COVID-19, Coronavirus, 2019-nCoV FYI

We, like you, have been following this pandemic and have had a number of questions. What follows is bits and pieces we’ve been able to find regarding just what on Earth is happening to us.

What does COVID-19 stand for? In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease. Formerly, this disease was referred to as “2019 novel coronavirus” or “2019-nCoV”. There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses.

Coronaviruses are a large family of viruses that are common in people and many different species of animals, including swine, cattle, bats and even cats. Animal coronaviruses can rarely infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus COVID-19 (now technically identified as SARS-CoV-2). In order to become a threat the virus must first make a jump to a human, which is actually rare, and than be in a form that allows it to spread person to person efficiently.

There’s been a lot of talk about influenza but COVID-19 (SARS-CoV-2) is not the flu. It is more closely related to the common cold. It has different symptoms, can spread faster, and belongs to a different family of viruses. The coronavirus has been attacking humanity for generations and includes now seven members that infect humans. Four of them cause the common cold, OC43, HKU1 (commonly called the Hong Kong flu but now known to have originated elsewhere), NL63, and 229E and have been infecting humans for at least a century, that we know of. Two others include, MERS and SARS(1) both much more severe diseases. This new coronavirus is now designated SARS-CoV-2.

COVID-19 like its close relatives is a respiratory virus but unlike the others this one seems to infect both the upper and lower respiratory areas. In general, an upper-respiratory infection spreads more easily, but tends to be milder, while a lower-respiratory infection is harder to transmit, but is more severe. This double infection could explain why the virus can spread between people before symptoms show up, making it more difficult to control. Perhaps it transmits while still confined to the upper airways, before making its way deeper and causing more serious symptoms. This is hypothetical, an educated guess since its biology is still poorly understood.

Why do some people have mild or no symptoms and others get critically ill? We are just beginning to understand how this disease progresses and most ideas are still a guess. It now seems that our own immune systems may be a key player in how this disease progresses.

It appears that younger, healthier people exhibit mild or no symptoms because the virus is easily identified and dealt with by their immune response quickly, causing few symptoms. With older people it now looks as if they are often likely to suffer what doctors call a cytokine storm or cytokine release syndrome (CRS).

Cytokine release syndrome (CRS) or a cytokine storm is a form of systemic inflammatory response that can be triggered by a variety of factors such as infections. It occurs when the immune system over-reacts and a large number of white blood cells are activated that release inflammatory cytokines, which in turn activate yet more white blood cells and on and on. It doesn’t appear that the disease is the real problem but it is the bodies response that overwhelms the lungs with inflammation and mucus/fluids.

It seems that this issue with immune response in some patients is why chloroquine is showing promise. It is an immunosuppressive drug and anti-parasite commonly used in malaria treatment that can effect and help control the immune overreaction. There are additional drugs that may fall into this category like colchicine, an anti-inflammatory pill used to treat gout. Tests of these along with Zithromax Z-Pak that could fight secondary infections caused by bacteria, that include infections of the lungs, sinus, throat and tonsils.

What Is The Risk

There is no doubt that COVID-19 is a serious epidemic/pandemic and in the best of cases a number of people will die, but there needs to be some perspective. Here are a number facts that need to be understood:

  • Influenza outbreaks occur almost every year and some strains show up simultaneously.
  • A good flu season (usually winter) kills about 20,000 Americans. A bad one 50,000.
  • We still do not know the mortality rate. It has been quoted as high as 7% and as low as .8%. The real reason we do not know this, is we have not been able to identify how many people are infected. If a lot of people get infected and show no symptoms there is no way of knowing unless we test everyone and in many cases test a number of times.
  • Today we are not capable of treating this disease or vaccinate against it but we probably will over the next 2 to 6 months.
  • Our attempt to get everyone to self-quarantine and shelter in place has only been partially effective. Most countries are trying to reduce the speed of infection to prevent medical facilities from being overwhelmed, It isn’t about if you will catch it and how bad it will be but how seriously it will impact the more medically vulnerable. Many younger people aren’t taking it seriously, endangering their relatives and others.
  • Almost all epidemics follow a bell curve. They spread over time, peak and than fall victim to what is called herd immunity. Generally the faster they go up the faster they come down.
  • As of now, much of what the experts and government officials tell us concerning the COVID-19 epidemic and the economy is educated guessing. Simply put, we are in uncharted waters and there is no reference from history we can learn from.
  • Nationwide the infection rate is currently .03% that’s 30 people in every 100,000 that have been infected, with an overall mortality rate of 0.00048%. The maximum infection rate is now estimated to be around 6% or less than twenty million Americans total with a maximum number of deaths at 320,000 assuming a 1.6% mortality* and without any intervening therapies.

Common Terms:

Mortality Rate – Defined as the percentage of the people who get the disease that will probably die. In hindsight you take the number of deaths and divide it by the number of total infected people. It can be expressed as a fraction (numerator over denominator). As of now we have no idea what the denominator is.

Virus v Bacteria – Bacteria are the microorganisms that are single-celled and occur in various forms and shapes. They can either be found as parasites feeding on host’s body and can also be beneficial aiding in digestion and other functions. Viruses are a parasitic agent that originate in and attack the body of a living host. They harm the host body with infections and are controlled by the immune system. Viruses are not yet considered living or non-living as research is still in process.

Herd Immunity – A form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, whether through previous infections or vaccination, thereby providing a measure of protection for individuals who are not immune. It results because the uninfected population drops to a statistical level where the disease has trouble finding new subjects to infect. It is often discussed when looking at population numbers that refuse to get vaccinated for things like the measles and you see unexpected outbreaks..

Cytokine – Any of a number of substances, such as interferon, interleukin, and growth factors, which are secreted by white cells of the immune system and have an effect on other processes.

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