On December 30, 2019, Dr. Li Wenliang, an ophthalmologist at Wuhan Central Hospital in the Hubei province of China, messaged his fellow physicians, alerting them to the appearance of what he thought as SARS. Thirty-nine days later, after becoming infected with the very virus he tried to warn his colleagues about, he was dead at thirty-three. By that time, the disease we now know as COVID-19 had already spread to dozens of countries.
Before the SARS outbreak in 2002, only two coronaviruses were known to cause disease in humans, but neither caused much more than the common cold. The SARS coronavirus, however, went on to kill about one in ten people it infected. A decade later, in 2012, MERS, another deadly coronavirus, emerged. Like SARS, MERS spread to infect thousands of people across dozens of countries, but that time, one in three died. Today, we’re fighting to protect ourselves from—and to defeat—the COVID-19 coronavirus.
Where are these emerging infectious diseases emerging from?
All human viral infections are believed to originate in animals.
To understand COVID-19 and other deadly viral outbreaks, we have to understand their history and evolution if we’ll ever have a chance at preventing future pandemics. We also have to look back and take lessons from the past. How did we successfully beat back SARS? Why is it more difficult with COVID-19? What do we have to do to slow the pandemic today before we even have a hope at a vaccine?
I covered all of that in my recent four-hour webinar—from origin stories of past killer pandemics to what we should be doing today to stay safe—and then dove into the clinical side of COVID-19 and discussed what the disease looks like and the best way to treat it. If you missed the webinar, the following is an overview of what I covered.
FROM THE BEGINNING
The Emergence of MERS
The Emergence of SARS
- SARS-CoV causes the SARS coronavirus, and SARS-CoV-2 causes the COVID-19 coronavirus.
The Emergence of COVID-19
Coronaviruses Infect Pigs Right Off the Bat
COVID-19 May Not Have Been the First Coronavirus Pandemic
- To date, four human cold coronaviruses have been discovered, which means seven coronaviruses in all can cause human disease as far as we know. We believe we got SARS from civets, MERS from camels, and COVID-19 perhaps from pangolins.
- Molecular clock analyses dating human coronavirus OC43’s emergence suggest that the bovine coronavirus now causing “shipping fever” disease in cattle, jumped to humans around 1890. Indeed, that same year, 1890, there was a pandemic, presumed to be influenza.
PUMPING THE BRAKES
Slowing an Outbreak
Slowing a Pandemic
- That same day, the world confirmed its 200,000th
- When the window on containment closes, as it did in the United States, the strategy pivots to suppression and mitigation.
TREATING AND AVOIDING COVID-19
The Clinical Course of COVID-19
- COVID-19 is thought to have an average incubation period of about five days, which means we are infected and possibly infectious for almost a week before we may even know we have the disease.
How to Treat COVID-19
- Presently, there is no specific proven therapy for COVID-19.
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- Given our near-total ignorance of the immunological aspects of COVID-19, I will not jump on the snake-oily spamwagon to promote foods to boost immunity. We just don’t know if enhancing specific arms of the immune system could make things even worse.
How to Avoid COVID-19
- If you must leave your home to provide essential services such as direct care or food delivery, maintain a safe distance from others and sanitize your hands every time you touch a public surface. It’s critical not to touch your mucous membranes—your eyes and the inside of your nose or mouth—with unsanitized hands.
- The virus can’t pass through your skin. It can only replicate in live cells, and our skin’s outer layer is covered by protective dead skin cells. To get into your lungs, the virus has to find its way to your mucous membranes, the moist lining of your eyes, nostrils, or mouth.
- Coronaviruses are “enveloped” viruses. As they emerge from our infected cells, they cover themselves in the outer layer of our cells. Although that oily coating makes it harder for our immune system to detect them because they look like us, it also makes them susceptible to disinfection and environmental inactivation.
How to Inactivate COVID-19
DIY Hand Sanitizer
Basic Recipe: The easiest method would probably be to just use 80-proof liquor straight up as a hand-sanitizing rub. Pour it into a squirt or spray bottle and apply enough to completely cover all surfaces of your hands and then rub them together and leave on for 30 seconds. The addition of a gelling agent such as aloe vera is not recommended as it might compromise antiviral efficacy.
Fancy Recipe: Assuming you have all of the ingredients, you can make a gallon of COVID-19 hand sanitizer by combining 12 cups of an 80-proof liquor (40% alcohol-by-volume) with ¼ cup of glycerine (also spelled glycerin or called glycerol) and a teaspoon of regular strength (3%) hydrogen peroxide and then just fill the rest of the gallon container with water. To make just a quart, simply quarter the recipe: 3 cups liquor, 1 tablespoon glycerine, ¼ teaspoon hydrogen peroxide, and water. Again, don’t add anything else.
- This 1:50 recommendation is for standard bleach (5% sodium hypochlorite). If you have 2.5% hypochlorite bleach, use two teaspoons per cup, and if you have 10% hypochlorite bleach, you only need a half teaspoon per cup.
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What If You Come Down with COVID-19?
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- It’s important to understand that respiratory droplets are not just gobs of mucus. When you’re outside on a cold day and your breath fogs, those are respiratory droplets. That vapor plume you’re exhaling is made up of tiny water droplets straight from your lungs. On a warm day, you breathe out that same cloud—you just can’t see it.
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- Until we know more about how the COVID-19 virus is transmitted, it seems prudent for those in close contact with coughing patients use eye protection (at least a face shield) and N95 respirators.
HOW COVID-19 ENDS
- Herd immunity would stop the pandemic—when a critical portion of the population is immune to the virus. When there are no longer enough susceptible individuals for a virus to infect, jumping from person to person, the chains of transmission are broken.
- Mass vaccination is the ideal way to accomplish this. Without a vaccine, the only way to achieve herd immunity is through mass infection.
- This is why “flattening the curve” is critical. We can’t wait until 80 percent of the population is infected.
PREVENTING FUTURE PANDEMICS: Having Our Meat and Eating It Too
- We were spared by the last pandemic: In 2009, swine flu only triggered a category 1 pandemic, killing a half million people. It did, however, reveal that industrial pork production was a new origin point for pandemic viruses.
- At this time, neither H5N1 nor H7N9 has acquired the capacity for easy human-to-human transmission, but neither has been eradicated. They’re still out there, still mutating.
- How can we stop the emergence of pandemic viruses in the first place? Whenever possible, treat the cause.
“It is curious, therefore, given the pandemic threat, that changing the way humans treat animals, most basically ceasing to eat them, or at the very least, radically limiting the quantity of them that are eaten—is largely off the radar as a significant preventive measure. Such a change, if sufficiently adopted or imposed, could still reduce the chances of the much-feared influenza epidemic. It would be even more likely to prevent unknown future diseases that, in the absence of this change, may result from farming animals intensively and killing them for food. Yet humanity doesn’t even consider this option.”
- This may be changing, thanks to food innovations like plant-based milks, egg products, and meats.
- Our food choices don’t just affect our personal health but our global health. Not just in terms of climate change, but in terms of pandemic risk.
- While these products may not be the healthiest from a personal standpoint, they tend to be healthier than their animal-product counterparts and, from a pandemic standpoint, they present zero risk.
- Crises like these can bring out the worst in people, like all the hate crimes and harassment against Asian-Americans, but they can also bring out the best.
- You can support those on the front lines from being overwhelmed by staying safe, and, if you can, staying home.
- During the webinar, I was excited to announce that my entire four-hour lecture will be turned into a month-long series of videos on NutritionFacts.org, so stay tuned.
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Michael Greger, M.D.
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This content was originally published here.