 44% devaluing of the Cedi was his undoing. It was one of the reasons Kutu Acheampong gave for usurping the government of the 2nd Republic.

The Ghanaian economy continued its nosedive through the NRC and SMC eras. The blowback from Acheampong’s “Yentua” policy, droughts in the 1970s, drop in prices of our exports, the oil crisis, and Kalabule all helped to take the economy lower and inflation higher. The ever-expanding role of the government in the economy did not help.

By the time shots rang out in Accra on June 4, 1979, things were economically dire. Rawlings continued with the military habit of regulating the economy in his short reign of terror from June till September. Even worse, he saw the private sector as the enemy. The razing down of the Mokola market epitomizes this perfectly.

If the economic situation President Hilla Limann inherited when he took office on September 24, 1979, was nothing short of dire, it managed to get even worse over the next two years. Among other things, due to overvalued exchange rates and low prices we paid our farmers for cocoa, our share of the international cocoa trade was less than 20%. Farmers were smuggling their cocoa outside to sell. State enterprises continued to make losses. The few remaining businessmen who Rawlings had not chased out or killed found it impossible to make any money. Foreign investments, which had started dwindling since Acheampong’s Yentua policy, kept getting smaller. According to World Bank data, by 1981, Ghana received only $13.3 per capita in net development assistance compared to an average of $26.3 for all sub-Saharan countries. Inflation skyrocketed to 120%.

Would the Limann government have instituted much-needed changes?Well, we’ll never know because on December 31, 1981, shots rang out again. Enter Rawlings 2.0 in the blockbuster, “PNDC Cometh! Run for your Life”.

As he killed, tortured, and imprisoned to prevent another vainglorious military officer from taking his place and removing detractors, he also pushed an economic plan straight out of the Marxist playbook. He sought to rule through “Defence Councils” made up of those who bought into his populism – students, workers, soldiers, and the disgruntled. He forced traders and controlled prices. Not realizing it, he was expanding the government’s role in the economy and making the bad situation even worse.

Another issue he had to grapple with was the lack of support from Russia and the other eastern bloc nations that he had expected. You see, the world in those days was split between the superpowers – USSR and the USA. Those Third World leaders who espoused socialist philosophy looked to Russia and Eastern Europe for help. Those who believed in free-market economics looked to the west. A lot of developing countries straddled the middle. Rawlings came out like a Castro-Gaddafi wannabe. They were his idols. He hoped they would support Ghana’s recovery. Libya did what it could to help, but it was not enough. Russia could not because they were embroiled in their economic problems that would ultimately lead to the USSR’s implosion.

To make things worse, a brutal drought hit Ghana in 1982-83, leading to famine. Fires also erupted due to the drought. Into this cauldron of killings and brutality, economic ruin, drought, and famine returned one million Ghanaians expelled from Nigeria. A change in economic policy was needed, and in 1983, Rawlings and Kwesi Botchwey, with the help of the IMF and World Bank, made that change.

Unlike the government of Hilla Limann that he overthrew, Rawlings had the luxury of having the opportunity to change. Limann never got the chance to explore another way of getting Ghana ahead. As a matter of fact, Rawlings rid the country of the opportunity to change peacefully twice. The overthrow of the Liman government was the second time. The first time was in June of 1979. The country was preparing for elections when Rawlings burst onto the scene then. Ghana was already on her way to a peaceful change of direction when he ushered in those four months of terror. The PNDC under Rawlings was able to push much-needed Economic Recovery Programs (ERPs) through. The policies he instituted in 1983, including price hikes on goods and the selling of state corporations, were policies supported by the IMF and World Bank. So this led to the return of foreign investments and loans. It would only follow that Rawlings would try to polish up his act by reducing the acts of terror, allowing the return of a free press and free and fair elections. It was also self-serving on his part to get an Indemnity Clause inserted in the constitution of the 4th Republic and morph into a democratically elected first president of said Republic.

In the eyes of some, the economic improvements he ushered in should make up for all the human rights abuses perpetrated under his watch. They argue further that only Rawling’s force of will and the power of the gun allowed him to push through those policies. And that no civilian government would have been able to achieve that without the people rioting.

In other words, Exitus acta probat!

Now that is an argument I refuse to agree with. In the first place, we never got the chance to find out. Ghana has been through economic upheavals since 1992, and we have not needed bloodshed to solve those problems. We have had disagreements over election results that have been settled amicably through the courts. We are capable of peaceful change but were denied that opportunity by coup plotters like Rawlings, Acheampong, and the rest who always felt they were the only ones with the answers.

Could Ghana have had this economic recovery without all the bloodshed? Was all that loss of life necessary? Or was the blood that was spilled the prerequisite for the improvements? A necessary offering? Did Ghana then enjoy an economic recovery steeped in the blood of others? Much like blood diamonds from Liberia back then, did we, thanks to Rawlings, enjoy a ‘blood’ economic recovery? I believe we did, and in the process, we also sacrificed the belief and desire to uphold and protect human rights.

Harlow vs Fitzgerald - the Qualified Immunity Doctrine Matures

By Nana Dadzie Ghansah

Ernest Fitzgerald. Courtesy of the NYTimes

If the 1967 Supreme Court ruling in the case Pierson vs Ray birthed the doctrine of “Qualified Immunity”, the 1982 decision Harlow vs Fitzgerald cemented the concept.

Background

In 1965, Lockheed was awarded the contract to build the C-5A Galaxy cargo plane for the Air Force. Even though Boeing had the best overall design, Lockheed had the lowest bid and thus won. Their bid was for $16 million per plane for a project total of $1.9 billion. In a few years, the cost of a plane amount would balloon to $40 million.

The project was plagued by technical difficulties and significant cost overruns which both Lockheed and the Pentagon hid from Congress. There was however an engineer and management analyst in the Department of the Air Force who knew how much more the project was costing taxpayers. He first discovered the cost overruns on a routine visit to the Lockheed complex in Marietta, GA in January 1966. He kept up with the overruns even though Lockheed tried to hide them. His name was Ernest Fitzgerald.

With time, Congress got wind of how expensive the C-5A project had gotten. On November 13, 1968, with the unexpected costs standing at $2.3 billion dollars over budget, Fitzgerald was invited to testify before Congress regarding these cost overruns.

Even though he was asked by the Air Force to not divulge any information about the cost overruns and problems at Lockheed, Fitzgerald did not heed that directive. His testimony was stunning. The Air Force brass was livid.

The initial congressional hearing occurred at the tail end of the Johnson presidency. The investigations and Fitzgerald’s appearances continued into 1969 with Nixon in office. In late May and early June of 1969, Fitzgerald testified four times before the House Armed Services Committee and the Joint Economic Committee at their request.

Now Fitzgerald’s testimonies were not only annoying the Air Force brass but also reportedly, President Nixon and three of his aides, Bryce Harlow, H.R. Haldeman, and Alexander Butterfield. They thought he was not a team player and needed to be removed from the Air Force.

Even before the president got involved, Fitzgerald was socially and professionally ostracized at the Pentagon after his initial testimony before Congress. Many of his assignments, especially those involving the C-5a were pulled and he did not get any new responsibilities. Led probably by the Air Force Secretary Robert C. Seamans and working together with the White House, he was secretly investigated, suffered a smear campaign, and was accused of divulging classified information. Finally, it was decided that the best way to get rid of him was to abolish his position in the Air Force. On November 4, 1969, Fitzgerald was notified that his job had been abolished in a reduction in force, and economic reorganization. His termination became effective on January 5, 1970.

He appealed his termination to the Civil Service Commission (CSC). He won his appeal and was reinstated to his Pentagon job with back pay in December 1973. However, he was not assigned to any more jobs that involved weapon systems. It was also during these CSC hearings that the role of the Nixon White House in Fitzgerald’s firing came to light.

In January of 1974, Fitzgerald filed a suit for damages in the United States District Court in Washington DC. The defendants were 8 officials of the Defense Department, White House aide Alexander Butterfield, and “one or more” unnamed “White House Aides” styled only as “John Does.” He alleged the defendants conspired “…to deprive him of constitutional and statutory rights resulting in permanent injury to his career and personal injury to his dignity, privacy, and reputation, as well as mental anguish.”

The district court dismissed the lawsuit under the statute of limitations. The Court of Appeals affirmed the lower court decision but reasoned that the defendant Alexander Butterfield, one of Nixon’s aides, might not be covered by the statute of limitations due to a memo he had written in 1970 and that had come to light during the Watergate hearings. The memo was written around the time Fitzgerald was fired. In the memo, Butterfield stated, “Fitzgerald is no doubt a top-notch cost expert, but he must be given very low marks in loyalty; and after all, loyalty is the name of the game. Butterfield went on to recommend that Fitzgerald should at least be made to “bleed for a while” before being offered another job in the administration. The Court of Appeals thus remanded the action against Butterfield for further proceedings in the District Court.

Following that and extensive discovery, Fitzgerald filed a second amended lawsuit in DC district court in July 1978. As defendants, he named the former President Nixon, White House aide Bryce Harlow and other officials of the Nixon administration. By March 1980, only three defendants remained: Richard Nixon and White House aides Harlow and Butterfield. Nixon and the other defendants claimed protection from qualified immunity. Moreover, Nixon claimed absolute immunity as he was president when the actions were taken. The district court ruled that the case could go to trial and that Nixon could not claim absolute Presidential immunity. He could only claim qualified immunity. Nixon and the other defendants appealed the ruling of the district court but the Court of Appeals upheld it.

Nixon vs Fitzgerald

On November 30, 1981, the lawsuit landed before the judges of the United States Supreme Court. By this time, the lawsuit against Nixon had been separated from that against Harlow and Butterfield. The question was, “Was the President immune from prosecution in a civil suit?”

On June 24, 1982, the judges decided in favor of Nixon. In a 5–4 decision, they ruled that the President “is entitled to absolute immunity from damages liability predicated on his official acts.” Justice Powell in writing the court’s opinion stated that absolute immunity was a function of the “President’s unique office, rooted in the constitutional tradition of separation of powers and supported by our history.” He also argued that “because of the singular importance of the president’s duties, diversion of his energies by concern with private lawsuits would raise unique risks to the effective functioning of government.” The court however also stated that the President is not immune from criminal charges stemming from his official (or unofficial) acts while in office.

Interestingly, in 1997, the SC in Clinton vs Jones would add that a President is subject to civil suits for actions committed before he assumes the presidency.

Harlow vs Fitzgerald

The other part of the lawsuit involving Harlow and Butterfield was heard separately by the judges in the same time span and became known as Harlow vs Fitzgerald. The question here was, “Are presidential aides entitled to immunity from civil suits?”

In an 8–1 majority, the judges held that government officials are entitled to qualified immunity but not absolute immunity. The court stated that “government officials performing discretionary functions, generally are shielded from liability for civil damages insofar as their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known.”

In ruling this way, the judges were hoping to protect state actors from frivolous lawsuits that would dampen the desire for government workers to exercise their duties in cases where the legality of their actions is uncertain.

However, this has led to the unintended consequences that have not always been good and have challenged the civil rights law Section 1983.

For several years after the ruling government officials and policemen who violated the civil rights of others in new and novel ways and got sued, mostly got off free as the illegality of their actions had not been established. However, subsequent offenders did not always. Judges dealing with such cases had to conduct a two-step inquiry.

First was the question if the alleged facts show that, say, an officer’s conduct violated a constitutional right of a victim. Then the judge had to determine if the illegality of the officer’s actions was or was not “clearly established. If there was a precedent, then the action had been clearly established as being illegal and the officer did not get qualified immunity and could be sued. If there was no precedent, then he got qualified immunity. Unfortunately in the 2008 case Pearson vs Callahan, the judge ruled that this 2-step framework was not mandatory. Since then, a lot of judges have forsaken the 2-step process and are not even examining if a plaintiff’s civil rights were violated. Also, in looking at the illegality of officers’ actions, judges are giving them more leeway.

The Supreme Court ruling also gives government officials and policemen another advantage. Qualified immunity is usually invoked before the case goes to trial before a jury. In all other lawsuits, if the challenge a defendant brings up to prevent a trial fail, he/she cannot appeal the case before the trial is over. Yet, in cases involving qualified immunity, the officer or government official can appeal the denial of qualified immunity before the trial. This increases the time and cost of civil rights lawsuits against state actors thus making such cases unpopular with civil rights attorneys.

And even if the plaintiff prevails in a lawsuit, most jurisdictions indemnify police officers against having to pay compensation to victims. Like UCLA law professor Joanna Schwartz found out in a survey she did in 2014 for her NYU Law Review article “Police Indemnification, 44 large police departments, as well as 37 small and mid-sized agencies totally exempted their officers from paying for the damages of their misconduct. She found out in the study period of 2006 -11 “…governments paid approximately 99.98% of the dollars that plaintiffs recovered in lawsuits alleging civil rights violations by law enforcement.”

The Supreme Court created the doctrine of “Qualified Immunity”. It was not a law passed by Congress. No matter its intent, the doctrine has morphed into an instrument that allows some state actors to violate the civil rights of some of the nation’s citizens and escape the consequences of their actions. It is time for Congress to do something about it.

Qualified Immunity – the Birth of the Doctrine

By Nana Dadzie Ghansah

In 1871, the Reconstruction-era Congress passed the Ku Klux Klan Act. Section 1 of that act would later become known at 42 U.S.C. § 1983 or “Section 1983” in 1874.

It was originally passed to help African-Americans enforce the new constitutional rights they won after the Civil War. 

“Those amendments made slavery illegal, established the right to “due process of law” and equal protection of the laws, and guaranteed every male citizen the right to vote. Although these Amendments became law, white racist judges in the state courts refused to enforce these laws, especially when people had their rights violated by other state or local government officials. The U.S. Congress passed Section 1983 to allow people to sue in federal court when a state or local official violated their federal rights.” (Excerpt from “Jailhouse Lawyer’s Handbook, Chapter 1).

The law states that:

“Every person who, under color (under state authority) of any statute, ordinance, regulation, custom, or usage, of any State or Territory or the District of Columbia, subjects, or causes to be subjected, any citizen of the United States or other person within the jurisdiction thereof to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws, shall be liable to the party injured in an action at law, suit in equity, or other proper proceeding for redress.”

This basically meant that if you believed that a state actor like a cop infringed on your civil rights during an interaction or a county clerk treated you differently because of your religious beliefs, you could sue them.

There are legal rules made by judges as they issue rulings on cases, as opposed to rules and laws made by the legislature. This is known as common law. From all indications, once Section 1983 became law, there is nothing in the common law from that era that gave state actors immunity from being sued.

This all would start to change in 1967.

In 1960 the Supreme Court ruled in the Boynton v. Virginia case that segregation of interstate transportation facilities, including bus terminals, was unconstitutional. Starting in May of 1961, a civil rights organization called Congress of Racial Equality (CORE) decided to test if the SC ruling was being adhered to in the Jim Crow South. It started organizing bus rides to the south called “Freedom Rides”. The “Freedom Riders” were a group of white and African-American civil rights activists. The aim was to have mixed racial groups ride into the southern states that still maintained Jim Crow laws and use the facilities there to challenge local laws or customs. The riders were confronted by the police as well by very violent white protesters in the southern states. However, it drew attention to the civil rights movement.

About a year before the SC ruling, three Episcopalian priests formed the Episcopal Society for Cultural and Racial Unity (ESCRU) to fight for racial equality and against segregation in the Episcopal Church and its institutions. It was headquartered in Atlanta, GA. 

In the spirit of the Freedom Rides, the ESCRU organized a “Prayer Pilgrimage” from New Orleans, LA to the Episcopal Church Convention in Detroit, MI. The aim was not only to visit Episcopal Churches and schools along the route to preach de-segregation but also to challenge the Jim Crow laws by having a mixed racial group of pastors use transportation facilities in the states with these laws.

On September 11, 1961, an interracial group of 27 priests set off on this “prayer pilgrimage” on a chartered Trailways bus from New Orleans. On arrival in Jackson Mississippi on September 13, fifteen (12 whites and 3 backs) of the integrated group of priests entered the “Whites Only” lunchroom of the Trailways bus terminal. They were asked by 2 cops to “move on” but refused. The group was arrested and thrown in jail by a Captain JL Ray.

One of the priests in the group of 15 was one Father Robert L. Pierson. Incidentally, he was the son-in-law of the then Governor of New York State, Nelson Rockefeller. This led to the incident getting a lot of press coverage. 

The priests faced a local judge named James Spencer on September 15. He found them guilty of Breach of Peace (using a now-repealed Mississippi law) and sentenced each of them to four months in jail and a $200 fine. After a few days in jail, they were released on bond.

Led by Fr. Pierson, the group appealed the case in county court. A judge at the county court dismissed the case against the clergymen.

The group subsequently brought a Section 1983 suit against the policemen and the judge for depriving them of their constitutional rights per Section 1983 of the 1871 law. At the district court in Jackson, the jury found in favor of the cops and the judge. On appeal, the Court of Appeals for the Fifth Circuit ruled that the local judge was immune from liability. They also ruled that even though the Mississippi law was unconstitutional, “Mississippi law does not require police officers to predict at their peril which state laws are constitutional and which are not.” 

The case finally landed in the Supreme Court as Pierson vs Ray in January 1967. It was decided on April 11, 1967. Eight out of the nine judges agreed that “…Judge Spencer was immune from liability for damages, and that Section 1983 would not apply in a judge’s case”. Further, the stated that “Congress would have specifically so provided had it wished.”

Regarding the policemen, Chief Justice Earl Warren wrote:

“The common law has never granted police officers an absolute and unqualified immunity, and the officers in this case do not claim that they are entitled to one. Their claim is, rather, that they should not be liable if they acted in good faith and with probable cause in making an arrest under a statute that they believed to be valid. Under the prevailing view in this country, a peace officer who arrests someone with probable cause is not liable for false arrest simply because the innocence of the suspect is later proved.” 

With that decision the court basically ushered in the legal concept of “Qualified Immunity”, thus diluting the whole spirit of Section 1983.

“Qualified Immunity” basically means that state actors like policemen can’t be sued unless the plaintiff can demonstrate to the court that they violated “clearly established law.” It further means that as long as the cop was believed to be acting in good faith in line with his work, he or she cannot be held liable for a bad outcome.

That ruling would create a police force that could not be held liable for infringing on the civil rights of the very people they had sworn to protect.

How an Effective COVID-19 Vaccine Could Lead to Better Influenza Vaccines


The Influenza A Virus. Courtesy of the CDC

There is a very high probability that at least one of the many COVID-19 vaccine candidates out there will be successful and help humanity achieve the protection it needs from SARS-CoV-2.

It probably will not happen this year then there is still a lot of work to be done by all the teams involved and the 7 months left will probably not be enough.

A lot of doubters look at the fact that RNA viruses are tough to make vaccines for but we have them – yellow fever, measles, and polio are a few examples. Others look at how difficult it is to make a vaccine against the influenza A and B viruses. That is true but a study of the structure and properties of the flu virus explains why. A comparison of the flu virus with the SARS-CoV-2 virus exposes why we all should be hopeful that an effective vaccine for the latter is possible.

Interestingly, I think the technologies and thought processes driving the development of a COVID-19 vaccine might give us a much better flu vaccine.

One fact that needs to be emphasized over and over again is that COVID-19 is not Influenza. They may share symptoms and some pathology but they are caused by different viruses, have different contagiousness, fatality rates, and clinical pictures. 

Both are RNA viruses. Where SARS-CoV-2 is part of the Beta-coronavirus family, the influenza viruses belong to the Orthomyxoviridae family.

The COVID-19 virus is made up of a single strand of RNA. That of the flu is made up of a single strand to but that strand has 8 segments. That is one of the important differences.

Though there are four types of influenza viruses: A, B, C, and D, only Types A and B cause the outbreaks of disease in humans yearly. Flu A is the most dominant and virulent type and the only type that can cause pandemics. 

The viral genome of flu A codes for about 14 proteins. Two of these are hemagglutinin (HA) and neuraminidase (N). Hemagglutinin is more numerous than neuraminidase. The two are very important glycoproteins because they are integral to how the virus enters the cell. HA binds to cells of the nasal epithelium that express sialic acid. Once in the cell, the viral genome replicates. It is at this point that neuraminidase facilitates the release of the virions.

Hemagglutinin and neuraminidase are also used to name the different subtypes of the virus. 

Originating mainly from birds, there are 18 subtypes of hemagglutinin and 11 subtypes of neuraminidase.  Types H1 to H16 and N1 to N9 are found in birds. Types H17 – H18 and N10- N11 were isolated from bats recently. While there are potentially 198 different Influenza A subtype combinations, only 131 subtypes have been detected in nature.

The subtypes currently found in humans are H1N1(the Spanish Flu) and H3N2 (Hong Kong flu). Rarely, H1N2 has been seen. H2N2 was the cause of the Asian flu pandemic in 1957 – 58 and the subtype that caused the Spanish Flu is H1N1.

Flu B is only found in humans. There are 2 subtypes. It also has the hemagglutinin and neuraminidase glycoprotein structures too.

The genome of SARS-CoV-2 is much larger than that of the flu. Where the flu A has 13,588 bases altogether in the 8 segments, SARS-CoV-2 has about 30,000. Both viruses need an RNA polymerase for replication. One hallmark of RNA viruses is how often replication leads to mutations. Whereas the SARS-CoV-2 virus has a proofreader that can excise out mutations in the replicated genome, the flu virus does not have that capability. 

Thus flu viruses show a high incidence of mutations, about 50 a year. None of these are proofread and repaired. Moreover, the virus has the ability to exchange pieces of genome between the 8 segments. Also, when two flu A types are present at the same time in a host, they can switch out gene segments, producing a new type. This phenomenon is known as reassortment and is how H1N2 came to be. It resulted from reassortment event between circulating human seasonal influenza A(H1N1) and influenza A(H3N2) viruses.

Thus the high rate of mutations, the ability to exchange genes between the segments (a process called antigen drift), and reassortment lead to an ever-changing structure of the glycoproteins not only in the virus but more importantly, on the viral envelope. The viral hemagglutinin and neuraminidase do not only allow the virus to bind to and enter the cell but they also are the antigens used for Influenza vaccines. This ability to constantly change its genetic identity leads to the vaccines that have very low efficacy, year after year.

The SARS-CoV-2 virus on the other hand does not mutate as much. The vaccine candidates against the virus target the spike glycoprotein on the envelope that has been stable through different types of the virus. The spike protein, but for some minor changes, has stayed grossly the same through SARS-CoV, MERS-CoV, and now SARS-CoV-2. It is thought that its structure will not change significantly to make vaccines as ineffective as with the flu virus.

As mentioned earlier, due to antigen drift, flu vaccines have low efficacy and must be re-engineered annually. Yearly, a global survey has to be done for the flu A strains circulating as well as the nature of the HA antigens. A projection is then made about which strains of flu A and HA antigen types to include in a vaccine, that also contains flu B. 

It is no wonder flu vaccines are sometimes only about 20% effective.

One way to improve the antibody response is to use a wide collection of influenza viruses that incorporates the most common amino acids found in hemagglutinin. This technique is known as computationally optimized broadly reactive antigen (COBRA).

Now, as mentioned earlier, the dominant glycoprotein on the envelope of the flu virus is Hemagglutinin (HA). HA is structured like a mushroom, with a stalk and head. The head has the binding sites for the virus and is the dominant antigen in the inactivated, live attenuated, and

recombinant HA vaccines. Unfortunately, it is that part of HA that sees the most mutations. However the stalk, like the spike protein of the SARS-CoV-2 virus, has stayed conserved over the decades. In studies where it was used as the preferred antigen, it produced antibodies that are more broadly reactive. 

Instead of presenting it as an inactivated or live version, the genetic material that codes for the stalk could be presented in a vector just like it is being done with COVID-19 vaccine candidates. That will also shorten production time then the present flu vaccines need embryonated eggs for production.

COVID-19 has dealt the world a terrible blow but it does have some silver linings. The use of vectors to present genetic material as a vaccine, the choice of conserved parts of the virus as antigens, and the avoidance of inactivated and attenuated viral products may not only give us more vaccine possibilities but also hasten how vaccines are produced.

One possibility is that we may finally get better and more effective  Influenza vaccines.

Those RNA Viruses

Note: this a really basic discussion of a very complex and ever-evolving topic.

From Duffy S (2018) Why are RNA virus mutation rates so damn high? PLoS Biol 16(8): e3000003. https://doi.org/10.1371/journal.pbio.300000

he genetic information that codes for traits in all living organisms are found in DNA or RNA or a combination of the two. Even viruses, not really seen as living organisms, have genetic material. They either code them in RNA (RNA viruses) eg. Influenza or DNA (DNA viruses) eg. Herpes.

Where DNA viruses are quite big, RNA ones are much smaller. Also, RNA viruses replicate (multiply) way more than DNA viruses.

(Just a reminder, DNA and RNA are made up of bases called nucleotides).

To exert their disease-making effects all viruses have to enter the cells of the organism they are attacking. So they find a receptor that fits them on the membrane of the cell, fuse with that receptor and then worm their way into the cell.

Once in the cell, a DNA virus finds its way into the nucleus of the cell and fuses with the host organism’s DNA. As it divides and multiples, it uses the organism’s enzymes it needs for multiplication — the polymerases. Ensconced in the nucleus, DNA viruses tend to be more stable over time. They multiply and mutate less and therefore may be easier to treat.

The RNA virus on the other hand, stays in the cytoplasm and divides in there, using its own polymerases. Being smaller, using its own polymerase and away from the influence of the host organism, the RNA divides very fast and often. This leads to the RNA virus being able to switch out the nucleotides in its RNA often resulting in a different strain than what entered the organism — a process we commonly term “Mutation”!

It has been calculated that RNA viruses mutate on an average of once every 50,000 base pairs per infection. DNA viruses do that once every 50,000,000 base pairs per infection.

Now DNA viruses have mutations too but one, they are not as frequent and besides, the organisms polymerases can cut out these renegade nucleotides. The RNA’s polymerases lack this repair ability.

Mutations in RNA viruses are often set off when the environment in the cell changes — like when it senses the presence of a new vaccine or antibodies or medications. This ability to multiply fast and often is the reason why we never seem to get a good enough vaccine for the flu. That is why we sometimes need to treat viral infections like HIV and Hepatitis C with more that one medication.

This ability to mutate often also leads to instability of the RNA virus — it can generate a lot of mutants which do not survive or which may even be more virulent. Much more virulent than the organism that entered the cell.

Now in most normal humans, the body is able to mount a level of immunologic reaction to the vast number of viruses that affect humans. However, if the virus is totally new to humans, that ability is not available for months to even a year. Thus when a novel RNA virus spills over from another mammal into a human, those initial months to a year are very unpredictable. We are dealing with a virus that can mutate into a more virulent strain and against which the body still has no defense.

COVID-19 is an RNA virus that spilled over recently!

 

The Whistleblowers

I have wondered how Li Wenliang, an ophthalmologist, became the face of the group of doctors in Wuhan I call “The Whistleblowers”. These were the doctors whose warnings about the outbreak of a contagious and novel pneumonia-causing virus in Wuhan, China went unheeded by those in authority.

So I decided to do some digging. Reporting in the WSJ, NYT, and other online publications have been very helpful in this effort.

By the second week of December 2019, doctors around Wuhan were seeing patients with symptoms that included fever, coughing, fatigue, and aching limbs. Initially, some doctors thought it was bronchitis but soon most realized the condition was atypical pneumonia. They tried to treat these cases unsuccessfully with antibiotics.

Even though a lot of the patients came from the Huanan Wet Market, the connection was not made until later.

On December 16, an ER doctor named Ai Fen admitted a 65-year-old man to the emergency room at Wuhan Central Hospital whose only symptom was fever. A chest CT showed bilateral lung infections he was given antibiotics and antipyretics. The fever did not break so he was transferred to a tertiary center for advanced care. It was only after the transfer that Dr. Ai learned that the man worked at the wet market.

On December 27, Dr. Ai admitted another patient with similar symptoms. She ordered a chest CT and lab work. By the next day, she had seen 6 more such cases. Four of them worked or were in some way affiliated with the Huanan wet market.

She started to wonder if she was seeing a contagious disease. She notified the hospital leadership, who in turn notified the district CDC office. That office had been getting similar reports from other hospitals and clinics in Wuhan.

On December 30, she got the lab results back from the patient she had seen 3 days earlier. It read “SARS Coronavirus”.

A terrified Dr. Ai notified the hospital leadership of her findings. She also shared a photo of the lab result and a video of a chest CT scan showing pneumonia caused by this new virus with a medical school classmate.

Somehow, this photo and video clip ended up on the phone of an ophthalmologist who also worked at Wuhan Central. His name was Li Wenliang.

That afternoon, he shared it with his group of med-school classmates on WeChat with over 100 members.. (Bear in mind that in China, all social media sites are spied on by the government.) He posted:

“7 SARS cases confirmed at Huanan Seafood Market…Patients quarantined in the Emergency Department of our hospital.”

Another member warned that he could be censored for sharing such information.

He replied:

“Coronavirus confirmed, and type being determined…Don’t leak it. Tell your family and relatives to take care.”

Well, who can avoid sharing such juicy information in this age of social media? By that night, the information was all over WeChat.

The censors showed up shortly thereafter.

The next day he was reprimanded at work. On January 3, he got a visit from the police who warned him and censured him for “making false statements on the internet”. He was made to sign a letter of admonition promising not to do it again.

Reportedly, eight Wuhan doctors in all were admonished by the police for discussing the outbreak on social media in the first week of January 2020.

One of these doctors was Dr. Xie Linka, an oncologist at Wuhan Union Hospital. She learned from her Pulmonology colleagues that the hospital’s respiratory unit was housing many patients with an unknown type of pneumonia. She also later posted on WeChat warning members in her chat groups to wear masks and ventilate areas.

Dr. Liu Wen, a neurologist at Wuhan Red Cross Society Hospital was another doctor who was admonished. He also found out about cases in his hospital and posted about or discussed it on WeChat.

By December 30, doctors who were seeing and treating these patients with the strange new pneumonia knew what the authorities in Wuhan would not accept — that it was contagious and had human-to-human transmit-ability.

On December 31, the Wuhan branch of the National Health Commission issued a statement that confirmed the outbreak of a disease that had so far infected 27 people. It further said:

“The investigation so far has not found any obvious human-to-human transmission or infection of medical staff. The disease is preventable and controllable.”

On January 1st, 2020, Dr. Ai admitted a patient with symptoms of the strange new pneumonia. He ran a clinic near the Huanan market and had been treating a lot of those patients in the preceding weeks. Now he was sick. She alerted the hospital leadership and stressed that she believed the disease was contagious. She asked her staff to put on masks when treating those patients. For that, the hospital leadership admonished her the next day for spreading rumors and destabilizing Wuhan.

Unbeknownst to Dr. Ai, one Dr. Lu Xiaohing, Director of Gastroenterology at the Wuhan Municipal Hospital had received news a week earlier on December 25 2019 of the medical staff at two hospitals in Wuhan who had fallen sick while taking care of patients suffering from new and strange pneumonia. Dr. Lu did share the news but it is unclear if he was also admonished.

These admonishments may have shut up the whistleblowers but not the spread of the virus. With cases mounting not only in Wuhan but in other cities and international concerns increasing, a team led by the SARS expert and renowned epidemiologist, Dr. Zhong Nanshan, was sent to Wuhan. On January 20, 2020, Dr. Zhong would announce what the doctors in Wuhan had known all along — that the virus could be transmitted from human-to-human. At that point, there were 198 cases reported and three deaths.

Sadly, the very group of people who tried to warn the authorities all long that the virus had the ability to be transmitted human-to-human would suffer from this virus because they were not heeded. One of them was one of the whistleblowers — Dr. Li Wenliang.

On January 7, Dr. Li saw a patient with angle-closure glaucoma at Wuhan Central. Unbeknownst to him, the patient was a storekeeper at the Huanan wet market who had the virus. By January 10 he had developed a fever and a cough. On January 12, he had to be admitted because of extreme dyspnea. Dr. Li did not do well. About a month after he contracted the virus from a patient, he succumbed to pneumonia, dying on February 7 at the age of 34. He left behind a pregnant wife and a son.

As of March 4, 2020, China’s National Health Commission reported that more than 3,300 healthcare workers nationwide had been infected and at least 13 have died. Overall, 105, 938 patients have contracted the virus so far worldwide. 3567 people have died and 58,625 have recovered. Whereas the severity in China seems to be waning, the outbreak is on the increase in Iran, South Korea, and, Italy. Also, though the mortality rate looks low, it is very contagious and seems to be still spreading quickly. If millions get infected, even a low mortality rate will still result in lots of deaths.

The outbreak is also having a rather terrible impact on the world’s economies and may lead to a worldwide recession.

This makes me wonder what could have been if only those authorities in Wuhan had listened…listened to those doctors…those whistleblowers.

May Dr. Li Wenliang rest in peace. May all the doctors and nurses all over the world who are caring for patients afflicted by COVID-19 and other infectious diseases be safe.

Not The Last One

“From winter, plague and pestilence, good lord, deliver us!”
– From the play, “Songs from ‘Summer’s Last Will and Testament” by Tom Nashe
Sooner or later, the world will gain control over the COVID-19 outbreak. It will be through containment, effective treatment, a vaccine, or a combination of the three. History teaches that. Even the Black Death ended. Even the incurable HIV/AIDS has been controlled.
History also tells us that sooner or later, human behavior will lead to another epidemic or even pandemic. How is that?
Disease outbreaks occur through uncleanliness, vectors, lack of prevention (Anti-Vaxxers, etc), and zoonotic spillovers.
There are areas of the world that still lack clean drinking water and these areas still have outbreaks of cholera and typhoid.
The mosquito still transmits yellow fever and other viral diseases that are endemic in areas in the Tropics and flare up into epidemics every now and then. Even the bubonic plague broke out not too long ago in Madagascar!
Then is the fact that viruses are spilling over from other mammals to humans causing events like the COVID-19 and SARS outbreaks.
Lastly, refusal by some to get vaccinated means that occasionally, we are going to see diseases like measles and polio break out.
Human behavior does not only lead to the direct breakout of diseases. What we do after these diseases break out will ensure that we will forever see epidemics or even pandemics.
Since time immemorial, the attitude of those in power towards the outbreak of diseases has worsened these events. One can almost predict these reactions and the Chinese authorities epitomized it wonderfully during the initial weeks of the COVID-19 outbreak in December 2019. Instead of appreciating the observations of Li Wenliang and his colleagues that there was a new cluster of patients presenting with SARS-like pneumonia, they censored them.
When a disease breaks out, there are always those, often healthcare workers, who notice the initial cluster of cases and sound the alarm.
Those in power will often deny these reports. Then as the cases mount, they’ll seek to suppress the scientific or observational findings of those who are seeing this cluster swell.
When that does not work, they try to argue that things are not so bad.
By the time leaders realize things are bad, the initial outbreak is beyond containment.
We can forgive the lack of scientific knowledge for the reasons leaders in the Antiquity and Middle Ages gave for the epidemics that afflicted them. The Antonine plaque of 165 AD in the Roman Empire was blamed on an angry Jupiter. It was smallpox. The Church claimed The Black Death was due to bad miasma. Others said it was caused by the Jews and slaughtered them for that. It was bubonic plague.
(Looking at how Copernicus and Galileo were treated, I doubt the Church would have listened.)
However, to deny outbreaks, seek to suppress their reporting or make light of their severity has to be unforgivable in our present times. This is especially egregious since early action can contain disease outbreaks. And yet those in power do it.
We saw President Woodrow Wilson and other allied leaders do it during the Spanish Flu epidemic in 1918 leading to 50 million people dying worldwide. They suppressed information about the epidemic so as not to depress morale during the 1st World War.
It happened during the outbreaks of bubonic plague in San Francisco in the early 1900s. 190 people ended up dying.
We saw President Reagan avoid the issue of HIV/AIDs until 1985.
We saw several African Heads of States, like Thabo Mbeki of South Africa, refuse to accept the fact that HIV/AIDs was killing their people in the 1990s and 2000s.
We have seen the Chinese reactions to SARs and COVID-19.
It is not only leaders who misbehave when diseases break out. Among the general population, denial abounds too. That is often compounded by crazy conspiracy theories. This is followed by a period of panic and hysteria. When these reactions do not work, fear sets in. Deep crippling fear. Finally, people learn to accept the new reality and a rational response ensues.
In that regard, we of the present day are no different than the Flagellants in Europe of the 14th century, who whipped themselves bloody to get God to stop the plague during the Black Death.
Another factor that adds to the possibility is the unwillingness of governments to spend the money necessary to prevent these diseases from breaking out. Preventive programs in the hotspots of the world are often underfunded. Even developed nations are cutting back. The US recently axed its Pandemic Team as well as the PREDICT Program – a program made of scientists working around the world to hunt down the viruses, like COVID-19, that could lead to the next epidemic or pandemic.
So yes, human behavior being what it is plus economic policy that often short changes public health, we will continue to see epidemics and pandemics. Even in spite of all the scientific advancements, yes, we will continue to see these events.

If it Walks Like A Duck

There is a saying that goes, “If it walks like a duck, quacks like a duck, and swims like a duck, it is a duck!!! “
It is not a camel, it is not a cat…it is a duck!
We have a novel respiratory virus breaking out in a part of a country where the people are known for capturing, trafficking in, and eating all manner of wild animals, a country with a huge bat population and responsible for two other recent breakouts of respiratory viruses. The previous epidemics were found to be caused by viruses that spilled over from bats, were incubated in rodents, and then jumped over to humans.
Would it not be smart to suspect that this recent outbreak may have followed the same path since the behaviors in that population have not changed?
Walk like a duck, quack like duck!!!
And thus scientists who know and understand the phenomenon of zoonotic spillovers have sequenced the genome of this virus and found it to have 96% similarity to a coronavirus from a bat. 96%!
To the men reading this, if a DNA test had that level of similarity, that child whose paternity you refute would be yours!!!
Yet, in spite of all the evidence, some insist on calling it a zebra instead of a duck. Instead of looking at the science, some insist on wallowing in mind-boggling conspiracy theories.
Look, the COVD-19 is not a lab construct. It spilled over from a bat, going first through another mammal and the earlier we accept that, the sooner we start finding ways to prevent more zoonotic spillovers.
Learn the term: ZOONOTIC SPILLOVER!!!
A team of researchers has taken an intellectual shot at rumors that COVID-19 was engineered. In a paper posted on Monday on the scientific online forum Virological, the scientists – who include top epidemiologists like W. Ian Lipkin from Columbia University; Edward Holmes from the University of Sydney; and Kristian Andersen of Scripps Research – said very important genetic clues indicate that COVID-19 was not created in a laboratory.
The paper states:
“It is improbable that SARS-CoV-2 emerged through laboratory manipulation of an existing SARS-related coronavirus. As noted above, the RBD of SARS-CoV-2 is optimized for human ACE2 receptor binding with an efficient binding solution different from that which would have been predicted. Further, if genetic manipulation had been performed, one would expect that one of the several reverse genetic systems available for beta coronaviruses would have been used. However, this is not the case as the genetic data shows that SARS-CoV-2 is not derived from any previously used virus backbone.”
In other words, the researchers found that the way the virus binds to humans cells is way more efficient than any computer program would have produced.
Also, the “spikes” the virus uses to attach to human cells is based on a structure yet unseen in any lab. If the virus had been engineered, the makers would have used an available backbone used by scientists.
This means that there are two possibilities for COVD-19 origin:
– natural selection in a non-human animal host prior to zoonotic transfer, or
– natural selection in humans following zoonotic transfer.
So in short, COVID-19 IS HIGHLY LIKELY THE RESULT OF A ZOONOTIC SPILLOVER NOT A LAB-MANUFACTURED ORGANISM!!!
No amount of conspiracy theorizing will change that. No novels written in 1981 with predictive passages about Chinese scientists will change that. No statements by irresponsible politicians, nefarious state agents, and clueless media members will change that.
Thus, instead of wasting our time on hollow theories, the world should bring pressure to bear on China to get its people to change their ways.
Historically, the areas around the world’s rainforests have been seen as the hotspots for zoonotic spillovers and two of the deadliest – Ebola and Marburg – came from Africa. Yet, when a group of people actively hunt and capture wild animals from an area of the world with huge bat populations, traffic, sell, and slaughter them on open markets without any control, is the risk in this area not much greater than round the areas around rainforests?
In fact, all of humanity needs to be wary about encroaching on the habitats of these bats and/or hunting and eating all manner of wild animals nilly-willy.
Imagine the COVID-19 virus had not been a respiratory virus but one that causes hemorrhagic fever like Ebola? Just imagine!
Don’t think it can happen?
Well, we have had SARS, MERS, Ebola, Marburg, Nipah, Hendra spillover in just the last 50 years from bats and they have 60+ other viruses they are willing to share!!!
Let’s wise up!!!

When We Encroach

He is seen as the first patient who got sick but some researchers believe the virus had already started raging earlier than that December 1st when he was admitted to a hospital in Wuhan, China with pneumonia. By December 10, there were 3 more patients and by the end of the month, there were 40 cases.
Soon the world would hear of a virus that was making people sick in Wuhan, China, and was going to spread even beyond China.
Initial work by Chinese virologists soon showed what the causative agent was – a coronavirus not found in humans. Now there are several strains of the coronavirus. Four types are found in humans and they usually cause the common cold. The ones found in other mammals are the ones that cause severe disease in humans. The two known ones are severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV). Whereas the coronavirus that caused SARS was isolated from a civet, the source of MERS is thought to be a camel.
The strain causing the people of Wuhan to get cases of pneumonia was named 2019-nCoV (novel coronavirus). Further work showed it shared 79.5% percent of the structure of another non-human coronavirus that had caused an epidemic in 2002-2003 – the SARS-CoV – and was 96% identical at the whole genome level to a bat coronavirus.
So a virus found in bats is causing disease in humans.
Now this phenomenon is not new. Pathogens from vertebrate animals that cause disease in humans are called “Zoonoses”. The process whereby the pathogen (bacteria, prions, protozoa, fungi, worms, viruses) springs over from the animal to the human is termed a “Spillover”.
Roughly 80% of viruses, 50% of bacteria, 40% of fungi, 70% of protozoa, and 95% of worms that infect human beings are zoonotic. Most of the identified reservoirs are mammalian in nature (roughly 80%). More than 60% of the roughly 400 emerging infectious diseases that have been identified since 1940 are zoonotic. Thus zoonoses are of particular public health interests.
We all know the famous ones like HIV-AIDS, Ebola, the flu, SARS, and even rabies. We get these diseases through direct contact with the body fluids of an infected animal, exposure to their habitats, through vectors like mosquitoes, and from eating contaminated meat.
Of all the pathogens, viruses seem to be the most lethal. They are simple creatures that mutate easily and are unaffected by antibiotics.
These diseases that reside in animals and have the ability to infect humans can be the cause of serious epidemics and even pandemics as seen with the Spanish Flu and HIV. They are also more difficult to eradicate than those pathogens whose final reservoir is the human, like smallpox and polio. One mammal that seems to get implicated in all this is the bat. It has been implicated in the spillovers of several zoonoses like Ebola, SARS, Nipah, and the ongoing 2019-nCoV outbreak. With an immune system that makes them able to harbor a lot of viruses without getting sick, they are the reservoirs of about 60 zoonotic viruses. It is estimated that each bat species harbors 1.79 zoonotic viruses. (The coronaviruses that caused both SARS and MERS are thought to have originated from bats, then infected the civet and camel respectively, and then humans).
Although it is impossible to predict when the next zoonoses spillover or what even allows certain pathogens to spill over, there are characteristics of these phenomena that allow epidemiologists to predict the areas on the planet which are hot spots for zoonotic spillovers.
In a 2012 paper by Morse et al in the Lancet, they teased out several hallmarks of zoonotic spillovers.
First, the frequency of emergence of new pathogens is on the increase. This increase seems to correlate strongly with increasing population density. Thus the expansion of human habitation, agriculture, travel routes, trade, and general changes in land use may be leading to humans getting exposed to more pathogens. We are encroaching on the habitats of these animals. This also means that areas with more biodiversity will see more of these zoonotic spillovers. So areas in the world with high population densities and biodiversity are more prone to see these events.
Based on these hallmarks of zoonotic spillovers, a few models have been created to depict how a new disease emerges. The 3-stage one by Morse et al really simplifies it. The first stage sees humans encroaching into the habitat of these wild animals through changes in land use or even caving (bats). Through contact, the pathogen spills over causing disease locally. This can range from small clusters of human cases to large outbreaks, some with the limited person-to-person transmission (eg, Ebola virus) and some without (eg, Hendra virus in Australia). The third stage is the large spread leading to a pandemic.
Also based on these same hallmarks, certain areas of the world are seen as hotspots. These are areas around the world’s rain forests – Latin America, West, and Central Africa, Southeast Asia, and the Pacific Islands. This is quite understandable due to the biodiversity of these forests and the fact that they are being encroached on actively for commercial purposes as well as due to population growth. Thus we first saw Zika come from Brazil and Ebola from Sudan and the Congo simultaneously in 1976.
Another important hotspot has spawned the present 2019-nCoV epidemic and also gave us SARS – Southern China.
The area has a huge population of bats. Moreover, it is also famous for the culinary culture of “Yewei” or “Wild Flavor” Cuisine. This involves “such exotic fare as camel hump, dried tiger penises, and bear bladders”.
Like Karl Taro Greenfeld writes in the book “The China Syndrome”, “Yewei” has become the perfect symbol of China’s newfound wealth; the Chinese would even call the period of the economic boom in the South “the Era of Wild Flavor.”
Some also attribute the attainment of sexual prowess and therapeutic effects from eating these exotic meats.
Thus in provinces like Guangdong, where SARS developed and, Hubei, where Wuhan is, there are thousands of wild animal markets or “wet markets” where one can buy all manner of animals including chickens, snakes, raccoons, dogs, civets, cats, monkeys, otters donkeys, sheep, pigs, foxes, badgers, bamboo rats, hedgehogs, and pangolins.
So inasmuch as these “wet markets’ have become symbols of China’s growing affluence, they may also be a vulnerability. They may be breeding grounds for zoonotic spillovers.
Between 2000 and 2003, Lee, Lau, and Chan, researchers from Hong Kong surveyed these markets in Guangdong and Shenzhen. This is an excerpt from their report:
“The animals are packed in tiny spaces and often in close contact with other wild and/or domesticated animals such as dogs and cats.”
Animals are stacked vertically so waste rains from one species to the other and since they are often slaughtered in the markets, blood joins in the fray.
The team further wrote, “The markets also provide a conducive environment for animal diseases to jump hosts and spread to humans”.
Interestingly, it was during this period that SARS broke out. This makes southern China a potent hotspot for zoonotic spillovers. The situation is further complicated by a political system that discourages sharing information and reporting such incidences.
Even as I write, the 2019-nCoV zoonotic spillover is looking more and more like it has the hallmarks of a pandemic. It has spread to 23 countries, sickened over 14,000 people, and killed 299 in China and one person in the Philippines.
It has been shown to be transmitted from human-to-human, even in cases where there are no symptoms, and even may survive on inanimate objects. A vaccine is at least a year away but with all the efforts being made worldwide, there is hope that the outbreak can be brought under control.
It will not be the last zoonotic spillover the world will see. Not as long as we keep encroaching on the habitats of wild animals and keep enjoying wild and exotic meats.

The Report of the Ghana National Reconciliation Commission

The Generals He Executed Without Trial

Thanks to the help of an amazing young Ghanaian activist, the Silent Years Group has gotten hold of a digital copy of the complete NRC report. We are going to start serializing that report so all Ghanaians can read and learn from the past so we do not allow our nation to be hijacked again.

For those who want to read it, the link to download it is below.

GHA_National_Reconciliation_Commission_FinRepDownload