In these troubled times, everyone is deeply troubled by the Coronavirus. Today’s post, Your Coronavirus questions answered, was repurposed with the aid of the Content Gorilla plugin from the video Two virus experts answer your questions on coronavirus/COVID-1. Grammarly was then used to correct the grammar and punctuation to give my readers a more enjoyable experience. You can read the full unedited context of this video here. There’s also my personal views about The Coronavirus and doing the right thing
Coronavirus Questions Answered By Experts
Today, two of Australia’s leading researchers on viruses and vaccines, Professor Michael Wallach and Dr Lisa Sedger, both from the University of Technology Sydney will answer questions about Coronavirus (COVID-19) from the general public.
We’re going to start with Dr Sedger who will explain how long the Coronavirus can survive in various temperatures on a surface? Say a door handle or a counter at a public place.
Coronavirus Questions Answered – What Affects The Coronavirus
Dr Sedger: Well, that’s an interesting question because we hear a variety of answers. Some people say that these types of enveloped viruses can exist for two to three days, but it really depends on the amount of moisture and humidity and what happens on that surface afterwards, whether it’s wiped off or something, so potentially for longer than that, potentially up to a week. But with cleanings and disinfectants etc. not very long.
And what’s an envelope virus?
Dr Sedger: Well, viruses are basically nucleic acids, so DNA like in all of the cells in our body or RNA, and then they have a protein coat and then outside of that they have an envelope that’s made of lipids.
So it’s just an outer layer of the virus, and if it’s made of lipids you can imagine any kind of detergent-like when you’re doing your dishes, disrupts all the lipids and the fat that’s how you get all the grease off your plates right? So any detergent like that will disrupt the envelope of the virus and make it non-infective.
So cleaning surfaces is an excellent way to try and eliminate an infected virus particle from, for example, door handles and surfaces etc.
Confusion Of The Coronavirus Questions Answered
What is confusing people is all the different symptoms listed on social media, such as Facebook. One may say it starts with a dry cough, and if your nose is running, it is not COVID-19. Is incorrect? Can we please have an accurate list?
“So, again, the primary symptoms are, in fact, a cough and shortness of breath and fever. But it’s not to say you’ll also have upper respiratory effects. The virus goes into the lung and attaches to the alveolar cells, or to the cells that make up our air sacs which helps our breathing. And it has to get there to cause this disease.
So if there’s upper respiratory involvement, which includes sneezing and runny nose etc., it’s probably not the main effect of the virus. Again I would say if you see that somebody is sneezing and wheezing and that’s it, it’s probably an allergy, but it does frighten people. I was on the train this morning, and I know if I, God forbid, sneezed, the whole train would empty pretty quickly. You know we’re just coming into winter, and actually, it’s an excellent question because at the moment what’s building is a sense of fear. But we must keep in perspective that there will also still be the typical seasonal cases of flu so just because somebody sneezes or has a sore throat does not mean that they’ve got COVID-19.
And we need to make sure, and I think we mustn’t stigmatise people who have symptoms because it may not even be COVID and we’re all at risk from any respiratory tract infections and already have been for years. That’s not a new thing. We just need to keep things in perspective.”
Coronavirus Questions Answered – Flu Comparison
And Professor Wallach, why do we make a bigger deal about Coronavirus than the flu?
Professor Wallach: Yes and I understand the question. Flu exists. We get it seasonally every year, and then we get pandemic flu and yes people do die from influenza. I think it was 16 thousand people in the US died last US winter. But the issue with this virus is that we don’t yet know how to treat it particularly well. At the moment we’re trialling antiviral drugs in China. There are clinical trials on experimental drugs. There are drugs that doctors are using. But until that data comes in and we know what regime of antiviral drugs to use, then we don’t yet know how to treat it with antiviral drugs. The other thing is with the flu we have a vaccine.
People can take the vaccine. Somebody gets sick in their family, and the other family members can receive the vaccine and prevent the spread of the virus. So the difference is with flu, we have ways to control it. We know about the disease. We know how it presents. With this virus, we need to understand the clinical presentation and in different cohorts. So different age groups, different countries, different situations, we’re still trying to work out the symptoms. And we don’t yet fully know how to control it by antivirals, and we’ve yet to find a vaccine.
I think one of the reasons we’re so careful is when it broke in Wuhan at the beginning the mortality rate was extremely high. And with related viruses like SARS and MERS that went as high as 35%, whereas flu mortality rates are usually around 0.1%. So it was that very high mortality rate that gave a real shock. Had it continued, it would have been devastating. We’re very fortunate that now we see it dropping down to the two to three per cent level and some say much lower.
And we also know now that some people get COVID to have very minimal symptoms and almost don’t even know that they’ve been sick. So I think that fear and anxiety, in that sense, is lowering.”
Coronavirus Questions Answered – How Long Before A Vaccine
Something that everybody wants to know is how far off is a vaccine?
Professor Wallach: So we are working on vaccines in Australia. The group in Melbourne was the first to be able to isolate and grow the virus, and I’ve been in touch with them. This morning we’re working collaboratively, nationally as well as internationally. Worldwide, we have about 15 vaccine projects going. Plus all sorts of industry companies are aiming to make vaccines. One company in Israel early on announced that they believe that they can get to a vaccine within a few weeks.
The problem with the vaccine is you may produce it quickly, but it’s testing it and making sure that it’s going to help. If the formulation is incorrect, there’s a fear with COVID19, to make a long story short, it can exacerbate the disease. So everyone has to take it slowly and carefully so that we don’t cause more problems than we currently have. But I’m optimistic and believe that we’ll get there.
The WHO declared it would take 18 months. I would like to present a more optimistic view, not based on anything substantial, but I think we can do better than that. And it is a high learning curve for the next time this happens. Recently we’ve just seen Africa experience a very significant outbreak of Ebola virus, and the administering of an experimental vaccine that has mostly controlled that outbreak. I think through the people working in vaccines and the people who do the safety and efficacy studies, we’ve learnt a lot from how to administer vaccines, how to get the data we need to show safety more quickly than we might have in the past. So in a sense, we’ve learnt, we’re always learning from viral outbreaks.
It might not be the same virus, might not be the same country, even the same continent. Still, we’re learning how to do these things more efficiently and more quickly and always the issue is weighing up safety versus the ethics of the need to administer or get the drug out there as soon as possible.”
Coronavirus Questions Answered – Response To Temperature
Dr Sedger, how does this virus respond to cold or warm temperatures? Is it like the flu which thrives in cold weather? We’ve all heard so many different things about this.
Dr Sedger: I will be frank and say I’m not sure that we know. What we know is when there’s a high humidity a virus can exist for longer because they don’t dry out. So that envelope we talked about is less likely to be dried out. And once that’s dried out the virus is less infective. It’s not infective at all if it’s disrupted that envelope. But whether it likes cold temperatures high temperatures, we think it’s not a warm temperature virus. We believe it’s more a cold temperature virus. China’s just been going through their winter. Maybe one of the reasons it’s been prominent in Italy is they’ve just had winter. We also think the coexistence of seasonal flu in Italy at the same time is probably one of the factors that have made it more severe. So yeah look, different circumstances in different countries, different climates.
It’s not just about climate though; it’s about the susceptibility of various populations. Therefore it’s a hard question to answer.
We can all see there seem to be two camps. On the one hand, there are those people who are genuinely really concerned, quite worried about the situation. We see that in the panic buying. And then there’s the other camp of people who are saying “oh it’s all been blown up, it’s all hype, we don’t need to worry about it, it’s too early to panic”. Many of us are wondering, how do you reconcile those two views out there in the community?
The ABC interviewed me early on in this outbreak and speaking to other groups, I took a low panic view, maybe because I’ve been thinking about a pandemic for many years. And for me, it was always not a question of if, but when.
I look at this in a positive sense. We’re facing a pandemic that, yeah, as terrible as it is, is nothing in comparison to what could be if it’s the pandemic flu. For example, we experienced the Spanish flu in 1918, which killed somewhere between 20 to 50 million people. So the order of magnitude of mortality right now is low compared to other potential pandemics. If you take China out of the equation, we’re at about 1500 people who died worldwide.
That’s not to say we shouldn’t show great respect to the value of their lives. It’s mainly affecting the elderly with complicated illnesses and probably would have had the same effect if they had the flu. So my take on this whole thing is we all have to stay calm. We all have to accept the fact that this is part of nature. These viruses are out there all the time. We know them. I can detect now flu viruses in wildlife birds that are coming into this country now that can mutate and start infecting humans.
So we have to be prepared. We have to face up to them together in a collaborative, a scientific and professional way, and we could win. If we panic and react in the way, the market is, for example, of course, that’s an improper way to respond. Instead, this is part of being of our biology. Viruses exist that can hurt us, and they will always exist. Yeah look, I think there are a few factors that we can learn from this. One is to work out where these viruses come from, and a lot of these RNA viruses exist in bats which seem to transmit into wild animals through bat droppings. I think one of the lessons we, the world all over, might need to learn is how we deal with the marketing and selling of wild animals which some people use for foods. That may then prevent these viruses from getting into the human population. So I think there are lessons to be learned, number one.
But Michael I would disagree with you in one sense, that it is maybe not as bad as pandemic flu. On the other hand, we do have vaccines for the flu. We do have antivirals, and we have a whole world that has various levels of immunity to flu and different strains of the flu. In contrast, this virus is entering into a naive, immune population. And that’s why it’s so significant.
It may be that as our immunity at a population level increases, as a disease this will become far less significant. But the first outbreak of it in a naive immune naive population will always have the highest level of morbidity and mortality. And that’s where we have learned from other diseases like Ebola. As I mentioned, what we already know about the flu, how we already control the flu and the development of new and novel antiviral agents will be just as effective and essential, I believe, as will the development of vaccines. So I think there’s a lot to learn to prevent this or limit, I should say, to limit the severity of the outbreak and maybe even prevent it from happening again.
As I’ve said, if we stop trapping wild animals and eating them, we may prevent the outbreak of some of these types of RNA viruses. So I certainly agree with that. And China is now putting into law a restriction on the sale of wildlife in their markets. What I’m trying to do, and I hope we both agree, in proportion to influenza, even seasonal flu that killed in one year up to 600,000 people worldwide. I’m just trying to put things into balance to prevent people from panicking. To understand that, yes, this is affecting the elderly.
And anyone who is elderly, suffering from heart or respiratory conditions, they must isolate themselves. My wife’s parents live in a retirement village, and they decided to close off the entire retirement village. Nobody’s allowed in as a means of preventing people from bringing in COVID-19 and infecting that area. And I certainly agree with that sort of strategy.
Coronavirus Questions Answered – Can You Catch It Again?
“Normally I would have said no because we imagine there’s a good immune response that will then provide you protection from reinfection. That’s what our immune system does. But this is a new virus. We don’t yet fully understand how our immune system clears it. We don’t know whether the virus can remain for a more extended period. I would say though that there are only a few cases of people who after being treated, appear to have recovered, have then gone home, and have then had a relapse. There are only a very few numbers of cases that have been like that, so for all intents and purposes, I don’t think that’s something we should fear, and it’s not something we’ve seen with the previous SARS outbreak in 2003”.
Coronavirus Questions Answered – The Mortality Rate
There was an announcement by Angela Merkel preparing Germany for 70 per cent of the population being affected. Lisa may say the number is lower; I don’t know until we build up herd immunity. The mortality rate, based on CDC and which are writing, is probably overestimated.
Some estimate the mortality rate as being much lower. So again, I think and would like to hope that as we developed new vaccines, as we develop drugs, as we develop approaches to quarantine, people test them, keep them at home, isolate them, we’ll get the mortality rate under control. And I’m going to express an optimistic view. This world has fantastic capabilities of doing world-class science, and if we apply it and work together, I think we can control this problem.
Also, the mortality rate is related primarily to people who are turning up with symptoms. But we’re now beginning to appreciate there is a more significant number of people who could be entirely asymptomatic, who are not tested. This virus will indeed have infected many more people than will be examined, and if we did have surveillance of every single person being tested then there are two questions here: are you testing for the presence of the virus? If they had virtually no symptoms and not a significant illness you might not find the virus, but if we test for the presence of an immune response to the virus, we would honestly know how many people were infected.
And then we could get an accurate estimate or at least a much closer approximation of what the mortality rate is.
Coronavirus Questions Answered – Do People With Sniffles Have It?
We would also like to know, do we stop testing for this disease and just assume that everybody with the sniffles has it?
So first of all, the primary symptoms are not sniffles. They’re fever and coughing or shortness of breath. It’s the sniffles though that causes it to be spreadable. That’s a good question: what the health authorities will decide to do at various stages of this pandemic. We’re now at what I would consider the early seeding phase. The virus has now seeded the world, and different countries will go into exponential phases like described in Wuhan at different times. And how they handle that will be a crucial question. I’ve seen all the different approaches from the seed from the US, Israel, Iran.
Health authorities will need to control the number of occupied beds. For example, again in Israel, they’re starting to treat patients at home because they just went over their bed limits. So at some point, I think, depending on how the epidemic goes, if we can keep it under control, we can maintain the testing regime. We can keep control. If the exponential rise is too fast, we will lose control, and the testing will become meaningless.
The Lancet published a paper this week profiling survivors versus those who have succumbed from the infection. We’re starting to learn what some of those factors are. As clinicians, we can better predict who is likely to be the more severely ill people so they can better predict who should go to the hospital for treatment and, as Michael has said, who is better just treated at home.
Coronavirus Questions Answered – Preventing The Virus
So the truth is it’s here, and it’s probably in more people than we realise, because we haven’t tested as many people and we now realise some people are asymptomatic or don’t show classic flu-like symptoms. So it’s here, and you can’t say that you’re not going to get sick. That’s the first thing that has to be said. The second thing is we can minimise the spread if we wash our hands regularly. Try not to touch our face, our eyes, our ears and our nose. Dispose of a tissue when you sneeze or cough or, sneeze into your elbow.
It’s about common sense. It’s no different than protecting yourself from any respiratory virus infections, like seasonal flu or even a pandemic flu.
Can The Caronavirus Be Transmitted In The Swimming Pool?
Coronavirus Questions Answered about swimming pool transmission?
I would think quite small because the virus would be quite diluted in the swimming pool. Secondly, swimming pools are all treated with chlorine, for example, and chlorines are very active antiviral agents. You’d have to drink a lot of swimming pool water to get the virus.
Coronavirus Quarantine In The family
How would quarantine work in a family?
We think of quarantine as being away from work or away from public places but, if you are infected, then the people in your family areas at risk as your work colleagues would be at work. Again I think it’s about common sense. Don’t share food utensils. Wash your hands. Don’t keep touching your face and your mouth and your nose. Get rid of tissues in a helpful sort of clean manner. It’s about minimising transmission. Let me just add to that, that all the data indicates that children likely will only get very mild symptoms, if at all. Yeah so if you’re a family member and you’re worried about your children, this is one time that you can be happy about this.
All the results so far indicate that children aged 0 to 9, there’s not been a single death. Whereas what we do know is the elderly appear to be more susceptible to more severe disease. So that’s where if I’m sick, it’s better not to go and visit my grandparents or something like that. That’s where quarantine within the family works in a practical sense.
Life After The Coronavirus
Professor Wallach, once you’ve recovered from Coronavirus, can you just go back to your healthy non-isolating life?
So the current understanding, according to colleagues also in the US, is if you go through one infection, you’re probably immune against reinfection. There have been reports of cases of people getting reinfected. Still, the opinion that I heard so far is that it’s perhaps recurrence of the same infection that probably went down in terms of clinical symptoms. But the virus remained that just came back up. It happens with the flu all the time. The question is, what should be your behaviour after you go through a bout of the virus? I guess I would still be careful, which Lisa can maybe add to, it could be the virus will continue to mutate.
Fortunately, I heard this morning that they’re not that worried about this virus mutating at the rate that flu does and we’re hopeful that we will develop herd immunity. People who have gone through it then will be reasonably safe unless you have some immune disorder and then it will become part of our environment to flu is. Yeah, I think I just want to finish with a positive note. I mean, we live in a fantastic era of medical research and science. We’ve sequenced parts of the virus within a very very short period.
We now track the virus in its entire sequence. We know, we have clinical trials for the drugs. We have people working on vaccines. We have epidemiologist better understanding of the disease susceptibility within our populations. I mean, we learn a lot from other existing outbreaks of infectious diseases. And I remain positive that you know the medical and scientific community working together will be able to solve this. I’m quite confident that there’s a reliable response. That’s not to diminish that people have died and it’s been tragic. But we live in an era where we’re exposed to infectious agents, and we are getting better and better at controlling most of those infections. So I’ll just add and put in a plug for a program I’m very much involved with called Spark, working with people at Stanford.
We’ve established a program for precisely this time when there are sudden outbreaks, and the program involves 23 countries and around 70 institutions all working together for outbreaks of Zika, Ebola and now Coronavirus. We’re currently working together collaboratively like never before. We’re putting our egos aside, and we’re saying we have a social responsibility to do better, especially in case of a pandemic. And we’re doing it, and we’re very proud to be able to say we have 15 projects going on now collaboratively that we just formed over the past two weeks together with our colleagues all over the world. I also believe in a very bright future.
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