Our guest contributor Dr Neil Lamb continues his fortnightly Shareable Science Blog. Neil is the Vice President for Educational Outreach at the HudsonAlpha Institute for Biotechnology and Shareable Science will explore how genetics is relevant to people in their everyday lives. 

As headlines trumpet the continued spread of COVID-19, the wall-to-wall coverage has generated a secondary outbreak of breathless hype, misinformation and anxiety. Acknowledging that we’re in the midst of a rapidly evolving situation, let’s pause, take a deep breath and do our best to separate fact from myth.

What are COVID-19 and SARS-CoV-2?

COVID-19 (coronavirus disease 2019) is a respiratory infection first identified in Wuhan, China in December 2019. It is caused by a novel type of coronavirus named SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Viruses and the disease they cause often have different names.

What are coronaviruses and where do they come from?

Coronaviruses are a large family of viruses so named because proteins studded across their surface stick up like the points on a crown. These spikes assist the virus in binding to cells in order to gain entry. They are zoonotic, which means they can sometimes be transmitted between animals and people. As we’ve noted previously, the initial genetic analysis of SARS-CoV-2 suggests it may have passed through one or more species of animal before being transmitted to humans.

How does this virus compare to SARS, MERS, influenza and the common cold?

Coronaviruses usually lead to mild upper respiratory infections, like the common cold. However, three times in the last eighteen years coronavirus outbreaks have caused serious disease across the world: SARS (severe acute respiratory syndrome) in 2002, MERS (Middle East respiratory syndrome) in 2012 and now COVID-19. NBC news recently published a comparison of the three diseases in terms of numbers, geographic spread and breakdown of cases by age.

The seasonal flu is caused by any of a number of types and strains of the influenza virus, an altogether different family of viruses. The World Health Organization lists the similarities and differences between COVID-19 and influenza. Unlike COVID-19, influenza has been studied by scientists for decades and we know a great deal about symptoms, risk of infection and ways to treat seasonal flu.

How does genetics impact our understanding of COVID-19?

In January, researchers published the first sequence of the viral genome responsible for COVID-19. Within a week, the sequence information was used to develop a test to detect the presence of the virus. Additional genomic studies showed the virus was similar but distinct from the viruses responsible for SARS and MERS. Sequences from several of the earliest Chinese patients were nearly identical, suggesting the virus had only recently entered the human population. As the virus has spread, certain strains have acquired genetic changes. By sequencing the virus of different patients, these genetic changes can be compiled into a viral “family tree” and used to track disease transmission. Other researchers have used the genetic sequence to identify ideal targets for vaccine development.  

DISEASE SPREAD

How does the virus spread?

The Centers for Disease Control and Prevention notes that the virus primarily spreads from person to person, through little drops of liquid called respiratory droplets. These are produced when an infected person coughs or sneezes. People must generally be within six feet of someone who is contagious to encounter these droplets and become infected.

According to The World Health Organization, preliminary studies suggest the virus may persist on hard and soft surfaces for a few hours or up to several days, depending on the type of surface, temperature, humidity etc. This means the virus may possibly be spread when someone touches a surface or object with the virus on it and then touches their own mouth, nose or eyes.

When are individuals contagious?

The Centers for Disease Control and Prevention reports the period of infectiousness for COVID-19 isn’t fully known. Some studies suggest people who have contracted the coronavirus are “shedding” infectious viruses – and can, therefore, infect others – even before they develop symptoms. Scientists have also found that some individuals continue to shed the virus after they have recovered, however, it’s not known whether they are shedding intact, infectious virus or inactive fragments of the viral genome.

Are specific groups more at risk for COVID-19 than others?

The Centers for Disease Control and Prevention notes that to date, most confirmed cases of COVID-19 have occurred in adults. Infections have been reported in children of all ages, but the data suggests that older adults (ages 60 and above) are at higher risk for serious COVID-19 illness. The risk may be twice as high in these populations, possibly because our immune systems change as we age, making it harder to defend against disease and infection. The risk is also higher for individuals with chronic conditions such as kidney, lung and heart disease. It is harder for the body to recover from illness when these underlying disorders are present.

Can I catch COVID-19 from my pet?

The World Health Organization says “At present, there is no evidence that companion animals/pets such as dogs or cats can be infected with the new coronavirus. However, it is always a good idea to wash your hands with soap and water after contact with pets. This protects you against various common bacteria such as E.coli and Salmonella that can pass between pets and humans.”

Is the virus mutating as it spreads?

All viruses mutate, acquiring changes in their genome over time. This is a natural part of the life cycle of a virus. To date, the number of mutations seen across COVID-19 patients is relatively small. These changes can be used to track patterns of viral spread, but scientists don’t believe these changes are likely to make the virus more severe or spread more easily across populations.

Will COVID-19 stop spreading during the warmer months of summer?

It is possible that the number of cases will slow as the Northern Hemisphere enters spring and summer. However, not all coronaviruses follow a seasonality pattern. Additionally, while China, North America, and Europe experience warmer weather, the Southern Hemisphere is headed into fall and winter. Transmission rates may actually increase in those regions over the next several months.

How can I minimize my risk and slow the spread of the virus?

The best way to prevent COVID-19 is to avoid being infected. The CDC has a list of guidelines to help minimize the spread of respiratory illness, which includes common-sense advice like steer clear of close contact with individuals who are sick, avoid touching your eyes, nose, and mouth, and wash your hands often with soap and water for at least 20 seconds.

Can I protect myself from infection with a saline nasal rinse, by eating garlic, gargling with bleach or coating my skin with sesame or essential oils?

Each of these ideas has been touted on social media platforms as a way to prevent disease. None of them are effective – and some are actually dangerous. The World Health Organization has an article that exposes the myths behind many rumors about the cause, prevention, and treatment of COVID-19.

Should I wear a facemask?

The Centers for Disease Control does not recommend wearing a facemask for people who are well. A facemask should be worn if you are ill, or caring for someone who is ill. 

SYMPTOMS/TESTING

How are individuals tested for COVID-19?

Accurate testing is critical to identifying and tracking the spread of COVID-19. A healthcare provider collects a specimen from the nose, throat or lungs of an individual suspected of being infected. The sample is sent to a testing lab, where technicians extract the genetic information and search for sequences specific to the SARS-CoV-2 virus. Different technologies and approaches may be used, but the entire process generally takes 4-8 hours to obtain results. [Side note: Because coronaviruses use RNA rather than DNA as their genetic code, the laboratory will often first make a DNA-based copy of any viral RNA present in the patient sample.] 

Is there a shortage of testing kits for COIVD-19?

In the United States, the testing process has been slow to roll out. While COVID-19 testing was initially only allowed at the Centers for Disease Control and Prevention headquarters in Atlanta, local and state public health laboratories have now received permission to offer testing using the CDC kits. A problem with the chemical components of early test kits required them to be remade, but kit availability has drastically increased over the last several days. Many private testing labs have also created their own COVID-19 screens, working under an FDA policy that allows rapid development and deployment of these tests.

What should people do if they develop symptoms and are concerned about COVID-19?

If you believe you have been exposed to COVID-19 and develop a fever and symptoms of respiratory illness, such as cough or difficulty breathing, call your healthcare provider immediately. The Centers for Disease Control and Prevention has published a set of guidelines for individuals who are sick with COVID-19 or suspect they are infected.

How many people have tested positive globally/nationally/in my state?

The current COVID-19 status can be found at both the Situation Dashboard from the World Health Organization and the COVID-19 GIS Dashboard developed by Johns Hopkins Center for Systems Science and Engineering. Both include number and geographic locations of cases, as well as data on deaths and those who have recovered.

SYMPTOMS/OUTCOME/TREATMENT

What are the symptoms of COVID-19?

Patients with COVID-19 have a mild to severe upper respiratory illness characterized by fever, cough, and shortness of breath. Symptoms may appear as quickly as two days or as long as 14 days from exposure. As with other respiratory conditions, the severity of COVID-19 varies among patients. An analysis of nearly 45,000 confirmed patients in China found that 81% had mild symptoms, with 14% were classified as severe (involving serious pneumonia and shortness of breath). The remaining 5% of patients were critically ill, having developed respiratory failure, septic shock and/or multi-organ failure.

What percentage of individuals affected with COVID-19 recover? Is it more deadly than the flu?

Although recovery times vary, the vast majority of people who get sick with COVID-19 will recover. People with mild cases recover within a few days, while those with more serious cases may take weeks or even months, depending on the severity of their symptoms.

We don’t have a clear understanding of the risk of death from COVID-19. Initial information from China suggested death occurred in approximately 3% of infected individuals. That figure is likely too high, as many people with mild cases of the disease were not counted in the overall numbers. A separate analysis of nearly 1,100 patients with lab-confirmed COVID-19 determined a 1.4% death rate. It will likely be some time before the actual rate is known. For comparison, the death rate of seasonal influenza is approximately 0.1%

How is COVID-19 treated?

There is currently no effective treatment for the virus that causes COVID-19. Antibiotics are not successful against viruses; neither are flu-based antiviral medications such as Tamiflu and Relenza. Treatment is instead supportive, addressing the symptoms associated with the illness. This means providing fluids, fever-reducing medication, and, in severe cases, treating symptoms associated with pneumonia or respiratory distress.

When will a vaccine or antiviral treatment be ready?

Possible vaccines and drug treatments are rapidly being developed. Genetic Engineering and Biotechnology News recently published a list of 35 potential treatment options under exploration. While many will enter the clinical trial process as early as this spring, it will likely take 18 months before any vaccine would be ready for widespread use.

STAYING UPDATED

Where can I receive up to date information about COVID-19?

Coronavirus Disease 2019 Situation Summary – Centers for Disease Control and Prevention 

Coronavirus disease (COVID-19) outbreak – World Health Organization

Where can I get information about travel restrictions/concerns?

Coronavirus Disease 2019 Information for Travel – Centers for Disease Control and Prevention

 
The HudsonAlpha Institute for Biotechnology is a nonprofit institute in Huntsville, AL dedicated to developing and applying scientific advances to health, agriculture, learning, and commercialization. The state-of-the-art facilities co-locate nonprofit scientific researchers with entrepreneurs and educators. HudsonAlpha has become a leader in genetics and genomics research and biotech education and fosters more than 40 diverse biotech companies on campus. To learn more, visit hudsonalpha.org.

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