Viral Basics on a Slow Friday. (written for Schloss Rudolfshausen [Germany] blogpost in March 2020)

The outbreak of the new coronavirus and COVID-19 has brought a diversity of opinions regarding the severity and seriousness of infection.  Although I am not an expert on infectious disease, as an ecologist and evolutionary biologist, I can offer a viewpoint from a different angle.  I have concerns about people who do not seem to be taking this virus and disease seriously and view it as not particularly more dangerous than the common cold or the flu.  This is not a correct way to think about COVID-19. 

*It is impossible to fight something we do not understand.  If we do not understand the epidemiology of this coronavirus, we are more or less helpless until we know more.  We can’t predict the number of cases, incubation periods, how long it will persist, the number of deaths, the exact health conditions that predict mortality, whether or not the virus will become resident or transient, how fast it will mutate, or whether it may start affecting other age groups and susceptibility categories.  We are ignorant and that is extremely dangerous.  The smartest thing we can do in our ignorance is to be very careful.

*It is not just another flu or cold. First, there are several flus and colds and not just one, and they vary in their intensity.  Influenza A has many variants and there are many rhinoviruses that are the primary source of the common cold.  Second, Influenza A is responsible for several hundred thousand deaths worldwide each year, and the death rate of COVID-19 is at least ten times higher. Third, the death rate for those people who are sickened enough by COVID-19 to be hospitalized is many times higher than that.  The severity of this disease has been understated and this is an incredibly dangerous thing to do.  We won’t know the true mortality statistics for this virus until a sufficiently large number of people have had the opportunity to recover and that recovery period is going to last weeks.  Until disease experts have greater knowledge of the disease progression, we should be overly careful.

*The risks of viral infections are magnified when they are serious enough to require hospitalization.  A body weakened by a viral infection is susceptible to secondary infection and that infection in a hospital setting is very likely to be pneumonia.  This is one of the primary risks for the elderly (and infants) who require hospitalization.  In the case of COVID-19, patients with respiration conditions will almost certainly require the use of a ventilator and the pneumococcus bacterium is a frequent resident of hospital ventilators.  In the 1918 Spanish Flu pandemic, the cause of death on most death certificates (in the US) was pneumonia with influenza as a contributory cause.  Anyone risking a secondary infection by being careless about a primary infection is showing a dangerous lack of appreciation of infectious disease.

*In the 75 years since the widespread availability of antibiotics in 1945, the public has slowly lost the collective memory of what life was like before modern medicine.  Before vaccines were introduced in the early 1900s, 1 of every 4 infants died by age two and 1 of every 4 young adults died of tuberculosis, typhoid, and other infectious diseases. Death by infectious disease was a threat to every age group because there was no way to stop the simplest of infections.  However, in the modern age of antibiotics and vaccines, we have lost our fear because we are quite sure technology will come to the rescue.  But technology is based on information and in the case of COVID-19 we have very little information and the rescue will take time.  Being incautious with unknown pathogens is a step back into a deadly past.

*It is an incredibly naïve thing to say that if I don’t have any pre-existing health conditions, I shouldn’t worry about avoiding this virus.  While that may be true to the best of your knowledge, the fastest way to find out if an organism has an adaptation for survival is to subject it to a lethal stress.  The fastest way to find out if you have no pre-existing conditions is to contract the disease and wait to see if you survive.  If you don’t, you were wrong.  No matter your age, your medical history, your family history, or how great you feel today, a virus will demonstrate very quickly whether you have an undiscovered weakness. The disease experts are not yet sure of the full range of indicators for COVID-19 and until they are, the only realistic policy is caution.

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