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COVID-19

They call it a “novel coronavirus” because it’s new; but it doesn’t seem all that new anymore. In fact we are learning that it was around late last year, with some suspicions that the virus that causes COVID-19 was circulating in Wuhan China as early as August of 2010.  More recent data shows the virus was at least detectable in Italian sewage as early as December. What has become known as SARS-CoV-2, (which stands for Severe Acute Respiratory Syndrome Coronavirus 2) simply isn’t so new, anymore, yet we still lack a lot of understanding of the past, present and future.

Perhaps the most important thing to take away from the growing body of information suggesting the virus was around for some time before we knew about it is that the incubation time is relatively long and asymptomatic transmission is very likely. For these reasons and many others, understanding this coronavirus is challenging, with new information coming at us daily. It is not at all unusual for differing guidance to come from credible authorities at the same time. That’s why, in keeping with Amaze’s belief that every one of us must become well informed and confident enough to make our own decisions, we’re making detailed information about the virus available here. 

What is A Virus? What is SARS-CoV-2?

A virus is essentially a parasite. Parasites require hosts. In the case of the SARS-CoV-2 virus, we are the host. Once hosted, a virus seeks to thrive and reproduce, and because of its dependence on the host, they lack the ability to survive for long outside the body.

Each virus must find a way to create a home inside its host. For the SARS-CoV-2 virus, that generally means latching it’s spiky surface to receptors on healthy cells in our bodies. These spiky surfaces, which are comprised of a protein, are particularly adept at latching themselves to cells called ACE2 receptors and these happen to be most prevalent in the lower section of our lungs.

You can think of the connection between the spikes on the coronavirus and the ACE2 receptors in our lungs as two matching pieces of velcro, one with the hooks and one with the loops. Velcro attaches to some things better than others. For example, a piece of velcro won’t adhere at all to a smooth surface, while it might make a weak connection with carpet, but a very good connection with a matching piece of velcro that has the opposite construction (hooks vs loops).

The virus gains access to the lungs through the respiratory tract (airway) which includes your, nose, throat, and lungs. This is the most important thing to understand regarding transmission of the disease. Essentially, viral elements must detach and leave our lungs and find their way into a new host. That’s why sneezing, coughing, shouting, singing, and even breathing are the means of expelling the virus while breathing in allows access to a new host.

The ACE2 receptors are particularly common in the lower respiratory tract, deep into the bottom of our lungs. This is why COVID-19, the resulting diesase, tends to be a deeper respiratory ailment than other common colds and flus caused by other viruses. It’s essentially a matching game, and the spiky SARS-CoV-2 virus matches well with our lower lung region.

What Happens If I Get COVID-19?

There’s still a lot we don’t know, but what we do know is that about eight of ten cases are mild. Unfortunately, for those who’s symptoms are not mild, the lungs can experience a serious attack making it difficult to take in enough oxygen. In turn, when breathing is strained, our hearts start to work harder, pumping more blood through our lungs in pursuit of oxygen, only to be disappointed at the poor oxygen exchange that takes place. 

Doctors are also starting to see indications that lung damage is taking place even in people reporting mild symptoms or no symptoms at all, calling into question the eighty-percent of cases being mild referenced above.

The strain on the heart that some people experience due to low oxygen exchange can cause cardiac arrest or, in some cases, other organs such as the kidneys and livers can stop functioning normally due to insufficient oxygen.

Serious, but less common effects of COVID-19 include rashes, swollen legs, and even clogged heart catheters. Strokes have been observed as a result. And while the reasons aren’t yet clear, it’s starting to look like the virus can attach to ACE2 receptors found in other parts of the body such as blood vessels. There are also some theories that suggest an immune system response is causing the release of chemicals that cause coagulation (thickening of the blood).

There is still a lot we do not know.

Transmission of the Disease

To contract the disease, it takes a certain amount of virus to overcome our inherent resistance. The amount of virus necessary to make a person ill is referred to as the infectious dose which varies by person . It is thought that the necessary dose of SARS-CoV-2 necessary to make us sick is relatively low–in the hundreds of viral particles. Sometimes we take in just a few and fight them off without ever knowing it. And sometimes we take in thousands. We call the amount we actually taken in, the “viral load.” Obviously the more we take in, the more that can attach to our lungs and other parts of our respiratory system and thus the harder it is for our bodies to fight them off.

We can expel hundreds of particles with every breath; thousands with a cough, and millions with just a single sneeze.

It’s also important to understand that your cough or sneeze doesn’t need to be the result of being sick. It could be from an allergy or just a gag reflex from a spec of salt or pepper. If the SARS-CoV-2 virus is being hosted in our lungs, we can expel some of the virus through any means that pushes air our of our lungs. That’s why we know asymptomatic transmission is possible, and even likely; however there is much debate about the extent.

How Do I Tell if I've Had It?​​

In short, we look for antibodies, or more specifically, immunoglobulin proteins.

“Ig” stands for ‘immunoglobulin,” which refers to a class of proteins that serve as antibodies that fight viral and bacterial infections. These proteins are produced by our blood plasma and attach to foreign substances, such as bacteria and viruses in an attempt to destroy them. There are five classes of immunoglobulin, including IgA, IgD, IgE, IgG and IgM. For the purpose of understanding how we fight and how we detect SARS-CoV-2, we’ll only address IgG and IgM.

IgG (Immunoglobulin G) is the most common antibody found in our system. IgG tends to protect us against future infections, but it takes time to form and be detectable after initial infection. Forming IgG antibodies is the goal of vaccinations. IgG antibodies suggest we had the coronavirus sometime in the past.

IgM (Immunoglobulin M) is typically found in the blood and lymphatic system. IgM is the first antibody we make when initially starting to fight off an infection. The presence of IgM suggests we HAVE, or have HAD the coronavirus in our system.