Thanks for your congratulations on my success. Sorry about my tardy reply to your letter (KP News, May 2020), but I’ve been so busy lately, what with over 11 million COVID-19 cases and over 500,000 deaths around the world. In the U.S. alone there are over three million cases with 135,000 deaths. At the rate I’m going, get ready for four million by the fall.
Hmm — that’s more than 1% of everyone in America.
By now everybody knows my symptoms — dry cough, fever, impaired breathing — and how I spread from one person to another, by breathing or touching little moisture droplets that hang in the air or on a surface after an infected person sneezes or coughs. I am astonished at your inability to follow the commonsense advice to wear a face mask, wash your hands often and stay 6 feet away from other people.
If everybody wore face masks, I’m told my infection rate would be cut at least in half in a couple months. As a professional pathogen, I’ve got to tell you that as a thinking species, your behavior is not only irrational, it’s self-destructive. I can fill a room with infectious droplets at least for a while after one good sneeze from an infected person. Don’t you realize that 20% of all COVID-19 cases make people sick enough to require oxygen or hospital care and that the U.S. fatality rate is 4.6%?
What do you not get about this?
The U.S. testing rate is eighth in the world. Certainly nothing you can be proud of and rather embarrassing for a country of your size and wealth IMHO. And as I spread, keeping up with tests is just going to get harder.
How about if we add a few million school kids to the mix, huh? Don’t forget the teachers and staff and their families. Looks like I’ll be meeting all of them soon.
OK, OK, I am aware that your vaccines against me are moving faster through the clinical trial process than I thought. I am particularly annoyed by the progress of the RNA vaccines. These are proving so safe and effective that they have graduated into very large placebo-controlled trials with 30,000 subjects. While these trials may continue for over a year, some results will be available this fall.
China has a vaccine they deemed to be safe after an early test and immediately rolled it out to soldiers in the Chinese Army. If you want a quick vaccination against me right now, simply go to China and join the Army! Or I suppose you could volunteer for one of the large trials.
But it’s the emerging antiviral drugs that really scare me: the drugs that specifically inhibit my growth inside your lovely lung cells. There’s one, Remdesivir, that targets my ability to copy my genes and thus grow. Hospitals are using this against me now. I suspect even better (I mean worse for me) versions are coming. Much worse for me is a drug that will block my ability to mature my proteins — a protease inhibitor. The structure of an inhibitor of my protease was recently published and this is the basis of a new drug.
When a cocktail of these drugs that work by different methods is made into a pill, it could be extremely effective against me. I can say this with some confidence because such a drug cocktail was devised against the human immunodeficiency virus that largely prevents AIDS.
But I am confident that even with all your vaccines, masks and drugs I’ll be with you for a long time, probably forever in one form or another. I’m digging into parts of the world that have poor health care systems, like Africa, South America and Asia. Look how hard it has been to eradicate the last cases of polio, even though you’ve tried. Ironic, isn’t it, that once you recognize a pathogen like me, and you have the supplies and drugs to block infection, like polio in Pakistan, your efforts are thwarted by religious extremists and politicians.
Good thing that doesn’t happen in your country, right?
I’ll still be around because when changes or mutations occur to my set of genes, I can keep them when they are beneficial to me. Meaning: I evolve! While you’re watching!
A tiny change in my spike protein lets me replicate myself faster after I infect a person and allows me to spread faster. But this change does not lead to any increase in severity of disease. This little change has spread all over the world, since early spring, simply because my new form spreads from person to person faster than my original form.
How about that? I don’t want to be more lethal — that’s a dead-end for a virus (just look at Ebola, which historically, at least, burns out in confined outbreaks). But I do want to be more transmissible, so that you can spread more copies of me faster.
Gotta get back to work. Stay in touch, especially after someone coughs!
Richard Gelinas, Ph.D., whose early work earned a Nobel prize, is a senior research scientist at the Institute for Systems Biology. He lives in Lakebay.