Questions Amid COVID-19: FAQ’s Answered By A Microbiologist

Published: Monday, May 4, 2020

With so much information going around about COVID-19, it’s often hard to parse out the facts from the noise. Based on what is currently known, here we will demystify and answer some frequently asked questions about coronavirus, its impacts on human health and what comes next.

What’s the difference between coronavirus, COVID-19 and SARS-CoV-2?

COVID-19 is an infectious condition cause by a specific coronavirus called SARS-CoV-2.

For example, the flu is an infectious condition caused by an influenza virus (e.g. H1N1).

Isn’t the virus mutating, therefore making it worse?

Yes, the virus has undergone some genetic changes which has led to a crop of various viral strains, but this does not necessarily mean it’s getting more deadly. While the concept of viral mutation is likely to invoke fear and uncertainty in many, in reality mutations are a natural part of the virus life cycle and rarely result in a noticeable impact in infectivity. Check out this article in Nature Microbiology for more information.

If I catch coronavirus (SARS-CoV-2), can I get it again?

Like insurance or a lawyer, protective immunity ensures that you when a certain microbial foe attacks, they’ll be there to defend you. As of right now, data is limited as to whether or not immunity against SARS-CoV-2 is protective, and if so, for how long. A previous study by Wu et. Al in 2007 examined nearly 200 SARS- recovered individuals for SARS-specific antibodies and found that the antibodies were maintained for about two years after initial infection but showed a significant reduction by year three meaning those individuals might be susceptible to reinfection. While data like this this could provide a benchmark of what is to be expected, what we can glean from SARS can only be extrapolated so far. Moreover, presence of antibodies does not necessarily mean that they are effective at neutralizing the microbial offender. Further, protective immunity can vary depending on the invading microbe, the person’s health state (i.e. genetic predispositions, pre-existing conditions) as well as whether they are male or female, as your sex can impact your immune systems reaction.

For now, it is believed that coming down with COVID-19 could afford you some protection against a reinfection but the duration of this protection remains unknown. Additionally, this could be complicated by the notion that SARS-CoV-2 could be a seasonal infection and that any immunity gained from this year’s infection may no longer be valid if and when the virus comes back around in a modified format (e.g. mutation) that your body does not recognize anymore — not necessarily a more infectious version of the virus, just a different version. For example, think of it somewhat like the seasonal flu: it is an infection that comes around each year, is not necessarily more deadly with every passing year but because the virus does mutate a bit each year our body does not recognize last year’s version, thus we need a seasonal flu vaccine. Overall, only time will allow us to develop a better understanding of our immunity against SARS-CoV-2; time for more research and time for ill patients to recover and be studied.

For additional information about immunity and COVID-19, check out What is Herd Immunity and What does it Mean for COVID-19?

But once we get a vaccine for COVID-19, then we’ll all be good, right?

It is important to keep in mind that while vaccines can be truly lifesaving, as the case with any vaccine, they do not prevent infection. They simply give your immune system a head start to prepare its defenses in case you were to encounter the actual infection at some point in the future–basically it’s like a sneak peek at what might lie ahead, so get ready just in case. This strategy results in a less intense and more rapid clearance of an infection if you were to encounter it in your daily environment at some point down the line.

Further, it is interesting to consider that while some vaccines induce lifelong immunity, other protect merely for weeks. In an article written by Jon Cohen for Science he interviews Dr. Stanley Plotkin– a physician and emeritus professor at the University of Pennsylvania and one of the world’s most renowned vaccinologists who says, “We simply don’t know what the rules are to inducing long-lasting immunity… For years, we were making vaccines without a really deep knowledge of immunology. Everything of course depends on immunologic memory, and we have not systematically measured it.” While research are still working on demystifying the immune system, just keep in mind that inoculating against a pathogen is often far less dangerous than naturally acquiring the disease.

How far away are we from a vaccine, anyway?

Source: PLOS Blogs

While it’s not necessarily unreasonable to think that we could see a vaccine against SARS-CoV-2 as early as next year– the truth is vaccine development is a tedious, arduous and costly endeavor, often times never making ending in early stages of development despite looking promising. In the U.S., before a human vaccine can make it to market, thus being deemed safe for administration, they must be thoroughly vetted through clinical trials and approved by various federal regulatory entities, such as the FDA. Getting from preclinical research to market is a process that averages 12 years, according to Sanofi Pasteur via vaxopedia.org. Now, consider the fact that immune system effectiveness vary greatly with age. This means that vaccines are not always ‘one-size-fits-all’. And beyond preclinical studies, clinical trials ultimately require the voluntary participation of humans to undergo the treatment in questions. According to an article by Clinical Leader, on average 30% of all clinical trial participant will drop out, thus potentially impacting the results, prolonging the study, making the success of clinical trials an uphill battle.

Is it ok to expedite vaccine development?

Vaccine efficacy and safety are of utmost concern when developing a vaccine. It is important to consider that an expedited timeline may not permit for the measure of efficacy and safety evaluations that are customary when introducing a vaccine to the market.

What’s the deal with a ‘second wave’? Are we reopening too soon?

Much of what we know about pandemics is based on previous pandemics, however this is not always the best metric depending on the causative agent and the technologies of the time. Nonetheless, the Spanish Flu Pandemic of 1918 has come up a lot since the onset of COVID-19. Looking back on data from the year-long pandemic, the Spanish Flu had three distinct peaks corresponding to the increase and decrease in cases over time. In the case of COVID-19 (or any pandemic, really), it is not an unreasonable scenario to expect a similar pattern. The logic behind that is simple: as long as there is infection (i.e. infected individuals, contaminated surfaces) along side suitable hosts (i.e. uninfected/non-exposed individuals), then there is high likelihood that the infection will continue. Perhaps its not a question of will there be peaks, but when and what will those spikes mean for us — something we cannot resolve just yet.

In terms of reopening, while an increase in cases upon may largely be inevitable, currently, most places are working on a ‘phased-return’ model with the intention to closely monitor any increase in cases, maximize human health, minimize the impact to our economic stability. During this time, we must continue to take precautions as a lift in social isolation orders does not mean the threat of COVID-19 is gone–so keep your distance, keep wearing your masks, don’t touch your face and wash your hands frequently.

What are the prospects of another COVID-19-like outbreak? How come we didn’t see this coming?

Zoonosis, an infection transmitted from animals to humans, will always be a real possibility; and those frequently involved in the study of infectious diseases always knew a global outbreak to be plausible. The prospects of another infectious epidemic or pandemic always remain. What is unknown is the finer characteristics of a future event.

Much of we know is based on analyses conduced post hoc, or after-the-fact. However, some scientists are working to change that and collect data in real time. Dr. Kristian Andersen, an associate professor at Scripps Research, explains that while reporting is important to outbreak detection, prevention is the key to ‘outsmarting outbreaks’. He suggests that insights gleaned from the outbreak must be in real time versus gathering data and then publishing a paper years later. This means a country must have the capacity to actually detect the disease. Second, there must be active surveillance and third, that any data uncovered should and must be open and available to others. Recently, Dr. Andersen’s group is working on combining these three pillars (‘Capacity’, ‘Surveillance’, ‘Open’) into what is called the WestNile 4K project that will allow non-academic labs to share samples and data in real time. Although his project focuses on West Nile virus, it can be translated to other infectious diseases. Using phylogenetic studies and real-time, open reporting, perhaps next time we will see it coming sooner.

Will things ever be ‘normal’ again?

For many, they have been able to work cooperatively, finding creative ways to access the good they need, get work done and even home-school. Some have relished in the free time the ‘shelter-in-place’ mandates have provided or the additional time with family. Yet, others toil with financial woes and food insecurity. It goes without saying that a continued focus on mental health will be necessary as we move forward during these largely unprecedent times; and while it’s too soon to say anything with a great deal of certainty, what is known is that humans as a species are resilient and many acts of solidarity have exemplified that and shown us that even if we need to redefine “normal,” that it can be rewritten.

Recently, there have been talks of reopening business and slowly reestablishing our previous patterns but for now, keep practicing good hygiene practices as this a good method of reducing many forms of infections beyond coronavirus.

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What do you think if working/schooling from home became the new normal? Will we will ever be able to look at toilet paper and hand sanitizer the same way again?

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And for a really cool video showing possible outcomes of various social- isolation scenarios , check out Simulating an Epidemic.

ABOUT THE AUTHOR

Alex Kirkpatrick is a doctoral student in the Molecular Immunology & Microbiology discipline of the Integrated Biomedical Sciences Ph.D. program. She is interested in host-pathogen interactions, cellular biology, microscopy, protein purification, ELISA, cell culture, immuno-techniques. Read the article Alex Kirkpatrick: Cats, Bacteria and True Crime Documentaries >>