Coronavirus FAQs

These are strange times. It seems like we can’t go anywhere or talk to anyone without the subject coming up. There’s a lot of anxiety and fear in the unknown. As a virologist, I wanted to take time to address some of the common questions that are circulating about the novel coronavirus. Perhaps some answers, even if they are not totally settled, will at least relieve a bit of fear in this troubling time. Many of these questions deserve complex, nuanced answers. But for the sake of clarity and time, I have chosen to answer them as concisely as I can, giving references for anyone who wants to dig deeper. I’ve broken the questions into separate sections: (1) Biological, (2) Medical, (3) Public Health, and (4) Philosophical. I hope that these answers will lead to a better grasp of the virus and provide resources if you want to know even more.

Biological

1. What is a coronavirus?

Coronaviruses make up a large family of single-stranded RNA viruses, a few of which cause diseases in humans ranging from the common cold to more serious illnesses such as SARS (Severe Acute Repertory Syndrome) and MERS (Middle East Respiratory Syndrome).[1],[2] The novel virus (SARS-CoV-2, named due to its similarity with the virus that caused the 2003 SARS epidemic) that causes COVID-19 (Coronavirus Disease) is thought to have originated in late November to early December 2019.[3],[4],[5]

2. Where did the novel coronavirus come from?

The genetic sequence of SARS-CoV-2 is very similar to a strain of coronavirus that had previously been found in bats in China, sharing 89.1% of its genetic sequence with this strain.[6] This suggests that the virus probably originated in bats (a natural reservoir for coronavirus strains) before it infected humans. However, there are some key genetic elements in SARS-CoV-2 that indicate that the virus likely jumped to another animal species, possibly a small mammal called a pangolin, before jumping again to humans.[7] Most of the first human cases have been linked to the Huanan seafood market in Wuhan, China, and it is possible that the animal carrying the novel virus was present at the market.[8],[9],[10] However, it should be noted that this is not definitive, as the first human could have been infected before traveling to the market.

3. But how does a virus “originate”?

Different virus strains emerge through multiple pathways. Some viruses even have multiple mechanisms to form new strains. The influenza virus, for instance, can change in a couple of different ways[11]: (1) by point mutations in the RNA introduced when a copying error is made during the process of replicating the genome to produce new virus particles and (2) by recombination, in which two different strains of influenza infect the same cells and their genome gets mixed and matched (somewhat akin to the way a human baby’s genome is formed) during the process of producing new virus particles. It is these recombination events that usually cause pandemics because the new virus is very different than any other virus that has already been in circulation. Coronaviruses can also undergo recombination in this way[12], and it is likely that a recombination event caused the emergence of SARS-CoV-2[13]. A plausible scenario could be as follows: a pangolin gets infected with two different coronavirus strains, one commonly found in bats and the other commonly found in pangolins → the two strains attempt to replicate in the same cell → some of the pangolin coronavirus genome is incorporated into the bat coronavirus genome via recombination during replication → a novel coronavirus strain is formed.

4. Is the virus still mutating?

There have been reports of COVID-19 patients with strains of SARS-CoV-2 that differ from one another, which could indicate that the virus is mutating.[14] However, the differences in these strains are very small, which means they probably shouldn’t be considered different strains at the moment. All viruses (as with anything with genetic material) will mutate as they are replicated, so it is no surprise that we should find a few mutations between patient samples. However, the bigger question is how fast SARS-CoV-2 is mutating, as this will determine if there will be a “second wave”, if it will become seasonal, or if the virus will die out once we achieve “herd immunity”. Fortunately (though I say this tentatively), coronaviruses are unique among RNA viruses because they are the only known RNA virus that actually have a “proofreading” protein in their genome, which works to reduce the overall mutation rate of the virus. This could be good news in terms of the longevity of the virus.

5. Will the virus naturally die out in the summer, like the flu?

Now we are entering into territory where our answers are not as solid as we might like them to be. But first we need to be clear on something. The flu doesn’t actually die out in the summer. There are significantly less cases in the summer compared to the fall and winter, but people still catch the flu in the summer. Further, the flu is active in tropical climates as well, and the seasonality of influenza in those climates differs from the seasonality in temperate climates. Honestly, we don’t have all the answers as to why this is (see question 7).[15] However, since this is a novel virus that had not infected anyone in the world prior to late 2019, the likelihood of the summer naturally slowing the virus is low simply because there are so many naive hosts (people who have not had the virus, and therefore do not have immunity) for the virus to infect. Even if the virus becomes seasonal (see question 7), it would likely not fall into that pattern within the first year. Other factors, such as widespread immunity, could cause a decrease in the number of cases in the summer, complicating the picture of seasonality.

6. Will there be a second wave in the fall?

The short answer is that we don’t know for sure. It is certainly possible, and we should be preparing now for what that might look like. However, as noted in question 4, coronaviruses are unique in that they have a “proofreading” protein in their genome, which works to reduce the overall mutation rate of the virus. If the virus doesn’t mutate quickly, it might be possible that enough people will be infected by the virus and build up immunity to it that the virus does not have enough naive hosts to infect, leading to its effectual demise (see question 8). This is what seems to have happened with the SARS epidemic in 2003.[16] So, there is a glimmer of hope, but we shouldn’t bet on it just yet.

7. Will the virus become seasonal?

Seasonality of viruses is not well understood, even for influenza. We have some ideas of what contributes to seasonality, but it is not overtly clear what mechanisms are most important.[17] Since there are other human coronaviruses that are seasonal (some of the viruses that cause the common cold), it is possible that SARS-CoV-2 could become seasonal. Or, if the virus behaves like the 2003 SARS epidemic, then it could simply die out on its own. The good news is, even if it does become seasonal, that will be different than the pandemic state it is in right now and be less cause for alarm. Many people will have been infected with the virus, or very similar strains of the virus, and will have immunity built up. For a recent example of this, the 2009 influenza pandemic strain became seasonal and still circulates today.[18]

8. What is “herd immunity”?

Herd immunity is a phenomenon that happens when a large percentage of a population has built immunity to a particular infectious agent, whether through infection or vaccination, such that there is indirect protection from the agent for those who don’t have immunity. What this means is, if enough people have immunity to the virus (or infectious agent), the virus will not be able to effetely spread to enough people to continue propagating. If the virus cannot spread to a new host that doesn’t have immunity, the virus will effectively die out (perhaps only persisting in very low numbers in the population).

Herd immunity is a very important concept in infectious disease and public health, as many vaccination programs rely on it. Take measles for instance. The vaccine for measles is not 100% effective, but rather ~97% effective with two doses.[19] Thus, to protect the 3% of cases where the vaccine didn’t work, and to protect those who cannot receive the vaccine (i.e. children less than 12 months old and those with a specific allergy), herd immunity must be established. There has been a lot of studies on this and we can even determine with some confidence what proportion of the population needs to be vaccinated to achieve this herd immunity.[20] And, unfortunately, the recent anti-vaccination movement has shown the true power of herd immunity, with a resurgence of measles outbreaks in areas where heard immunity has dropped below the threshold needed to provide protection.[21],[22]

9. Will there be another pandemic in the future?

Almost certainly. Although this might seem like a totally new phenomena for many of us in the US, pandemics occur with surprising frequency. It has only been just over 100 years since the 1918 flu pandemic, the deadliest pandemic in recent history.[23] Several flu pandemics have happened since that time, the most recent happening in 2009, as mentioned earlier.[24],[25],[26] There have been a couple of pandemic flu scares even since then. The flu community is constantly on alert to look for the next pandemic. The last SARS epidemic happened in 2003, and it has been noted long before this novel pandemic that coronaviruses hold pandemic potential.[27],[28] This is what viruses do naturally. The better question for us in America is, “why does this feel like a new thing?” See question 18 for what we might consider doing in cases of future pandemics.

10. Why does this seem to be the first pandemic that I have ever experienced?

The simple answer for this, in America, is that we have been pretty lucky. The last major pandemic to really effect America in a notable way was in 1968.[29] However, to truly get a disease that has had as much or more effect on the American economy, you have to go back to the 1918 Spanish Flu.[30] It is odd that we seem to have lost the true horror that this pandemic caused in our collective memory, as several more recent historians have pointed out.[31] Perhaps it was because of the wars that took our attention away from it, or perhaps it was so deadly and life altering that our grandparents and great grandparents simply refused to talk about it. Whatever the case, it certainly left its mark on the shaping of history.[32]

However, outside of America, this is not the case. Other pandemics have rocked eastern countries in recent times, which is probably why we could see the quick and decisive response by countries such as China, Hong Kong (not a political statement), and South Korea. They knew what a pandemic could do and were prepared to take swift action to stop the virus. Hopefully we will learn our lesson here as well (see question 18).

Medical

Disclaimer: I am a virologist, not a medical doctor, and I am not giving medical advice. Please see the referenced sites for more information about medical advice and health issues pertaining to COVID-19.

11. What are the symptoms of COVID-19 and how can you distinguish it from other illnesses, such as the flu?

There are several sites that you can access that give comprehensive lists of symptoms, such as the CDC, WHO, and Johns Hopkins. Common symptoms of COVID-19 include fever, cough, fatigue, shortness of breath, and body aches. A recent symptom that has been added to screening is loss of taste or smell. Part of the difficulty of determining who is infected with the virus is the non-distinct symptoms that the virus causes, especially since it started at the end of flu season and continues on into allergy season. If you are experiencing symptoms and have a fever, loss of taste/smell or shortness of breath, you should definitely get tested (there are also good resources online that will tell you where you can get tested). Further, if you are in an area where there is an outbreak, or if you have been around someone who is suspected to have the virus, and you are experiencing symptoms, you should get tested. Really, the only way to know for sure if you have the virus or not is with the test.

12. How deadly is the virus?

This is a tricky question, because the answer is relative and needs to be put in perspective. One study estimated the case-fatality rate for COVID-19 in China to be around 3.5–4.5%.[33] But that’s an average for everyone, across all ages and underlying conditions. The rate is very different if you are over 80 (upwards of 18%) or under 50 (less than 1%), or if you have any one of a number of underlying conditions.[34] In Italy, it has been estimated to be much higher, around 7.2%.[35] So, the technical answer is different for everyone, and it even differs by country (likely due to the measures each respective country has taken to combat the virus, along with other environmental and culture factors). To put it in perspective, the case-fatality rate of the 1918 Spanish flu was somewhere around 2.5%.[36] Case-fatality rate is different than the true fatality rate, as it only takes into account known cases. The actual fatality rate could be much smaller; however, if you have the case-fatality rate of two different infections, you can compare them, as with this pandemic and the Spanish Flu. But this is not the only metric used to judge a pandemic.

13. What is the best metric to determine how bad the virus is?

To get the best handle on how the virus is behaving and how far it has spread, what we really need is a strong testing infrastructure that can reliably sample a population and estimate the true total incidence rate of the disease. But since this has been impossible to do in most places, we must rely on less precise data or data from smaller populations.

Since we don’t know the true overall infection rate, it is possible that the true mortality rate is lower than the case-fatality rate. However, this does not dampen the impact that we have observed the virus to have. What I mean is this: regardless of whether the actual mortality rate of the virus is 3.5% or 0.1%, over 200,000 people have died worldwide as of this writing. Actually, it has been suggested that the death rate from the virus might be the best metric to base our models and policy on, since it is a concrete, reliable metric that is not based on unknown data.[37] And as mentioned above, the case-fatality rate is a useful metric when comparing two different areas that have done similar testing. The best metric to use will depend on what you are trying to find out. But please don’t assume that public health officials haven’t taken into account the fact that they don’t have all the data. We have all known this from the beginning, but decisions had to be made before all the data was available (see question 17).

14. What are the treatment options?

Currently, there are no FDA approved drugs to treat COVID-19. Hospital treatment is focused on treating the symptoms, not the virus itself. Under normal circumstances, it takes as many as 10–20 years to successfully bring a new drug to market. This is discouraging news for anyone hoping an experimental drug will surface to save the day, although there are ways to fast track drugs for diseases that have a particular need for therapy. What most clinical trials for therapy are focused on now is trying to use drugs that already have FDA approval (or were already in the process of getting approval) that were designed for other uses, such as HIV[38], influenza[39] or Ebola[40]. Since they have already passed the required safety tests, clinical trials can instead focus on whether or not the drug, or combination of drugs, can be used to treat COVID-19, significantly lowering the time to complete trials. There are many different trials (>500) going on to see which therapies are the most effective.[41],[42],[43] The most promising of these drugs seem to be the anti-malarial drug favipiravir and the Ebola drug remdeivir as of right now.[44],[45] However, this picture is far from certain and we will have to wait until all the data is in to see if any of the treatments fare well. So, all we can do at this point is play the waiting game. But please, whatever you do, do not take medical advice from non-medical professionals, even if they are the president.

15. When might we expect a vaccine?

Like treatment, vaccines take a long time to develop and run through clinical trials, especially when it is a novel vaccine. In the case of the flu vaccine, once the strain is selected for the flu season, it takes about 6 months to develop, test and produce the vaccine. This rather quick turnaround is because we have been using the flu vaccine platform for many years and the platform itself has already undergone all the necessary safety trials to get FDA approval. For a novel vaccine, development can take anywhere from 6–15 years, or longer. Given the current circumstance and a multitude of people working on a vaccine for SARS-CoV-2, the NIH has suggested we might be able to get a vaccine out in ~18 months from when it first goes into trials, which is blazing speed.[46],[47] Encouragingly, the first clinical trials have already begun in the US and across the world.[48],[49] Optimistically, we could see a vaccine by fall 2021, if all things continue at the pace they are and there are no hurdles that arise (which I wouldn’t hold my breath about that).

Public Health Policy

Disclaimer: I am not a public health official, and the following answers are my personal thoughts based on the data I have been able to look over and some suggestions as a virologist and an American. I do not claim to be an authority in this field.

16. When should we end the lockdown?

The simple answer to this question is I don’t know. Again, I am not a public health official. But I do have some thoughts, that you should take with a grain of salt. The point of the lockdown was never to stop the virus. To stop the spread of the virus, we would have had to be much more proactive on the front end (see question 18). The goal of the lockdown is to slow the spread of the virus, so that everyone didn’t get it at once and overrun our hospital system. Regardless of the actual mortality rate of the virus, if the hospital system is overrun, more people will die. We also needed time to get our testing/screening infrastructure set up and tested so that we can have a proactive response in identifying and quarantining patients with the virus. This is not only crucial to slowing virus spread, but also to our understanding of the virus, which will help us make informed decisions going forward. We wanted to slow the spread of the virus, and it seems that we have had some success in slowing viral spread.

So, should we open up now? I don’t know. This is a question that really the world doesn’t know. What I do know is that we can’t stay in lockdown for 18 months until we get a vaccine. What I also know is that you will never make everyone happy, regardless of your decision. So, will the cases increase if we open back up now? Almost certainly. Will they spike to the point where our hospital systems will be over run? Maybe, maybe not. I think that there is much more risk of this happening in large cities than in rural areas, and I think we should take this into consideration when opening certain areas. Part of the problem in politics in general (in my opinion) is that we try to make rules that equally apply to different parts of the country that have very different population densities, culture and issues. My best guess for the current situation is that we should follow the plan of public health officials and slowly open back up in phases, staying cautious and minimizing large gatherings. And regardless of what the “right” thing is, practically speaking I don’t think you’re going to keep the majority of the American public locked down for much longer. So perhaps it’s better to open with measured guidelines than to try and force a lockdown. I honestly don’t know. Could it be bad? Absolutely. Could it be fine? That’s also possible. Regardless, we will find out soon enough.

17. Did we overreact?

I don’t think so. Again, we have said from the beginning that we simply don’t have the data to truly know what was going to happen. We still don’t have the data to know a lot of things that are potentially vital to public health decisions for this pandemic. We might not have the complete picture for years! You see the problem, right? We did not have the option to wait for the complete picture before we had to make a decision. We have to make decisions based on past experience and the limited data we had. And in that case, I think the right decision was to be better safe than sorry. I mean, if it had turned out to be anything like 1918 Spanish Flu again and public health officials had done nothing, can you imagine how much fire they would have been under? Can you imagine how many people would have died? Further, the irony of the situation is this: if the public health policies did actually work as planned, then it is going to seem like we overreacted. So, even with a little bit of hindsight, the picture is not clear. I think we made the best decisions with the data we had, and I think we need to think long and hard before we decide to not react to the next pandemic.

18. What could we have done better, and how should we prepare for a future pandemic?

Testing and contact tracing.[50] The way to stop a pandemic is to nip it in the bud. This is what the flu community has been saying and trying to do for years, even to the point where they have been criticized for being overly cautious. But there is real data that indicate that this strategy works, even from this current pandemic. South Korea acted swiftly with rigorous testing and contact tracing, and it worked.[51] The mortality rate, and even overall infection rate, for South Korea is lower than most other countries.[52] Basically, what we should learn from this pandemic is what Asian countries have learned from multiple epidemics and pandemics: be prepared. Have a plan and be ready to execute that plan when the pandemic starts. We even had an advantage. The first cases for this pandemic started in December 2019 in Wuhan, China. We had at least a month, if not more, to prepare and set our pandemic plan in action. But we really didn’t start scrambling until February, or later. Proper testing protocols and reagents didn’t hit their stride until mid-March. We can do better than that. And we must, if we don’t want this to happen again.

Philosophical

Disclaimer: The following questions are more opinion based and should be viewed through that lens. I humbly offer my thoughts and do not claim to be infallible in these answers.

19. Has the media over-hyped the virus? Who should we believe?

Absolutely. The media over-hypes everything. That’s how they make money. There was a time in American history where the main TV channels were able to draw large percentages of all American viewers because there were only a few channels in competition. Today, hundreds of TV and news outlets compete for all American viewers, which means they each receive a much smaller percentage. Most mass media business models are based on advertising revenue, which means the more viewers they have, the more ad money they get. Thus, it is to their advantage to play on your fears and anger to get you to watch or click on their articles. And this is ALL media that have ad-based profit models, left and right, not just those who are your political opposites. When reading an article from a news site, you should probably take multiple sources into account, from all sides of the issue and then make as objective of a decision as possible. As a practical measure, if you read a news article from a site that typically agrees with your political ideology (and be honest), you should probably view that article with more skepticism than you normally would, because you are already pre-biased to be uncritical of the source.

Who should you believe? That’s a hard question. When it comes to public health policy, you should try to stick with reliable sources such as the CDC, WHO, reputable scientific journals (Nature, Science, NEJM, etc.) and reputable medical centers. Will there be bias in these institutions? Sure. Everyone has bias (yes, that includes me and you). But these institutions are run by scientists and physicians who have dedicated much if not all of their lives to this study, and they are the experts in the field. They will disagree from time to time, but that’s the whole point. That’s what keeps them in line. Yes, they are fallible and will not get everything right. But the collective expertise of these sources is our best bet.

20. Should I be afraid of getting COVID-19?

This question is related to question 12 about how deadly the virus is. Let me be clear, the virus does seem to be more dangerous than seasonal flu, especially due to the pandemic nature of it (that is to say, there was no immunity before the virus emerged). And if you are in a higher risk group, such as above the age of 50 (the risk incrementally goes up from 50 onward, at least by most studies) or have an underlying condition such as heart disease or asthma, then you should take extra precautions. If you know someone who is in these risk groups, you should be careful not to expose them to extra risk. However, all that being said, this virus is not the end of the world. People will die, and that is tragic. My heart breaks for the families that are affected in this way by the virus. But that doesn’t mean we should be terrified of the virus. Unfortunately, the media plays on our fears, and it is in their best interest that we think the world is ending or that we are all going to die (see above). Politicians, left and right, have politicized it to push their own agendas, also playing on our fears and emotions, to drive an even further divide in our country. This is almost as tragic as the loss of life from the virus itself. We need to be careful when people try to manipulate us in this way.

Should we be concerned? Yes. Should we be afraid? I don’t think so. At some point, you or someone you know will likely get it. And odds are you will be sick for a week or two and then recover (this does not mean the sickness will be a breeze, though it could be very mild). My position has always been in the middle: this virus is concerning and will cause a lot of infection and death. However, it will not be the end of the world. With the proper precautions, we can (and seem to have begun to) diminish the overall impact of the virus and get through it together. Don’t let anyone manipulate you into being afraid or into thinking that it’s no big deal at all. Neither of those positions seem to be tenable.

21. Why are there such differing opinions about the virus?

Maybe I’m having too much fun in the philosophy questions. Obviously, there are many reasons why people are divided on this issue. However, I want to highlight two major reasons that I think account for the strong opinions about this pandemic. The first reason is that no one really knows exactly what the virus is going to do. Health officials have some ideas based on virology and past pandemics, but we have such limited data that it is hard to be sure about almost anything right now. (Please don’t read that and think I’m saying that our limited knowledge backs up your own opinion about the virus. That’s the point, no one knows for sure.) The second reason, and this is what drives the different opinion, is that the virus got politicized. I guess this isn’t surprising. It’s just disappointing. In our political culture, things have to be polarized. In the case of the pandemic, that typically means that either you have to believe that the world is ending and anyone who thinks otherwise hates people and is scientifically/medically ignorant, or you have to believe that the virus is no big deal at all, and it’s probably either a hoax, a conspiracy, or worse. Let me be clear: neither of these positions are correct. The truth, as usual, is somewhere in the middle. But America is so divided and polarized that we typically aren’t allowed to take the middle ground. This speaks to a much deeper problem in our society today.

22. Is this the “new normal” when a pandemic hits?

I hope not. I hope that we are able to learn a lot from this event and be much more prepared for the next one when it comes along. It really depends on what causes the next pandemic. If it is a flu strain, we have a surveillance system in place to catch it early, and we have many years of experience with flu vaccines. This doesn’t mean it would be easy to stop a flu pandemic, but it does mean we would have a decent shot. As for another coronavirus, I believe this pandemic will accelerate coronavirus surveillance and pandemic preparedness. But what if it is another virus that is completely new, maybe one that doesn’t normally infect humans, or a virus that has only caused mild disease in the past? Fortunately, I think the likelihood of this happening is low (though not zero). However, the emerging platform of mRNA vaccination is an exciting prospect that could be a beacon of hope in this area. If we can develop the mRNA vaccination platform to work efficiently, vaccines could be made against a multitude of infectious agents in a relatively short amount of time. This would be a game changer, and I am very excited about this prospect. There has been a lot of work on mRNA vaccines recently[53], and the first SARS-Cov-2 vaccine to enter clinical trials in the US is based on an mRNA platform. We will have to wait and see how it fares. In the meantime, see question 18 for what I think we can work on now to improve our response to the next pandemic.

23. How does this virus compare to the flu?

It is hard to make such comparisons, especially to seasonal flu since one is in a pandemic stage and the other is seasonal (see questions above). From the limited data we have, it is safe to assume that once we make it through the year, COVID-19 will have claimed more lives than seasonal influenza in the US. The death toll in the US is already four times higher than the number of deaths that the 2009 H1N1 flu pandemic caused during the whole year of 2009–2010.[54] Worldwide, COVID-19 has not yet claimed as many lives as the 2009 flu pandemic, but it likely will surpass that number (or at least be comparable) over the course of the year. If it turns out that SARS-CoV-2 has infected many more people than we estimate who were either not tested or asymptomatic, then all this would mean is the virus is highly contagious, likely much more contagious than the flu. So, in my opinion, this virus seems to be more dangerous/deadly than seasonal flu, and is on par (if not above, depending on which metric you use) with recent flu pandemics.

24. What about all the conspiracy theories? Is there any truth in them?

One of the most surprising things to me in this event has been the proliferation of conspiracy theories. “China manufactured the virus in a lab!” “The whole pandemic is a hoax!” “It’s a government ploy to cover up elite human trafficking rings!” The theories range from being marginally plausible to… well, let’s just say extremely incredible, in the literal sense of the word. Is there any truth in them? A good conspiracy theory is typically founded on a grain of truth- that’s what makes people believe them. Can we really trust China’s official reporting of the numbers of coronavirus cases? Probably not. But then the theorist will take it to the extreme and come up with a whole scenario that is not based on evidence or fact. “You can’t trust China’s reporting, so they must have intentionally created the virus and released it on their own people!” That’s ridiculous, even if only for the simple reason that if China had been trying to design a virus as a biological weapon, there are so many other options that would have done much better (or worse, depending on whose perspective you are looking from)! So, let me clear up some of the most common conspiracy theories that I have seen, with references to actual data and trustworthy information:

SARS-CoV-2 was not manufactured in a laboratory.[55]

The number of cases and deaths in the US is actually being under reported, not inflated.[56],[57]

Vaccines are not evil.[58]

There is a list of “preventative measures” going around that claims to be from Johns Hopkins University that claims the virus is “a protein molecule (RNA)”, which is just wrong. It is most certainly not from Johns Hopkins, and it has many biological errors.[59] (This one isn’t so much of a conspiracy theory as it is just misinformation that drives me crazy every time I see it.)

Do not drink bleach or other cleaning products to treat the virus.[60]

25. Is there any good that could come from this pandemic?

I want to end this article on a positive note, highlighting some good that we might be able to see during this troubling time. Is there any good? I think so. I have been able to talk with friends and family on zoom calls more often than I would have done had the shutdown not happened. This has brought me great joy, getting to participate in discussions that location would have kept me from. Further, although there is a sense of divide in the country with all the differing opinions, I also feel a sense of “we’re all in this together”, unlike if the virus had only affected certain groups. Many people have gotten to spend more time with their families while being at home. Also, this could be the event that really sparks the work from home movement, as the infrastructure has now been implemented in many businesses for employees to work at home. If it has proven effective, companies might opt for this to clear up office space, travel time, and even to give their employees more flexibility and freedom. This would clear traffic from our crowded roads and could have a significant impact on air pollution. I also see heightened awareness for pandemic preparedness and scientific research, which I appreciate. And politically, whether you agree with the coronavirus legislation or not, it was at least nice to see both parties work together (as well as can be expected) to come to a fairly quick decision to help the American public. Sure, both sides still pushed their agendas, but at the end of the day they got something out and didn’t let it die in Congress. What other good things do you think have come, or might come, from this pandemic? Perhaps just focusing on finding at least a thin silver lining might help us cope as we continue to battle this virus. We often don’t have control over what we are dealt, but we do have a choice in how we respond. And sometimes, that can make all the difference.

_______

I hope these answers bring you some comfort. As I said at the beginning, most of these questions deserve much longer and complex answers. Use this as a starting point for your curiosity! And remember, wash your hands, avoid large crowds if at all possible, and follow public health guidelines. We will make it through this! Stay safe, my friends.

References

[1] https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

[2] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus

[3] https://www.nature.com/articles/s41586-020-2012-7

[4] https://www.nature.com/articles/s41586-020-2008-3

[5] https://www.nature.com/articles/s41591-020-0820-9

[6] https://www.nature.com/articles/s41586-020-2008-3

[7] https://www.nature.com/articles/s41591-020-0820-9

[8] https://www.nature.com/articles/s41586-020-2012-7

[9] https://www.nature.com/articles/s41586-020-2008-3

[10] https://www.nature.com/articles/s41591-020-0820-9

[11] https://www.cdc.gov/flu/about/viruses/change.htm

[12] https://jvi.asm.org/content/84/7/3134

[13] https://www.nature.com/articles/s41591-020-0820-9

[14] https://academic.oup.com/nsr/advance-article/doi/10.1093/nsr/nwaa036/5775463

[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656132/

[16] https://www.who.int/ith/diseases/sars/en/

[17] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656132/

[18] https://www.cdc.gov/flu/pandemic-resources/burden-of-h1n1.html

[19] https://www.cdc.gov/vaccines/vpd/measles/index.html

[20] https://www.sciencedirect.com/science/article/pii/S1473309915000535

[21] https://www.cdc.gov/mmwr/volumes/66/wr/mm6627a1.htm

[22] https://www.sciencenews.org/article/holes-herd-immunity-led-25-year-high-us-measles-cases

[23] https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm

[24] https://www.cdc.gov/flu/pandemic-resources/1957-1958-pandemic.html

[25] https://www.cdc.gov/flu/pandemic-resources/1968-pandemic.html

[26] https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html

[27] https://www.nature.com/articles/nrmicro3143#Sec8

[28] https://virologyj.biomedcentral.com/articles/10.1186/s12985-015-0432-z

[29] https://www.cdc.gov/flu/pandemic-resources/1968-pandemic.html

[30] https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html

[31] See Gina Kolata’s Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It” (2011). Kindle link: https://www.amazon.com/Flu-Influenza-Pandemic-Search-Caused-ebook/dp/B004YEJ6P8/ref=sr_1_2?dchild=1&keywords=flu+book&qid=1587848175&sr=8-2

[32] Some make the case that influenza directly effected the outcome of WWI as President Woodrow Wilson caught the Spanish flu as he went to the meeting that resulted in the Treaty of Versailles. Wilson was reportedly against harsh terms for Germany before the meeting, but gave in to the terms during the meeting, perhaps because of the physiological and neurological effects of the 1918 flu. If this indeed is what happened, then it could be argued that the Spanish flu impacted the treaty, which in turn lead to the rise of Nazi Germany. See references 30 and 31.

[33] https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30246-2/fulltext

[34] https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/

[35] https://jamanetwork.com/journals/jama/fullarticle/2763667

[36] https://wwwnc.cdc.gov/eid/article/12/1/05-0979_article

[37] https://www.nature.com/articles/d41586-020-01008-1

[38] https://www.nejm.org/doi/full/10.1056/NEJMoa2001282

[39] https://www.medrxiv.org/content/10.1101/2020.03.17.20037432v4

[40] https://www.gilead.com/purpose/advancing-global-health/covid-19/remdesivir-clinical-trials

[41] https://www.thelancet.com/journals/landig/article/PIIS2589-7500(20)30086-8/fulltext

[42] https://clinicaltrials.gov/ct2/who_table

[43] https://www.mdpi.com/1422-0067/21/7/2657

[44] https://www.mdpi.com/1422-0067/21/7/2657

[45] https://scitechdaily.com/clinical-test-results-released-for-antiviral-remdesivir-treatment-of-covid-19/

[46] https://directorsblog.nih.gov/2020/03/19/to-beat-covid-19-social-distancing-is-a-must/

[47] https://www.cnbc.com/2020/03/16/first-human-trial-for-coronavirus-vaccine-begins-monday-in-the-us.html

[48] https://www.nih.gov/news-events/news-releases/nih-clinical-trial-investigational-vaccine-covid-19-begins

[49] https://clinicaltrials.gov/ct2/results?cond=covid+19&term=vaccine&cntry=&state=&city=&dist=

[50] https://www.cdc.gov/coronavirus/2019-ncov/php/principles-contact-tracing.html

[51] https://www.npr.org/sections/goatsandsoda/2020/03/26/821688981/how-south-korea-reigned-in-the-outbreak-without-shutting-everything-down

[52] https://www.worldometers.info/coronavirus/country/south-korea/

[53] https://www.nature.com/articles/nrd.2017.243

[54] https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html

[55] https://www.nature.com/articles/s41591-020-0820-9

[56] https://www.medrxiv.org/content/10.1101/2020.03.14.20036178v2

[57] https://www.forbes.com/sites/joshuacohen/2020/04/14/underreporting-of-covid-19-deaths-in-the-us-and-europe/#74e9ab8c82d7

[58] https://www.who.int/vaccine_safety/initiative/detection/immunization_misconceptions/en/index6.html

[59] https://hub.jhu.edu/2020/04/03/coronavirus-misinformation-rumors-social-media/

[60] https://www.nytimes.com/2020/04/24/us/politics/trump-inject-disinfectant-bleach-coronavirus.html

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