March 30, 2020
The genomic analysis of SARS CoV2 looks like it may have been around longer than we think in humans. It subsequently seems to have undergone natural selection with some genes winning out and thus becoming more deadly to humans. In an interesting article in the Journal Nature Medicine, Dr. Anderson and colleagues tried to answer the question of origin. It is an interesting read see the link below.
There is not much new information out there about the coronavirus, therefore, I thought that I would take this time to look at these events in the context of which they offer us insight into life in general.
What can we as a society derive from such experiences as this pandemic. What if this virus was killing preferentially the 0 to 20 year olds? The first place that I travel to is the fear of vaccines. For the better part of the last few decades many educated Americans have turned their backs on vaccination because of unfounded fears about the etiology of autism and other diseases. They have safely done so as the rest of America has kept herd immunity at bay by fully vaccinating.
Now we are witnessing the effects of a virus of 120 nanometer size wreaking havoc worldwide with a reproductive rate, R0, of 3 which means for every infected human, three others will get infected. The death rate as stated in multiple newsletters so far will likely end up somewhere less than 1% and mostly in individuals older than 60 years of age. This is not a good thing but safe if you are under 20 years old. But again I ask the question, what if this virus was killing preferentially the 0 to 20 year olds?
What about measles? Measles is also 120 nanometers in diameter and has an R0 of greater than 12 which is 4 times more contagious than SARS CoV2. Measles severely hurts 0.1% of all children exposed through brain inflammation or one child in a thousand will suffer serious disease. Corynbacterium diphtheria is 5 times larger than measles but has an R0 in line with SARS CoV2. The case fatality rate for this bacterium is 5% in children. That is a nightmare.
This is just a sampling of the vaccine preventable diseases that would make SARS CoV2 look weak in comparison if it were to be rereleased into society by a loss of herd immunity. I have had many a discussion with my 81 year old pediatric colleague, Dr. Koontz, who lived through these events yearly with children before I was born. His eyes have seen what mine have not. For that reason I have to trust his eyes and his memory. This is what I call relying on wisdom where mine does not exist.
For this current pandemic, no one truly remembers the 1918 influenza nightmare so we were complacent as a society for this event's risk as we lacked true memory of a pandemic. We as a medical society and government did not heed the warnings of 2003, 2009 and 2012 when epidemics looked like they might flip into pandemics. We had no stockpile of masks and gowns to protect healthcare workers. We had limited ventilators to keep people alive. These are unfortunate failings on our part and we will learn from them as all great societies do. But that will be another time.
If this virus was killing children and a vaccine existed, what would you do? I would be first in line for my children.
Vaccines are here now. They are protecting millions of children every year from very nasty viral and bacterial predators. Life is better because of them. I hope and pray that more parents wake up to this reality and get back to following the CDC's recommendations for preventing these infectious diseases.