The Dangers of COVID-19: What You Need to Know

The novel coronavirus — COVID-19 — continues to multiply throughout the world. It was first reported in Wuhan, China in December 2019 after an unusual outbreak of pneumonia cases was noted. The disease was linked to a Chinese food market.

The World Health Organization declared COVID-19 to be a pandemic in March of 2020. As of early September 2020, there have been:

  • 25.5 million confirmed cases of COVID-19 and 852,000 deaths globally
  • 5.9 million confirmed cases and 182,585 deaths in the United States

In the U.S., the spread of this pandemic has continued to keep many people home and businesses shuttered. Some businesses have closed permanently, with the economy devastated. Many people are afraid of becoming ill, particularly the older population and those with chronic health conditions.

The virus causing COVID-19 is not the deadliest we have known. Ebola kills about 50% of people it infects. The coronaviruses causing  SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) lead to in death in approximately 10% of infections.

So what makes COVID-19 so dangerous? This article will offer some insight on the virus and explain some of the reasons why we need to vigorously defend ourselves against infection as we wait for a vaccine:

 

COVID-19 is the Worst Pandemic in a Century — And Deadlier Than the Flu

Although researchers won’t be certain until testing becomes more widespread, COVID-19 is estimated to be about 10 times deadlier than seasonal influenza, which causes death in about 0.1% of those infected.

Scientists are still unable to determine the actual percentage of deaths resulting from COVID-19. That’s because there are many mild cases and deaths which have gone unreported and testing has been lagging in many areas.

One piece of good news is  that COVID-19 isn’t the most contagious virus we face.

While this virus is deadly, health experts consider it to be contagious at about the same levels as seasonal flu, with each person infecting another two or three.

That’s in stark contrast to measles, where each person may infect 18 others. In chicken pox, each person can affect a dozen more.  But here’s where the good news ends: both measles and chicken pox, while highly contagious, are currently controllable by vaccination.

 

Nobody is Immune From COVID-19

COVID-19 is called a “novel” coronavirus.

That means it’s a new coronavirus, one not previously identified. While there are other types of coronaviruses commonly circulating among people and causing mild illnesses such as the common cold, the virus causing COVID-19 is not the same.

That means nobody has natural immunity to it.

 

COVID-19 Spreads Easily

Since COVID-19 spreads easily from person to person as it infects the upper respiratory system, it is considered quite dangerous to humans. And as of yet, no vaccine exists.

Since the virus is found in the upper airway, mouth, and nose, it can spread easily by coughing, sneezing, and likely even by loud talking or singing.

And unfortunately, infected people can unknowingly spread the virus for days before they start experiencing symptoms themselves. Some may not ever experience any symptoms, yet have the ability to transmit the virus to others.

Neither MERS nor SARS spread as easily or widely as COVID-19.

 

Increased Risk by Age, Sex, and Presence of Chronic Health Conditions

With COVID-19, mortality increases with age. The highest fatality rates are seen in those people over 65.

In addition to age, a number of other chronic conditions increase the risk of severe infection:

  • Cancer
  • Obesity
  • Diabetes
  • High blood pressure
  • Underlying lung, heart, or kidney disease
  • Organ transplant recipients
  • Sickle cell disease

Gender presents another risk factor for COVID-19. Men are observed to be dying at higher rates than women, although researchers aren’t clear on the reasons for this.

 

About 5% of Patients With COVID-19 Become Critically Ill

According to researchers, this virus acts like no other pathogen previously seen.

When the virus finds a welcome home in the lining of the nose, it finds cells rich in a cell receptor called ACE2, which under normal conditions helps regulate blood pressure. But scientists at the Wellcome Sanger Institute have found that the COVID virus uses this receptor to enter cells, hijack the cell’s own machinery, and use it to reproduce and invade new cells.

In the initial phase of illness, victims of the virus may develop dry cough, fever, sore throat, loss of taste and smell, body aches, and headaches.

If the immune system fails to defeat the virus during the early stage, it travels more deeply into the lungs. The most distant branches of the lung, tiny air sacs called alveoli, are lined by cells rich in these ACE2 receptors. When the immune system cannot meet the challenge, patients can develop pneumonia, with coughing, fever, and shallow, and rapid breathing.

Some patients with pneumonia recover, but others deteriorate, often rapidly. They may develop the further complication of ARDS, acute respiratory distress syndrome. Blood oxygen levels fall drastically and it becomes even harder to breathe. These patients often end up on ventilators.

 

COVID-19 Can Cause a Storm of Inflammation

As the body tries to fight the virus, it triggers an inflammatory response. In about 15% of people, this immune system response leads to an overreaction called a “cytokine storm.”

Cytokine production is a normal immune attempt to kill the virus. Normally,  the immune response peaks early, clears the virus, and helps produce antibodies and immune cells specific to the virus. But in some COVID-19 patients, the cytokine response continues too long and too strongly.

 

Many Organs Can Be Damaged By COVID

Of course, COVID-19 infection can damage the lungs and become fatal solely due to respiratory complications.

However, the virus — or at least the body’s response to it — can damage many other organs in the body.

  • Heart and Blood Vessels. By binding to ACE2 receptors, the virus enters cells,  including those lining blood vessels. Infection can result in blood clots, cardiac inflammation , and even heart attacks.
  • Brain. Some COVID-19 patients suffer from seizures, strokes, confusion, and brain inflammation. Researchers are still trying to determine the underlying reasons for this.
  • Liver. Up to 50% of hospitalized COVID patients have enzyme levels signaling a struggling liver. Experts believe this damage may be the result of drugs given to fight the virus together with an immune system in overdrive.
  • Kidneys. Kidney damage is common in severe COVID cases, making death more likely. While the virus can attack the kidneys directly, kidney failure could be part of systemic complications, such as rapidly dropping blood pressure.
  • Eyes. The inflammatory eye condition known as conjunctivitis is common in very ill COVID patients.
  • Intestines. Emerging data suggests that the virus can infect the lower GI tract, which is rich in ACE2 receptors. About 20% of COVID patients suffer from diarrhea.

 

COVID-19 and Children

In the U.S. and world-wide, fewer cases of COVID have been reported in children from birth to age 17 years when compared to adults. And as with adults, children infected with the virus may have typical symptoms, few, or no symptoms.

Infected children are less likely to develop severe illness compared to adults. However, once they become ill, they are at risk for serious complications. About 1 in 3 children hospitalized with COVID in the U.S. are admitted to intensive care units, which is the same percentage as adults.

Children with severe COVID-19 can develop complications such as respiratory failure, shock, kidney failure, and clotting or heart issues. They are also at risk for MIS-C, potentially fatal multisystem inflammatory syndrome.

 

Treatments and Vaccines on the Horizon

Most individuals who become ill with COVID-19 can recover at home by doing the same things you would do if you had the flu — getting adequate rest, staying hydrated, and taking over-the-counter medications to help fever and body aches.

In the meantime, scientists are diligently working to develop effective treatments.

Scientist are looking at convalescent plasma, which is from recovered COVID patients. This form of treatment has been used over a century to treat a variety of illnesses from measles to polio, chickenpox, and SARS.

In this situation, antibody-containing plasma from a recovered patient is given by transfusion to a COVID patient. The donor antibodies could help fight off the illness, possibly shortening its length or reducing its severity. However, to date, the best results for convalescent plasma have been shown only in those who are critically ill.

The steroid drug dexamethasone has shown promise in decreasing the risk of death in seriously ill COVID patients. These are potent anti-inflammatory medications so their use makes sense. As you’ve seen previously, patients can develop an over-reactive inflammatory reaction with COVID.

Remdesivir, an antiviral drug now in the news and the subject of a clinical trial at the University of California at Irvine, appears promising as a treatment for COVID-19.

The use of hydroxychloroquine and chloroquine (drugs used to treat malaria, lupus, and rheumatoid arthritis) has had mixed results at best when used to treat COVID. Some studies suggest no benefit and possibly a higher risk of death due to heart rhythm abnormality. Their use is controversial. Some practitioners have combined them with the antibiotic azithromycin with some anecdotal success, but no hard data.

Research is proceeding at warp speed to develop a protective vaccine against COVID-19. More than 250 vaccine candidates are being pursued around the world, with several dozen already in clinical studies. The first vaccines for COVID may be in production by the end of 2020 or early in 2021.

 

What You Can Do to Protect Yourself Now
  • It’s important to clean your hands repeatedly and thoroughly with an alcohol-based hand sanitizer or wash them well with soap and water. This helps to kill viruses that may be on your hands.
  • Maintain about 6 feet of distance between yourself and others. Why? When anyone sneezes, coughs, or even just speaks, they send small liquid droplets out from their nose or mouth. These droplets may contain virus particles you could breathe in if you are too close.
  • Avoid crowded places. When people gather together in crowds, you’re more likely to come into contact with someone carrying COVID-19. And obviously, it’s harder to maintain physical distance in a crowd.
  • Try to avoid touching your eyes, mouth, and nose. Your hands have touched many surfaces, where they could pick up the virus. Once they are contaminated, your hands can transfer the virus to entry points such as eyes, mouth, or nose. Once the virus enters, it has a good chance of infecting you.
  • Wearing masks is especially important when it is difficult to maintain 6 feet of distance from others. Masks can help slow the spread of the virus and keep people who may have the virus from transmitting it to others.
  • Make sure you and your family members (including children) use good hygiene practices. This includes covering your mouth and nose with your bent elbow or a tissue when coughing or sneezing. Dispose of any used tissues quickly and then wash your hands. This can help you protect people around you from COVID-19 as well as other cold or flu viruses.
  • If you have even minor symptoms such as coughing, mild fever, or headache, stay home and self-isolate until you are completely recovered. Have any supplies you need delivered. If you absolutely need to leave your house, wear a face mask to prevent infecting others.
  • If you have significant symptoms of fever, cough, and especially difficulty in breathing, seek medical attention immediately. It’s best to phone first and follow any directives from your local health authority. Calling in advance will help you most effectively locate the right health facility. It will also help prevent spread of the virus to others.
  • Keep up to date on the latest information from trusted sources, such as the CDC, WHO, or your local and national health authorities. They are the best source of advice on what people living in your area should be doing to protect themselves from COVID-19.

 

Note: This article does not constitute medical advice. Any action should be taken only after consulting with your physician.

 

Sources for This Article Include:

UCI Health. Why is COVID-19 so Dangerous?
https://www.ucihealth.org/blog/2020/04/why-is-covid19-so-dangerous#:~:text=But%20it%20is%20a%20virus,Plus%20there%20is%20no%20vaccine.

World Health Organization. Coronavirus disease (COVID-19) advice for the public.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19)
https://www.cdc.gov/coronavirus/2019-ncov/faq.html
https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html

Science. How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes. April 2020.
https://www.sciencemag.org/news/2020/04/how-does-coronavirus-kill-clinicians-trace-ferocious-rampage-through-body-brain-toes

Ragab, Eldin, et al. The COVID-19 Cytokine Storm; What We Know so Far. Front Immunol. 16 June 2020.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html

Harvard. Treatments for COVID-19.
https://www.health.harvard.edu/diseases-and-conditions/treatments-for-covid-19

McKinsey and Company.
https://www.mckinsey.com/industries/pharmaceuticals-and-medical-products/our-insights/on-pins-and-needles-will-covid-19-vaccines-save-the-world#

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