Comments regarding CV19
The news today prompts me to clarify certain issues regarding the coronavirus pandemic. These are scientific issues that are important in developing both a rational personal and public response to this virus. So, hear me out.
The virus is very infectious, that is measured by its RO number. Furthermore, it propagates via the respiratory tract and it attaches to the ACE receptors on the nose, pharynx, throat, and lungs. The ACE receptor is very prevalent throughout the body and is found on blood vessels (important in the regulation of blood pressure) and in many other organ systems. Please realize that the CV19 virus is a “novel” virus. This means we, as hosts, had never “seen” it, and thus did not have any immunity to it. The fact that we did not have immunity, that it is very infectious and that it propagates via the respiratory system makes us very susceptible to becoming infected. Indeed, today the CDC stated that millions more than suspected have been infected. A study performed by Penn State and published in a peer-reviewed scientific journal stated that as many as 80 million Americans have been infected! Interestingly, this same publication stated that once 1 percent of the population is infected, there is nothing that will stop the pandemic. Indeed, we now know that in New York City, where the infectious rate was at 9 percent, the rate of infections increased in those that were at home and lived in multi-generational families. We can only “flatten the curve” by social isolation (particularly of those who have been identified as vulnerable by the CDC), frequent washing of hands (soap is best!) and the use of masks (though this remains somewhat controversial — I would do it; what do we have to lose?) I suggest restriction of outings only to those that are necessary. If you must go to a place where there is a lot of people, with restricted air flow, decrease the time there, as we know that likelihood of infection increases with the time in a “dangerous place” (the concept of viral load). Thus, I would avoid crowds and closed-in spaces with restricted airflow and decrease my exposure time to them. Exercising outside, in wide open spaces with a lot of sunlight, is probably the best! We will not decrease the amount of people infected until two things occur: the development of herd immunity — which will occur after 60 percent of the population gets infected; and, when we develop a vaccine — and we might be months to a year from this. The number infected by the virus increases in a logarithmic scale, so the number will increase rapidly.
Morbidity: this denotes the percent of people who exhibit symptoms once infected. The CDC is stating that as much a 25 percent of those “infected” have no symptoms, and thus could be spreading the disease. It is more likely that young people are asymptomatic. Thus, the importance of adhering to the CDC recommendations.
Case Mortality: this denotes the percent of those who die due to CV19 once they contract the disease. Since so many people have been infected, we now know that the mortality rate is in the 0.8- to 1.2-percent overall rate. Important to consider that the mortality rate will be higher in vulnerable populations. This explains why it makes sense to practice “reverse isolation” — isolate vulnerable populations as not to expose them to the virus until the vaccine gets here.
So, I hope that this short explanation will decrease our collective anxiety and permit us to act rationally and based in science (remember, since this is a “novel” virus, we know very little of the biologic behavior of the virus, of the host/virus relationship, and we had no therapies to treat it).
Finally, decrease your anxiety, but do not let your guard down! My final suggestions are:
Do not expose yourself to crowds unless you must. If you must, decrease your exposure time.
Wash your hands often. Soap is good!
Use a mask, particularly when near others.
Practice social distancing and strategic isolation
Practice “reverse isolation” — do not expose those who are vulnerable to undue risk.
Be happy we are alive, and spread love!
RENE R. RIGAL, MD
Submitted via email