Twenty Something Socially Isolated
A Concerned Twenty Something Cora Watanabe, texted on a Google thread;
“Thank you for answering my questions, I’m puzzled because they say 14-day quarantine should do it and my state locked down for two months, masked up, kept social distance and didn’t let ships or airlines come. And when it started flattening out in June we were around 600 infected and like 11 deaths, we’re still not fully open and there has been a spike in the last two weeks. Now we have 1071 infected and 19 deaths. Could it be because asymptomatic people are unknowingly spreading it? “
Thank you for the question.
Much of the current spread appears to be within families, at the essential workplaces and among friends. Studies conclude that asymptomatic people are spreading virus in the community. Contact tracing and questioning confirms those studies. Also some individuals have more virus titer per droplet then others. Whereas the R0 might be 2-3 for the typical spreader, meaning they transfer virus to 2 or three others, the “super spreader” might infect 10 or more people. This is what happened with the Chinese doctor in Hong Kong in 2002 which was traced to spreading SARS-1 to ten people who go on ten planes heading toward ten countries, all contact traced to starting from the ninth floor of the Metropole Hotel. Epidemiology has shown asymptomatic spread of SARS-COV-19 is occurring.
What’s more, since 80% of those infected have mild symptoms, and symptoms are not always signs to others, many of this subset might not even appear sick. It is conceivable that such mild symptoms might not be of concern to a healthy young person. The saying goes “denial isn’t just a river in Egypt”. Some people may hide their symptoms, perhaps being afraid of the possible consequences. No one wants to be stigmatized. Some might be unwilling to even consider what might be happening to them. Unfortunately, people do not behave rationally always in times of emotional trauma. People respond differently to difficult circumstances. Grandmothers insist on kissing their grandchildren. The kids hug their cousins on weekends. Brothers and sisters return to households where they encounter parents who themselves are working “essential jobs” in grocery stores and other high traffic circumstances.
Panoramic photography and other key feedback mechanisms suggest, contrary to Cora's above assertions, that many people are not diligently practicing all of the recommended safety measures that public health authorities advised. Wearing a mask, washing hands after touching door knobs, mail boxes, gas pumps, grocery packaging. Keeping appropriate distance. If you are jogging, you need more than six feet between yourself and the person behind you. If you are singing karaoke without a mask, even at home, you are projecting virus 20 feet or more if you happen to be asymptomatic infected. HAVC circulates air. Pressure differential moves air. Virus in the air or on surfaces can survive up to a few days according to variables of humidity, light and heat. You need to be Be social using video chats and keep a physical distance from everyone who leaves the home every day. Clean touch points constantly and correctly.
If everyone were truly doing all of the right things we would drastically reduce the length and quantity of infectious chains. You see that those efforts work because you noted that the curve flattened, and many infections were prevented by the measures that were taken. Absence bias often hides good and bad news. The numbers clearly indicate if we all do our part we can make this virus go extinct in humans.
That is at least until the virus crosses over again from its reservoir in animals. Scientists don’t know yet what the reservoir is for SARS-COV-19. It is known to come from bats. For Sin Numbre Virus, the virus that caused an outbreak that occurred in 1997-98 in the four corners region of New Mexico, the reservoir was found to be Deer Mice. Other animals like white foot mice, and rice rats are also known to harbor that virus from the Hantavirus family. Hanta Pulmonary Syndrome is deadly and it is spread by dry fecal matter. This is why we must avoid sweeping the shed. and dry dusting where rodents hang around. Wet the area down first to keep dust from the air we breathe.
Rational scientific inquiry and discovery ought to be how we source and inform our precautionary behaviors. What good is having science and public health systems if we fail to listen to them? SARS-1 and MERS are the two previous zoonotic coronaviruses, meaning that they came from the animal kingdom and crossed over to infect humans, causing chains of infection in 2002-2003, and 2012. Both raised concern about coronaviruses because before SARS-1, the known coronaviruses were stable in humans. There were only two that caused common cold symptoms, so there wasn’t much investment put into solving things that didn't seem to be large threats. Two additional coronaviruses were known to cause the common cold similar to Rhinoviruses and Parainfluenza.
So there are now seven known coronaviruses that infect humans. There are over a hundred known coronaviruses that affect animals exclusively, thirty eight of those have been sequenced. But when a 64 year physician died in a Hong Kong hospital on February 22, 2003 after a mysterious illness producing Sudden Acute Respiratory Syndrome it was the beginning of something big. Hundreds more soon followed (774 in all died from over 8,000 cases in 29 countries) The coronaviruses officially went on the radar of people working in public health as a serious brand new potential threat to humanity. However as bad as those two viruses are, both of them produced only short chains of transmission. These were not sustained chains of infections in humans.
In other words, every time there is a new infection in a person, it is a zoonotic event from an animal reservoir. That is what is called a “dead end”. Dead ends usually indicate that the problem has stabilized, at least for the time being. Still we could have invested in pan corona anti-viral back then, the writing was certainly on the wall, many scientists advocated that we get prepared for the worst, but no one seemed to want to make the investment. Not that it is anyone’s fault, but we could have saved a lot of lives had we made that investment. We have incredible scientific capability in the United States; we could have easily developed those drugs given enough lead time.
SARS-1 virus had a different affinity than MERS for cell receptors. Affinity for certain receptors on organs and cells that a virus can attach to is one factor that makes some viruses more successful than others. This is why MERS has short chains and the new Coronavirus, SARS-2, is able to produce long chains of infection. SARS-2 (Also known as SARS-Cov-19) like many viruses is a recombination of genes, or a mixture of three amino per base that select for a high affinity on their binding proteins for ACE-2 receptors on human cells. People have ACE-2 receptors on many organs, including but not limited to the lower respiratory tract, kidneys, and on the surface of red blood cells.
To understand how viruses work, the closest thing on the Coronavirus family tree to SARS-2 is a bat virus called RATg-13. It is on the same branch right next to SARS-2. Whereas SARS-1 is on a completely different branch indicating that they aren't very close in nature. I am just surveying other peoples work here, so I don’t have a tree of my own to share with you.
I can nonetheless point you to a source that can answer any questions you might have. Nextstrain.org open sources the phylogenetic information so anyone can go and examine the sequences for themselves. The Horseshoe bat carrying RATg-13 was found in a Cave within Yunnan Province, China, Live virus was isolated and sequenced in 2013, compliments of the hard working people at EcoHealth Alliance and PCR technology.
The bat genome is 96% the same genome sequence as SARS-2. Further studies prove that the RATg-13 virus has a low affinity to ACE-2 receptors. This is important because it can bind just not easily. SARS-2 on the other hand has a high affinity to ACE-2 receptors, this along with the matching segments of genome, and the law of probability, puts the bat virus on the same branch sitting very close to SARS-2 in the virus family tree. Those two viruses can’t get away with a claim that they aren’t related.
This incidentally is another piece of evidence that evolution really does happen in real time with viruses. Observable in real time, that is good science. It is the only science I trust. Also since 4% is a lot in terms of DNA and RNA, there is has to be another animal that we are missing on the tree. There could be several but there is, at minimum, one animal reservoir for the novel Coronavirus. Researchers have the same problem with finding the reservoir animal(s) for Ebola Virus, although it was discovered for another dangerous filovirus called Marburg Virus. The unknown reservoir could be another bat, or it could be a shrew, it could literally be any animal in the forest. This is why we need to support the work of EcoHealth Alliance and others who get suited up and carefully take samples from wildlife. That way we can be better prepared for the next pandemic.
If they find the reservoir for SARS-COV-19, the next step is to develop a vaccine and inoculate the animal host to prevent or decrease new spillovers. This was accomplished with Hendra Virus in 1994. 13 horses and their trainer were killed by that Paramyxoviridae family virus so named after the town where it was discovered. Developing a vaccine for the horses also helped people. This was all possible because there are daring people who risk their lives by going into bat and snake infested, caves to get blood samples from the bats. Researchers isolated the HeV virus from a flying fox, also found in the deceased horses to get a match. The racehorses had amplified the virus titer and then passed it onto humans. Similarly, In Malaysia, Bangladesh and India, the Nipah Virus caused another recent spillover from the dangerous Paramyxoviridae family. Nipah likewise has a reservoir in fruit bats which has caused reoccurring outbreaks in the far east, infecting pigs, in turn killing hundreds of people, those who handle the animals.
CEPI, a nonprofit was formed to develop a vaccine for the pigs just as Hendra was developed for the horses. This is called a One Health Solution. Peter Daszak from EcoHealth Alliance coined the phrase and made the scientific community aware that animals are connected to people by infectious chains. If you think about it, dogs get their rabies shot and this prevents kids from being bitten. It is a broken chain made possible by science. Infectious diseases are on the rise in recent decades. It is time that we start to listen to and more importantly, we must lend our support to the scientific community. We need to stand together and make the right investments for all of our children’s future.
Scott Britton 7/8/2020