By Elliott Oppenheim, MD, JD, LLM Health Law, Florence
Viruses have been around for billions of years. They survive and will continue to mutate and survive. The human immune system is vigorous and strong but COVID-19 is stressing it to the max. How did this happen? It is critical to understand the meaning of this pandemic in an historical sense; where it came from and where it will go. Charles Darwin published the Origin of the Species in 1859. In that he proposed that all living things evolved from common ancestors. That is true about COVID-19 this, nefarious virus culling the flock, so to speak. A few years later, 1866, Gregor Mendel worked on pea plants and determined that there was a pattern of inheritance; that offspring got what their parents gave them.
Though viruses aren’t technically living, like a dog or cat, they are very good at infectivity. They need a host organism in order to reproduce. Nevertheless, they are subject to evolutionary pressures.
What is occurring now with the spread of COVID-19 is an example of Darwinian evolution; survival of the fittest. Those people who “get it” and survive will pass on those successful immunity genes to their progeny. Those who get it and don’t survive, will not procreate.
Some people have a genome that can resist this infection; others do not. If we look at those who get the virus and live, they have immunocompetency to survive. COVID-19 has punched us in the gut where we are relatively defenseless. The virus is novel; new; haven’t seen it.
COVID-19 is extremely dangerous for several reasons. It is highly infective because humans, apparently, lack the immunologic ability to stop it in the respiratory tract, in the upper airway. For most colds, the general infectious flotsam and jetsam that we see all the time, most of us naturally resist the infection or, if we get it, it lasts a few days and our immune system gangs up on it and kills it off. That is not the case with COVID-19. It is the Exterminator of viruses.
Many human immune systems do not recognize COVID-19’s antigen as dangerous and it gets into our bodies.
COVID viruses have probably been around, as with many viruses, for million of years. In order to survive, they change their genomes by mutation. That is the reason you will see assorted genetic variations and mutations in the animal kingdom. These Darwinian adaptations ensure survival… those that don’t adapt, don’t reproduce.
This particular strain of COVID virus, known as 19, it appears, lived well on bats … until, somehow, “it got loose” and was transmitted to a human. This is very much like your dog coming home with a tick. … and then the virus took off because the human genome was unprepared. COVID-19 seems uniquely able to gobble up pulmonary tissue and to poison the heart muscle.
An antigen is a bit of foreign substance, usually DNA or RNA that annoys our immune system. We react by creating an anti-body and that antigen-antibody reaction confers immunity. Measles, mumps, chicken pox, and polio are example of viruses which wrecked havoc until we created vaccines. Once you get it, you have immunity but it is much nicer if you don’t get it. That’s why we create vaccines.
A vaccine challenges our immune system and creates a protective wall: immunity. Once there is a vaccine, and everyone is vaccinated, the virus will be gone … until the next one evolves.
This pandemic is “nothing new.” The Black Death, or Black Plague, peaking in Europe in 1347 to 1351, bubonic plague, evolved as early as 3,000 BC. It killed maybe as many as 200,000,000 people and was spread by sailing ships… filled with rats (not unlike bats). Consider that the earth’s population during the Plague, was 370 million… so maybe …almost a 50% mortality. The black plague was due to a bacillus called Yersina pestis and was spread by flea and tick bites, living on rats and through airborne aerosol spread … ha choo … like COVID-19. COVID-19’s mortality rate seems to be about 4-6%, depending upon your sources.
With the Plague, it became obvious that those who quarantined, lived … and of course, killing the rats …
Ignaz Semmelweis, 1860’s, a Hungarian physician, is known as the “savior of mothers.” He figured out that hand washing before delivery made the difference between mothers dying after childbirth.
Handwashing destroys the material which make viruses. Bacteria have cell walls but viruses do not. Viruses are harder to eradicate. Yet, handwashing denatures the viral proteins and genetic material … which is why you need to wash for 20 seconds. A virus is a sub-microscopic particle which must replicate inside of cells. A virus is the most simple form of life. If you wash your hands, you kill it.
Joseph Lister died in 1912 and was the father of antisepsis; autoclaving; sterilization. His work is the foundation for PPE’s; personal protective equipment; gloves and gowns. His work forms the basis for modern cleanliness.
Here is an important takeaway. All the masks, PPE’s, hand-sanitizer, social distancing, and respirators do not affect the virus. Like Ebola, H1N1, Swine flu, Influenza A and B, these viruses are always “there.” What happens is that their infectivity reduces due to mutation and human responses… and low population in nature … but the virus is “always there,” lurking. … until someone eats a bat.
Have we learned anything from COVID-19? The earlier the response, the better the outcome. Israel responded early and aggressively. They have a low catastrophe incidence. We must react aggressively and early. The final point is that humans are part of evolution and the vulnerable will succumb. If we take precautions seriously, we can modify and assist natural selection in our favor and survive. … get out of the rain … get off the tracks when you see an oncoming train.
The reason some people live and others are smitten is because of this genetic susceptibility … and, of course, taking precautions … which is “like” genetic susceptibility… if you are smart enough to avoid the threat, you survive. It’s similar to being smart enough to “getting out of the rain” so you do not die of hypothermia. … or running from a forest fire. … or getting off the tracks when a train is coming.
When a vaccine emerges, and it will, it is imperative that everyone … everyone … undergoes vaccination or, when the virus returns, the spread will create more havoc. The danger, too, is that without everyone getting vaccinated a more lethal strain may emerge with a much higher mortality. There will be another lethal pandemic. If we cease precautions too early we may invite a worse calamity because the virus may mutate to a more infective sub-type before the original form “burns out.”
Perhaps the world will have learned its lesson from COVID-19. “Those who fail to learn from history will be forced to repeat it.” Not my quote but a good mantra.
Note to self: Don’t eat bats.