The Second Wave… (some thoughts on the next wave of the pandemic)

They say a little knowledge is a bad thing.  But what about too much knowledge?  About pandemics. About viruses.  I was a pre-Med student.  I worked in a free clinic doing what were known as VDRLs and RBC/WBC routinely. I had no certification at the time, just the desire to help. You didn’t need it at the time. There were no free clinics or HMOs, or anything in those days.  There were barely ambulances and no 9-1-1.  That was in college in the 1970’s.

In the 1970’s, our patients at the free clinic were working people.  A bus driver who was feeling giddy, head-aches, and out-of-sorts for weeks.  Turned out he had lead poisoning from the fumes of his bus (yep gasoline, as bad as it is today, was worse in the 1970’s).  A “society lady” who had had an illegal abortion by a syndicate (La Cosa Nostra) doctor in the back of a Caddy going down Lake Shore Drive one night and became infected.

That sort of thing.

I later became an NREMT, WEMT, and WMI Instructor of EM for 15 years.  I was a volunteer at art festivals and part of Benton County Fire One in the rural areas of Washington State.

As a punk kid, I had contracted the 1957 Pandemic Influenza A (wave 1).  Three strains they believed I contracted, two of which they identified as H2N2 and a variant H2N3.  I was placed in isolation at the new Seattle Children’s for a week, living off of a glucose drip and no solid food, with my parents wearing masks and wondering if I would survive as they looked down.  Eventually, that Influenza A killed over one million people World-wide.

Dad had been more optimistic for me.  He had survived the Spanish Influenza A (H1N1) as a 5-year old, like me catching it early in the “null” wave of Fall of 1917.   It went on to have three subsequent waves; the second one striking the USA after the first, with a certain vengeance.  At least that is how Dad remembered it.  Eventually, it killed over twenty to fifty million people World-wide.  That’s 20-50 MILLION people in three waves.

So.  I know.  A little about. Medicine.  And a lot about Pandemics.  A virus does not generate a pandemic or is named a “pandemic” easily.  It must be special.  This is one of the first pandemic caused by a coronavirus, not an Influenza A.

The coronavirus is a mRNA (messenger RNA).  Its replication pathway is a contorted and somewhat unusual according to some articles. Its RNA is HUGE.  Truly HUGE (~310 kDa).  Those red spikes on the surface are one of its only protein structure.  It has four and sometimes five proteins. That red thing is called the “Spike” protein (S).  It also has an H(E) protein and an N(1) protein variant.

From what I can tell from the literature, this coronavirus has been with us for a l-o-n-g time. Yet, it was never considered a threat, as the variants that appeared pathogenic were self mediating.  In other words, patients infected with them, built immunity and survived.  The RNA replicant strings did not mutate fast enough or at all, to keep up with most human immune responses.  These were and are the “alpha-” variety.

Then came the “beta-” variety.  They have a section of the replicant string that changes rapidly. They made their appearance in the early 2010’s.  These are the SAR-CoV and MERS-CoV types. These were documented in 2016, in an excellent article.*

As I write this, The Chinese medical establishment is tracing back the most recent coronavirus origins.  It appears that, like all previous pandemics, it began quietly.  In November, 2019.  A 51-year old man was afflicted and did not easily recover.  Doctors treating him thought it was SAR at first, but he developed no headaches, only severe fever and pneumonia.  This must have been the “null” wave.

After that, sporadic reports, as the virus went global.  Then it struck again in January, 2020 with greater severity in Wuhan and took the World by surprise.  Deaths were reported.  The virus was already mutating and was global.  This is the first wave.


*Coronaviruses: An Overview of Their Replication and Pathogenesis

Anthony R. Fehr and Stanley Perlman
Department of Microbiology, University of Iowa Carver College of Medicine, Iowa City, IA 52242

Abstract

Coronaviruses (CoVs), enveloped positive-sense RNA viruses, are characterized by club-like spikes that project from their surface, an unusually large RNA genome, and a unique replication strategy. Coronaviruses cause a variety of diseases in mammals and birds ranging from enteritis in cows and pigs and upper respiratory disease chickens to potentially lethal human respiratory infections. Here we provide a brief introduction to coronaviruses discussing their replication and pathogenicity, and current prevention and treatment strategies. We will also discuss the outbreaks of the highly pathogenic Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and the recently identified Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV).

Full PDF of article here…  nihms671207


 

 

 

 

 

 

 

 

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