Quo Vadis, Corona?
On the current pandemic, saturation affects the general population and front-line health care providers. There is a fed-up among people about SARS-CoV-2 and its many circumstances: political, economic, media, and health. All we need is breath!
It is not prudent playing to be Nostradamus or pretending to guess the future as a vulgar XXI Century’s seer. SARS CoV-2 has demonstrated an unquestionable capacity to surprise. From its natural origin to the ways of contagion.
Even so, there are reasonable predictions about this small microbe. A virus that paralyzed the blue planet one year ago. The new virus is a tiny piece of genetic material with no life of its own that changed human history. With its mutations, human beings’ lives also mutated. The virus is small, but a bully.
I set out five questions in the following paragraphs.
1. Where the hell is the virus’s origin?
We rest still where we were a year ago. The bug’s natural origin is unknown. You are right: coronavirus is fluttering around the bats and other strange mammals.
The Chinese government not completely opens its doors and windows to the WHO’s research. There is nothing new under the Beijing sun. A strong dictatorship, communist and rich, is not defined by its transparency.
We know the information based on rigorous scientific data. One accepts the bug comes from bats. Coronaviruses live in their anatomies for thousands or millions of years.
At some unknown time, the zoonotic coronavirus jumped to other mammals. An evolution crash happened. Two different viral species meet in the same mammal’s cells through a natural and random event.
In the new cellular scenario, the two viruses exchanged a small piece or segment of nucleic acid (RNA). This biological phenomenon is genetic recombination. It is necessary to create a new species, a phenomenon well known as the origin of pandemics flu.
The original virus produces 10,000 to 100,000 million viral copies or virions per infected cell. The neonate finds new hosts to infect mammals such as pangolins, felines, minks, and humans. All intermediary hosts lacking natural immunity against the invader. The Bible says, “Be fruitful and multiply and replenish the earth” (Genesis 1:28). The phenomenon is extraordinary, but it is not new, nor it is the first, nor will it be the last. It is evolution.
2. How many virions are?
It is unknown how many individual viruses there are on any given day (as today) on planet Earth. Prof. Yates (Bath University, UK) proposes around three million humans’ infections daily (official figures are lower). Coronavirus is tiny (80 to 120 nm; one nm or nanometer is one-billionth of a meter). It is a thousand times smaller than a hair’s diameter.
The total amount of virus per day (or the “planetary” viral load) fits in a can of soda (its volume is 333 cubic centimeters). The total viral volume is less: about 160 ml.
The surface occupied by the viral cloud is equal to a tennis court and a third. It is a surface like the one used by the denialist Djokovic, the last Australian Open winner.
Let us add something else. Putting the viruses in a row, like collar beads, the “viral collar” would be equal to going to the Moon and back 25 times! Mars is much farther away.
3. Is it a variation like a mutation?
The “Chinese” virus (Mr. Trump Dixit) of Wuhan has a mutant order written in its big genome (around 30.000 letters). Natural evolution makes roughly two mutations a month.
The change or loss of some amino acids is not related to a specific nationality or geography. The phenomenon can occur almost in several places. It depends on chance and the viral adaptation.
Sometimes, the virus looks for new opportunities. It is a viral escape to impose the most capable dominance. It is different if the mutated variants travel by air or train: a Brazilian mutant can land at Tokyo airport. Will be the new lineages worse than the “original” from Wuhan or its chiropteran ancestor? Good question.
Data are suggesting increased transmissibility among humans. Also, it looks having an increased virulence and reduced responsiveness to some vaccines. It does not mean an absolute lack of response. But it is possible to reduce responsiveness to specific therapies (monoclonal antibodies).
Some computational studies (University of Liverpool) predict the possibility of future infections. Of 40 times more mammalian species. This fact could occur with several different types of coronaviruses still unknown. Moreover, 126 mammalian species may be susceptible to SARS-CoV-2 disease (Nature Communications).
Calm down, then: “The Zoonotic Crown” series is still not finished. If the fantastic current episode were to end this year, it would be one more from a never-ending series. It will continue.
4. What about “my” vaccine?
The word vaccine comes from the Latin vaccae (cow, beef). Is this the reason why some people speak of “herd” immunity? I mean when they refer to collective or community immunity.
In the current pandemic, no one knows for sure what the smallest protection figure is. Most experts say 60–70%, but the harsh reality is that it is unknown. There is a rule common to all respiratory viruses. The greater the number of people vaccinated, the lower the possibility of transmission. So, it is crucial to vaccine many people.
Human agglomerations in closed unprotected places are the ideal way of contagion. Coronavirus can spread by aerosols and survive in the room (remember flu or measles). Non-pharmacological protection measures will still be valid. Even with vaccines, until we can get a glimpse of security on the horizon.
It is a historic milestone. Today we have six approved vaccines on the market (Coronavirus Vaccine Tracker). In only ten or twelve months. And more than forty are at an advanced research stage. Efficacy, efficiency, tolerance are so far excellent. And there is a favorable impact on the statistics. About the number of general admissions, ICU admissions, and associated mortality. Israel is a good example. Unheard of, never seen before. Congratulations, human beings.
A question: Which vaccine should I receive? Whichever one health authorities I get and when I get it, without skipping a turn.
Many investigators follow this goal. Likewise, a new model is against many coronavirus species. There is a model called mosaic nanoparticle tested in mice. It shows excellent prospects. It is effective against the eight coronaviruses tested. And against four more untested in the original mosaic. A whole world is opening against old and new infections.
5. Prescribe or cure?
The Cinderella of the pandemic nightmare is drug therapy. There are hundreds of pages about old drugs and new molecules with supposed efficacy.
Cheap dexamethasone (and other steroids) works quite well. But in patients who start to go wrong (WHO). Many other drugs (hydroxychloroquine, lopinavir) have deflated. They died of success. Remdesivir does something less than expected. Some novel anti-inflammatory used in rheumatoid arthritis too. Many more drugs have fallen out of the race by failing to measure up. But this, I suppose, will arrive. There are newcomers (plitidepsin) on perspective.
As it happens with HIV infection, it is possible combination therapy will achieve. By attacking different therapeutic targets of the viral structure. The possibility of finding a new drug for coronavirus prophylaxis is real. Also, it occurs with HIV and influenza. The Pharma industry must already be digging the mine.
Suppose the forecasts and mathematical models come right (Science). In that case, the current pandemic coronavirus may adapt to new scenarios. It can happen after mutating as much as possible.
Will the coronavirus be one more seasonal virus? Like, four previous respiratory relatives swarming every winter in children and adolescents’ noses. Or stop its way, as 2002-SARS and 2012-MERS did.
Yet, problems will not finish with the foreseeable end of the pandemic coronavirus. Think in future pandemics (CNN, April 29, 2020). Many people warn since several years ago about the coming epidemic(s).
I do not intend to be a prophet. Russia has reported to the WHO an outbreak of H5N8 avian influenza. Seven cases of bird flu transmissible for the first time to humans. I hope that this worrying news does not go any further because COVID-19 would be only a joke if it were to happen.
1. Do not lower the preventive guard (society).
2. Invest in research (industry and politicians).
3. Inform the community with rigor and professionality (media).
4. Teach and tell (teachers and parents) to young people. In schools, colleges, and homes. Teach how to behave (like seismic warnings in Japan) whether a new pandemic arrives .
After all, a pandemic is a microbial earthquake with global effects.
PS: Quo Vadis, Corona? is an English version of a paper published in Cuaderno Extremeño para el Debate y la Acción (in Spanish).