A Primer on SARS-CoV-2 & things to do while stuck at home

 

SARS-CoV-2. Micrograph from NIAID

First, where I’m coming from… There is the “Germ Theory” in which pathogenic microbes cause infectious disease.  Then there’s the “Terrain Theory” in which the “terrain” a person provides is the determining factor in disease, with the microbes being a symptom of diseased tissues as well as a provacateur of further disease. As a former virologist/infectious disease researcher and a current herbalist, I feel that both pathogens and terrain are important, with one or the other being more dominant, depending on the situation.

On one hand, folks lucky enough to be in a healthy environment and who practice healthy eating and living habits are generally less susceptible to infectious diseases;  while someone who is unhealthy for various reasons may wind up with issues due to a microbe that would otherwise be harmless (eg. Candida). On the other hand, there are multiple pathogenic microbes that will infect and cause disease in healthy people. Hantavirus, certain influenza strains, and ebola virus, are some (extreme) examples of this.  So,  I take the middle road…

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WHAT ARE CORONAVIRUSES?

  • A family of viruses that infect birds and mammals (including us, obviously!)
  • Coronaviruses are called such because the bits that stick out from the spherical viral particle resemble the Sun’s corona, or outer layer.
  • Several coronaviruses cause upper respiratory tract infections in people and are one of the causes of the common cold
  • “Betacoronaviruses” are part of the coronavirus family and include the currently  circulating SARS-CoV-2 virus, the SARS-CoV virus that caused the SARS epidemic in 2003 and MERS-CoV that caused a small but severe outbreaks from 2012-2014.

SARS-CoV-2 & COVID-19

  • SARS-CoV-2 is the name of the virus causing the current    pandemic
    • “SARS” is for Severe Acute Respiratory Syndrome        SARS-CoV-2.  Image from NIAID
    • “CoV” is for coronavirus                                                                                                                                                                           
    • “2” is because this is highly related to SARS-CoV that caused the SARS epidemic (their genetic code is ~ 80% identical).
  • COVID-19 is the name of the disease that SARS-CoV-2 causes:
    • “COVI”for coronoavirus
    • “D” for disease
    • “19” for 2019, when it emerged (the first case was identified on Dec 1st

Spread of SARS-CoV-2

  • The increased case numbers being reported here in the US are due both to viral    spread but also to increased testing identifying previously unknown cases.
  • The 1st case was reported on Dec 1st, 2019. As of March 29th, there were 715,076 identified cases of COVID-19 worldwide. The number is likely higher simply because not everyone is being tested. Mildly symptomatic or asymptomatic infections are likely being missed. 
  • Estimates are that an infected person on average infects 2-2.5 other people. Based on this, you can see how this can greatly increase the number of cases over time. If those 2 people then spread it to 2 more people each, etc… This is one of the reasons that social distancing has been evoked. If folks aren’t out mixing with a bunch of other people, it reduces the odds of transmission.
  • SARS-CoV-2 is spreading much more than SARS-CoV did in the 2003 SARS epidemic. Recent research suggests that this may be due to a surface protein that differs slightly between the 2 viruses. This difference may allow SARS-CoV-2 to replicate not only in the lungs as did SARS-CoV, but possibly also in the upper respiratory tract and maybe even in GI tract as well https://www.medrxiv.org/content/10.1101/2020.03.05.20030502v1 This report is a preprint, meaning that the research hasn’t yet been peer reviewed.
  • There is evidence from the above small study that viral shedding can be as earlier as the 1st week of symptoms, and others note it may also be happening in the presymptomatic phase https://science.sciencemag.org/content/early/2020/03/24/science.abb3221  So, even if you feel fine, you should still be practicing hygienic techniques like social distancing, frequent hand-washing, disinfecting surfaces, covering your mouth/nose (not with your hand!) when coughing or sneezing.
  • The same study cited above found that aerosolized virus (the form in viruses spread from coughing or sneezing) can last in the air an average of ~ an hour, with the upper end of range being ~2.5 hours. This and the surface survival data exemplify why it’s important to cover one’s mouth when coughing or sneezing, preferably with a tissue or the crook of your elbow (and not your hand). Don’t forget to regularly disinfect handheld devices….phones, tablets, etc.

More on COVID-19

  • A recent research review puts the worldwide average case fatality rate at 2.2% https://onlinelibrary.wiley.com/doi/full/10.1111/tmi.13383 Tho the WHO has it at 3% as of March 3.   This means that approximately 2-3 out of every 100 people infected die.  But estimates  this vary from country to country. In Italy, it has been estimated as high as 10%, while in the US it’s less than 1.5%, and in Germany it’s 0.5%. What these numbers actually represent is complicated, as they’re influenced by who is being tested, by availability of health care, and other factors. As more are tested, these rates may turn out to be lower than current reports.
  • Symptoms emerge on average ~5 days post-infection but may show up sooner or even out to 2 weeks post-infection. The most common symptoms:  Fever (often low), cough (often dry at first) and fatigue. Others include headache, diarrhea, low white blood cell count; and at the more serious end of the spectrum, difficulty breathing, lung damage/pneumonia-like effects, haemoptysis (coughing up blood), and cardiac injury. Loss of taste and smell is coming out in anecdotal reports.
  • Elderly folks or those with chronic health issues (eg. lung, heart) are those most at risk for severe disease

SOME PERSPECTIVES

  • As of 27 March, COVID-19 has killed over 33,300 people globally, with the rate here in the US surpassing 1,200.  As mentioned, the average global case fatality rate is somewhere on average around 2-3% at this point (higher in the elderly). 
  • For comparison, the case fatality rate of the average seasonal flu is about 0.1%. That for SARS was about 10% and MERS was a whopping 34% (though both infected far fewer people than the current pandemic virus).
  • Though it has a lower case fatality rate, this season’s flu has infected over 34,000,000 people in the US, with over 16,000 deaths
  • 2000 children die daily, worldwide, from diarrhea
  • This all is not to belittle the current serious pandemic but to put it into context. We don’t panic about seasonal flu and we shouldn’t panic about this. Instead, we should treat it with respect and take the appropriate precautions being put out by organizations such as the WHO.
  • Because this is a new virus in humans, there are a lot of significant unknowns, and this along with the case fatality rate can generate a lot of fear. Coupled with stretched hospital resources, and emergency departments being in triage mode, this means that this is a serious situation. But freaking out and hoarding aren’t helpful.

TESTING

  • There are a variety of approaches being used to test for infection with SARS-CoV-2 with pros and cons for each.

MEDICAL TREATMENT

  • At this point, it’s supportive.
  • There are existing drugs that are currently under investigation for repurposing, but none are recommended for use as yet, pending results on efficacy and safety.  This is despite what you may hear on the news.
  • There is no vaccine. Efforts are underway. But development of a vaccine for the similar SARS-CoV ran into some hurdles (there still isn’t one commercially available to my knowledge). For one, there is a quirk of the immune response to some viruses that can make vaccine development challenging. Also, given the relatively limited extent of the SARS epidemic, there ultimately wasn’t a lot of interest in funding clinical trials. So, in terms of a vaccine for SARS-CoV-2, it’s not going to be here tomorrow or next month or…  Though many labs are working on it. More details: http://www.virology.ws/2020/03/11/sars-cov-2-the-vaccine-landscape/

HERE IS A SITE PROVIDING MORE DETAILS ON THE PANDEMIC (that is updated regularly)…        https://arstechnica.com/science/2020/03/dont-panic-the-comprehensive-ars-technica-guide-to-the-coronavirus/

SO, WHAT CAN YOU DO WHEN UNDER A “STAY THE HECK AT HOME” ORDER?

  • Use stress-relieving techniques. Whatever works for you:  Sitting and focusing on your breath. Music. A good book. Start turning your soil for a garden if lucky enough to have a yard. Go for a walk in nature (outdoor exercise is still allowed in CO as long as you are maintaining a safe distance from others).  This is for quality of life and also because chronic stress may disrupt healthy immune system function. Keep in mind that if you have any symptoms as all, it is critical that you stay in to prevent spread.
  • Get some fresh air (not in a crowd) – Research during the 1918 flu pandemic found that folks who had access to fresh air fared better than those who were cooped up.  Get out on your porch, balcony, etc, at least for a few minutes daily.
  • Connect – Especially if you live alone. Call loved ones. Even use the dreaded internet to connect.  Even if you aren’t hugging anyone at the moment, simply hearing a voice can be enormously supportive.  If you need supplies but can’t get out, ask someone.
  • Disinfect – When you need to go out for anything, going to the store or other necessary trips, use disinfectant on your hands while out, wash your hands thoroughly with soap (regular ol’ soap is fine) and don’t touch your face. Mind you, hand washing and not touching your face is most important of all. 
      • For example, as soon as I get back to my car, I use a spray of 70% ethanol and some essential oils. (This level of alcohol is sufficient, but I like adding some essential oils for scent, about 8 drops per ounce). You can use this on your steering wheel, door knobs or any other surface not damaged by alcohol.   
      • You can also use chlorine bleach (sodium hypochlorite) diluted with water as a surface-cleaning solution as long it’s not on a surface it will damage – 4 teaspoons bleach per quart of water as per the CDC. Make sure the bleach hasn’t passed its expiration date.
  • Herbs – here’s a blurb I posted on FB recently on stuff you may have around the house or yard. Keep in mind, this is simple support for your respiratory and immune systems to help you stay healthy, and is not a substitute for social distancing, hand-washing and using disinfectants to keep your space clean.

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Given that a lot of folks are stuck at home, now’s a good time for tea making. Here are a few ways to make an aromatic tea to help keep you healthy using stuff you may have in your kitchen, yard or other nearby outdoor space….  A few ideas:

– Pine/Fir Needles and Citrus Peel – finely chopped      

– Thyme and Citrus Peel

 

– Marjoram and Citrus Peel

– Rosemary, Sage and Citrus Peel

– Ginger, pinch of Cinnamon, a couple Cloves – skip this one if you’re feeling dry

Add Mint (Spearmint, Peppermint, Lemon Balm, Catnip, etc), a pinch of Black Pepper and/or several finely chopped, ripe Juniper berries to any of the above if you’ve got them available. For flavor, add a small amount of local, raw honey after steeping.  A couple/few cups a day. Switch your blend up to keep it interesting.

Note: A medicinal tea is strong. If any of the botanicals here result in a wimpy, mildly-flavored brew, then steep it longer or add more herbs. Or, it could be that your Thyme or what-have-you herbs have been in the spice cabinet for too long.  Dry herbs (other than roots, seeds and dried berries) maintain their properties for only about a year if stored properly…

Here is a link to tea-making instructions. Use the “hot infusion” method described: https://basmati.com/…/witchin-kitchen-3-methods-making-medi…

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  Steams with aromatic plants are a great way to provide a pleasant atmosphere  when stuck at home.  Use what you have on hand. Mint, Rosemary, Marjoram, Thyme, Cloves, Cinnamon, Allspice, Ginger, Citrus peels, etc. I love Pine or Fir Needles as well as Juniper Leaves/Berries. Simmer a couple of handfuls in water on the lowest setting. (Don’t leave them unattended or you may wind up with a bunch of firefighters at your door. Ask me how I know).  Yes, you can do the same with essential oils or using them in a diffuser, just don’t diffuse all day…you can overdo it.  But I find the scent to be richer and more complex using the plant bits themselves. 

© 2020, Anna Marija Helt, PhD, Osadha Natural Health, LLC  

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