100 questions to a microbiologist about coronavirus

1. Let's start with the basics. What is a virus?

It is a small piece of the genetic code of RNA or DNA, protected by an outer protein coat.

2. How common are viruses?

They are everywhere. If you add together all the viruses that exist in the world, their mass will exceed the mass of living matter - plants, animals and bacteria combined. 10% of the human genome is the DNA of viruses. The Earth is actually the planet of viruses!

3. Why is it so difficult to stop the spread of the virus?

Viral particles are incredibly small. After someone coughs, billions of these particles can be in the air.

4. How small are viruses?

They are tiny. You can't even see them with a standard microscope. One hundred million virus particles coronavirus new type will fit on the head of a pin. That's how small they are.

5. What do viral particles do?

They try to invade a living cell in order to multiply, infect other cells and other hosts.

6. Why would they?

This is their way of reproduction. Viruses act like parasites. They hijack living cells to force each one to produce new viruses. Once inside, the virus sends out hundreds or thousands of copies of itself. As a result, the captured cell often dies.

7. What does it mean to be infected with a novel coronavirus (SARS ‑ CoV2)?

This means that SARS ‑ CoV2 has begun to multiply in your body.

8. What is the difference between SARS ‑ CoV2 and COVID ‑ 19?

SARS ‑ CoV2 is a virus and COVID ‑ 19 is the disease that this virus causes.

9. Is it easy for a virus to enter a living cell?

This primarily depends on whether the cell has a suitable receptor for a particular virus. Imagine a keyhole and a key. Not every key will fit an existing well. Most viruses are blocked by our immune system or they cannot get inside, since we do not have receptors suitable for them. Therefore, 99% of them are not dangerous to humans.

10. And how many types of viruses are there and how many are dangerous to us?

Of the millions of species, only a few hundred are dangerous to humans. New viruses appear all the time. Most of them are harmless.

11. How many viral particles does it take on average to get infected?

We do not yet know this regarding SARS ‑ CoV2. But usually not much.

12. What does a SARS ‑ CoV2 particle look like?

Like a small string of spaghetti, rolled into a ball and wrapped in a protein shell. The shell has spine-like processes sticking out in different directions and giving it a resemblance to the solar corona. All viruses in this family look similar.

13. How many coronaviruses affect humans?

There are seven coronaviruses in total that are spread from person to person. Four cause mild colds, but the other three can be fatal. These are viruses that cause atypical pneumonia (SARS), Middle East respiratory syndrome (MERS) and a new type of coronavirus (SARS ‑ CoV2).

14. Why is it called a "novel coronavirus"?

The name means that the virus is new to humans, this is exactly what we have never seen before. Our immune system has evolved over two million years. But since this virus has never caught our body, there was no way to form immunity to it. Our lack of immunity, the ability of the virus to spread quickly and its relatively high lethality are why the emergence of SARS ‑ CoV2 is so worrisome for everyone.

15. How often are new viruses to worry about?

Rarely. Examples include viruses that cause diseases such as HIV, SARS, Middle East respiratory syndrome. The emergence of a new virus is a very big problem if it can spread easily among people and if it is dangerous.

16. How fast does a new virus spread?

SARS ‑ CoV2 spreads fairly easily from person to person through coughing and touching. It is an airborne virus.

17. Are there any other distribution methods?

According to some reportsModes of transmission of virus causing COVID ‑ 19: implications for IPC precaution recommendations, you can also get infected through feces and urine, but this has not yet been proven.

18. How is the new virus different from the previous ones?

It has four important differences:

• Many people who become infected do not show symptoms for several days. This leads to two problems: people unwittingly infect others and we do not know who to quarantine. This is especially troubling because SARS ‑ CoV2 is highly contagious.
• In 80% of cases, COVID-19 occurs in a mild form, similar to the common cold. Because of this, people do not isolate themselves and infect others.
• By symptoms, the disease can be confused with flu, so many believe that they have it.
• Most importantly, the virus is very easily transmitted from person to person, because in the early stages it is concentrated in the upper part of the throat. When an infected person sneezes or coughs, billions of viral particles can enter the air and other people.

19. Doesn't it cause pneumonia? What does the throat have to do with it?

The disease often starts in the throat (so a swab is taken from there for analysis), and then descends into the lungs and becomes a respiratory infection of the lower respiratory tract.

20. I often hear the word "asymptomatic". What does it mean?

That a person does not have symptoms of the disease, it does not manifest itself.

21. So someone can get infected with this virus and have no symptoms at all?

Unfortunately yes. Many people who become infected have no symptoms for the first few days, and then they develop signs of a cold or mild fever. This is the opposite of SARS, in which a person has symptoms for a few days, but you can only infect someone while you are sick.

22. If you have no symptoms, can you infect others?

Unfortunately, yes. This makes it much more difficult to slow the spread of the virus.

23. What is the likelihood that scientists will create a vaccine that will prevent coronavirus infection?

High enough, but no guarantees. Failure is also possible. For example, scientists have been looking for an HIV vaccine for 35 years, but it never came out. I am optimistic and believe that we will receive a vaccine against SARS ‑ CoV2, but we will have to repeatedly test it for efficacy and safety, and this takes a lot of people and time.

24. Let's say a vaccine appears pretty soon. How long will it be before we can vaccinate millions of people?

Vaccines-candidates will appear within a month or two. But due to the need for rigorous testing for efficacy and safety, it will take at least a year before a vaccine is approved by a major regulatory authority and we can administer it to humans. And the production of millions of doses will take from one and a half to two years. And this is an optimistic forecast.

25. Why so long?

It is not the creation of a vaccine that takes so much time, but its testing. Once a candidate vaccine arrives in the laboratory, it needs a series of clinical trials. First on animals, and then on gradually increasing groups of people.

26. Is there any progress yet?

Just weeks after the discovery and isolation of the SARS ‑ CoV2 strain in early January 2020, vaccine development began. Many governments and companies have allocated funds for this, and scientists from all over the world are rushing to work on it.

27. Do scientists from different countries collaborate or compete?

Both, which is not bad. But in general, international cooperation is well maintained. This is encouraging.

28. Can't you develop a vaccine faster?

Unfortunately, there is no way to take a shortcut. The human immune system is complex and unpredictable. Virus mutations can occur. Children differ from adults. Men and women can have different reactions. We must make sure that the vaccine is 100% safe for everyone who receives it. To do this, the product is tested in various doses on a wide range of healthy volunteers under carefully controlled conditions.

29. How deadly is the new virus?

Most scientists believe that it kills 1-2% of those infected. The WHO is now calling a different figure (over 3%), but this figure is likely to decline when it becomes clear how to account for the many undetected and frivolous cases. Mortality rates are clearly higher among the elderly and those with chronic diseases.

30. Should we focus on the average mortality rate?

Not really. To understand the risks, it is more important to know that for certain groups of people the virus can be fatal, and for others it is less dangerous, but it can lead to completely different consequences.

31. Then what numbers should we focus on?

In 80% of cases it is a mild illness, but in 20% it becomes more serious. In a bad situation, patients have heat and shortness of breath. As a result, some require hospitalization and some require intensive care if their lungs are severely infected.

32. Which groups of people are most at risk?

First, seniors like me: I'm 71. The older you are, the higher your risk. It is also elevated for people with chronic conditions such as diabetes, chronic obstructive pulmonary disease, cardiovascular disease and immunodeficiency.

33. How much higher is their risk of dying?

Their mortality rate rises to 10 or even 15%. And the risk increases when a person has multiple diseases.

34. And why does the risk increase so much if there are other diseases?

Because in this case, the immune system is weakened and reacts worse to any virus, especially this one.

35. The virus appears to have little or no effect on children and young adults. This is true?

So far, it looks like it, but, as with many other factors of COVID-19, confirmation is needed.

36. If so, why does the virus affect older people more?

We do not know. It will take some time to understand this.

37. Does it have any other unusual features?

You can infect others even if you yourself are asymptomatic and feel good. This is unusual, although it also happens with HIV.

38. COVID-19 is often compared to seasonal flu. Is this comparison correct? For example, are they equally dangerous?

In the United States, seasonal flu typically infects up to 30 million people a year, and less than 0.1% of them die. But this is still a large number of people. On average, 300,000 people die from influenza worldwide. The new type of coronavirus is 10-20 times more dangerous, and we cannot now protect ourselves from it with a vaccine.

39. Does a new virus spread as easily as the flu?

It seems that yes.

40. Do they have the same reasons too? Is the flu also caused by a virus?

Yes. It is caused by the flu virus. But the flu virus and the coronavirus are very different. Graft against the flu will not help against the coronavirus, but will significantly reduce the risk of contracting the flu. The common cold, for which there is no cure or vaccine, is often caused by another type of virus - rhinovirus, and occasionally another coronavirus.

41. How does the disease progress when the coronavirus settles in the body?

It usually starts with a cough. Then the temperature rises. Then it rises very strongly, breathing problems appear.

42. At what point does medical care become critical to survival?

Usually when there is a very high temperature, and the lungs are so infected with a virus that you find it hard to breathe or you need a ventilator.

43. How is the new virus different from diseases like measles, mumps and chickenpox?

SARS ‑ CoV2 is much less contagious and dangerous at the moment, but we still don't know much about it. And the listed diseases are well studied.

44. If coronavirus is not as dangerous as other viruses, why are they so afraid?

Because a new threat that can kill or make us seriously ill, makes us very nervous. But the antidote to fear is reliable information. Therefore, for US residents, I highly recommend watching it on the website of the Centers for Disease Control and Prevention. In other countries, I advise you to focus on the website of the local ministry of health or WHO.

45. How often should you visit these sites?

Scientists are constantly learning new things about the virus and updating information, so it is best to check resources frequently.

46. Has humanity ever destroyed a virus completely?

Yes. Smallpox that used to kill millions of people. And we are very close to eradicating polio thanks to the Bill & Melinda Gates Foundation and governments in many countries. We must not forget how this disease terrorized everyone.

47. How is the new virus spreading around the world?

By road, air and sea. Viruses travel by plane today. Some passengers may have SARS ‑ CoV2.

48. So every international airport is a breeding ground for a new virus?

SARS ‑ CoV2 is already present in most countries and not only at major international airports.

49. The epidemic began in China, so those who came from this country pose the greatest danger in terms of the spread of the virus in the United States?

The virus emerged in 2019, and since then 20 million people have arrived in the United States from around the world. Most of the direct flights from China were suspended four weeks ago, but that hasn't stopped the virus from entering the country. In China, cases of COVID-19 are now more likely to be imported from other countries, and the epidemic in China itself, apparently, is still on the decline. (Peter Piot answered questions on March 12, 2020. - Approx. ed.).

50. In other words, is the presence of a large airport a guarantee that the virus will spread throughout the country in less than three months?

Yes. But this is not a reason to completely cut off ties with the world.

51. Why did Japan close schools?

This is done in other countries as well. Because scientists do not know how much children, who can be carriers of the virus, accelerate its spread. Japan is trying very hard to slow down this process. Children usually transmit viruses quickly because they do not wash their hands and generally do not particularly care for personal hygiene. They also make a great contribution to the spread of influenza, which is why schools are closed in many countries during epidemics.

52. Are there any coronavirus medications that can be taken to relieve symptoms or be cured?

There are no drugs that have been found to be effective yet. There are a lot of drugs in clinical trials now, so hopefully that will change soon.

53. What is the likelihood that drugs will be created, and how soon could this happen?

In the coming months, we will likely find that some of the drugs already available are helping to heal. That is, we will be able to use drugs that are currently used against other viruses, such as HIV. But it will take time and a lot of tests.

54. What about antibiotics? They are usually referred to in difficult cases.

It is a virus, not a bacterium. Antibiotics work against bacteria, but not viruses. They can help with secondary bacterial infections, but by themselves they do not affect the new virus.

55. What about all the media talked about on the internet?

Most of what is written about is complete nonsense. More and more fake drugs will appear. Only if the tool has been written about in many trusted sources, you can be sure that it is scientifically confirmed. So be careful and don't spread rumors.

56. And the masks? Are they useful?

Very limited and only under certain conditions. For example, depending on the type of surgical mask, less than 50% of viral particles are filtered out. But a mask can reduce the spread of the virus if you are sick yourself.

57. What are their advantages and who should wear them?

Mask tight to the face if wear it right, will slow down the spread of viral particles when coughing. It will not protect you from other people. It is a means of protecting other people from you. Wearing a mask when you have symptoms of a cold is showing respect for others. This item also has an additional plus: wearing a mask, you are less likely to touch your mouth, which means you are less likely to bring the virus into your body if it gets into your hands. Also, this remedy is a must for medical workers.

58. Is there anything you can do to avoid getting infected?

Wash your hands often, try not to touch your face, sneeze and cough, covering yourself with an elbow or a paper handkerchief, do not shake hands or hug. All this reduces the risk. If you get sick, stay at home and talk to your doctor over the phone about the next steps.

59. Scientists often talk about mitigation. What does it mean?

It's about slowing the spread of the virus and trying to limit its impact on the health care system, public life and the economy. Until there is a vaccine, all we can do is slow down the spread. It is very important.

60. How else can you slow down the spread of the virus?

Observe sanitary standards and basic politeness towards each other. Plus, use social distancing measures: work from home, stop traveling, close schools and cancel mass events.

61. Do some viruses spread more easily than others?

Yes. Measles is the worst. It can be contracted by entering a room that was visited by an infected person two hours ago! So when people stop vaccinating, measles outbreaks occur. This is a very serious illness. The common cold also spreads quite easily. And here HIV it is much more difficult to get infected, nevertheless, 32 million people died from it.

62. What will it take to stop the coronavirus?

No one really knows for sure, but China has proven that it is possible to reduce proliferation significantly. To eradicate SARS ‑ CoV2 completely, a vaccine is needed.

63. How long does it take for a virus to spread across a country the size of the United States?

Under normal sanitary measures, the number of people infected seems to double approximately every week. This means that in about 14 weeks, 50 infected people will turn into a million. Naturally, we can take steps to slow down the process.

64. How effective is hygiene practice? If people follow the prescriptions, the number of people infected is markedly reduced?

It changes depending on how careful people are. Even small changes are important because they can take the strain off the health care system.

65. Could it be that there are thousands of unrecorded cases of coronavirus among the population?

Millions of flu cases are reported every year. This year, some of them are actually COVID-19. In addition, many of those infected do not have symptoms or they are very mild, so the answer is yes.

66. What exactly does a positive test result mean?

That the virus is present in the biological fluids of the person who passed this analysis.

67. Does everyone need to get tested as soon as possible?

COVID-19 testing should be made more accessible because we still don't know enough about who gets infected and how the virus spreads in society. They would provide important data.

68. Why did South Korea have a "without leaving the car" testing system?

Because they are trying very hard to slow the growth of the outbreak by finding everyone infected as quickly as possible.

69. What is the main symptom after which you should be on your guard?

Cough.

70. Can you determine the temperature?

High fever is an alarming sign, and if it is present, it is worth seeking medical help. But one temperature measurement at airports and at border points will not help, and many of those infected are not detected.

71. How many percent of people who tested positive were admitted to Chinese hospitals without a fever?

About 30%.

72. Could the virus return to the country after the outbreak has subsided there?

SARS ‑ CoV2 will probably never go away without our efforts, just like smallpox and polio.

73. So the only way to deal with it in the long term is through a global vaccination?

We really don't know. Global measures may work, but the vaccine is likely to be effective only as long as the virus doesn't mutate too much.

74. Or maybe the new virus will "burn out" like some others?

We do not know, but in general it is unlikely. SARS ‑ CoV2 is already established around the world. Now this is not only a problem in China. Most likely, there are hundreds of thousands of people infected, but have not yet passed the test. Like the flu virus, SARS ‑ CoV2 can stay with us for a very, very long time.

75. Will it come back in waves? If yes, then when?

Again, we don't know. But this is a very important question. This is likely to be the case, but it is too early to say with certainty. The Spanish flu epidemic of 1918-1920 had three outbreaks. Perhaps in China, after the opening of schools and factories, there will be a second wave of coronavirus. But until we see this with our own eyes, we cannot be sure how SARSCoV2 will behave.

76. Let's say we get lucky in the coming months. What can be considered luck in the current environment?

Warm weather could slow the spread of the virus, although we do not yet have evidence that this will be the case. Singapore is only a few hundred kilometers from the equator, but the warm climate has not stopped the virus there. It is likely that SARS ‑ CoV2 will mutate into a less dangerous form and fewer people will die from it. This was the case with the swine flu in 2009. But I wouldn't rely on that. It would be luck to find an effective drug therapy quickly. Actually, that's all.

77. Do people at high risk have the same mortality rate everywhere?

Unfortunately not. Where modern, well-equipped hospitals are available, mortality rates will be significantly lower thanks to respirators and fewer secondary infections.

78. How do I know which patient group I will be in: with mild symptoms or among those requiring hospitalization?

It is impossible to know for sure, but age over 70 and chronic diseases increase the risk of severe illness and death.

79. Should I worry that I will get sick?

If you are not in a high-risk group, I would not worry too much, but I would do everything possible to avoid infection, because the individual's response is impossible to predict. Over the next few years, we will all be at risk of contracting this virus, just as we are at risk of colds and flu. Therefore, everyone should be prepared to self-isolate if necessary.

80. How is everyone going to be at risk?

We all communicate with other people, and you can't argue with biology. I would try to take reasonable precautions, but at the same time, I do not dwell on anxiety. It definitely won't help.

81. If everyone eventually gets the coronavirus, why try to avoid it? Now I will be ill and will continue to live in peace.

It is necessary to slow the spread of infection, that is, to reduce the number of new cases and the total number of cases, so that doctors can save the most difficult patients. Otherwise, medical facilities will be overcrowded and unable to help people with other serious illnesses.

82. Is it true that after recovery you can get infected again?

We don't know, but it looks like it's possible. There is no complete certainty yet. More research is needed.

83. Does permanent immunity, as with measles and mumps, happen?

We do not yet have an answer to this question.

84. This immunity is very important for those who have recovered. And for the whole society too? Why?

This is important for vaccine development because it relies on the body's ability to provide an immune response and on the stability of the virus. And, naturally, in the presence of immunity, the number of those who can become infected will gradually decrease.

85. Will the coronavirus become seasonal, like the flu?

Little time has passed yet to determine whether SARS ‑ CoV2 will have seasonal mutations and how billions of viral particles will change through millions of carriers.

86. So, this virus can mutate by itself and take on new forms with new symptoms?

This is completely unknown. If so, new vaccines will be needed to prevent the mutated versions of SARS ‑ CoV2 from acting.

87. Since the virus naturally mutates, does that mean it could become more deadly? Less?

Yes, both are possible. This is a new virus, so we have no idea how mutations will affect it.

88. If the coronavirus becomes a constant threat, what does it mean for me and my family?

This means that we will all learn to live in new conditions and observe safety measures. We need to be especially attentive to the needs now. elderly family members.

89. They say the virus can live on the kitchen table for nine days. It's true?

SARS ‑ CoV2 is likely to remain viable for quite some time on some surfaces, but we do not yet know how much.

90. The greatest epidemic of recent times was the Spanish flu pandemic of 1918-1920. Then it was not a new virus, but a mutated influenza virus. Can SARS ‑ CoV2 compare to it?

SARS ‑ CoV2 is just as contagious and appears to be just as deadly, but time will tell. Consider that in 1918, healthcare was far from what it is today in developed countries, and there were no antibiotics to treat bacterial pneumonia, which was the leading cause of death.

91. Is there a chance that all this is a false alarm and in the summer we will be surprised at our panic?

No. The coronavirus has already spread to over a hundred countries and is very easily transmitted. More and more sick people appear every day. This is not a drill. It's real.

92. It is hard to believe that a new virus could suddenly infect millions of people. When was the last time?

With SARS and MERS, but they are incomparable in scale. HIV was a new virus that has infected 70 million people, 32 million of whom have died.

93. HIV affects poorer countries more strongly. Will it be the same with the coronavirus?

Yes exactly. In rich countries, the death rate will be much lower because they are better off with drinking water, artificial respiration equipment, anti-infectious measures and the like. This can potentially be a huge problem where the health care system is poorly developed, such as in Africa. When the virus reaches the world's most resource-limited countries, the consequences can be disastrous.

94. So you are not very optimistic?

In general, I am an optimist, but at the same time, many things cause discomfort and anxiety. I understand that people are afraid, especially if they are in a high risk group. But there is good news as well. We are already seeing progress in international cooperation, especially in the field of science and medicine. We are seeing more transparency in government and the rapid development of therapeutic agents.

95. What are your main concerns?

The spread of the coronavirus can quickly overwhelm any country's healthcare system and deprive people of access to healthcare. I also fear that overreaction and fear can damage the economies of countries, and this is additional suffering for people.

96. What should we psychologically prepare for?

To the fact that in every city that starts testing, many "new" cases will be found, as well as to an increase in the number of deaths, especially among the elderly population. In fact, these are not new cases of infection, they already exist, it is just that they are not known about them yet.

97. What encourages you?

• Modern biology is developing at an unprecedented rate.
• The threat is focused not only on the global medical community, but also on government leaders.
• We isolated the virus in a few days and quickly sequenced it (determined the amino acid or nucleotide sequence. - Approx. ed.).
• I'm sure there will be a cure soon.
• I hope there will be a vaccine.
• We live in the information age. This will help everyone - provided that we expose fake and dangerous news.

98. How prepared is the US for a pandemic?

The United States and other high-income countries have had ample time to prepare. We have all learned the lesson of China's unprecedented massive quarantines that have slowed the spread of infection.

99. Who are you most worried about?

About countries with limited resources. Every death is a tragedy. When we say that, on average, 1–2% of those infected will die from the coronavirus, this is a very large number. 1% of a million is 10 thousand people. And I also worry about the elderly.

But 98–99% of people will not die. Seasonal flu kills tens of thousands of Americans every year, but people don't panic. Although the flu should be taken much more seriously and graft From him. We have learned to live with seasonal flu and I think we will have to learn to live a normal life in the presence of COVID-19 until an effective vaccine is available.

100. Are there more pandemics in the future?

Undoubtedly. This is part of the lot of humanity and an integral part of living on the "planet of viruses". This is an ongoing battle. We need to improve our combat readiness. That is, to seriously invest in preparing for pandemics and to create a global fire brigade long before our home is on fire again.