Coronavirus Update: Science and reality behind coronavirus

coronavirus update: Thescience and reality behind coronavirus

Coronavirus Update

coronavirus update: The science and reality behind coronavirus and understand not only. How does thiscoronavirus work? How does it infect the body? Whatdoes it do? How can we actually attack It?

Coronavirus Update

We have an opportunity to really provide some peace of mind. Some level of control in the hands not of every individual but the entire community. I'm really excited about the fact.

That this coronavirus has attacked us in 2003 and we have the benefit of that insight and scientific knowledge. But we also today have tools that we didn't have then we have more genomics. We have more bioinformatics. We have supercomputing and together with those tools.

We have a real shot at not only defeating this virus but overcoming this pandemic. So for me to take you through this complex story of this coronavirus. Today we will understand this virus.

Coronavirus Update

How does the virus infect your body?. And more importantly, explain the symptoms that are associated with this infection. What can we do to control and prevent its spread?. What is on the horizon is that the entire world's scientists as a community. They are working together to cure this infection and prevent us from getting this in the first place.

 There are some questions we won't be able to fully answer yet is how long is this pandemic will this pandemic last?.  This one-hour special must have a separate loop, maybe a slightly different lens. While the world is working very significantly on how to kill the virus. We want to take this lens of what to do to your body. 

Coronavirus Update

 And how can we prevent it from getting into your body into the cells?. How can we actually treat the host or the patient to prevent it from becoming a severe fatal disease? So while on the one hand, scientists were working hard to develop a vaccine. It's important and realistically important to first identify a treatment now for those that are severely ill.

what is the coronavirus?

you've seen a lot of names

• Coronavirus
• COVID-19
• SARS-CoV-2
• SARS

Coronavirus Update

They're all in a sense to mean the exact same thing. This virus is an RNA virus. What I mean by that the genetic signature inside this virus that little curly is made of an RNA that can reproduce.

Coronavirus Update

But most importantly the virus has on its surface an envelope or capsule. Then you see the spikes. The spikes form a crown. That's why it's called coronavirus. It created this disease in China and that's why COVID-19 was the first name for coronavirus disease in 2019.

Now the World Health Organization has created an official name this is the latest scientific name SARS-CoV-2. Why SARS-CoV-2?. Because this is the second-generation daughter virus of SARS?. Why is that important to us?. It's given us a head start. It's given the scientists a head start since 2003 2004 2005 to fully understand this family of coronaviruses specifically saws and now SARS-CoV-2.

What's exciting about that is we now have in our fingertips, supercomputing, genomics, bioinformatics, That wasn't as advanced even in 2003. This is now allowing us to understand how contagious is kind of coronavirus?. Because sadly this mutation has allowed SARS CoV-2 to become a thousand times more infectious than that of SARS. And that is the fear. The fear is SARS, It is endemic limited in its scale and scope. But now SARS-CoV-2 is a pandemic. So the question that we need to understand.

Coronavirus Update

• How Does the Virus  Infect Your body?
• What does this do?
• How does it affect the cell?
• How does it affect the lung?
• What organs does it affect?
• What happens to your lungs?

This is an opportunity for us to take a different lens of understanding the host effects rather than just the virus itself. And if we look at the host effects we now truly have a shot. Like trying to block it, and block the ability to get to SARS.

Coronavirus Update

So firstly an infected person can contaminate 2.6 other patients. How does that happen? It's droplets and this Nanoparticle of a virus forms droplets. These droplets can go on surfaces. Then go into your hand.

The important fact is that your hand is now a vector. We'll come back to how we can use that fact to our advantage and kill the virus. But the lungs, what happens inside the cell?  

Lung

Body Receptors ACE2

ACE2

ACE2

Coronavirus Update

Coronavirus Update

This virus has now hijacked this receptor in our body called the ACE 2 receptors. This receptor is on blood vessels. These receptors on the kidney, and even on the heart, but most importantly on this, what we call the alveolar cells of the lung.

It's in a very important receptor called ace 2 because it's there in your body to protect your lung tissue from injury. What has happened is that a virus through its spikes has figured out a way to interact with that receptor and use that receptor to dock. 

Coronavirus Update

The virus goes on now to take advantage of the cell itself and use the cell as a factory. It's now taken on what we call taking the RNA inside the virus itself it breaks it up. And remarkably takes what we call the Golgi apparatus the machinery of the human cell.

Coronavirus Update

Coronavirus Update

To reproduce itself and repackage and in so doing it propagates. So this is the issue of how the virus actually regenerates and sheds. Now we are full-circle because that shedding of that positively charged patient can contaminate others.

Coronavirus Update

And the opportunity however to stop not just unfortunately shedding. But stopping that propagation is what containment is all about.

Coronavirus Update: How deadly is coronavirus? 

Coronavirus Update

Not only this is Virus. It is highly contagious. But it is also deadly. This is the map or the results that the Chinese had about the patent of disease progression in China. 

There are three types of symptoms or patients

1. Mild
2. Moderate
3. Severe & Critical

Coronavirus Update

What you see from this is the patience that. And it is severe and critical progressed very rapidly to the intensive care unit and rapidly to death. This can happen as rapidly as three to four weeks. But it doesn't exclude the patients who are mild or moderate. While rare it doesn't exclude them.

In this chart

Coronavirus Update

44,000 cases in mainland China have separated the fatality as it relates to age. As one could see from this chart. The orange is greater than 80 and 70 to 79 and 60 to 69 are the predominant patients who die of this disease. But unfortunately, there are deaths in patients 40 to 49, 30 to 39, 20 to 29 and even 10 to 19. So while it's certainly the majority of patients who have mild symptoms. The young unprotected yet from this fatality rate. Why does this happen?

Coronavirus Update

Coronavirus Update

Coronavirus Update

The way this virus works is as it replicates. And it overtakes this protective ACE-2 receptor fibrosis. This means scarring and that's why a hundred percent of these patients will have fatalities and have this ground-glass effect in their lungs. And there's no longer any oxygenation.

The body tries to take this over sadly we end up then with what we called SARS. Which is severe acute respiratory syndrome in essence? The body can't get enough oxygen to the rest of the organs. And we have what you called multi-organ failure.

Coronavirus Update

This happens unfortunately not only mainly in the elderly but also those with pre-existing conditions. You could see patients with cardiovascular disease, diabetes, respiratory disease, and high blood pressure, have these pre-existing conditions or prone if they get infected to end up with SARC. We are now learning on a day-by-day basis what are the clinical effects of SARS.

We understand and begin to sort of see hypertension, severe hypertension, cardiac failure. And even a very interesting finding of low potassium in the blood. So the Chinese again are putting out this data in rapid fashion. And allowing clinicians and people looking after such patients to find ways to combat the SARC. This is also important for us to understand.

These are the patients who will require ICU. We'll talk a little bit again about flattening the curve. We really have an opportunity as an entire community and as a country to not only flatten the curve but not overwhelm the healthcare system. So that the ICU in this medical staff can be available to treat these patients. Not only with these pre-existing conditions but to take a patient from critical and severe all the way back to moderate and mild.

Coronavirus Update: How deadly is It?

It is important for all of us to understand the ability of this virus to spread. And how it does. So it has a spreading factor of about 2.6. What does that mean? The New York Times has put together a video that I think beautifully explains the role contagious capability of this virus.

Coronavirus Update

Coronavirus Update

Coronavirus Update

Coronavirus Update

Coronavirus Update

 Let's imagine five people are sick and one cycle meaning it's within these five people. If there is an infection rate of 2.6 and that's mathematically we call it exponential. What would happen within two cycles that would become 18 people who are sick? Three cycles 52 people are sick. Four cycles 140 people are sick. And after five cycles we have over 300 people that are sick.

This is what we mean by isolating people that are infected. This was the value of the test. The purpose of isolating people who are sick is to flatten the curve. What we mean by that is if we can identify these patients that are ill. We can actually with protective measures or with isolation flatten the curve.

Coronavirus Update

And the importance of flattening that the curve is we can protect the healthcare systems capacity. So that we can actually have sufficient ICU's. Sufficient medical personnel. Sufficient medical supplies. To deal with the inevitable, severe and critically ill patients who may die of this disease.

Coronavirus Update

So it's beholden to all of us to work together to identify those patients or yourselves or your family members or your friends who have visits from overseas. 

Coronavirus Update

Who may have the symptoms of this disease and either self isolate even without a test. Because it's critical for all of us to create the extinction of this virus by self-isolating. And allowing the healthcare systems to man with the very ill patients.

Coronavirus Update: Symptoms associated with infection

If we have to self isolate or have patience isolate so they prevent this exponential growth of this pandemic. We need to understand what the symptoms are even without the test. So this is the issue we can and through the experience again of the Chinese understand how we recognize at least an infection.

Coronavirus Update

We need to know who's most vulnerable. Our main mode of risk are children at risk. We need to ask the question of how long does a virus stays in your body?. About the last question disturbingly there are now some reports that the virus can stay in your body for more than 30 days. So the first question is to recognize either yourself, your friend, your family member that has an infection.

Coronavirus updates: How do I recognize an infection

Coronavirus Update

And this is a report again from the Chinese experience of over thousands of cases. Here are those who answered by province in the country as a whole where the Chinese rapidly got the information.

That fever and cough, a dry cough are some of the hallmarks of this infection. So anybody with a fever or dry cough should suspect without a test even. And go to the extent of self-isolating. And prevent them from contamination either among their family members, their friends, and co-workers.

Coronavirus Update

What's of concern, however, is what percentage is severe or critical. The good news is that 81% of symptoms are mild. But the concern is in patients with pre-existing conditions in the elderly.

If you take again this case report now 44,000 confirmed cases in mainland China. You see from their experience patients who will require hospitalization are called that severe or critical in intensive care. If you add those together that represents 18 percent.

So if you then extrapolate. What potentially could happen in our country. And the number of patients that could get infected and then say 18 percent of such patients will require hospitalization of intensive care units. That means we need sufficient beds. That means we need sufficient ICU personnel. That means we need to preserve at all costs the resources of the healthcare system. That is why I can emphasize so much that we need to flatten this curve.

Coronavirus Update

And not generate this peak. Because if we generate the speak and 18% are severely or critically ill. There is no way our country can manage that onslaught or what I call this tsunami.

Coronavirus Update

However it's in control now I'm going to talk a little bit about the science of soap simple things like the science of soap. The power of soap is the idea of washing your hands.

Coronavirus Update

That you toll as a kindergarten day is not trivial as it relates to this disease. It's not trivial as it relates to not being overwhelmed in the healthcare system. It's not trivial in terms of exponentially spreading this disease.

Coronavirus Update: Science of Soap

Coronavirus Update

The purpose of this presentation was not only to try to lay fears. But also to provide information that we as a community and as a nation can actually control. So I really feel it was important for me to speak about the science of soap. 

Because we can not only control. We can prevent the spread. I'll speak a little bit about how long the viruses last and services on the surfaces with the surfaces of your hand. Or surfaces of your computer and your phone.

And how we can do containment lessons we could learn from China. And then we'll speak a little bit about the role of testing lessons we can learn from Korea. I recognize that we are in a little bit of a bind because of the lack of testing. But I think what we all wouldn't do now is understand that perhaps even without testing. We can now control and prevent the spread.

The science of soap-  The viruses are not bacteria so antibacterial soap is a myth as it relates to killing the viruses. Because it has this fatty greasy layer on it.

Coronavirus Update

As an envelope loves getting on to surfaces that will fit to which it is really here such as your hand. So your hand is a vector. But if you took this vector of the hand and understood the signs of soap. Where the virus has this fatty layer. And the skin is the surface.

Coronavirus Update

Detergent straightforward regular detergent, dishwasher fluid, hair shampoo, detergent soap, acts as a surfactant. What does that mean? it actually goes and orientates itself. These soap particles towards the fatty layer of the virus and in doing so it actually orientates and lifts off these viruses. And creates this clean surface.

So we have the ability to understand the science of soap. Its natural ability to act as a detergent, the ability to reason for at least 20 seconds. Because your hands of nooks and crannies you need the detergent to enter onto and create this interaction with the virus. You then need to rub and wash because you need to be lifted from the surfaces.

Coronavirus Update

However, what's exciting about this virus is because it is an envelope virus. What does the soap do?. The soap can crack that envelope. And if he cracks that envelope. You're able to kill that virus. So each one of us can be washing your hands and cracking that envelope and preventing the spread. This is the power and the science of soap.

What have we learned from Korea? It turns out to prevent the overwhelming of the health care system. And in fact to protect health care workers. One can do drive-by testing and I think this is a national initiative which we should take on and learn this experience from Korea.

What do we learn from China? China has taken the draconian step of containment. We are unfortunately beyond that point now. So we are now left and therefore with the opportunity to control it. At least within your control of actually taking on the power and the science of soap.

Coronavirus Updates: Strategies for Treatments 

The question is always asked: what is the hope for cure today? and also what can we do to prevent infection in the first place? 
As we talked about what we can do to prevent infection in the first place is this issue of self-containment? Washing your hands the power soap. And frankly, the most important one of the most important things is the elbow bump stop doing handshaking.
The issue of the cure is a complex issue. Because we have to talk about what is the difference between a treatment for those of their ill versus what is a vaccine? that will prevent the infection from happening.

Coronavirus Update

I'll try and explain the difference between a treatment and a vaccine. But I think we also would like to discuss what new treatments are being developed today?. And I'm excited to say that the entire world community of scientists and pharmaceutical companies and biotechnology companies are frantically working 24/7. 

And to find new treatments that are being developed. I'll have to address with scientific vigor about how long a vaccine will take to develop. But I think of great concern is what is our manufacturing capacity should we need some of these vaccines and all these treatments urgently.

 So let's start the first question 

How long will it take to develop a treatment or vaccine?

First let's even talk about what's the difference between a treatment and a vaccine. Because I think there's a lot of confusion around there. A vaccine is like what you have for the flu. We create a subcutaneous shot and using a vector is sometimes a common cold vector or what we call an adenovirus. 
In which we put the sequence of this SARS CoV-2 into this to train and educate your body to recognize this virus. And have readily available killer cells to prevent you from getting infected. That's a vaccine unfortunately that will take a while to develop because testing needs to be done. 
But the effectiveness of that vaccine is giving you true protection. On the other hand, we have patients that are ill, critically ill, mildly ill. That we can take a patient that is mildly ill and prevent from becoming critically ill. We can take a patient that's critically ill from becoming severely to the point of fatally ill. And to understand how we can do that.

Coronavirus Update

The treatment for these kinds of patients is much closer at hand. This virus works by hijacking a receptor in your body. This receptor uses the machinery of the lung.

Coronavirus Update

This actually replicates and infects the lung to the point of fibrosis and death. Worse, this virus has found a way to evade the immune system. It's found a way to actually kill the natural killer cells in your body. 

Coronavirus Update

The T cells in your body. From the data again from China what we've discovered is that the patients who died not only are the elderly. But they have a low natural killer cell and T cell count.

So we're beginning to understand this complex biology of this virus. And that's why we're looking at it from a perspective, not about the virus  but the host.So if we could understand the host reaction and create counter-reactions to this. We have a shot for treatment.

About Coronavirus treatment- There are multiple strategies

The first strategy is to take this concept that the virus has hijacked this receptor in our human body called the ACE. So this ACE receptor is the first port of entry.

Coronavirus Update

So if we could block the entry of this virus through this ACE receptor. We could block the entire cascade of its ability to use the engine and the machinery to regenerate. Well happily and luckily we've now have scientists. 

And this is as recently as this month understanding this ACE receptor through the power of genomics. Through the power of supercomputers. Through the power of protein folding. This complex receptor in our human body is now being able to understand. Because we can understand this receptor.

Coronavirus Update

Coronavirus Update

We can find systems to create decoys and sponges. So that this receptor cannot be attacked. So that the virus can be as a Trojan horse blocked from entering this. This complex science is now being attacked worldwide by scientists around the world and is a very exciting strategy.

The other strategy is to say we could block the machinery. And the answer to that is yes. Because we now understand how this virus replicates.

Coronavirus Update

The third strategy is could we block what we call the endosomal packaging and block that and what's exciting is we've now discovered potentially.

Coronavirus Update

This potentially because science is not fully borne out and this is experienced in China. That old drug repurposed can actually block these packaging systems inside the human cell and ameliorate this disease.

Coronavirus Update

The fourth strategy is to actually kill the factory of the virus itself. It turns out the way this virus works in a fez found a way to kill the natural killer cells and T cells of the human body. 

Coronavirus Update

From the results we've seen from China in the patients who had a fate. A fatal outcome in the elderly the lymphocytes or what we call the natural killer cells and T cells are depleted.

Coronavirus Update

Significantly depleted whether that's in effect of the virus or whether the patients are immunosuppressed so had pre-existing conditions including cancer. It's not clear yet but what is important and is clear is that these natural killer cells or T cells are depleted.
However we have in our system the ability to kill infected cells. So a very interesting strategy is to activate these natural killer cells. That, as you
could see from this diagram, can identify lock on to and put. 
And really push what they call granzymes into these cells and destroy them. The way it will destroy them. It will actually completely almost dissolve the cell and in doing so we can then kill the factory itself.So the opportunity here now is not to affect the virus. But the factory of the virus and to prevent its depletion. And in so doing it may induce also a memory or a vaccine. And maybe even have a dual effect of reducing the infection, killing the infected cell and allowing the patient's own immune system to get reactivated. Now, these are the four opportunities that now face us as strategies for the scientific community to come together and work frantically towards. 

1-Blocking the receptor preventing it from entering.2-Destroying the machinery preventing it from replicating.3-Preventing from repackaging and shedding and4-Killing the factory itself.

These are opportunities that give us hope. And I hope will provide some level of comfort that the world working together will be able to find a way to stop this virus. Stop this pandemic and learn a lot about infectious diseases. 

The question that many people are asking 

Coronavirus Update

1. How long will this pandemic last?.

2. what is the duration of the viral load in the infected patient?.

3. Is there any hope that this pandemic will die out?

It's very important for us as scientists to explain what we know, they explain what we don't know? At this point, I don't think we really understand who knows how long this pandemic will last. It could be many months. One of the earliest reports. 

It is the duration of this viral load in an infected patient lasting in the range of 35 to 37 to the eight days. And whether a patient can actually reinfect it himself. It's not quite clear yet. The hope that this pandemic will die out. I'm sure with the work of the community of scientists then we will find a way to prevent the regeneration of this particular virus. 

And I'm convinced that with all the community of scientists working on this disease a vaccine will be found. But it's also important to dispel some myths. The question is to come up as can I get the SARS virus from my pets. 

Again it's an unanswered question because there's just been a recent report of an infected dog from Hong Kong. But the question is could that pet reinfect humans?. There's no evidence today yet that it's transmitted from pets to humans. It's a human to human contact.

Coronavirus Update

These are the kinds of information that we will be able to say to you we don't know. It's important for us not to enter into conversations such as xenophobia. This is a pandemic that affects the world. This is a pandemic where the entire world working together can overcome it. The Chinese one started there this now is across the entire world.

Coronavirus Update

Coronavirus Update

Coronavirus Update

The Chinese have put out very important scientific and clinical information. so their concept now of xenophobia is one of the most destructive things. We can do as it relates to public health and the opportunity for scientists to work together. 

The public-private relationship. The ability of governments to work together. And villages for the community to work together is so critical for us to beat this disease. We will do that. I'm confident the science of today will enable us to do that. This is all about coronavirus update: the science and reality behind coronavirus.