James Lyons-Weiler, PhD – 2/25/2020

Here is a list of a few important things you may not yet know about the novel Coronavirus. There are some technical points up front; details on issues related to government action on quarantine and treatments follow.

I thank Dr. Theron Hutton, MD for leads on treatment.

1. The virus is called SARS-COV-2. It is a close relative of SARS. It has a very different Spike protein from SARS, and is a different virus with a distinct disease progression. The disease caused by SARS-CoV-2 is called COVID-19 (IPAK hypothesis of original antigenic sin).

2. Because SARS-CoV-2 has a distinct spike protein it is thought to engage a slightly different mechanism for cellular entry (for those up to speed, it binds less strongly to the protein ACE2 on the surface of human cells than SARS). I have found a motif pattern in the Spike protein that might be useful in determining which data from studies from various studies of SARS might be most relevant for SARS-CoV-2.

3. Our best available data at this time indicates that this virus was not made in a laboratory. It most likely is an older virus related to SARS and is rare in nature and was transferred to humans either in a laboratory studying the virus or from a spillover event from someone handling an infected animal or its meat. The most likely candidate for the reservoir species is a bat.

4. Infected people without symptoms can spread the virus. Infected people without symptoms can spread the virus before they start showing symptoms. The period of asymptomatic transmission is anywhere from one to two weeks – or longer.

5. This virus has a basic reproduction number of about 2.6. That means typically people spread the virus to between 2 and 3 people. Superspreaders do exist. However, the lengthy asymptomatic period and multiple modes of transmission means those 2.6 people are easy for the virus to find.

6. The virus is thought to spread via body fluids – and, unfortunately aerosolization – and can be found in body fluids and in feces. Masks are best saved for the infected to prevent spread, but knowing who is infected is difficult due to the prolonged asymptomatic prodromal period. It is important to know that greetings in public should no longer involve shaking hands or high-fives, hugging or kissing – even in areas of the world where SARS-CoV-2 has not yet been found. Elbow bumps are ok.

7. There is no vaccine for SARS-CoV-2 , and it is extremely unlikely that a vaccine will be will play a role in ending this pandemic. This makes isolation and even mildly effective treatments incredibly important. It is best not to rush to a vaccine with the spiked protein either, because animal studies have shown that animals vaccinated and SARS with a spike protein vaccine have had a high mortality rate. Individuals who have had a past SARS or MERS infection may reasonably be expected to be at increased risk of a serious severe case of COVID-19.

8. Treatments under study include nutriceuticals and supplements; Supplements that might have a positive effect, noted by colleague Dr. Theron Hutton, MD, include N- acetyl cystein, selenium, spirulina and high dose glucosamine (See "Nutraceuticals have potential for boosting the type 1 interferon response to RNA viruses including influenza and coronavirus" and antiviral drugs such as Disulfiram and Chloroquine Phosphate (See: "Disulfiram can inhibit MERS and SARS coronavirus papain-like proteases via different modes". See "Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro". See "Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia". Selenium and other micronutrient deficiency is considered to play a role in severity of a coronavirus infection (See: "Micronutrient Selenium Deficiency Influences Evolution of Some Viral Infectious Diseases"

9. The disease from SARS-CoV-2 infection has reasonably high case-fatality rate to take this outbreak seriously. If you contracted coronavirus you currently have about a 2 to 3% chance of dying. However those who die usually have some cardiovascular disease or other problems leading to lung issues. Children seem to not be at as high risk of death from SARS-CoV-2 infection.

10. The best way to protect yourself and everyone else to stay away from people. While that is not feasible especially for people in the medical community it is imperative that everyone understand that they can pick up and spread the virus without having any symptoms for a long time. Don't share food or utensils for cell phones.