Like most of you, we are keen to learn about the development of the current health crisis relating to the coronavirus pandemic. Amidst the upheaval all around the world, not just in Canada where we live, we strive to explore avenue to understand the situation and to give hope by being better informed and to pass these hopes onwards. We believe that in the darkest of hours, there is hope – hope transcending physical health, mental health, finance and overall, spiritual well-being.

As the first of our modest finding, we just want to share mainly from our viewing of the presentation given by Dr. Patrick Soon-Young, the executive chairman of the Los Angeles Times. The full presentation produced by LATimes can be found at  :

https://youtu.be/ddlRvqhGdPk?t=1529
https://youtu.be/ddlRvqhGdPk?t=1529

Dr. Patrick aims to educate viewers to better understand “how the virus infects our bodies and strategies toward treatment can help us allay our anxiety about it”.  

Indeed Dr. Patrick does a wonderful job with plain language and offers many thought provoking insights with hope and optimism. Optimism of how the health science community has been working very hard to come with workable solutions by deploying different strategies to overcome the SARS-coV-19 coronavirus pandemic and how we as individuals have certain control over how we can protect ourselves with simple measures.

We seek to unpack what we learnt from Dr. Patrick. Along the way, we might include some observations of our own as it applies to our lives.

Fighting Fear with Better Understanding

Dr. Patrick lets us know that “because it’s very clear to me that there’s a lot of fear out there and what adds to the sphere is confusion. But if we could present the science and really try and understand not only how does this corona virus work – how does it infect the body – what does it do and how we can actually attack it – we have an opportunity to really provide some peace of mind some level of control in the hands of every individual and the entire community”.

Real Shot At Defeating Coronavirus

This current pandemic is caused by a type of corona virus, whose ‘relative’ had attacked us in 2003. We actually have the benefit of the insight and basic scientific bioinformatics knowledge enhanced by advancement with newer supercomputing technologies not available back then.

The main message is : There is sufficient ground for optimism in overcoming this pandemic in our journey in the fight.

What Is The Coronavirus

The terms SARS-CoV-2 or Corona Virus or simply SARS refer to the same virus.

COVID-19 refers to the disease caused by the virus.

SARS-CoV-2 is an RNA virus. ( An RNA virus is a virus that has RNA (ribonucleic acid) as its genetic material.[1] ) Those curly things stored in the virus are genetic materials that get reproduced in the host it attacks – in this case, us humans!

This type of virus is encapsulated within an envelope or capsule to protect itself and it protrudes spikes looking like little crowns all around the capsule. This is why it earns the generic name “Corona Virus”.

The previous generation coronavirus had its previous generations’s vicious brush with us earlier in 2003.

SARS-CoV-2 is therefore a 2nd generation which evolves to be many more times more effective in its infection, regeneration and killing mechanism, overwhelm our efforts to contain it to the extent to reaching pandemic level of global health crisis.

Dr. Patrick emphasizes that it is very important to explore the host effect – i.e. what happens to the host attacked by the virus – rather than restricting to just a study of the virus itself.

How The Virus Infects Your Body

From an infected host, the virus replicates rapidly and starts to shed. When the host sneeze or coughs, tiny droplets expelled from these actions carries the virus and drops on surfaces around. These contaminated material gets directly on people’s body particularly mouths, nose, eyes, hands or indirectly by touching contaminated surfaces with their hands and then touching their face. Our hands, it turns out is a very important vector of contamination. This underscores the importance of proper hand-washing.

Once the virus finds its way into lungs of a human, the invasion begins. It happens that our respiratory cells have receptors called angiotensin-converting enzyme 2, or ACE2. ( ACE-2 expressed in the lung, kidney, and gastrointestinal tract, an cardiovascular tissues are shown to harbor SARS-CoV. ) Somehow the corona virus succeeds in figuring a way to interact and attach itself to the ACE2 receptor of the respiratory cells.

How Does The Virus Enter Your Body

Coronavirus attaching to ACE2 Receptor of human cell

Once the virus ‘docks’ onto a cell, it burrows into that cell and use the cell as a factory to regenerate itself in super-quick succession.

The virus invades the host’s respiratory system till it begin to shed from its new host through oral fluid expulsion through sneezing, coughing and even talking. If the host touches his mouth with his hand, his hand then becomes a vector of contamination. This underscores the importance of physical distancing to avoid contamination.

How Deadly Is Coronavirus

Datawise, the China statistics shows fatality rate at about 15% for age group greater than 80, around 8% for age group 70-79 and around 4% for age group 60-69, see graph below:

For USA so far, it’s about 10.4% for 85+, 4.3% for 75-85 and 2.7 for 65-74, see graph below:

It is important to note that while fatality is much higher in the older age group, there still are fatality in the younger age group as well. So there is no sure assurance that younger population is exempted from this attack.

As the virus replicates and works its way into the host’s organs, fibrosis occurs causing massive scarring of tissues. This scarring causes the ‘ground-glass’ effect on the lungs , damaging the organ and rendering it non-functional. The lungs get damaged until it can no longer provide oxygenation to the body. At the point, the medical term is Severe Acute Respiratory Syndrome (SARS).

Deprived of sufficient oxygen, multi-organ failure often sets in.

This vulnerability of human body to coronavirus attack occurs not just in population of older age group but also those with pre-existing health conditions like cardiovascular disease, diabetes, hypertension etc.

https://ourworldindata.org/coronavirus

Population with pre-existing conditions contracting COVID-19 are much more likely to need intensive medical intervention and be care for in ICUs (Intensive Care Units).

Dr. Patrick mentioned that Hypokalemia (low potassium level) has been observed among COVID-19 patients.

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Please do not take this to mean that taking potassium supplement is going to cure COVID-19 or anything like that. Whether it is the result of COVID-19 or a contributing vulnerability has yet to be verified through further studies.

Hypokalemia is best described as low level of potassium (K+) ions  in the blood serum. Mild low potassium does not typically cause symptoms. Symptoms may include feeling tired, leg cramps, weakness, and constipation. Low potassium also increases the risk of an abnormal heart rhythm, which is often too slow and can cause cardiac arrest.

 It was found that as the SARS-CoV-2 coronavirus attacks human cells via the ACE2 (Angiotensin- converting enzyme-2) receptors, it also attacks the renin–angiotensin system (RAS), causing low electrolyte levels in particularly potassium ions.

https://www.thailandmedical.news/news/covid-19-research-updates-chinese-study-reveals-that-hypokalemia-present-in-almost-all-covid-19-patients 
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These data points to the importance of ‘Flattening The Curve (of transmission/infection’ so as not to overwhelm the healthcare system, giving these critically ill patients a chance to get help and recover from critical to severe, then from moderate to mild and all the way back to full recovery.

How Contagious is COVID-19?

The rate of infection at time of Dr. Patrick’s presentation stood at 2.6. That means 1 infected person will probably infect 2.6 other persons. At this rate, at end of 1st cycle of infection, 5 are newly infected, at 2nd cycle there will be 18, at 3rd there will be 52, 4th cycle results in 140 and at 5th cycle, another 300 new infections results.

Hence the purpose of ‘flattening the curve’ is that if we can identify these patients that are ill we can actually, with protective measures or with isolation flatten rate of infection increases. Mandatory or self-isolation measures are example of efforts to ‘flatten the curve’.

As the virus can stay in our body for more than 30 days, when we chance anyone with fever or dry cough, preventive measure of self-isolation can be life saving.

We can then protect the healthcare systems capacity by having sufficient Intensive Care use resources, sufficient medical personnel, sufficient medical supplies to care for severe and critically ill patients who may otherwise die from this disease.

Handwashing – The Science And Power Of Soap

Do you believe that by properly washing your hands you are also helping health care system?

This simple, mundane act done is just too important to be considered trivial in terms of stopping the exponential spread of COVID-19.

First off, viruses are not bacteria. So antibacterial soap is a myth as it relates to killing viruses.

However, because of the fatty greasy layer on the virus’ envelope, it loves getting onto surfaces that will adhere to, such as your hand. Understanding that your hand is one of the virus’ favourite vector also make us appreciate the power of soap.

Regular detergent, dish washer fluid, hair shampoo, hand soap etc. acts as a effective surfactant.

( Surfactants are compounds that lower the surface tension (or interfacial tension) between two liquids, between a gas and a liquid, or between a liquid and a solid. Surfactants may act as detergents, wetting agents, emulsifiers, foaming agents, and dispersants. )

When soap particles comes in contact with the fatty layer of the virus, it actually orientates and lifts off these viruses and creates this clean surface.

Because our hands have nooks and crannies that you need the detergent to enter onto and create this interaction with the virus, you need to allow sufficient time to rub and wash.

Having a fatty envelope for the virus proves to be its Achilles heel because soap has the ability to crack that envelope and possibly kill that virus.

How To Stop SAR-Cov-2 – Is There Hope?

The first line of defense in preventing infection lies in practicing physical distancing and meticulous washing of hands and avoiding touching face with unwashed hand.

There needs to be accurate and timely testing in place. This allows limited resources to be used when it is most efficient having known the extend and intensity of the infection.

The next level when infection occurrence appears is to implement isolation and begin the resource intensive task of contact tracing. Tracing enables the public health authorities to pinpoint possible cluster(s) and control further out-break.

Treatment Options including Vaccination

Turning our attention to the person being infected, the question naturally will be – what treatment is available to get the infected patient recover.

From this point on, the efforts are focus on stopping the virus in its track and to render it harmless and die off.

Fortunately we have quite good data available for health scientists to work out some probable strategies

Strategy 1 – Blocking The Virus’ Entry Into The Human Host

Having known that the virus has found a way to connect to the ACE2 receptor of our human cell as the ‘port of entry’, our obvious question is : “Is there a way to disable to block this ability”

Health scientists all over the world is racing to unpack our knowledge of genomics, especially about protein folding to create decoys and ‘honeycomb’ to outsmart the virus. When we can stop the virus from attaching to the ACE2 receptor, we literally block its entry in our body.

We are thankful that we have the power of supercomputing to speed up analytical simulation to cut down precious time compare to the previous attack in 2003.

Strategy 2 – Blocking The Virus’ Machinery

The 2nd strategy is to attack the replication machinery inherent in the virus itself.

When we destroy its replication machinery (its reassemblers), we stop the exponential regenerate of itself together with the associated harm it will cause and the ability to infect others.

Strategy 3 – Block The Virus’ Packaging

Within the virus is their preprogrammed endosomal packaging. Think of them as incomplete virus fetus that can be shed away to enter other host cells. The host cells materials are then hijacked to regenerate itself as a full function virus.

What if we can effectively cripple this packaging process?

There are indeed many exciting developments towards this strategy.

Strategy 4 – Kill The Virus Factory Itself including vaccination

The last obvious strategy is to kill the virus itself.

Every healthy human has built-in mechanism to fight off foreign invasion into our body.

This work is carried out by what combination of ‘Natural Killer-Cells’ and ‘T-Cells’ and ‘B-Cells’. They are our ‘soldiers’, forming an important element of our immune system.

When the body detects foreign invasion, our immune system quickly send these Natural Killer-Cells and T-Cells to challenge the enemy and a battle is fought within our body.

If we can find ways to ‘train’ our immunity soldiers to recognize immediately and know to vanquish the virus invaders, we will have a fair good chance of winning the battle.

This effort to boost one’s immunity falls into the science of immunization or vaccination as we commonly call it.

We Are Not Helpless – We Can Win

As we can see, there is a good chance that we can win this battle with COVID-19 pandemic.

The unknown element is time – when will we be able to wrestle the mercilessly monster of a virus to the ground?

At this point, nobody knows.

It is indeed a time for international cooperation towards developing solutions.

This blog is just a casual observation and sharing about what I learnt about coronavirus. Nevertheless it has intrigue me to learn more – especially how I get better protect myself, the one love and the my neighbours at large.

I would also like to take this opportunity to thank everyone involved in the various professions putting in herculean efforts to keep us all safe and keep the essentials running – these cannot be taken for granted.

Meanwhile, local governments and common citizens like you and me have an important role to play – to do whatever is necessary to cut off or at least minimize the chance of the virus’ spread across the community.

Wash Our Hands and Observe Physically Distancing – Are these too much to ask?