Friday, March 20, 2020

TOTAL MUST READ: What Makes Covid-19 "Novel"?

In other words, What makes Covid-19 different from other coronaviruses, like the one that causes the common cold? What makes Covid-19 (SARS-CoV-2) much more of a threat than "SARS-classic"? This article from The Atlantic goes into non-technical detail to explain that, and along the way explains why epidemiologists and governments are freaking out over this pandemic.

Below is a significant excerpt, but as usual there's much more. To give you an idea of the very important topics that are covered--beyond these excerpts--Here is brackets are summaries of those topics. As you'll see, they cover many of the questions that have been coming up, and answers are offered.

[For anyone wondering why Covid-19 is less of a threat in certain places than others, mutations--so common for all viruses--offer an explanation. For example, the Singapore version of Covid-19 mutated in a way that made it less virulent--thus the success of Singapore's control efforts in comparison to some other countries.] 
[Want some bad news? Covid-19 appears to attack other organs--in addition to both the upper and lower respiratory systems. For example, many of the Seattle deaths have actually been from heart arrhythmia.] 
[The human immune system fights all this, of course, but as in SARS-classic that can lead to a "cytokine storm," in which the immune system basically ends up working against the body.] 
[Why do some people get really, really sick, while others don't? Age is a factor, but only one of a variety of factors.] 
[Will warm weather blunt the virus? Rather doubtful, based on the evidence so far.]

Why the Coronavirus Has Been So Successful

We’ve known about SARS-CoV-2 for only three months, but scientists can make some educated guesses about where it came from and why it’s behaving in such an extreme way.



But much about coronaviruses is still unclear. ...

To be clear, SARS-CoV-2 is not the flu. It causes a disease with different symptoms, spreads and kills more readily, and belongs to a completely different family of viruses. This family, the coronaviruses, includes just six other members that infect humans. Four of them—OC43, HKU1, NL63, and 229E—have been gently annoying humans for more than a century, causing a third of common colds. The other two—MERS and SARS (or “SARS-classic,” as some virologists have started calling it)—both cause far more severe disease. Why was this seventh coronavirus the one to go pandemic? ...

The structure of the virus provides some clues about its success. In shape, it’s essentially a spiky ball. Those spikes recognize and stick to a protein called ACE2, which is found on the surface of our cells: This is the first step to an infection. The exact contours of SARS-CoV-2’s spikes allow it to stick far more strongly to ACE2 than SARS-classic did, and “it’s likely that this is really crucial for person-to-person transmission,” says Angela Rasmussen of Columbia University. In general terms, the tighter the bond, the less virus required to start an infection.

There’s another important feature. Coronavirus spikes consist of two connected halves, and the spike activates when those halves are separated; only then can the virus enter a host cell. In SARS-classic, this separation happens with some difficulty. But in SARS-CoV-2, the bridge that connects the two halves can be easily cut by an enzyme called furin, which is made by human cells and—crucially—is found across many tissues. “This is probably important for some of the really unusual things we see in this virus,” says Kristian Andersen of Scripps Research Translational Institute.

For example, most respiratory viruses tend to infect either the upper or lower airways. In general, an upper-respiratory infection spreads more easily, but tends to be milder, while a lower-respiratory infection is harder to transmit, but is more severe. SARS-CoV-2 seems to infect both upper and lower airways, perhaps because it can exploit the ubiquitous furin. This double whammy could also conceivably explain why the virus can spread between people before symptoms show up—a trait that has made it so difficult to control. Perhaps it transmits while still confined to the upper airways, before making its way deeper and causing severe symptoms. All of this is plausible but totally hypothetical; the virus was only discovered in January, and most of its biology is still a mystery.

The new virus certainly seems to be effective at infecting humans, despite its animal origins. The closest wild relative of SARS-CoV-2 is found in bats, which suggests it originated in a bat, then jumped to humans either directly or through another species. (Another coronavirus found in wild pangolins also resembles SARS-CoV-2, but only in the small part of the spike that recognizes ACE2; the two viruses are otherwise dissimilar, and pangolins are unlikely to be the original reservoir of the new virus.) When SARS-classic first made this leap, a brief period of mutation was necessary for it to recognize ACE2 well. But SARS-CoV-2 could do that from day one. “It had already found its best way of being a [human] virus,” says Matthew Frieman of the University of Maryland School of Medicine.

This uncanny fit will doubtlessly encourage conspiracy theorists: What are the odds that a random bat virus had exactly the right combination of traits to effectively infect human cells from the get-go, and then jump into an unsuspecting person? “Very low,” Andersen says, “but there are millions or billions of these viruses out there. These viruses are so prevalent that things that are really unlikely to happen sometimes do.”

Since the start of the pandemic, the virus hasn’t changed in any obviously important ways. It’s mutating in the way that all viruses do. But of the 100-plus mutations that have been documented, none has risen to dominance, which suggests that none is especially important. “The virus has been remarkably stable given how much transmission we’ve seen,” says Lisa Gralinski of the University of North Carolina. “That makes sense, because there’s no evolutionary pressure on the virus to transmit better. It’s doing a great job of spreading around the world right now.”

1 comment:

  1. Thanks Mark!

    Great explanation of what the virus does.

    Sad about temperature probably not having a huge impact per the article.