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Excuse Me … What’s a Virus and Why is This One Such a Disaster?

What is a Virus - Woman in Mask

As someone who has been involved with medicine now for most of my life, I find that I have inadvertently fallen into that sad group of people who assume that what I know is also what everyone knows. It turns out this is not always true. Imagine my surprise when a dear friend of mine who is well-informed and incredibly intelligent remarked to me that she was shocked to recently learn that viruses are not “alive.” Forty-plus years ago as a student of some biology, or microbiology class this issue was put to rest for me, and I really hadn’t given it much thought since then.

At that time, I was taught that one of the criteria for something to be alive is that it be able to reproduce on its own. This is not true for viruses. A virus is composed of some nucleic acid, either RNA or DNA, surrounded by a layer of protein. In some cases, like coronaviruses, the protein layer is also covered by a lipid (fat) layer. A virus can only reproduce after it has invaded a host cell. The type of cell the host belongs to (elm tree, bat, human, etc.) varies by the specific virus. Some viruses can use a wide variety of different organisms as host cells, whereas other viruses are limited to infecting one or just a few different organisms in order to reproduce or replicate themselves.

There are millions of different viruses, but only a relatively small number have been well described. Altogether viruses can infect every plant, animal, protozoan, fungi, bacteria, and any other life forms that exist. Isn’t that something that there are viruses that infect bacteria?  Who would have thought, right? The viruses that do this are called bacteriophages. Amazingly enough, antibiotics have zero effect on viruses. Anti-viral agents have the ability to lessen the destructive power of some viruses in their host organisms. Compared to the number of bacteria that we can control by antibiotics, we have very few effective anti-viral agents. It turns out that hydroxychloroquine is not one of them. (Sorry, I really just couldn’t resist.)  Hydroxychloroquine isn’t an antibiotic either. It is an antimalarial agent, and malaria is the disease caused in humans by the intracellular eukaryotic parasite called Plasmodium.

In general, bacteria are about 100 times larger in size than viruses. There are about 5 x 10 to the 30th power bacteria in total around the world. That’s a lot. The total biomass of all the living bacteria is greater than the mass of all of the plants and animals in the world combined. And there are even more viruses than bacteria!

Of all the viral pandemics that have affected people throughout history, each of them (except smallpox) were “novel” or “first-time” human exposure situations. SARS-CoV-2 is the virus that is causing our present pandemic and it is in the family of coronaviruses, like SARS, MERS, and most human cold viruses. The disease it causes is called COVID-19. Before its emergence on the world scene, by virtue of it being novel, no person had immunity to it. Right now, all of the people who have been infected are either dead, are recovered and have some degree of immunity, or are still sick with their infection.

Why exactly is infection with SARS-CoV-2 so horrible?  It is the combination of extremely high infectivity, a high degree of spread early in the course of illness when victims have few or no symptoms, and generally mild illness. Since it is usually mild, these folks can be around longer to spread the infection to others. Yes, we have lost 318,957 worldwide, 92,402 U.S, 4,630 PA, and 263 Lancaster people with this virus as of the evening of May 18, 2020. How can we lose so many of us if the illness is generally mild?

It is because sometimes instead of being mild, it is devastating!  It is probably about 10 times more deadly than influenza, and much more infective than the flu. And we are coming to learn that although most of the time it is the elderly, or the males, or those with other ailments that die, it can also wipe out the previously young and healthy.

All of this makes “re-opening” our society quite problematic and challenging. And all the while the world is heavily committed to finding effective anti-viral agents and vaccines for this monster. Most likely “normal” will not seem anything like pre-COVID-19 life until most of us are effectively vaccinated.

Rest assured that at Medical Cosmetics we will provide the highest level of safety for our patients and our staff when we have decided the risk in the community is low enough that it will be safe for all of us. We will also be guided by the advice of the government, and certainly will not open up any time before our leaders indicate it would be safe.

Be smart, be considerate, be healthy, and take very good care.

Dr. Bill Carter

For all of us at Medical Cosmetics