By biggest COVID question

[RoseGoesToYale]

One of my burning questions about coronavirus is how the asymptomatic cases get over it. I mean, they get over it, right? They don't just stay carriers forever.

 

I'm no medical expert. My working knowledge of viruses (any virus) is it enters your system, it incubates for a bit, then the immune response kicks in and symptoms show up. Fever is usually one of those symptoms, the body essentially "cooking off" the virus by raising the body temperature high enough to break down the fats/proteins that make up the virus. Breaking a fever is a sign your body has won the fight. 

 

But what when there's no symptoms and no fever? Does it just float around in there for a bit before the immune system's like "Hey, we've got antibodies!" and then poof, gone? Or is it because some people's immune systems are just so efficient that it can hunt down the COVID cells before they get a chance to cause any real damage? But that makes no sense, asymptomatic people are still contagious for two weeks.

 

The media has ad infinitum explained who is dying or getting the severe cases in great detail... age, sex, pre-existing conditions, where they live(d), smoker?, pregnant?, access to decent healthcare? You name it. But they've barely detailed who isn't showing symptoms outside of children. Are they younger or older adults? Sex? Pre-existing conditions? Rural? Urban? Smoker? Pregnant? Hazardous occupation? House filled with asbestos? These are things I would like to know.

 

It begs the question... should everybody get tested? Obviously, especially somewhere like US, logistically this could be extremely difficult. The current recommendation is that you should only get tested if you're showing symptoms. But if a quarter of cases are asymptomatic and scientists are still trying to figure out how coronavirus aerosols work, the more we know who a carrier is, the better, since the government/police can urge them to stay tf inside their homes! This is why I wish they detailed the demographics of asymptomatic cases. Let's say there's a higher concentration of 20-somethings that are asymptomatic carriers than 40-something and older. Then the more of those 20-somethings we test and find positive can be ordered to quarantine away from others, and they might actually take things more seriously with a positive result, encouraging them to not go out and congregate.

 

-sigh- We need better testing and fast...

[Lord Jade Cross]

The problem is that there isn't the financial capacity to pull off doing a massive testing of everyone. Even with only focusing on suspicious cases, the amount of testing is staggeringly high and already they are facing pretty big setbacks with the testing. Healthcare system have not been designed to tackle a situation of this magnitude. With even lesser severe cases it struggles because healthcare is a business in it for the money. If it doesn't stand to make a profit, thousands can die and the system will turn a blind eye

 

[LeChat]

If it helps, I found an article where a doctor explained how asymptomatic people can still spread/have the virus, while not feeling ill.

 

https://www.minnpost.com/health/2020/03/how-can-an-asymptomatic-person-still-spread-the-coronavirus/

 

Also, as an aside, if you're interested, actor Idris Elba has discussed on his Twitter account how he and his wife have the virus and were asymptomatic--only experiencing a headache and aching body, with no other symptoms, despite self-quarantining themselves for around two weeks. He mentioned that he had a pre-existing condition (asthma), and was worried about that, but that he's grateful that his virus symptoms didn't become worse.

[Anthracite_Impreza]

I would've liked to have got tested when I felt a bit off a couple of weeks ago but alas, quarantine. If I did have it I barely noticed, it just felt like when you know you're coming down with cold but it never got past that stage.

[Guest]

I've had a bad cold since then so I might have had it... I honestly don't know. I was on antibiotics and cough syrups from the doctor for about a month back in Feb and they asked me if I had traveled to China recently, but didn't look more into it than that. 

[RoseGoesToYale]

30 minutes ago, Jade Cross said:

If it doesn't stand to make a profit, thousands can die and the system will turn a blind eye

Part of me wonders how many Americans have died in their homes, unknown, because they never went to a hospital because they knew they wouldn't be able to afford it. Especially with older people who have no family left, who would've noticed?

[Lord Jade Cross]

16 minutes ago, RoseGoesToYale said:

Part of me wonders how many Americans have died in their homes, unknown, because they never went to a hospital because they knew they wouldn't be able to afford it. Especially with older people who have no family left, who would've noticed?

Most likely more than are cared to be counted.

[Guest]

1 hour ago, Anthracite_Impreza said:

I would've liked to have got tested when I felt a bit off a couple of weeks ago but alas, quarantine. If I did have it I barely noticed, it just felt like when you know you're coming down with cold but it never got past that stage.

That was my experience a little while back just after a visit to the supermarket. The body creates "memory cells" to immediately engage and destroy the virus if it tries to invade again. Whether that could be used for future testing I don't know.

 

On a side note, I don't need to be convinced to stay indoors as I don't often go out anyway; I've lived here so long that local "leisure trips" are rarely worth my while. As for the government/cop lovers, unlike me they've likely never been threatened with police action for something stupid or for an honest mistake; now THAT makes me feel unsafe. I swear, just being an adult male, but not a wealthy and powerful one, automatically marks me.

[Ms. Carolynne]

I'm not sure, but from what I understand some places have cast a wider net , and there are a lot of people with either mild symptoms or asymptomatic cases. I heard on CNN that it's hypothesized that those are the biggest spreaders, since they might not be aware they're carrying it, and it's highly contagious.

 

The current statistics are pretty biased, for better or for worse, since a lot of places are only able to test severe cases. If you don't need medical assistance, you're not likely to be tested. I believe COVID-19 is deadlier in sheer numbers, than it is in the proportion of people who die from it. Of course, access to healthcare is very important too, as overflowing hospitals help it kill way more people (more infected = more with serious complications), as we've seen in Italy and Spain.

 

As for how / why people are asymptomatic, I don't know how that works. It's not too uncommon though.

[Skycaptain]

Generally, if this virus behaves in the same way as other corona viruses people who are asymptomatic carriers will be contagious for a few days to a couple of weeks. The main reason for transmission is simply that people are able to transmit the virus at low levels of infection before they start to show symptoms. 

 

This is a hypothetical timeline, but the principle is the same for most ailments 

 

Day zero, get infected 

Day two, have enough virus particles in you to be able to transmit to others 

Day four, symptoms start

Day five, symptoms noticeable enough to take action 

Day ten, symptoms ameliorate 

Day twelve, symptoms clear 

Day 14, no longer have enough virus particles to transmit to others

 

In such a hypothesis, days two to four are the biggest problem, because unless identified in a screening people are contagious without being aware of it

 

I haven't seen any studies suggesting that it behaves like HIV, where someone is contagious for life. 

[gisiebob]

so, the cold and flu like symptoms, they are largely all immune responses. the damage done by the actual virus, well if we didn't have these immune responses they would eat us alive. as long as they stay out of important places like our lungs, it would take a virus a long time to do noteable consumptive damage without immune systems. but with an immune system our body looks over a menu of available responses and chooses what is appropriate as far as it is aware. some notice and route the virus before they get nervous and bring out the big guns, some just start yelling "fire everything!"

 

consider this: what percent of people get asymptomatic cases of colds and flus? probably lots, but it would be nearly impossible to find out.

[Guest]

I'm just gonna leave this here: What We Need to Understand About Asymptomatic Carriers if We're Going to Beat Coronavirus

[banana monkey]

16 hours ago, Skycaptain said:

 

Day 14, no longer have enough virus particles to transmit to others

 

I

I wonder why the advice is to quarentine for 7 days if one lives alone then. (unless a temperature is still present) I'm pretty sure I didnt have it after my 7 days isolation but if I did I could have gone back to my normal activities (as per advice then) and spread it for another 7 if what you are saying is true. 

[Zagadka]

The basics I follow is that always assume I have something. I wash as much as possible and maintain my distance. I have a lot of family that are of vulnerable age that I interact with regularly, and I'm not risking things, so I always assume I'm infected and isolate. It isn't like work is clamoring for contact or anything.

[RoseGoesToYale]

14 minutes ago, banana monkey said:

I wonder why the advice is to quarentine for 7 days if one lives alone then.

Advice where? All of the advice I've heard is for self-quarantine for 14 days if you test positive or experience symptoms, regardless of whether you live with people or not.

[Nick2]

Report today suggested that the level of exposure might play a factor.  If you are not exposed for long your body can work to get rid of the virus.  So you show no evidence or just have light symptoms.  Those who get a good dose of the virus or are exposed for a longer period of time will develop more symptoms and overwhelm the immune system.

[Sally]

14 minutes ago, Nick2 said:

Report today suggested that the level of exposure might play a factor.  If you are not exposed for long your body can work to get rid of the virus.  So you show no evidence or just have light symptoms.  Those who get a good dose of the virus or are exposed for a longer period of time will develop more symptoms and overwhelm the immune system.

It's really the viral load that your body experiences.  If you're with someone who has the virus, and your exposure lasts for quite a while, your viral load is greater, and that means you'll have more extensive symptoms.   The recommendations to stay 6 feet away from people/wear masks/wash hands are to cut down on the viral load you may receive from someone who may be infected.  So it's not really a matter of your immune system being able to fight off the virus; it's a matter of how heavy the viral onslaught you experience from someone else.  

[gisiebob]

57 minutes ago, banana monkey said:

I wonder why the advice is to quarentine for 7 days if one lives alone then. (unless a temperature is still present) I'm pretty sure I didnt have it after my 7 days isolation but if I did I could have gone back to my normal activities (as per advice then) and spread it for another 7 if what you are saying is true. 

if you spent seven days in isolation after symptoms were apparent (in the example day 5, although this is a very rough example) then you would be isolated to day 12, still not ideal but not as disastrous as you were thinking

[Guest]

1 hour ago, banana monkey said:

I wonder why the advice is to quarentine for 7 days if one lives alone then. (unless a temperature is still present) I'm pretty sure I didnt have it after my 7 days isolation but if I did I could have gone back to my normal activities (as per advice then) and spread it for another 7 if what you are saying is true. 

In the U.S. it's 14 days minimum. 

[Skycaptain]

@banana monkey, in response to your comment about 7 days. The timeline I'd posted I did say was hypothetical, but the principle is the same whatever the actual figure. The seven days the government are saying could well be based on research from people who've had this 

[banana monkey]

On 4/2/2020 at 11:22 PM, RoseGoesToYale said:

Advice where? All of the advice I've heard is for self-quarantine for 14 days if you test positive or experience symptoms, regardless of whether you live with people or not.

The UK government (public health england or nhs uk cant remember which) advise that a symptomatic person isolates for 7 days, if you live in a household with someone who is showing symptoms you isolate for 14 (to account for the incubation period) but if you live alone you can come out of isolation after 7 days (if you dont have a temperature at that point). It appears that the U.S advice is different and I was not aware of that given that i dont reside there and there seems to be different things going on in different states. 

[Unleash the Echidnas]

On 4/1/2020 at 7:09 PM, RoseGoesToYale said:

Does it just float around in there for a bit before the immune system's like "Hey, we've got antibodies!" and then poof, gone? Or is it because some people's immune systems are just so efficient that it can hunt down the COVID cells before they get a chance to cause any real damage? But that makes no sense, asymptomatic people are still contagious for two weeks.

Hi, I suspect some of what you're looking for is the distinction between innate and adaptive immune responses. I am not well versed in the literature but it's my understanding innate responses are partially understood and less understood for SARS-CoV-2. A couple other areas of interest might be accessory proteins and pattern receptors. For a deeper dig, maybe try biology and pathogenesis of coronaviruses and books on virology.

 

I'm offering links to primary sources as I don't feel qualified to assemble a summary. My take away from what I've read so far is there's a lot of stuff involved and we're not really sure quite how it all fits together, but probably some people's immune systems are better able to detect a virus near the onset of viral replication and can therefore maintain lower viral loads and reduced symptoms. This isn't quite your efficiency hypothesis but it's in that direction.

 

 

On 4/1/2020 at 7:09 PM, RoseGoesToYale said:

It begs the question... should everybody get tested?

I would suggest not. Testing 7.8 billion people is a huge undertaking and would require resources which are probably better used elsewhere. Currently, there's probably something like 20-30 million completed tests. So getting into hundreds of millions of tests over the next few months is plausible. Within that framing, it seems to me the question you're asking is essentially what is the best way to use those tests. From what I know, China, South Korea, Taiwan, and New Zealand probably offer the most well defined answers at this point.

 

 

On 4/1/2020 at 7:09 PM, RoseGoesToYale said:

Fever is usually one of those symptoms, the body essentially "cooking off" the virus by raising the body temperature high enough to break down the fats/proteins that make up the virus.

As far as I understand, the mechanism of action described here is incorrect. Maybe try Hsp90-α4 and IL-6–COX2–PGE2.

[Guest]

Nothing here.

[Skycaptain]

@123383, that makes sense. We have 60K positive tests here, and the estimated infections are around 2 million. 

[daveb]

Some people are looking at the differences between how this has played out in California vs New York:

https://www.vox.com/2020/4/7/21205890/coronavirus-covid-19-pandemic-new-york-california

 

I think it will be a while before they have conclusive conclusions, but maybe there will be lessons to be learned from this.

[Calligraphette_Coe]

On 4/1/2020 at 10:09 PM, RoseGoesToYale said:

One of my burning questions about coronavirus is how the asymptomatic cases get over it. I mean, they get over it, right? They don't just stay carriers forever.

 

I'm no medical expert. My working knowledge of viruses (any virus) is it enters your system, it incubates for a bit, then the immune response kicks in and symptoms show up. Fever is usually one of those symptoms, the body essentially "cooking off" the virus by raising the body temperature high enough to break down the fats/proteins that make up the virus. Breaking a fever is a sign your body has won the fight. 

 

But what when there's no symptoms and no fever? Does it just float around in there for a bit before the immune system's like "Hey, we've got antibodies!" and then poof, gone? Or is it because some people's immune systems are just so efficient that it can hunt down the COVID cells before they get a chance to cause any real damage? But that makes no sense, asymptomatic people are still contagious for two weeks.

 

The media has ad infinitum explained who is dying or getting the severe cases in great detail... age, sex, pre-existing conditions, where they live(d), smoker?, pregnant?, access to decent healthcare? You name it. But they've barely detailed who isn't showing symptoms outside of children. Are they younger or older adults? Sex? Pre-existing conditions? Rural? Urban? Smoker? Pregnant? Hazardous occupation? House filled with asbestos? These are things I would like to know.

 

It begs the question... should everybody get tested? Obviously, especially somewhere like US, logistically this could be extremely difficult. The current recommendation is that you should only get tested if you're showing symptoms. But if a quarter of cases are asymptomatic and scientists are still trying to figure out how coronavirus aerosols work, the more we know who a carrier is, the better, since the government/police can urge them to stay tf inside their homes! This is why I wish they detailed the demographics of asymptomatic cases. Let's say there's a higher concentration of 20-somethings that are asymptomatic carriers than 40-something and older. Then the more of those 20-somethings we test and find positive can be ordered to quarantine away from others, and they might actually take things more seriously with a positive result, encouraging them to not go out and congregate.

 

-sigh- We need better testing and fast...

A lot of what I do on my job gets sold to labs  around the world and I have rubbed shoulders with people with PhDs in biochemistry. And since I have had troubles that are a result of genetics, I've read up on those. Disclaimer: I'm not a doctor or virologist and I don't play one on Tee Vee. 

 

The best defense is still not to get infected in the first place. I could name you one virus that is particularly deadly, faaar worse than this one. Through research and the principles of how vaccines work, a cure was found-- as long as you got treatment long before the symptoms showed up. But once you know how it transmits, how it goes about destroying which cells in the host, you can develop a vaccine that will prevent runaway infections and damage to the host. You may even find ways to treat infection once it occurs, to keep it from going into the runaway scenario. But what always seems to work is prevention-- to be forewarned is to be forearmed.

 

And science will always be the answer. It's a little disheartening to know that it wasn't listened to this time until it started spiraling out of control. Luckily, we had the tools to sequence the genetic material of this virus. And we also know that some people with certain genes have an almost innate resistance to the havoc it wreakes in some hosts and that has nothing to do with the virus itself, only on who will survive the infection and/or may not even get sick from it. I guess you could liken it to throwing something against a wall-- it doesn't stick or hurt the wall, but it does rebound in other ways.

 

But cellular biology is almost mind-numbingly complex and you have a zillion possibilities to test and discard before you find the answers. It's a little like panning for gold. I have little doubt a vaccine will be found for this one. 

 

But there is always the next one. Maybe this one is a wake-up call?