The intricacies of the Coronavirus

There is constantly new research emerging on the Coronavirus but here is some current information for you to help in understanding what it is and how it works as well as the best strategy of approach that we can take at this current time. Please keep in mind that with new discoveries happening, some of this information may be superseded by other information coming.

What is the Coronavirus?

As you would all know, there is much talk in the media about the current Coronavirus. But did you know that it actually belongs to a group of Coronaviruses (CoVs), some of which you no doubt already have heard of?  Severe Acute Respiratory Syndrome (SARS),  Middle Eastern Respiratory Syndrome (MERS), and now more recently the latest strain known as SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) which results in the illness called COVID-19. SARS-CoV-2 or the ‘Coronavirus’ is similar genetically to the original SARS that caused an outbreak in 2002.

How is the Coronavirus transmitted? And how serious is it?

The Coronavirus is a virus that spreads through contaminated droplets from an infected person sneezing or coughing. It can also be spread by the infected person’s contaminated hands touching or handling things around them which others then handle and in turn, get contaminated. Infection rates of this global pandemic are shown to double about every 7 days with each infected person passing the virus on to another 2.5-3.5 individuals. To put this into perspective, the Coronavirus spreads much more easily than the flu. The main issue with infection is that some people are asymptomatic (meaning they show no symptoms of carrying the virus) and hence unknowingly will be passing the virus on to others. This makes it harder to control and keep contained in one area, as opposed to the SARS virus in 2002 where anyone infected showed signs and symptoms within a short period of time hence it was easier to track and contain.

How does the Coronavirus do the damage that it does?

The Coronavirus has a relatively high virulence and pathogenicity meaning that it has the capacity to infect and damage a host with ease. Like most viruses, it is very fickle in that it is able to change its viral genes making it harder for the immune system to detect and fight it. Being a virus known as RNA viruses, it can enter cells initially undetected by our immune system and use the host cell’s materials and energy to reproduce and replicate itself as well as block the host’s innate immune response which would normally fight the virus off. The virus is a new virus that our immune system is not yet familiar with and hence has not mounted an immune response. The activation of the immune response takes about 2 weeks for someone who has not been exposed to the virus previously. All viruses that enter a host cell naturally activate virulence factors, which is an inflammatory response of the cell. A complication of the SARS-CoV 2 virus is that it activates a particular inflammasome (virulence factor in the host cell) which the cell then struggles to switch off resulting in overstimulation of the inflammatory response and thus an inflammatory storm.

How the ACE2 receptors assist the Coronavirus:

Of interest is that most SARS-CoV viruses use the ACE2 receptors on the host cells to enter and infect the cell itself. ACE2 receptors stand for “Angiotensin-Converting-Enzyme Receptor 2”. These receptors are found in a lot of different organs and organ tissues but in larger concentrations particularly in the tissues of the lungs, vascular epithelium and small intestine. This is why these tissues are more at risk of infection by the virus. The virus has a spike protein that binds to the ACE2 receptor, and it uses a cleavage site which means it can enter these cells more easily and begin its pathogenic (disease-producing or destructive) processes.

Delayed Immune response followed by complications:

After a certain delay, as mentioned previously, the host immune system eventually mounts an immune response to target the virus and the infected host tissue. This leads to damage to the infected cells because the only way to kill the virus is to kill the infected cells. This means that affected tissue is destroyed and for example for those with the lung tissue affected this can result in complications such as more serious cases of viral pneumonia (not treatable by anti-biotics) and potentially ARDS – Acute Respiratory Distress Syndrome and then septic shock.

At-risk individuals:

What has been observed is that the elderly (considered anyone over 60 years old) and in particular anyone with what is called co-morbidities or co-existing conditions (such as high blood pressure, diabetes, heart disease, cancer etc) as well as anyone who is immune-compromised has a greater risk in contracting the disease and having more severe consequences. In other words, there has been a greater incidence of deaths in these groups.

Multiple Medications

Many elderly people are on multiple medications, which is what increases their risk. Also,  many of these conditions mentioned (high blood pressure, diabetes, heart disease etc) involve chronic inflammation which only magnifies the issues around the coronavirus and its pathogenicity.

Diabetes

Similarly, high blood sugar levels as seen in diabetes also increases and accelerates inflammation further boosting the pathogenicity of the virus and increasing the damage to the host cells.

Ibuprofen and anti-inflammatories

And last but not least, certain common over the counter medications (such as Ibuprofen and most anti-inflammatory medications) often used for colds and flu’s, and to reduce pain associated with inflammation, can also potentiate the virus and its pathogenicity. This means that taking these medications will assist the virus in its infection and damage hence increasing the complications and reducing the chances for improved outcomes. More specifically, Ibuprofen increases the ACE2 receptors (mentioned earlier) and hence makes it easier for the virus to enter and infect cells.

Blood pressure Medications and the ACE2 receptors

In relation to the expression of the ACE2 receptors and the above mentioned chronic inflammatory conditions, people on blood pressure medications express more of the ACE2 receptors. They are considered to be at greater risk as the virus targets these cells and enters with greater ease. Hence if you have any damage from cardiovascular disease, the virus targets these cells and causes even more damage in this area. You can begin to understand how this complicates the treatment and reduces the chances for better outcomes. To be clear, this does NOT indicate that these hypertensive medications or other scripted medications should be ceased.

Some research indicates that men express more of these ACE2 receptors than women and equally that Asians tend to express more of these receptors than other ethnic backgrounds, but there is no evidence at this point to show that this would put them at greater risk.

Incubation and Symptoms:

Viral incubation lasts about 1-14 days after exposure (hence the 14 day isolation period which has been mandated by the government), with symptoms typically beginning to show at around day 5.

Most common symptoms of SARS-CoV 2 typically include fever, cough, shortness of breath, possible digestive involvement (diarrhoea) and other flu-like symptoms.

The tricky thing is that not everyone will have any symptoms or get obviously sick from this virus, and on the other spectrum there are those who have and will die from it, often due to other complications from the co-morbidities mentioned above.

Best strategy approach for most people:

  • Hygiene – Ensure proper hand washing and disinfection of surfaces around you
  • Avoid travelling to outbreak areas and crowded areas
  • Avoid touching your face (eyes, nose, mouth) as it is a common entry point for viruses
  • Stay at home if you are unwell or get the Coronavirus and seek medical advice as appropriate
  • If you are well, make sure you reach out to responsibly support those who are in isolation and are needing help.

There is much more you can do on a practical level to support your own health and wellbeing, by ensuring you get enough sleep, reduce stress levels and by taking vitamins and other supplements and/or herbs that boost immunity and help you recover faster if you do get sick. For further reading please check out our previously released article: ‘What do I need to know about the Corona Virus and what can I do?’

As you can see, the Coronavirus has certainly got our attention and much research is constantly happening to discover more and more about it and its intricacies. Vaccines are being investigated and are postulated to be released in 6 to 18 months. However, as we know, viruses have the ability to mutate and form new strains which mean the vaccine may be obsolete for these new strains once it comes out. Meanwhile, we will keep you up to date with the changes and developments – so please visit our site frequently to find out what is unfolding.