About the Coronavirus

Articles by Parish Nurse Donna Musselman

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What is a Coronavirus?

How Did the Coronavirus Come to Be?

How Does Covid-19 Spread Between Humans?

Who Gets Covid-19?

What is a Coronavirus?

Coronaviruses are part of a large family of viruses that affect vertebrates (mammals with spines). Research has shown that coronaviruses are extensive in the bat family. Other vertebrates known to be affected by coronaviruses are: members of the cat family, ferrets, camels, birds, cows, pigs, and humans. There are currently seven (7) coronaviruses known to infect humans; SARS-CoV-2, or Covid-19, is one (1) of them.


These viruses were first identified in 1965. The name coronavirus comes from the crown (corona in Latin)-like spikes on the surface of the virus cell. The Covid-19 virus is a round structure of proteins surrounded by a fatty membrane, with the spikes on top of the membrane. Inside the round structure is a very long chain of RNA (ribonucleic acid), a genetic material. The RNA extends through the fatty membrane & into the spikes on the crown.

Electron microscopy photo of Covid-19

The coronavirus is not able to survive on its own. It needs a host cell in order to multiply. I liken it to more of a parasite (an organism that lives within, on, or at the expense of another). Think……invasion of the body snatchers! ☺


In humans Covid-19 seems to have an affinity for attaching to cells that contain ACE2 (angiotensin converting enzyme). ACE2 is a protein found on the surface of many human cells. The spike proteins on the Covid-19 virus attach to the protein of the human cell like a key being inserted into a lock. Through a series of chemical reactions Covid-19 merges with the host cell and releases the long strand of RNA to, in a sense, hijack the host cell. Covid-19 then sheds the fatty membrane and turns the host cell into a factory to churn out new virus cells.

Electron microscopy photo of Covid-19
attaching/merging with host cell.

Where in the human body are these host cells found? They are found in:
the lungs, heart, liver, GI tract, the lining of blood vessels, kidneys, & mucous membranes (the linings of the nose, mouth, & eyes).

 

Symptoms of Covid-19 begin to occur anywhere from two (2) to fourteen (14) days after becoming infected. Symptoms can include, but are not limited to:
fever, chills, cough, shortness of breath, tiredness, body aches, headache, sore throat, loss of taste and/or smell, runny nose, conjunctivitis (pink eye), nausea and/or diarrhea, chest pain, blood clots, confusion. When comparing the symptoms to the cells Covid-19 hijacks, it becomes clearer to see where and why these symptoms occur.

Information gathered from:

  • NAM – National Academy of Medicine

  • APHA – American Public Health Association

  • NIH – National Institutes of Health

  • WHO – World Health Organization

  • CDC – Centers for Disease Control

  • Numerous scientific publications & articles

  • Numerous medical education platforms

 

How Did the Coronavirus Come to Be?

 In the beginning (pun intended!)…….no, really, in order to understand how we got to where we are I think it’s important to understand how we got to where we are.

 

Numerous scientific studies done by virologists (scientists who study viruses), epidemiologists (“disease detectives”, scientists, physicians, veterinarians who study diseases & the control of them), infectious disease specialists, etc. over the past 15 years seem to show a consensus that bats were the initial vector (something that transmits a disease or virus from one (1) animal to another) for Covid-19.

In the past 15 years researchers have completed genome sequences for over 30 different coronaviruses found in bat populations around the world. Bats are known to harbor numerous highly pathogenic (an organism/bacteria/virus capable of causing disease) viruses, such as rabies & Ebola. As well as what we now know as Covid-19. Bats are the only known mammals capable of sustained flight, which enhances their ability to disseminate the viruses they harbor. So how does this work?

Does a bear poop in the forest? Well, does a bat poop while flying? The answer is yes. And since bats can be found almost all over the place, guess what else can be all over the place. YUCK! As other animals roam the planet in search of food, is it possible some of what they ingest could be bat poop? Hmmmm….if virus particles are in the bat poop (which they have been shown to be) can another animal ingest the virus as they forage for food? Yup! And viruses, being what they are, are able to recombine into a different form in that “new” animal in order to survive. In the case of Covid-19 it seems that a pangolin (scaly anteater) was the next link in the chain. Then what?

In China, pangolins are considered a delicacy. (I’m with you….GGRROOSS!) Who eats anteaters? Well, who eats cows? Who eats fish? Over the millennia cultures all over the world evolved to eat, literally, a world of different things. Humans have learned to eat whatever is available/easy to capture/affordable in order to survive. That being said, another mammal used for food in China & Southeast Asia is the bat. If the food being consumed by humans harbors the virus that causes Covid-19, & with viruses being what they are, recombine in order to survive, well… you get the picture.

What I found as I did research for this article is that there are any number of steps between bats harboring coronaviruses & the transition to that virus being able to infect humans. However, it is all extremely detailed &, in some instances, at least for me, it became gobbledegook. To the best of my ability I have tried to simplify the path in order to make it understandable: even for myself.

Covid-19 is considered a zoonotic disease, a disease that can be spread between animals & humans. It is a virus that lives, in some form, in other animals &, over time, is able to change to a form that causes disease in humans.

To date there are seven (7) coronaviruses that cause disease in humans. There are four (4) coronaviruses that continually circulate in humans. Those four (4) generally cause mild symptoms one might see with the common cold. It is thought they account for 15% of all colds.

Another human coronavirus caused the SARS (Severe acute respiratory syndrome) outbreak that was seen in 2002-2004. That seems, at this time, to have burned itself out. Another caused MERS (Middle East respiratory syndrome). There have been outbreaks of that disease in 2012, 2015, & 2018. And the last, SARS-CoV-2, which began in late 2019 & whose story has not yet ended.

 

Information from:

  • NIH – National Institute of Health

  • Numerous scientific publications

  • Global Epidemiology of Bat Coronaviruses by Wong & Woo 2019 @ www.ncbi.nlm.nih.gov

How Does Covid-19 Spread Between Humans?

As of this writing the spread of Covid-19 between humans remains to be primarily of the respiratory droplet/aerosolization route. Just what is that?

 

Picture a cold winter day when you walk outside. What do you see? A puff of water vapor when you exhale? That is an example of aerosolization. And when you sneeze into your hands? Have you ever experienced the feel of drops of water on your hand? Those would be the water droplets expelled from the nose, mouth, and lungs during the sneeze. Think of droplets being the size of a pin head and aerosolization as being the size of a pin point.

 

Virus particles are minute enough to ride along on these droplets of water. And whether or not you are able to see it, those droplets and the aerosolization is present whenever we cough, sneeze, yell, sing, laugh, talk, play a woodwind or brass instrument, and just simply breathe.

 

The droplets we exhale and expel during activities cover a wide range of space. Simply breathing may result in those droplets falling to the ground at our feet or, perhaps, with a little help from the air current, travel 6 feet away. Engineering research has shown that droplets from an uncovered sneeze can travel up to 26 feet and at a speed up to 100 miles per hour!

 

Take a journey with me on a day in the life of a Covid-19 virus particle:

 

I’m going to the Farmer’s Market today. I put my mask on as I get ready to exit my car. Unbeknownst to me another person, also entering the market, just touched the outside of their mask before touching the door handle. That person feels fine but, unfortunately, has been infected with Covid-19 and isn’t having any symptoms yet.

 

I grab the same door handle & enter the market. Then my eye itches. And, not paying attention, I use the same hand to rub my eye. Wait! What does my eye have to do with a virus spread by the respiratory route?! Well……believe it or not, all of our body parts are interconnected.

 

Back in 1928 there was a song entitled “Dem Bones”. I remember hearing it as a child. One verse went: “The ankle bone’s connected to the leg bone; The leg bone’s connected to the knee bone; The knee bone’s connected to the thigh bone; Now shake them skeleton bones.”

 

SO……………………the lining of the eye is a mucus membrane. That membrane also lines the lacrimal (tear) duct. The lacrimal duct is connected to the nasal cavity (that is why, when we cry, we get a stuffy nose!). The nasal cavity is connected to the nasopharynx (the uppermost part of the respiratory system). The nasopharynx is connected to the throat. The throat is connected to the trachea (the wind pipe). The trachea is connected to the lungs. And voila! The Covid-19 virus just found its way into another host.

 

In the case of someone being within the breathing range of others infected with Covid-19, and without wearing masks, inhaling that infected air has a shorter route to reach the lungs. In this instance the virus enters the nose or mouth, passes the oropharynx (essentially where the mouth and nose meet at the back of the throat), glides down the throat and into the trachea. In either event the virus is a happy camper with a new home.

 

If we return to the first installment of these musings I mentioned that Covid-19 especially likes to attach to cells that contain ACE2. And those cells can be found in the lungs, heart, liver, blood vessels, kidneys, and GI tract. Every drop of blood we have passes through the lungs. That is where the blood picks up oxygen to take it to every other cell in our body. It is also where Covid-19 has the ability to become a hitch-hiker & take a ride to other parts of the body, with the potential to create issues in the heart, liver, kidneys, blood vessels, and GI tract. The human body is a completely, totally, interconnected network. And Covid-19 is capable of exploiting those connections.

 

Information from: NIH (National Institutes of Health)

                             Numerous anatomy and physiology text

                             NAE (National Academy of Engineering)

 

Who Gets Covid-19?

Covid-19, or SARS-CoV-2, came into being, to the best of our knowledge, at the end of 2019. Prior to that time no person living on this planet we call earth had been exposed to this virus; therefore, no person had any immunity to it. That being said, E V E  R  Y  O  N  E  has the potential to be infected with this virus. Let me repeat that….EVERYONE, any age, any gender, and any ethnicity, is susceptible to Covid-19.

There has been one instance of Covid-19 being diagnosed in a newborn in China. And there has been one instance of a 113 year-old female in Spain being diagnosed with Covid-19. Again, let me say, NO ONE is exempt when it comes to contracting Covid-19.

At the outset of the pandemic (a disease prevalent around the world) people over the age of 60 seemed to be the group hit hardest by this disease. Why? Perhaps for a number of reasons.

Many of the people initially affected were residents of personal care facilities. Besides being elderly, many of these people have underlying diseases such as: diabetes, hypertension (high blood pressure), COPD (chronic obstructive pulmonary disease), arteriosclerosis (hardening of the arteries), or even several chronic diseases at the same time. As humans age our cells do not replenish as rapidly or as well as they do, say, at the age of 5; or 25. When the effects of aging are coupled with chronic illness & then tripled by a virus such as Covid-19, the body is put into the situation of fighting 3 foes simultaneously. 

Symptoms of Covid-19 may appear anywhere from 2 to 14 days after being exposed to the virus. That is one of the reasons it is difficult to track the disease. Can you recall every place you’ve been & all the people you’ve come in contact with over the past 14 days? I certainly can’t! What about those unknown people you’ve simply passed by on your way into a store? It becomes easier to understand the difficulty of contact tracing when looking at the last 14 days of one’s own life.

What are symptoms of Covid-19:

  •     Fever and/or chills – when we get a fever the brain increases the temperature set point of our body. The body attempts to reach that higher set point by causing the muscles to rapidly contract and relax in order to create more heat as it tries to reach that new set point. That is why we experience chills as our temperature increases. It is also a sign that the immune system has gone to work in an attempt to kill whatever pathogen is invading the body.

  •     Body aches and fatigue (tiredness)

  •     Sore throat and runny nose

  •     Nausea, vomiting, and/or diarrhea – the GI tract is one of the areas of the body where cells with ACE2 reside

  •     Cough, shortness of breath – the lungs are one of the areas hardest hit by this virus. It seems many people develop “Covid” pneumonia. Coughing occurs as the body attempts to clear the lungs. Difficulty with breathing occurs as the lungs fill with virus particles and fluid caused by the resulting inflammation. The virus particles and fluid fill up the alveoli (tiny grape-like sacs in the lungs where carbon dioxide is exchanged for oxygen), thereby preventing the exchange of air.​​

Normal Chest X-Ray


The dark areas indicate air in the lungs. The white "shadow" on the right (as you look at the x-ray) is the heart.

Covid-19 Chest X-Ray

Lung fields are much lighter and have areas of white throughout, indicating air is not filling those areas.

  •  Headache, confusion

  •  Loss of the sense of taste &/or smell

 

While people of any age may develop the above symptoms of Covid-19 there has been documentation of occurrences of a multi-system inflammatory disease in children between the toddler and teen years. MOST of the children who exhibit this syndrome test negative for active Covid-19. Blood tests, however, show that these children have antibodies to the virus, indicating that at some time in the past they had the virus and their bodies fought it off. This syndrome can occur in children who have shown symptoms of Covid-19 as well as in children who have shown absolutely no symptoms of Covid-19.

 

“An inflammatory syndrome occurs when the immune system becomes overactive. In this case, the body releases cytokines [proteins that help regulate the body’s immune response], which help mediate a high fever. It’s a natural response to infection. But in this case, there seems to be an overreaction to the infection, which happens sometimes after viral infections. As the body is learning to become immune to the virus, it over-activates the immune system. That’s what we think is going on here.” (Pediatrician from New York Presbyterian Children’s Hospital)

 

In addition to the previous symptoms these children may also have:

  •    Abdominal pain

  •    Neck pain

  •    Rash

  •    Blood shot looking eyes

  •    Extreme tiredness


As the pandemic has continued it is now people between the ages of 20 – 45 who seem to be the most affected. Why? In all honesty the answer is mostly conjecture. At this time the change in the affected population is being attributed to people in that age range being in crowded public spaces: beaches, bars, parties, etc.

Those who contract Covid-19, on average, seem to be ill for about 2 weeks. However, there are documented instances of people being ill for 2 – 3 months. Symptoms can be mild, ranging from common cold type symptoms, to extremely severe, being in ICU on a ventilator for 2 months.

In 1873 Jules Verne wrote the novel “Around the World in 80 Days”. In 1956 the film version of the novel was released. Covid-19 was faster. It only took 60 days for the virus to spread around the world.

Information from:

    CDC (Centers for Disease Control)
    NIH (National Institute of Health)
    New York Presbyterian Children’s Hospital

 
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