We have been investigating the science concepts behind the approaches to fight COVID-19.  The purpose of this series is to better understand some of the current responses to the virus and think about how to proceed.  This week we will examine how the human body responds to the virus. Thank you for subscribing, and if you enjoy reading this, please forward the newsletter to your friends. ~ KevinQuote: “In fact, biology is chaos. Biological systems are the product not of logic but of evolution, an inelegant process. Life does not choose the logically best design to meet a new situation. It adapts what already exists...The result, unlike the clean straight lines of logic, is often irregular, messy.” ~ John M. Barry, The Great InfluenzaFlashback:

First, as I often say this year, I am not a medical doctor and this analysis is based on readings and attempts to explain a subject to myself as much to others.  With that in mind, all these points should be conditioned with the understanding that there is a lot that is still not known about COVID-19.  But decisions (good and bad) are regularly made under uncertainty.   Just as the virus spreads exponentially within a population it often spreads rapidly within the human body.  This is the case with viruses but there are elements of COVID-19 that makes this particularly the case.  Now of course there are examples where there are people, especially the young, where this does not apply and some of this information may help point to why.

Just as a virus spreads rapidly in our body our system has tools to detect the invasion of an unwanted virus.  Once detected it sends a signal to the body to respond.  COVID-19 has many diabolical elements.  These include the possibility that people are contagious before it makes them sick enough to force them to be confined.  Another element researchers are learning is that it seems to interfere with the tools the body produces to detect viruses.  So, in the early stages as it advances in some cases it is less detected.  Konno, Kimura et al explain that COVID-19 is unique at, “suppressing the induction of type I interferon more efficiently than its SARS-CoV” gene sequence. Thus, just like with the other challenge COVID-19 poses is that it gets additional time to spread before our body responds.  To me, only one word describes this: diabolical. But our bodies are generally not going to be passive, as Drs. Iwasaki and Medzhitov explain our body produces T-cells that respond to the virus.  They say, “T cells detect and kill those infected cells.”  It is the job of antibodies to clear out the virus from a system, but the T-cells are the aggressive fighters.  In fact, the fight can sometimes cause damage depending on the circumstances.

The challenge is that just as the body becomes more fragile it also generally produces fewer cells that detect viruses and fewer T-cells that are programmed to respond.  This is directly why as a national policy those with certain medical conditions and weak immune systems and/or senior citizens are so vulnerable.  Again, this is why new treatments like steroid injections and Remdesivir are important.  They help the individual recover.  They also generally accelerate the timeline for recovery which is good for the patient and their family but also good for the health care system.  This is because it can help shorten the time of the hospital stay making some beds more quickly available.  Again, because a virus spreads exponentially responses that allow for more hospital capacity can mean the difference in some hospital systems experiencing crisis or catastrophe.  Plasma treatments can also be helpful in this regard to dampen the worse aspects of an overwhelmed healthcare system.  As we wait for a vaccine of which many are designed to address these deficits in our immune system

While the healthcare community is taking this seriously there are numerous things society can continue to do to dampen the exponential growth of the virus.  These include distancing, washing hands, and when we must socially interact wear a mask. There are amusing memes online suggesting everyone claims to be an expert at immunology.  This is a fair point.  This is particularly the case when folks seek out information to confirm their existing beliefs. (a common critique of mine) My modest observation is, with a few exceptions, the communities that have fared best, are those that culturally know how to respond to epidemic conditions.  This often is the result of recently dealing with a respiratory virus. They know to quickly responded by changing their behavior.  I fear that is what has slowly happened in the US as each region has had to learn the hard way through considerable suffering, the lesson of mitigation.  Further background read The Atlantic.

News:

Yesterday was National Book Day… I read

I am enjoying the chance to share these newsletters with you in the form of the new podcasts and appreciate your continued feedback. You can reply to this email or leave your comments below.  I sincerely enjoy chatting and learning what folks think. Thank you ~ Kevin

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit modlinglobal.substack.com