Jul 5, 2020
I have lately been feeling the burden of the COVID-19 pandemic - the deep grief of it, if you will – and I retreated for some time from engaging in any COVID-19 conversations. But, Sherrie has convinced me to return and write down my musings about what I know from reading the medical literature for nearly six months now. And speaking from my medical experience as a physician.
Not all topics are addressed here, and I will leave those for another time. I have not talked about testing, particularly serum testing. I have not addressed death rates compared to the total population. I have not looked at age ranges, the percentages of fatalities in each of the age groups. I have not talked about indoors vs outdoors, or mobile vs stationary, or length of exposure. Or the virus on surfaces, or how to disinfect. And more. Those things will just have to wait, or you can find them elsewhere.
1) Just in case you are still wondering, it has been conclusively demonstrated by RNA tracking that COVID-19 developed naturally in bats in or near Wuhan, China, and then spread to humans via some secondary animal. Last I heard, there were several possibilities as to the secondary animal, but nothing definite that I know of.
2) The spread of the virus was horribly mismanaged by the government of China, when it could possibly have been contained there early on. It was and is now being even more terribly mismanaged by the U.S. Government, and by many State governments, resulting in a steadily worsening pandemic which is still in its 1st phase and still JUST BEGINNING. Many people believe that our current President is morally, if not criminally, responsible for at least tens of thousands of deaths.
3) COVID-19 is an RNA virus (not a DNA virus), therefore it is unstable and mutations are expected. The virus currently rampant in the U.S. is NOT the same virus that first arrived here, it is a variant mutation. The mutation affects the protein spikes on the surface of the virus, making them more “sticky.” This means the virus is MUCH easier to transmit and catch than before. Fortunately, this mutation does NOT seem to make the virus more virulent, which is to say it does not make people sicker or cause more deaths than previously. It’s simply that more people will catch this virus more easily.
4) I do not care what anyone says about masks not working – it is a lie. If everyone did it, properly worn masks could end our current outbreak of COVID-19 and prevent the so-called “second wave” which will arrive sometime in the Fall. As a physician, I wore masks in many different situations over my professional years, and clearly they prevented me and others from catching and spreading a wide variety of illnesses. Back in the '80s, during the AIDS epidemic, I heard many arguments that the HIV virus was smaller than the natural pores in condoms, therefore condoms would not work. It was all bullshit. WEAR THE MASK.
5) With regards to both asymptomatic transmission (non-infected carriers) and pre-symptomatic transmissionof the virus (spreading prior to symptoms appearing in someone infected), my recommendation to you is to ASSUME that both can occur, and that pre-symptomatic transmission is LIKELY. This is true of many, many other viruses, including the common cold, which is also a Coronavirus. If we are wrong about this and it doesn’t spread these ways, then lucky you.
6) Studies are now suggesting that the “immunity” gained from having the COVID-19 illness only lasts ~3 to 4 months, then fades. There are reports of people catching the virus a second time. This has serious implications about possible “herd immunity.” It is not clear if catching the virus again acts as a “booster” and gives improved immunity and lasting immunity. As an analogy, immunizations for many viral and bacterial illnesses over the years have needed a second “booster” immunization to achieve full immunity several months or years after the first immunization, otherwise the effectiveness fades. We need a lot more information here.
7) The implications of 3 & 6 with regards to developing an effective vaccine against COVID-19 remain unknown. If the virus continues to mutate, a vaccine will be unlikely, as the vaccine may only be effective against a past version of the virus. It is not known if the vaccine will produce lasting immunity. It is not known if a “booster” vaccine will remedy that. Recall that a vaccine for the 1918 Spanish flu was never found.
8) We are already hearing reports of people recovering from COVID-19 who have various residual symptoms that do not go away, predominantly neurological. We think this may be true in multiple organ systems in the body, and the residual symptoms may likely vary widely from patient to patient. Some are already suggesting this may also be true of patients not sick enough to require hospitalization. This is probably less likely in people with very limited or no symptoms, but we don’t actually know that. This is probably multi-factorial, but one of the main reasons for this phenomenon is discussed in 9 below. Recall that residual symptoms also occurred with the 1918 Spanish flu, sometimes severe (e.g., the “sleepy” sickness, which turned out to be a severe instantaneous Parkinson’s-like disease – Oliver Sacks' “Awakenings” patients).
9) Results from maybe a couple of hundred autopsies of COVID-19 patients, reveal findings of numerous areas of blood clotting in the brain, lungs, kidneys, and other organs. These are basically little “mini-strokes.” What they have found in these lesions is the presence of megakaryocytes, cells normally found ONLY in the bone marrow, and which produce platelets (thrombocytes) which normally cause your blood to clot if you are bleeding. This is a completely abnormal finding which has never been reported EVER before in the entire history of Medicine! The virus also is known to attach to hemoglobin molecules in the blood and it displaces oxygen, causing “altitude sickness” symptoms of hypoxia – low blood oxygen which is NOT the result of pneumonia. This is a very bad combination of effects of the virus. It is now thought that these multi-systemic “mini-strokes” are the cause (or one of the causes) of lingering residual symptoms after infection with COVID-19.
10) We are eerily and uncannily repeating the pattern of what happened during the 1918 Spanish Flu pandemic. The initial shutdown, the too early re-opening, the rage against having to wear masks, claims of totalitarianism, those who said it was all a hoax or blown way out of proportion, etc. That virus killed millions of people who need not have died. We have yet to see the results of this one.
11) I am personally not impressed with those who propose “herd immunity” by not taking precautions during the pandemic. First of all, we don’t know yet if that actually works, as I said before. Second, I am personally one of those at higher risk for having a more severe form of the illness, as are many people that I love and that I know. Third, this approach threatens the health and lives of my colleagues in hospitals where the sick people will be treated. Fourth, many non-COVID-19 patients who need care from accidents or illness will die because our hospital system is overwhelmed. We remain unprepared to deal with a pandemic of this size with our current for-profit medical system. I could go on…
12) We may be in the position of looking for a serum treatment(based on the blood of recovered patients) and/or an anti-viral drug of some sort and/or steroids (now being reported) as a combination therapy for infected patients to lessen the severity of the illness. We need to do whatever we can to further studies in these areas.
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