The world is mostly hibernating. We are waiting for it to be safe to go out. What will it take before it is safe to go back to work?

It requires immunity- people need to be know they have immunity. First- We need to know what provides immunity (if anything). Then we need to be able to test for immunity. And finally we need a vaccine that works or a very effective treatment. 

There are scientists and doctors throughout the country, including here in KC who are working hard, sometimes around the clock, to find treatment and vaccine options that will work.

We need to be able to identify and isolate any pockets of "hotspots" that flare up. We need to continue to take care with masks and social distancing to protect lives. 



What is so special about this virus?

 Predicting what happens next with an infectious agent must be made based upon looking at the reality and science of how that infection behaves in people and in the environment.

SARS-Corona-Virus 2 is a new virus in humans. That means no human being has pre-programmed immunity to this particular virus. We are all susceptible to it.

Our ability to fight it off depends on each of our capacity to mount a fresh immune response. That is hard to predict because there are so many outliers compared to the known factors that seem to be appearing as we study how the virus has been behaving in different populations. For example, despite the fact that elders seem to have a rougher time with the virus (probably because their immune systems are not as agile), there are some people of all ages that have suffered the ravages of the disease and have even died. Some question if there are two types of problems - one where the virus overwhelms a poorly functioning immune response and the other where the virus stimulates an overly robust immune response that itself causes harm to the infected person.




Where did this virus come from?

There are rumors that it started in a lab, or that people caught it from animals at a market. While we don't know exactly, the virus appears to be a natural mutation of an animal virus. Not likely from a lab either in China or by the US Army. The viral genetics can be traced back to bats with mutations occuring naturally rather due to laboratory manipulations.  

 There are many viruses that are common in animals but do not infect or do not cause disease in humans. Some of these animal viruses and their similarity to human viruses have been used to develop vaccinations such as the cow pox vaccine developed to lend some immunity to small pox (which was more deadly). But, with a little mutation or genetic change some safer viruses can become dangerous. Influenza viruses that start in animals, like swine flu, avian flu Or HIV (which moved from chimpanzees to humans) and other diseases sometimes move across to cause human disease.
Three coronaviruses have crossed over to cause human disease in the past couple of decades. The first is the SARS-CoV in 2003 thought to have crossed from chickens. SARS caused a serious pneumonia and had a 15% mortality rate- probably the reason it did not cause more disease since a balance between disease and death has to have a lower death rate in order to spread significantly. Then we had MERS CoV which we believe crossed from camels and also had a high mortality rate ~30%. Those viruses did not stick around or spread enough to have a serious effect on our nation.
But now SARS-CoV-2, the current virus causing COVID-19 disease, has an estimated 3.4% mortality and therefore is likely to infect much greater numbers (some estimate 80% of us will be infected before COVID-19 runs out.)

The bad news is that we have a highly infective disease with a relatively high (compared for example to the flu) death rate, that is yet low enough to allow the continued spread of the disease. We need a coordinated and effective response. Stay at home, stay well.



What is the meaning of "flattening the curve"?
This really means reducing the number of people who have the infection at any given point in time. A steep curve means many people are infected at the same time (this can overwhelm the hospital systems). A flat curve means fewer people are infected at any point in time. In this situation the infections are spread out over a longer period (which may allow a better response for each individual by the health system).


As an infection moves through the population it may infect at different rates based on opportunities for transmission. For example a sexually transmitted disease dose not infect people who abstain from sex. This respiratory virus is transmitted during close contact. There is some question remaining as to whether it is droplet spread (this evidence is strongest) versus aerosolized. In order to reduce transmission of a disease transmitted during routine human interactions, social isolation or staying home to stay safe is the ONLY means of prevention.


The only way to flatten the curve until we have vaccines and/or treatments available is to practice social distancing to reduce the spread of infection.



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