The Corona Virus- what we know so far......?

Horseshoe bat species from China that was origen of SARS virus

It sure has been a crisis “in situ” the last few months as the world scientific community scrambled to “figure out” what this virus is and at the same time implement a massive global public health strategy to stop the metastasis of the NEW corona virus. Those of you who follow my diet know I am personally against eating animals listed in the Bible as "unclean" or "unfit" for humankind. It's a simple choice you "get" to make.  There is such a long list of "clean" animals that I have enough options!

It is known that China among many other cultures have people that enjoy eating bats, snakes, and dogs that are known to transmit viruses such as SARS, MERS, Swine Flu and now the Coronaviurs. BUT researchers have yet to pinpoint when, where or how the virus was transmitted from animals to humans. 

According to Business Insider is was projected back on February 26, 2020 by the American Hospital Association, which represents thousands of hospitals and health systems, in a webinar that there could be as many as 96 million cases in the US, 4.8 million hospitalizations, and 480,000 deaths associated with the novel (new) coronavirus. 
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This Corona virus strain is new to humans as this particular coronavirus found a new species: ours! Research reports for thousands of years, a parasite with no name lived happily among horseshoe bats in southern China. One day it mutated dramatically or even took a segment of a different coronavirus strain that already inhabited its new host, and morphed into a hybrid or a better, stronger version of itself, Many people inaccurately thought this was just the coronavirus aka “common cold” and many took to social media using the phrase "more people die of the Flu each year and the country never reports it" and therefore, many people did not listen to CDC warnings and they kept congregating until this virus was out of control and we have been “chasing it" ever since.   
 
If it wasn’t for social media iPhones personal videos uploaded to twitter before China got after these folks and stopped the videos, we might never had gotten a glance inside China. One particular video that really disturbed me was from a mortician who was burning bodies she said within a "one hour mandate of death" from the government authorities. She said her staff was completely overwhelmed and her voice was in a disturbing panic. What was most concerning on these twitter videos the mortician fixed her voice and face so you could not tell who she was, but she take a chance and upload to "warn" the world.  Investigative reports tell us one tiny invisible spec got on one human and today we are battling a global pandemic. The world’s confirmed cases doubled in 7 days:

March 19, 2020 213,000
March 26, 2020 467,000
Deaths: 21,000
 
USA: March 26, 2020 80,000 confirmed cases

Scientists confirmed in the Journal Science on March 16, 2020 that for every confirmed case there are likely 5 to 10 more people in the community with an undetected infection.

Looking back over my social media postings in February I remember when I saw a personal cell phone video of people falling over and crashing onto the floor in the emergency department. I couldn't believe what I was watching. One of bodies filmed was left lying on the floor as people were walking around it. When these videos surfaced back in January, I remember talking to my kids (who are either in medical residency or 4th year med school as we watched in disbelief). I knew something with this virus was not right. It wasn’t until I saw the CDC post on twitter when the USA CDC began “screening” at 3 major airports on 1/27/2020. I said to my kids that day “when you see this happening pay attention.” 
 
Here is what we know so far:

• Scientists (Zhou, Q) published in the journal Science on March, 4, 2020 that SARS-CoV-2 binds to human respiratory cells in order to hijack them to produce more viruses. The New virus attaches to a receptor on respiratory cells called angiotensin-converting enzyme 2 or ACE2. ("If we think of the human body as a house and 2019-nCoV [another name for SARS-CoV-2] as a robber, then ACE2 would be the doorknob of the house's door. Once the S-protein grabs it, the virus can enter the house," Liang Tao)
• The viral spike protein is a promising target for vaccines, because it's the part of the virus that interacts with its environment and so could be easily recognized by the immune system.

• Viruses are somewhere between chemistry and biology responsible for many of the most destructive outbreaks of the past 100 years: the flus of 1918, 1957 and 1968; and SARS, MERS and Ebola.
• Like the coronavirus, all these diseases are zoonotic — they jumped from an animal population into humans. And all are caused by viruses that encode their genetic material in RNA.

• Once inside a cell, a virus can make 10,000 copies of itself in a matter of hours. Within a few days, the infected person will carry hundreds of millions of viral particles in every teaspoon of his blood.
• The virus onslaught triggers an intense response from the host’s immune system: Defensive chemicals are released. The body’s temperature rises, causing fever. Armies of germ-eating white blood cells swarm the infected region. This response is what often makes a person feel sick.
• The virus functions through us with no cellular machinery of their own, they become intertwined with ours. Their proteins are our proteins. Their weaknesses are our weaknesses. Most drugs that might hurt them would hurt us, too.
• SARS, MERS and the new coronavirus almost certainly all originated in bats.
• The most recent analysis of the 2019-nCoV genome found it shares 96 percent of its RNA with a coronavirus previously identified in a specific bat species in China.
• Coronaviruses are enveloped, single-stranded RNA viruses, which means that their genome consists of a strand of RNA (rather than DNA) and that each viral particle is wrapped in a protein “envelope.” Viruses all do basically the same thing: invade a cell and co-opt some of its components to make many copies of themselves, which then infect other cells. But RNA replication typically lacks the error-correction mechanisms cells employ when copying DNA, so RNA viruses make mistakes during replication. Coronaviruses have the longest genomes of any RNA virus—consisting of 30,000 letters, or bases—and the more material a pathogen copies, the more opportunity there is for mistakes. The reason it can be a common cold to deadly is that these viruses mutate very rapidly. Some of these mutations may confer new properties, such as the ability to infect new cell types—or even new species.
• Respiratory viruses tend to infect and replicate in two places: In the nose and throat, where they are highly contagious, or lower in the lungs, where they spread less easily but are much more deadly.
• The combination of dwelling in the upper respiratory tract, where it is easily sneezed or coughed onto its next victim OR in some people it lodges itself deep within the lungs, where it can kill gives Covid-19 the contagiousness of some colds, along with some of the lethality of its close molecular cousin SARS, which caused a 2002-2003 outbreak in Asia.
• Another insidious characteristic of this virus: By giving up that bit of lethality, its symptoms emerge less readily than SARS, which means people often pass it to others before they even know they have it.

The Covid-19 virus is, in other words, just sneaky enough to “wreak worldwide havoc.

• The medical community is now hearing, young people get this virus. They may not die, but many are being hospitalized. The average age was 44 in China, it was not in the 80s. 
• The time of exposure to symptoms; we originally thought it was 2 to 3 days, but now we're seeing that it can be anywhere from 2 to 11 days and we don't know why. It could be the number of viral particles that people are exposed to, or it could be various health factors related to the health of the patient. We just don't know. But during that entire time span, people could be asymptomatic and yet be shedding virus.
• If you have allergies, you're probably not going to have a fever. That's the biggest difference between Covid-19 and Allergies. And if you don't have a fever, it's more likely the allergy and not the Covid-19. If you have a fever, then I would start thinking, well, this could be something different. 
• ACE-2 receptors are in the lungs and the kidneys are also in the gut. If you happen to swallow the virus instead of breath it in, it may infect the gut instead of the lungs. And when you mount an immune response, one of the cytokines that's made in the gut is TNF alpha, and we know that TNF alpha alone can cause diarrhea.
• Critical point to grasp is that many people who have GI symptoms can also be shedding virus in stool. The data from the Chinese that are coming out right now are showing that viral shedding is 20 days. It's not 2 weeks, it's 3 weeks.
• Dr. Zwickey stated “I’m trying to change the vernacular from social distancing to physical distancing because people need to be social at some level to maintain coping skills
• There is a conjunctivitis that can be associated with Covid-19, although it's relatively rare. Data coming out of China and Italy suggest it's about 1 in 1,000 will develop conjunctivitis. The first thing to remember is this is a Covid-19 infection and this infection sheds the virus. A lot of times when we see the red eye, we think that it's limited to the eye. It's not. Also remember that this isn't bacterial, so the antibacterial drops that you drop in your eyes aren't going to work. This should be treated like you would treat any other Covid-19 infection, and it can be severe. People can develop a lot of inflammation in their eye from this particular virus.
• Viruses can infect any tissue for which there is a receptor, and for SARS-CoV-2 the receptor, ACE-2, is distributed among many different tissues. And because the receptor's widespread, there's widespread symptoms. We call this tissue tropism, that the virus is attracted to the tissues that express the receptor. Another virus that does stuff like this is measles. Measles binds to 3 different receptors in 3 different tissues, and as a result you see measles in the lungs and the gut, and in immune cells as well. So, it's true for other viruses, it's just that until you get the law of large numbers, we don't see the symptoms appear in high enough quantity to associate it with this particular infection.
• We know that if you disrupt the gut microbiome, you make anyone, animal, human or insect susceptible to infections. The best foods to eat for the microbiome is vegetables, especially vegetables with good prebiotic fibers such as onions, Jerusalem artichoke, sunchokes, leeks, garlic.
• Potatoes are a vegetable, but they're not the best for feeding the microbiome. Although it is better to eat a potato than a cookie, but asparagus or greens is better than a potato. The other thing that most of us forget is that spices are prebiotic. Cook with spices, such as rosemary, thyme, basil, oregano, cinnamon, all help feed the bacteria in your gut, your gut microbiome.
• The next thing that many people should do is take probiotics, and it is best to take probiotics with food. Kefir, kombucha, sauerkraut, and yogurt are all great choices. Stay away from sweetened yogurt and purchase plain yogurt and use organic fruit.

 
Non-influenza Respiratory Virus Review
1.  Human rhinoviruses (HRVS)
 Most frequent and leading cause of the common cold and upper airway pathogen. There are over 100 serotypes identified which cause disease in persons of all ages with the highest incidence documented in young children. Distribution from Pneumococcal to Shigella, to Meningococcal disease and Intestinal pathogenic.
 
2.  Parainfluenze – Most infections are in children and limited to the upper respiratory tract. Antivirals no proven efficacy. Children with croup see improved cliical outcomes with glucocorticoids and nebulized epinephrine.
 
3.  Adenovirus (hAdV) are divided into 57 serotypes and seven species. They manifest in respiratory tract, ocular, GI, genitourinary tract, and central nervous system, among others.  
Adenoviruses infect susceptible hosts by the mouth, nasopharynx or ocular conjunctiva. Key cellular receptors include CAR (coxsackie-adenovirus receptor). Confirmation of infection can be confused by latent infection in some tissues, such as the tonsils, and intermittent and sometimes prolonged shedding of virus from throat or in the stool for months to years after primary infection. Pharyngitis, laryngotracheitis, bronchitis, and pneumonia are common Adenoviruses.
 
4.  Coronavirus - are RNA viruses and commonly cause mild upper respiratory tract infections, although occasionally result in more severe disease in immunocompromised individuals. Two new human coronaviruses both found in bats are:
(2002) SARS-CoV – severe acute respiratory syndrome – associated corona virus. (Group B) (Intermediate mammalian hosts civet cats) (No vaccine)
(2012) MERS-Cov- Middle East respiratory syndrome-associated coronavirus which may cause serious viral pneumonitis, leading to hospitalizations and deaths. (Group C) (Intermediate mammalian hosts, dromedary camels) (No vaccine)
 
 
5. (2005) Human Bocavirus
Infection appears to occur year-round with peak in winter. Most children have antibodies to HBoV1 by age 6 and most adults have detected antibodies. V1 is respiratory and V2 is stool.
6.  Human Metapneumovirus (hMPV) - hMPV results in typically self-limited upper and lower respiratory tract infections in all age groups with a global distribution. Symptomatic disease appears to be more common among young children and the elderly. hMPV is the second most frequently isolated viral pathogen, after RSV, in children presenting with bronchiolitis. There is currently no licensed vaccine against hMPV, although several are currently under investigation. 
7.  Respiratory Syncytial Virus  (RSV) - (RSV) is an enveloped, single-stranded RNA paramyxovirus that includes two major groups, A and B, each of which consists of 5 to 6 genotypes. RSV is known to be an important cause of lower respiratory tract infection in infants and young children (e.g. acute bronchiolitis, wheezy attacks), resulting in hospitalizations and deaths. RSV infections in infants and young children can lead to severe lower respiratory tract illnesses such as pneumonia and bronchiolitis. At present, there is no established antiviral therapy or vaccine available for RSV.
 
To learn more about Covid-19 and Prevention check out "this week in Virology TWiV " An Ounce of Prevention Pod Cast recorded on March 31, 2020.  Click Here
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 References/Source:
 
1.  Yan, Zhang, Lif, Xia, Guo, Zhou (2020) Structural basis for the recognition of SARS-CoV-2 by full length human ACE2. Science ​
2.  Dr. H. Zwickey, PhD, Natural Medicine Journal
3.  Washington Post 3/19/2020 CoronaVirus Projections
4.  Pappas, S. LIVESCIENCE
5.  Kormann, (3//27/2020). From Bats to Human lungs, the evolution of a coronavirus. The New Yorker
6.  Ison, M., Lee, N. (2017) Noninfluenze Respiratory Viruses. ScienceDirect.
 

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