By now, you will have heard about a new, or novel, strain of coronavirus, originally known as novel coronavirus and now called COVID-19. With growing concerns surrounding COVID-19, it is important to remain informed of the facts regarding this viral outbreak. I have recently spent quite some time researching everything I can on the subject from some of the experts in infectious diseases and immunology and in this blog I wanted to bring you the facts and accurate information on this new strain of Coronavirus. Look out for my next blog where I will discuss all the diet, lifestyle, nutrition and herbal medicine strategies you can implement to protect you and your family.
What is coronavirus?
Coronaviruses are a large family of viruses, seven of which are currently known to infect humans. Four of these strains cause minor symptoms similar to the common cold and two are more severe diseases including Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). COVID-19 is the latest strain to have been identified within this family of viruses.
What is novel coronavirus (COVID-19)?
At first, COVID-19 was known as ‘novel coronavirus’, which means a new strain of coronavirus. Once scientists discovered what this strain of coronavirus was and how to identify it in tests, they gave it the name: SARS-CoV-2. When someone gets sick with this virus the illness is called COVID-19. For simplicity, the virus and the disease are being referred to by the same name, COVID-19
Novel coronavirus (COVID-19) was discovered in 2019 when an unusually high number of people in Wuhan, China, became ill with pneumonia after having an illness similar to the flu. When doctors tested them, they found these people had a type of coronavirus they hadn’t seen before.
Why is this virus more pathogenic than other viruses?
A few reasons
1. In short - That more of the virus can get into our cells if we become infected.
In detail - How the virus binds to a cell through receptors, it cleaves receptors for the virus to get into the cell. SARS and MERS didn’t have cleavage sites with Coronavirus there is a cleavage site in the receptor so the virus gets in the cell and more virus gets inside
2. In short - when the virus gets in the cell it stimulates a very strong immune response by turning on inflammation causing a cytokine storm (where the immune system goes haywire and overreacts and causes inflammation we can’t turn off). Creating damage in our cardiovascular system, lungs and kidneys.
In detail - There are a couple of different virulence factors that are inside the virus that when the virus gets in the cell it activates the immune response. One of these factors stimulates a very strong immune response. It turns on an inflammasome (a collection of proteins, receptors and mediators involved in inflammation) this particular virulence factor turns on one particular inflammasome and the problem is a lot of people are having trouble turning that inflammasome off so it’s creating a cytokine storm. The particular protein is called interleukin 1 (IL1) and usually IL1 would be stimulated early in a viral infection, it would drive fever make people fatigued and cause malaise and then it would be turned off. But with this particular virus the gene doesn’t get turned off so you get an overproduction of IL1 beta and that’s problematic, so that’s what’s making this virus more pathogenic. The other thing is this virus has a spike protein called ACE 2 that is binding to the cardiovascular system and the respiratory system. While ACE 2 is expressed in your vascular endothelial cells we’re seeing that the virus gets into those cells, it is also expressed in the lung, the kidneys, the Gastrointestinal tract. Because its expressed in the cardiovascular system if you have any cardiovascular damage you’re now getting attacked by a particular virus and that’s the cells that are getting destroyed. There’s a number of reasons this virus is problematic now and, in the future, as even if you recover there is the potential for CV, lung damage.
How is it spreading?
Transmission of COVID-19 occurs when infected droplets are distributed via human-to-human contact, usually when a sick person coughs or sneezes. It may also be spread via contact with contaminated objects as human coronaviruses can remain infectious on inanimate surfaces for up to 9 days. Airborne spread has not been reported for COVID-19 and it is not believed to be a major driver of transmission. How many people one person can spread it to is constantly changing but at this stage in the United States its about 1 person can spread it to 4 people. It started at 1:2 so it is becoming more infectious.
What are the symptoms of coronavirus?
80% of people who contract it have mild symptoms, 15% have more severe pulmonary complications, 2-3% of cases have resulted in fatality.
Greater concern is passing it on to ‘at risk’ individuals which is why hygiene practices are crucial.
Symptoms include sore throat, dry cough, fever, shortness of breath, fatigue.
COVID-19 doesn’t produce upper respiratory mucous, differentiating it from the common cold or flu.
COVID-19 in comparison to previous pandemicsl
This virus is killing people much faster than previous epidemics/pandemics like HN1 Swine flu, SARS, MERS and Ebola etc.
When we look at epidemics like the flu, in the US it kills around 18000 people per year and in the last 4 weeks the death rate from CoVid 19 is up over 4000 already. The other thing is because the virus spreads easily and because there is a mild version people get, people are able to be carriers without knowing they’re infected. Whereas what we saw with SARS and MERS everyone who got the virus was hospitalised because it was so quickly destructive which meant they didn’t spread it. With this virus because there’s a mild version there is huge amount of spread and the result is an inability to control it.
Our best guess right now is that it takes 48 hrs from exposure to symptoms, initially spiking a fever and you might have the infection for 10-14 days. The reason for that is that your immune system hasn’t seen this particular infection before so the first time your immune system experiences one type of virus you’re going to respond to it in 14 days. That’s the typical immune response. Everyone has the overstimulation but people that are getting hospitalised have even more over stimulation.
Its 70% like a typical coronavirus.
So, we’ve got damage from our own body’s reaction to it then the direct damage from the virus due to where the ACE 2 is expressed such as the cardiovascular system, lungs, kidneys and GI also some evidence it’s in the central nervous system. Wherever these ACE2 receptors are it allows for the virus to enter those cells and these cells die therefore we get damage in these areas.
ACE inhibitors (medications used to treat high blood pressure) increase the ACE2 receptors and allow for more of the virus to enter which can lead to an increased risk of death and more heart damage. It’s certainly not advised to go off your ACE inhibitors for blood pressure control but the medical profession are looking at whether some other blood pressure medications may be safer. This is still unknown.
Ibubrofen also increases the ACE2 receptor so it’s not recommended to use Nurofen if infected, even Panadol is not ideal as it depletes glutathione which is a major antioxidant needed for the free radicals produced from excessive inflammation.
Who is most at risk?
Individuals at highest risk for severe disease include people aged over 60 years and those with underlying medical conditions. Susceptible individuals include:
• The elderly
• Immunocompromised individuals
• People with serious or chronic medical conditions including heart disease, diabetes and lung disease
• People who have recently travelled to mainland China, South Korea, Iran and Italy
• Individuals in close contact with a confirmed case of coronavirus, particularly during the infectious period
We’re not seeing an increase in severity in those with asthma though due to T-Helper 1 And T-Helper 2 balance. The virus generates an overreaction of a TH1 response but asthma is a TH2 dominant condition so that actually helps with not overreacting to the virus.
How you can protect yourself from coronavirus
practising good hand and sneeze/cough hygiene provides the best defence against viral infections. These include:
• Washing your hands frequently with soap and water, before and after eating, and after going to the toilet.
• Covering your mouth and nose when coughing and sneezing, immediately disposing of tissues and using alcohol-based hand sanitiser.
• If unwell, seek immediate guidance from a medical professional. You may be advised to isolate yourself from the general population for up to 14 days to stop viral spread.
Social distancing is supremely important to Protect you and put less stress on the medical system.
What to do if you develop symptoms
If you do develop symptoms associated with COVID-19, including fever, cough, sore throat, tiredness or shortness of breath, seek immediate guidance from a medical professional. You may be advised to isolate yourself from the general population to stop viral spread.
Individuals who have recently travelled to an international high-risk area or who have recently been in contact with a confirmed case are at an increased risk of developing COVID-19 and are advised to contact a medical professional for assistance.
The onset and severity of infection in response to viral pathogens is greatly influenced by the virulence of the pathogen and the host’s immune defences. While little can be done regarding the virulence of COVID-19, improving your immune response is the most effective strategy to protect against any pathogen. See my next blog for all the diet, lifestyle, nutrition and herbal medicine strategies you can implement to improve your immune defences.
For further resources and guidelines on COVID-19 management: Australian Government Department of Health: COVID-19
World Health Organisation Coronavirus Disease (COVID-19) Outbreak
Centre for Disease Control and Prevention: Corona Disease 2019 (COVID-19)