1. Covid

Questions on COVID-19

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This article is written largely based on the 100 questions answered by Professor Peter Piot. Peter Piot has a whole long list of accreditations – he has a medical degree from the University of Ghent, a PhD in microbiology from the University of Antwerp, he co-discovered the Ebola virus, won major awards and is now the Director of the London School of Hygiene & Tropical Medicine. You can read his specific responses to the 100 questions here.

Q1. Let’s go back to basics – what is a virus anyway?

A virus is a tiny particle of DNA genetic code, wrapped in a protein shell.

Q2. How tiny is a virus exactly?

You can’t see a virus even with a regular microscope. 100 million viral particles of the coronavirus can fit on a small pinhead – that’s how tiny they are.

Q3. Why is it easy for a virus to spread?

Precisely because viruses are so tiny, just one droplet from a cough can carry billions of viral particles.

Q4. How does the virus spread from human to human?

The virus SARS-CoV2 spreads easily through coughs and touch. It is considered a respiratory transmitted virus. Recent findings indicate that it is possible that it spreads through fecal and urine contamination as well.

Q5. How does the virus transfer itself and infect us exactly?

Like parasites, virus particles try to latch onto living cells in order to multiply and “reproduce”. After hijacking living cells and other hosts, it multiplies by the hundreds or thousands. In doing so, it infects and often kills the hijacked cell.

Q6. Is it easy for a virus to hijack a living cell then?

It depends if the cell has the right receptor for the specific virus. Think of it as how a key needs a specific keyhole to work. Our immune system protects our cells from viruses. Thus, 99% of viruses are harmless to us humans.

Q7. What does it mean to be infected with COVID-19?

It means that the virus SARS-CoV2 has begun reproducing in your body, destroying your cells.

Q8. How many viral particles of the SARS-CoV2 does it take to infect one?

We don’t know how many exactly, but it takes very little.

Q9. What is the difference between SARS-CoV2, coronavirus and COVID-19?

SARS-CoV2 is the virus and coronavirus is a group of virus it belongs to. COVID-19 is the name of the disease which the virus spreads.

Q10. What does it look like?

The SARS-CoV2 virus particle looks like a ball of spaghetti, wrapped up in a shell of protein. The shell has spikes which makes it look like corona from the sun.

Q11. Why is it called the novel coronavirus?

It just means it’s new to humans. It means that our bodies have never seen this virus before and so there has been no opportunity for us humans to develop immunity from it.

Q12. How often does a novel virus emerge and cause harm?

Rarely. Examples include the viruses that cause diseases like HIV, SARS, MERS. It’s a huge problem when it’s harmful and humans have no immunity against it. The fact that it is highly contagious is worrying.

Q13. How many viruses exist on our planet and how many are harmful?

There are millions of virus types which exist. Only a few hundred are known to be harmful to humans.

Q14. How many coronaviruses are harmful to humans?

There are 7 coronaviruses in total which can spread from human-to-human. 4 of them results in a cold. The other 3 can be deadly: the viruses which cause SARS and MERS, and now the novel coronavirus, SARS-CoV2 – a coronavirus type that we have never seen before nor encountered. 

Q15. So how is this novel coronavirus different from the earlier coronaviruses we have encountered (SARS, MERS)?

The SARS-CoV2 is different in 3 ways:

  1. Infected people are asymptomatic (i.e. they have no symptoms). This means people who are infected feel fine and unknowingly spread the virus. This is completely different from SARS, where infected people had clear symptoms for a few days and became contagious only when they were sick.
  2. When infected people start feeling sick, it feels like a minor cold, flu or cough. So we dismiss it, don’t isolate ourselves, go on and infect others.
  3. The SARS-CoV2 is more easily transmitted than its coronavirus predecessors. In the early stages, the viral particles are concentrated in the upper throat. So when we cough or sneeze, billions of these particles are expelled and transmitted to other person(s).

Q16. How come it’s in the throat? Isn’t it a respiratory disease that affects the lungs?

The disease starts in the throat. That is why COVID-19 tests involve taking a swab from the throat. The virus then progresses downwards to the lungs and become a lower respiratory infection.

Q17. Is it true that the virus is asymptomatic, meaning zero symptoms are shown even though we’re already infected?

Yes. Many people don’t show any symptoms at all for days and go on to unknowingly infect others. It also makes it even harder for detection of the disease. 

Q18. Do you mean that people who have no symptoms and feel well, can still infect other people?

Unfortunately, yes. This makes it even more challenging for us to slow down the spread of the virus.

Q19. What is one main symptom we should be wary of though?

Coughing is the #1 symptom. Fever is next. But know that screening for fever alone at checkpoints etc is going to let a lot of infected people pass.

Q20. Is it likely that scientists will develop a vaccine or cure?

It is likely. But there are no guarantees. Failure is possible. For example, we have been searching for a cure for HIV for 35 years and we still don’t have one to date. Even if a cure for COVID-19 is developed, it would take lots of people and time to test if the vaccine is effective and safe.

Q21. How much time is needed?

It will take at least a year or two before we have a vaccine approved and available to inject into people.

Q22. Have we made any progress yet?

The good thing is that we started vaccine development immediately after SARS-CoV2 was first discovered in January 2020. Scientists around the world are working on it with great urgency. Governments and companies alike have provided them with funding.

Q23. Why isn’t there a vaccine yet for this global emergency?

The human body’s immune system is complex and unpredictable. Viral mutations can occur. Women can respond to a “vaccine” differently from men. Children can respond to a “vaccine” differently from adults. The vaccine has to work and be 100% safe for everyone.

Q24. Can’t it be developed faster?

To make sure the vaccine is 100% safe for everyone, clinical trials have to be done, first on animals and then successively on humans. It has to be tested across a wide range of human volunteers under carefully measured conditions.

Q25. How deadly exactly is this virus?

Scientists believe it kills 1 to 2% of people who become infected with the COVID-19 disease. The risk of death is clearly higher with older people and those with existing medical conditions.

Q26. Which groups of people are at high-risk?

Those who are older. The older you are, the higher your risk. Also, those with existing medical conditions such as diabetes, lung disease, pulmonary disease, cardiovascular disease or immune deficiencies.

Q27. What kind of high-risk are we talking about here?

The risk of death can be as high as 10 to 15%. The risk increases when you have additional health conditions.

Q28. Why does your risk increase so much if you have medical conditions like diabetes?

It’s because your immune system is poor to begin with and reacts poorly to any infectious viruses.

Q29. Why does the virus affect older people so much more?

We actually don’t have the answer to that right now. It’s something that is going to take a while to figure out.

Q30. Why do we keep hearing the COVID-19 being compared to the flu?

The novel coronavirus appears to spread as easily as the flu. The flu affects millions of people every year and less than 1% die from it. On average, the novel coronavirus is 10 to 20 times more deadly and we cannot protect ourselves via vaccination.

Q31. Is the flu also caused by a virus?

Yes. Flu is caused by the influenza virus. But they are very different. A flu vaccine or shot can greatly reduce your risk of flu. The common cold/flu is caused by another type of tiny virus called a rhinovirus.

Q32. How does it feel when the new coronavirus infects the body?

It typically starts with a cough. Then a fever. The low fever turns into a high fever and you feel a shortness of breath as the virus attacks the lungs.

Q33. Why do you need good medical care when you are infected with COVID-19?

It’s usually important when you are running a high fever and your lungs are compromised. It is a critical juncture to have good medical care available that would help you breathe, such as intensive care respirators. The risk of getting secondary infections would also be lower.

Q34. Is there any drug or medication I can take to make the virus less severe? What about antibiotics?

No drugs have been proven effective against the new coronavirus, but a lot of drug testing is going on now so hopefully there will be soon. Antibiotics work against bacteria, but this is not bacteria we’re dealing with, it is a virus. Antibiotics have no effect at all on the virus itself.

Q35. Has humankind eradicated a virus entirely before?

Yes. Smallpox, which used to kill millions. We’re also very close with polio.

Q36. Is wearing a mask necessary?

Masks are not foolproof. The N95 mask filters out under 50% of inbound, airborne virus particles. Masks are necessary for healthcare workers or for those working closely with the elderly.

Q37. What can we do the protect ourselves against it?

Washing your hands and not touching your face would be more helpful in lowering your risk of being infected. Practising safe distancing, working from home, etc would be extremely helpful.

Q38. How long will it take for the virus to spread through a large population like the US?

The SARS-CoV2 seems to double its infected population every week. That would mean 50 infected people can go to 1 million in 14 weeks. That is the simple arithmetic of contagion. But we can definitely put into place measures to slow it down, like social distancing, working from home, disallowing gatherings and events, etc.

Q39. Should I be scared that I’m going to get COVID-19?

If you’re not in the high-risk groups, it shouldn’t be so worrying but do everything you can to avoid becoming infected, such as washing your hands, distancing yourself from others, staying home, etc. Take sensible precautions and at the same time, don’t worry obsessively. It wouldn’t be helpful.

Q40. If I get the virus and recover from it, am I then immune to it? Will I still be contagious?

We don’t know the answer to both questions. But it appears that you may still be contagious even after recovery.

Q41. Is it possible that this whole novel coronavirus thing is just one big false alarm and we’d look back and say, “we really panicked over nothing!”

No. The COVID-19 disease is already well-established in more than 100 countries around the world and it’s highly contagious. Every day new cases are sprouting up. This is not a false alarm, it’s real.

Q42. It’s so hard to believe a new virus can cause so much damage all of a sudden, infecting millions of people. When’s the last time this happened?

In the past, the 1918 flu pandemic affected millions. The HIV pandemic was also new to the world and infected 70 million people, of whom 32 million died from it. More recently, the SARS and MERS were both new viruses, but they did not reach scale as they were not as contagious as the one we’re dealing with right now.

Q43. What’s the biggest fears about the virus?

The rapid spread of the novel coronavirus can easily overload any country’s healthcare system if it’s not properly managed. Fear and overreaction can also cripple the country’s economy and livelihoods can be affected.

Q44. Is there any good news at all?

We are seeing global cooperation, especially in science and medicine. The situation in China is also comforting, because it shows that the virus can be contained and cases can decline, but it could change.

Q45. Will SARS-CoV2 leave us once it peaks?

The SARS-CoV2 is already well established around the world. Like the influenza virus, it is likely to be with us for a long time.

Q46. Will it come back in waves?

We don’t know; but that is a very important question. The 1918 flu pandemic wreaked havoc on the world in three waves. It is possible that the SARS-CoV2 mutate into something less dangerous so fewer people die from it, as happened before with the swine flu in 2009. But We won’t know how the SARS-CoV2 will behave.

Q47. What will it take to stop this virus?

Nobdoy knows for sure but China has shown that its possible to curb the spread and stabilize things. A vaccine may be necessary to fully eradicate the SARS-CoV2, as long as the virus stays stable and does not mutate too much.

Q48. If a virus can mutate, does it mean that it can become more or less deadly?

Yes, it can go either way. It’s a new virus so we have no idea which way it’ll go.

Q49. Will there be more pandemics in the future?

Yes. It’s part of living on a virus planet. It’s going to be a never-ending battle and we need to improve on our preparedness.

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