We Shall Overcome

The initial comparison of sequences of COVID-19 genomes isolated from patients in different regions suggest that the rate of mutation is slower than expected. It might be too early to tell from comparison of Chinese and Italian patients that became infected with the virus at most a few months apart. According to Peter Thielen, a molecular geneticist at Johns Hopkins University, there was somewhere between 4 and 10 mutations of COVID-19 from the outbreaks in Wuhan, China in December to the US as of March 24th, 2020.

In an interview Peter Thielen says, "That’s a relatively small number of mutations for having passed through a large number of people. At this point, the mutation rate of the virus would suggest that the vaccine developed for SARS-CoV-2 would be a single vaccine, rather than a new vaccine every year, like the flu vaccine. I would expect a vaccine for coronavirus would have a similar profile to those vaccines. It’s great news."

Great news indeed.

Now, our world needs a unified response by authorities everywhere. That might be the hardest challenge. For example, in the US, several governors rejected Trump’s virus timeline because it used an “imaginary clock” to them. Strategies vary dramatically, from continuing societal lockdowns by implementing shelter-in-place orders to allowing the public to return to mingling as usual. Many leaders believe in achieving herd immunity before their economies suffocate or the virus fragments into multiple strains. Other leaders want to save lives and condemn leaders who refuse to flatten the COVID-19 infection curve. As implied in the previous post, the risks of staying in lock-down more than 2-3 months might outweigh the benefits.

Fortunately, there are many ways that doctors are helping their patients survive the COVID-19 infection, from basic anti-viral medications such as Tamiflu, chloroquine (also used against malaria), Bromhexine (an anti-mucus producing medication which is similar to Mucinex) to nitric oxide gas. One of the simplest methods doctors are using, especially when they have limited resources, is raising the temperature in the lungs by wrapping the upper body or using hot steam inhalation.

Another reliable method doctors are using is transfusion of immunoglobulins (IgGs) from recovered patients into acute patients. This is a polyclonal mixture of IgGs is similar to reagents that are obtained from rabbits, which used to be a popular source of reagents for detection, before wide-spread adoption of monoclonal antibody technology. Although relatively low-tech, this method is very effective at granting severely ill patients a fairly high chance of recovery. For example, IgGs is being used as a preventive measure for healthy healthcare workers in NYC.

In short, there is a path to recovery from Coronavirus. It is not going to be painless, and there are difficult decisions ahead. Individuals, families and small businesses are sacrificing a lot (both material and immaterial) during the lockdowns across the globe. The worst option could be a piece-meal and improper timing of return to business. Can we as a society select one of two opposing solutions and execute with cohesion despite the pain?