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Who doesn't know about coronavirus, the name of virus responsible for the death of nearly a million people (as per the end of August 2020) since its first appearance in China at the end of year 2019. However, not many people know that coronavirus actually belongs to a group of viruses, just like dogs have so many species in it. COVID-19, MERS (2012), and SARS (2002), are just a few members of the happy coronaviruses (or, coronaviridae, actually) big family.
Using dichotomy classification, coronavirus is classified as enveloped RNA virus. Virus is the most simplest life form of a living creature, even though some experts say that virus is not a living creature. This perspective difference is understandable, since virus can only live inside a living cell (or host cell), unlike bacteria that does not always need a host cell to live. The simpler infectious proteins known so far is called prion. Prion is definitely not a living creature, and therefore any disease cause by it, cannot be treated, at least until I wrote this article. But let's forget that and get back to the topic. Coronavirus group usually has a sphere form, with diameter ranging from 80 to 220 nm (nanometer). Compare this with HIV virus that has diameter of 120 nm. 1 nanometer is one per a million milimeter. Human hair has a thickness of somewhere around 0.1 mm.
Virus reduplicate themselves inside a host cell by 'hijacking' some key proteins to make a copy of themselves. Therefore, they cannot be killed by antibiotics. Antibiotics are generally designed to kill bacteria by disrupting its cell metabolism. Virus, however, is not perfect cell, and thus there is no target for antibiotic to attack.
For coronavirus, as said earlier, it has envelope. What does it mean? It means that, they have some kind of protective shield, that prevents chemicals from reaching and destroying its 'nucleus' (OK, virus has no mitochondria and nucleus, so that's why I put that word in a quotation mark). That's why, it is really difficult to find drugs to kill virus, especially coronavirus and HIV. Also, unlike bacteria and other pathogens whose cells are containing water ; virus' envelope is water resistant and hydrophobic (means hates / repels water) and there is no water inside the envelope. However, outside our body, it is really easy to kill the virus, since the envelope is made of special kind of protein called phospholipid bilayer. For those who has learnt Organic Chemistry, this phospholipid bilayer can interact with some compounds like alcohol (i.e. in hand sanitizers) or sodium hypochlorite (the chemicals added into swimming pool as antiseptic agent) or povidone-iodine (chemicals in Betadine), causing the virus 'armor' to collapse and eventually killing the virus. Since we cannot drink those chemicals, it is understandable why it is difficult to kill coronavirus inside the body. Well, though alcohol can kill coronavirus outside our body, I don't think drinking alcohol to kill coronavirus inside your body is a wise decision. However, there was an interesting statistic finding that says people who smoke a lot were the least prone to coronavirus. You can read it here. Remember that a statistic finding is basically two sets of data that shows a strong correlation, but no explanation. It's like telling you that when the population of stork increases, many babies will be born safely. This was what people thought in the medieval era. A statistic finding can be scientifically accepted after a long scientific investigation process, for example the habit of people in Bulgaria to consume yoghurt and their long life expectancy.
The sad news is, coronavirus can mutate easily. We know that viruses that cause SARS, COVID, and MERS are all from coronavirus family, but before the outbreak happened, there was no such case before. There are some possible explanations that can be offered, and one of them is mutation.
In my old 1993 textbook, it is written that "coronaviruses are responsible for about 15% of all colds in adults". While what I knew about coronavirus family is, their great grandma was known as HCoV-OC43, was traced to exist in 1950s, but now no longer exist. So, where are they now? Mutation and the 'survival of the fittest' offers an explanation to this. Another evidence of this is, some 'big cats' in a zoo were positively infected by COVID-19. While tigers and lions may have 'close relationship', but they are quite not closely related to humans (though, humans and cats are mammals). I don't know how could the zoo-keeper find this CST (cross species transmission) case, but this should give us more warnings, since it is possible that our lovely fur-ball can also act as the virus carrier.... as well as new host.... and this is confirmed in Belgium, where a house cat gets infected by its owner.
More About COVID-19
With this sophisticated ability to 'jump' between species, this means that the coronavirus must have had this ability since long ago, and recent findings suggest that coronavirus' natural hosts are..... bats..... Bats have lived even since the prehistoric era, and few even had coexisted with dinosaurs some 65 million years ago. And since bats are natural host for coronavirus, then the existence of coronavirus must have been at least 65 million years ago. So, thinking of this, the case-zero of COVID-19 (its scientific name is actually SARS-CoV2) from a fish-seller could actually be originated from bats. With its CST and mutation ability, it is possible that we will encounter a new type of coronavirus sooner or later, with different symptoms. At the end, drugs and vaccines found by scientists that will take years to make MAY be less useful, if not useless at all. Well, of course we have to be optimistic, but it is also important to be realistic.
I think, it is important to know some symptoms associated with COVID-19, and here is what I find from the Internet :
* fever
* dry cough
* tiredness
Less common symptoms:
* aches and pains
* disorientation
* sore throat
* diarrhoea
* conjunctivitis (eye sore)
* headache
* loss of taste or smell
Serious symptoms:
* difficulty breathing or shortness of breath
* chest pain or pressure
* loss of speech or movement
In several malls and public places, temperature check seems to be chosen to 'judge' whether someone has contracted the coronavirus or not. This is somewhat true, but not always. If you at least have heard about incubation period, then you will be shocked to know the fact. Incubation period is the time required for a person to show the symptoms since he / she was first contracted by the pathogens. In case of COVID-19, it is between 5 - 14 days. Now let's say that at day 0, Bob is first contracted by the virus, and the day after he meets 2 persons, and pass the virus (I don't say that the 2 persons will automatically be infected, that's why I use the words 'to pass the virus'). This 2 persons will pass to 2 persons each, making it to 4 at day 2. At day 3, the number of people carrying the virus becomes 8, and so on. By day 5, this makes 32 persons, and by day 14 this translates as 16,380. And this is when the symptoms starts appear (i.e., fever or high body temperature). Imagine, just by passing the virus into 2 person, this makes someone basically shares the virus to more than 100 persons in just a week, when the symptoms starts becoming noticeable. This is what happened when Korea decided to re-open schools, where one student meets about 20 other classmates in just day one. This reminds me on an old vampire movie.
So, basically we can just rely on our immunity / antibody to fight this virus (and most of the other viruses). If we are not confident with our antibody, this is why we have to always wear mask and do social distancing. Also, avoid rooms where the air is 'trapped' inside, for example air-conditioned room. Well, this is very difficult in this modern era, though. With the ability of the coronaviruses (including COVID-19) to mutate, vaccines and drugs developed by modern technology may have a reduced efficacy. And there is a possibility that when the virus mutates, its virulence will change. In this case, there are three possible scenario : first, it mutates and prefers to attack other mammals beside human ; second, it becomes more dangerous for human ; or third, still affecting human but with more 'friendly' properties. People may think that the third case means the disease is more treatable, but sadly our experience confirms otherwise. Remember the MERS case? Its fatality rate was 30%, while COVID-19 is somewhere between 0.5 - 5%. But because COVID-19 symptoms are 'less dangerous' than MERS, it becomes global problems. Why? Psychological problem. People (even the infected ones) tend to underestimate or not even realize that they have the virus. This is kinda interesting, because one of the most dangerous pathogen in my opinion is MDR-TB or Multi Drug Resistant Tuberculosis bacteria because it cannot be treated by antibiotics anymore, yet it doesn't cause a global pandemic. Let's pray that it won't.
What Does COVID-19 Do to Our Body?
COVID-19, just like other coronaviruses, likes to infect mucosal membranes. In simple words, mucosal membranes means something wet at your body. For instance, your respiratory tracts (throat, bronchus, alveoli or lungs) are examples of mucosal membrans ; as well as on your eyeballs, intestines, and genitals. Therefore, the COVID-19 virus can cause infection in intestines (diarrhoea) as well as eye infection (conjunctivitis), but so far the presence of COVID-19 virus in the genital fluid is never confirmed.
Can infection of COVID-19 cause a permanent damage? Well, the infection that takes place in the respiratory tract is a little bit tricky. COVID-19 infection can be explained with the leprosy case. Leprosy, was the disease that once said to be the worst world's nightmare from the Old Testament of the Bible until just a few decades ago. With a quick identification, treatment, and discipline, it can be cured completely without leaving any permanent damage, but very late treatment may not be able to recover the limbs that have gone. COVID-19 is just like that, except that leprosy take years to progress, while COVID-19 has an incubation period of 5 - 20 days. The ability to detect the virus during the incubation period is the key. If the virus has 'stayed' more than incubation period, then it may probably have successfully hijacked our cells and making copies of themselves. This causes apoptosis (death of cells), and if too many cells are died, then the damage is hardly reversible.
The stages of infection can be divided as follow
Stage 1 (days 1 - 4): early colonization period
The virus lands on nose, then moves and infects the throat, and hijacking cilliated cells in our throat. The function of cilliated cells is to remove particles (dust, germs, etc) entering our respiration system by catching it using a mucus-like fluid, then carrying it up against gravity, so then we can spit-it-out or maybe decide to swallow it and let our stomach acid kill them. Damage of cilliated cells may not show any symptom. Or, if the person is sensitive enough, he / she may feel itchy on the throat. Coughing is also another symptom, because when cilliated cells lost its function, then creating pressure is another alternative (back-up) mechanism to remove foreign particles out of our body. This is manifested by our body as coughing [and sometimes sneezing].
Stage 2 (days 3 - 9): upper airway infection
The virus propagates and migrates down the respiratory tract along the conducting airways, and a more robust innate immune response is triggered. Nasal swabs or sputum should yield the virus (SARS-CoV-2) as well as early markers of the innate immune response. At this time, the disease COVID-19 is clinically manifest. The person may also experience a reduced smelling ability. For about 80% of the infected patients, the disease will be mild and mostly restricted to the upper and conducting airways. These individuals may be monitored at home with conservative symptomatic therapy.
Stage 3 (days 7 - 14): hypoxia
Unfortunately, about 20% of the infected patients will progress to stage 3 disease and will develop pulmonary liquids. In this condition, the disease has progressed to a very severe state. Initial estimates of the fatality rate are around 5%, but this varies markedly with age. The virus now reaches the gas exchange units of the lung (alveoli) and infects alveolar type II cells. In this stage, large number of viral particles are released, and the cells undergo apoptosis and die. The end result is likely a self-replicating pulmonary toxin.
Therefore, the patient will have difficulties in breathing, because the gas exchange sites (alveoli) are reduced significantly in numbers. In simple words, this means the body will experience hypoxia (oxygen-starving) state, and many organs will be affected, especially brain. The wound healing may lead to more severe scarring and fibrosis. Recovery will require a vigorous effort and time. Elderly individuals are particularly at risk because of their diminished immune response and reduced ability to repair the damaged epithelium. The elderly also have reduced mucociliary clearance, and this may allow the virus to spread to the gas exchange units of the lung more readily.
As we can see, the lung image shows the sign of pneumonia. Pneumonia here can be resulted from over-inflammation (inflammation reaction that gone uncontrolled) or secondary infection. Secondary infection is usually caused by bacteria, i.e. diplococcus pneumoniae. From here, it is important to prevent the virus from entering our body. Taking a special supplement and plenty of vitamin C may also be needed. While we cannot bring this serial murder into court, we can equip our immune system with extra ammunition so that they have the ability to terminate the virus inside our body. What are immuno-modulatory and immuno-stimulants, and how they are different, we will discuss this in the next article.
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External Sources :
https://www.theguardian.com/world/2020/apr/22/french-study-suggests-smokers-at-lower-risk-of-getting-coronavirus
https://www.telegraph.co.uk/news/0/what-coronavirus-how-spread-uk-global-pandemic/
https://www.nationalgeographic.com/animals/2020/04/tiger-coronavirus-covid19-positive-test-bronx-zoo/
https://www.irishtimes.com/news/science/viruses-hijack-living-host-cells-and-then-replicate-themselves-1.4217903
https://phys.org/news/2020-04-coronaviruses-evolving-millions-years.html
https://www.nytimes.com/2020/01/28/science/bats-coronavirus-Wuhan.html
https://erj.ersjournals.com/content/55/4/2000607
https://www.bbc.com/news/health-51214864
https://www.livescience.com/cat-infected-covid-19-from-owner.html
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