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Covid-19: Ingredients for This Major Pandemic

Discussion in 'Doctors Cafe' started by Priyanga Singh, Apr 13, 2020.

  1. Priyanga Singh

    Priyanga Singh Young Member

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    Covid-19 outbreak and its ravaging effects are highlighting the vulnerable nature of human race once again, we have always been vulnerable towards infections and its not first time humanity is struggling to fight disaster which pandemic creates in terms of mortality, economy and social structure.

    recipe pandemic covid jpg.jpg
    What made Covid19 pandemic into existence, it didn’t happen overnight. It is multifactorial like most catastrophes are.

    Following are few most important factors, which lead towards this global catastrophe of covid19 crisis-

    Most Pandemic pathogens are Viruses including Covid19 Virus

    Most pandemic pathogens are fundamentally weird viruses. There are about 800 million viruses on every square meter of the earth and only few of them have caused calamitous outbreaks in past.

    There are several features of viruses, which make them most common pathogen for pandemic.

    · Higher capacity for genetic mutability

    · Generation time for replication in which large numbers of progeny virus are created each day, the human host is walking machine of virus replication.

    · Inability of a virus to be countered with a broad-spectrum antiviral

    · Virus can outsmart human immune system and difficult to develop vaccines and anti-viral treatment
    RNA virus hero of pandemic story jpg.jpg

    It is RNA Virus (RNA viruses are very tricky and prone for mutation)

    Viruses in general have high mutability among all microbes, the RNA viruses which have genomes made from RNA. When these RNA viruses make new copies of their genetic instructions, they don’t include a proofreading step where they check for mistakes, so mutations are far common and new variants are constantly being created. Covid19 virus is an RNA virus which mutated in bats and intermediate host, then jumped into human causing human to human infection.

    Pathogens of past pandemics and epidemics fall into this category of RNA viruses, including influenza, HIV, SARS, MERS, Zika, Ebola, polio and rhinovirus (the most prevalent cause of the common cold).

    high mutation rate of RNA virus jpg.jpg

    The structure of virus

    The structure of the virus provides some clues about its success in causing easy spread and infection.

    · Spiky ball shape- It is a spiky ball, these spikes recognize and stick to a protein called ACE2 (Angiotensin converting enzyme 2), which is found on the surface of human cells. This is the first step to an infection.

    spike structure virus jpg.jpg

    · Perfect fit with ACE2 of human cell- The exact contours of SARS-CoV-2’s spikes allow it to stick far more strongly to ACE2 than SARS-classic did, it is very crucial for person-to-person transmission. In general terms, the tighter the bond, the less virus required to start an infection. Since you don’t need whole loads of viruses to start the infection, person to person transmission is very easy and rapid.

    · Easy to activate spike halves

    Coronavirus spikes consist of two connected halves, and the spike activates when those halves are separated, without this separation virus cannot enter a host cell. In SARS-classic, this separation happens with some difficulty. But in SARS-CoV-2 (Covid19 virus), the bridge that connects the two halves can be easily separated by an enzyme called Furin, which is made by human cells and Furin is found across many tissues in humans.

    furin cleaves site jpg.jpg

    It infects respiratory tract and spread via respiratory droplets

    Respiratory viruses like Covid 19 viruses are much harder to stop spreading, because breathing is an essential part of life and it’s very hard to stop people from breathing on each other in closed crowded areas with increased aerosol concentration.

    infects respiratory tract jpg.jpg

    It infects animals and with slightest mutation it started infecting humans

    Covid19 virus is mutated strain of virus coming from bats (there is unknown intermediate host too), the virus must have mutated in bats and started to infect humans. The ‘zoonotic’ pathogens include all the big names like HIV, SARS-classic, Ebola and Nipah, having caused nearly every pandemic in human history. Just like the recent avian flu outbreak, the 1918 flu pandemic, which killed between 50 and 100 million people worldwide, began in birds. There are probably millions of viruses out there that infect other mammals and could potentially infect people.

    Bats seems to have nasty weird pathogens ready to go for pandemics

    One not-so-surprising finding was that the next pandemic will probably emerge from bats. No one knows why, but bats are absolutely riddled with nasty viruses. They’re known to be the source of many, many human pandemics, including SARS, which we picked up from cave-dwelling bats in China, as well as Ebola.

    bats as reservoir jpg.jpg

    Wrong distribution of resources and complacency of Authorities

    We aren’t ready for next pandemic these were words by Bill Gates in his Ted talk after Ebola epidemic. We should have prepared well for next impending global pandemic, but we didn’t. We got lucky in Ebola and SARS epidemics, and authorities and Governing bodies never cared enough to implement a strategy for next pandemic. Our failing to take viruses and pandemics seriously was a catastrophic mistake and we are paying price for this negligence. During an outbreak situation, early decisions regarding vaccine policy, resource mobilization, and countermeasure decisions made by political and scientific authorities in the control of an outbreak has very crucial role. Right and timely decisions could have prevented many of the downstream disastrous effects that affect the healthcare and other sectors.

    authorities complacency and defective distribution of resources jpg.jpg

    Globalization helped virus spread faster than ever

    Fast spread of Covid-19 around the globe has shown that our interconnected global economy has helped the virus spread like wildfire. The ability to get to nearly any spot in the world in 20-30 hours or fewer has increased chances of catastrophic pandemics. One can pack a virus along with our carry-on luggage, allows new diseases to emerge and to grow when they might have died out in the past without extensive spread. Closed long haul flights are perfect place to get contagion going.

    Perfect synergy with external factor: Chunyun in case of covid19

    The spring festival travel rush around the Chinese New Year festival is known as “Chunyun” and it lasts around 40 days, from 21st January to March 1st.

    Chunyun is world’s biggest mass migration and it includes citizens travelling home, both within China and from all over the world. For many overseas workers and students this period is the only time they can spend with their families.

    This coincided with disease outbreak in Wuhan where reported cases of unusual pneumonia were detected. These people who were infected became a “super-spreaders” (someone who transmits the virus to a greater number of people than the average victim) because of mass migration Chunyun.

    chunyun and globalization jpg.jpg

    People ignoring the warnings and precautionary measures to flatten the curve

    The public isn’t taking the outbreak seriously and many downplayed the risk of a crisis because it might not affect them (I am immunocompetent nothing can happen to healthy me attitude).

    The lack of available tests has suppressed the number of known cases in different countries, which may be causing underestimation of whole problem. The motivation for ignoring social distancing is different in various groups of people.

    covidiot jpg.jpg

    Author is medical doctor (Pathologist) and medical cartoonist, please visit https://creativemeddoses.com/ for educational mind maps and concise study related material.

    Further References

    RNA viruses are pandemic material, read more here https://academic.oup.com/ilarjournal/article/58/3/343/4107390

    Read more on covid19 virus structure here https://www.sciencedirect.com/science/article/pii/S0166354220300528?via=ihub

    Bats and few previous pandemics are closely connected, read more here https://www.sciencenews.org/article/bats-immune-system-viruses-ebola-marburg-people

    Bill gates predicted the outbreak and here is his famous talk

    and this catastrophic outbreak proves that we weren’t ready.
     

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    Last edited: Apr 13, 2020

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