A small deviation from the usual Podcast to begin a small series about Covid19, the current virus that is causing panic.

First, the bad news and then we will have some good news at the next podcast.

The virus is not the same as influenza, it is a different virus, it is small and this one, COVID19 affects lung tissue.  No matter who you are, this will cause lung issues and often a fever – because when you mess with the lungs you will get a fever, whether it is you are not breathing in deep enough, have a pneumonia, or do anything to injure the lungs.

When you get infected with Coronavirus – or, SARS-COV-2, or Covid19 – it is a race between your immune system and the virus. The virus infects your lungs, the lung cell is taken over by the virus and the entire cell becomes a virus factory. As soon as a bunch of virus is made the lung cell ruptures and virus is released to surrounding lung tissue.  In the meantime, your body senses the foreign protein of the virus and responds by sending in white blood cells and begins to make antibodies against the virus.  In a healthy person, you win – your body’s immune system overwhelms the virus, neutralizes it, and any cell that is infected is destroyed and your body then heals.  Most of this battle happens at the microscopic level.

We see, on CAT scans of the lungs- this battle.

There are two ways you lose the battle and die from COVID19. If you don’t have enough lung tissue then the virus will overcome you and you won’t be able to breathe. Typically this is people who have lost lung tissue to tobacco, pollution, or any lung illness that causes lung tissue to be lost (like advanced rheumatoid arthritis or cystic fibrosis). So if you have been diagnosed with Chronic Obstructive Pulmonary Disease (COPD) or emphysema, you are at risk.

In China, this was older men. Two reasons for that – about half the population of China smokes, and that is the men (about 2-3% of women smoke in China, about 60% of men smoke in China). Smoking slowly destroys lung tissue (which is why people with COPD and/or emphysema are prone to die from COVID19).  The death rate of older men in China is because – they don’t win that battle between the virus and the lung.

Men, by the way, are the weaker sex. We do not have as robust an immune system as women, and as we age our immune system wears out like our joints. Women have a better immune system than men – perhaps natural selection over time as women who had good immune systems provided long-term benefit for pregnancy and raising children. Women suffer from an over-abundant immune system with higher levels of auto-immune disorders like RA, and etc.

Sadly for people who have an auto-immune disease, the drugs they use to suppress that are things that will also suppress the immune system that you need to fight off infections, cancer, and in this case COVID19.

The other way to lose the battle against this disease is to have a poorly functioning immune system. Again, older people’s immune systems are weaker – hence this virus tends to pick off the older among us. Other people are those who have immune diseases, real ones like HIV infection, and man-made ones from people on steroids, people who have auto-immune diseases on treatment, and people who have had a kidney or liver transplant.

While 80% of people who become infected have mild or even NO symptoms, the remaining 20% of patients may need advanced support – and that is the group of people that can tax our hospital system. This is why you should not buy masks (they won’t help you and if hospitals cannot get them…).

Italy’s hospital system has too many patients for the number of ICU beds. Will that happen here? Probably not, but more about that in our next episode.

What Can You Do:

Don’t bother with hand sanitizer. Use soap and water instead. It is better than the hand sanitizer and works well.

Get a good hand lotion – preferably scented – you have less chance of bringing your hands to your face.

Don’t bother with wipes- instead use a spray bottle with a dilute mix of Clorox (two tablespoons of Clorox and one quart of water – please don’t try to make this stronger you will cause problems). Spray the surface and let it air dry. It will be way more effective than a wipe. If you prefer hydrogen peroxide, then use that.

Keep tissue paper- and use that to sneeze or cough in. Dispose of it properly.

If You Are At High Risk:

Make sure you are up to date with influenza vaccine, pneumovax, and other vaccines. No joke- get them.

Avoid public areas – just chill for a bit – if you can. If you cannot a mask still will not help you.

If you must be around crowds – wash before, wash after, wash again. After you wash your hands, wash your face.

Positive podcast about this is coming next.