Here is the 2nd article in the series written by Dr. Mathieu Millette, see the first article: My mother and SARS-COV-2.
In his famous number “L’argent” presented in 1969, Yvon Deschamps said that it was better to be rich and healthy than poor and sick. He was never as right as he was right now. This COVID-19 pandemic is really giving us a sense of “Back to the Future”. The last time we fought an enemy like that was a long time ago in the eighteen hundreds…
No, wait, we (I mean humanity) face it regularly. We only have to think of cholera, an infectious disease caused by the bacteria Vibrio cholerae and which affects millions of people every year worldwide, mainly in Africa. If left untreated, the bacteria multiply rapidly in the gut following the ingestion of contaminated food or water, causes severe diarrhea and can kill within hours. Over 100,000 deaths a year worldwide. I also remind you that malaria, caused this time by the parasite Plasmodium falciparum, causes episodes of fever, chills, muscle pain, headache and fatigue in more than 200 million people each year. This parasite is transmitted through its bite of the Anopheles insect (similar to our mosquitoes, but fear not, our Quebec mosquitoes do not carry this disease), of which 68 species are known to transmit malaria to humans. By the way, this parasite kills more than 400,000 tellurians annually, mainly in hot and humid climates in Africa, Asia and Latin America. There is also the flu, the famous flu that we have to beware of whenever the good weather leaves us and winter comes. This seasonal flu is the pandemic, that is, it infects the world’s population on several continents. Influenza, the famous “man flu” (but which can also affect women) and which we remember for life, is a viral disease caused by the influenza virus. It is a mutating virus, that is to say that it transforms at intense speeds, which means that our immune system does not recognize it from time to time and reacts very slowly to this invader. This seasonal flu kills about 3,500 Canadians year after year, mostly our elderly with other illnesses or young children.
So why are we making such a fuss with SARS-CoV-2? Why are almost two billion people confined to their homes all around the globe? The problem is that SARS-CoV-2 is an unknown virus and we don’t have medications to treat complications or vaccines to prevent its spread. In addition, it is an excellent virus. You will probably think that I hit my head. Let me explain it all from the perspective of a microbiologist … or rather put us in the virus capsule for two seconds. The ultimate goal of a virus is to multiply in order to spread its genetic material. To get there, it needs to infect a very large number of hosts. So a virus that is just fairly contagious and not too deadly is excellent because it can spread quickly through an untouched population, that is, one that has no immune defense against it. If a virus is too deadly, it will quickly run out of hosts because the entire population will be wiped out. In addition, SARS-CoV-2, very effectively infects cells that line not only all the tubing that leads to and from the lungs, but also several other organs including the intestines. The attacker enters through the ACE2 receptor, a kind of small flag on the surface of many cells in the human body. It serves as a front door. Once inside, it takes control of the infected cell and orders it to make millions of other viruses (copies of itself). Then it leaves its host (which heals and develops immunity, which is no longer useful) and is also spread quite easily by droplets of saliva or mucus when you sneeze, cough or clearing of the throat, by the hands and perhaps even via the faeces (this is called faecal-oral transmission). So, to protect ourselves, we cough in our elbow and wash our hands with soap before and after we go to the washroom. In summary, the current virus is just fairly contagious, as each infected person can infect between 1.5 and 4.5 people and is moderately lethal with a mortality rate of around 1% to 1.5% in Canada. These statistics are very difficult to assess, because the pandemic is not yet over, that it does not include patients who have not been screened or carriers with no symptoms (so they weren’t screened either).
The big problem is that we are not all equal when confronting this virus. Seniors over the age of 70, people with high blood pressure, type 2 diabetes, cardiovascular disease or chronic lung disease seem to be at much higher risk of, and even death, from severe complications and pneumonia. And men are more severely affected than women. What do you want, we are very sensitive!
I humbly allow myself to recommend to Mr. Yvon Deschamps (and to all our elders) to stay at home while the crisis passes and so that an effective remedy is found. I even adapted Mr. Deschamps’ text to the current situation: “I prefer to be old and confined than young and sick”.
Don’t miss the next articles in this series which will be put online in the coming weeks!
Mathieu Millette, Ph.D. Mcb.A. Doctor in microbiology and member of the Association of Microbiologists of Quebec