Understanding Viral Disease

Viruses are bits of DNA or RNA (like Corona) surrounded by a protein shell that can self-replicate only if they can get into a living cell and hijack the cell’s nutrients.

They cause diseases by replicating so many times that the cells that they are in either die from bursting from viral overload, or due to lack of nutrients that have been stolen by the virus.
Replicating time is usually quite short so that a virus that doubles every hour will produce about 4000 offspring in 12 hours- 2,4,8,16,32,64…….4000.

Your immune system needs time to recognize the threat and produce antibodies against the invader. This takes about a week to develop, so that rapidly growing viruses such as flu, which incubate in about 3 days have a few days leeway to make you sick and spread to others before you become immune. 

Very rapidly growing viruses such as Ebola make you sick very quickly and you don’t have much time to spread it around before you die, which is one of the reasons it doesn’t cause pandemics. HIV on the other hand incubates very slowly and doesn’t make you sick for years, which is why it’s been so efficient in gaining root in our population. 

Corona is a bit like flu, with a tactically clever incubation period of around 4 days and a mild early illness allowing us to spread it around for a few days before we get too sick.
Tactically, the way to deal with epidemics of this kind is to quarantine people so that the disease dies with dying patients (Ebola), or enough people become immune so that the virus can’t gallop around the planet without encountering immune populations when they come around again (seasonal flu), or we develop a vaccine and eradicate it in the same way (polio and smallpox).

For Corona, we don’t have the first option (fortunately) or the last one yet. Thus, contracting it and becoming immune is our current best bet and epidemiologists are trying to delay the peak infection load until mid-summer in the Northern hemisphere in order to have ICU beds that are not occupied by the usual chest problems in their winter. 

This is not going to suit South Africa and we can expect a higher mortality rate this winter not because our doctors are incompetent, but because of multiple diseases wanting unavailable high care treatment.

In the exponential example given above, it’s important to understand the significance of the original viral load at the starting time of infection. Sitting outside in summer with someone nearby giving you one particle of virus vs sitting in a crowded taxi inhaling 10 million particles, gives you one extra day for your immune system to recognize and produce antibodies (it’s not quite as simple as this, but the argument holds true). This is the reason why there’s value in self-quarantine and keeping your distance from others, especially crowds. By doing this you slow down the virus numbers from reaching the critical mass that makes you sick and gives your immune system an extra day or two to become effective.

Conversely, once you have been exposed, then strategies to kill viruses in the early stages such as frequently sipping hot fluids to wash the viruses in your throat down to your stomach where acid kills them, or to steam your sinuses with hot water or heat them every few hours with a hairdryer to the point of discomfort, will gain you some more immune development time. This will shorten the time between being infectious and your immunity dealing with it. 

Decongestants in this early stage may help you to deliver heat into your sinuses and nasal passages more effectively. Remember that these strategies are of value only if you have been exposed, they do not help if you haven’t been exposed. Currently, there is testing to help confirm who is sick and who has been exposed, but as the epidemic grows and we learn to clinically recognize the disease the need for testing will fall away. 

I believe that our unique situation in South Africa, with crowded commuter taxis and crowded squatter camps, will pave the way for a more rapid epidemic peak. Draconian measures such as those in China will be impossible to impose so we will get sicker quicker with more mortality, but should develop a herd immunity sooner and could be through it when Europe is peaking.

Dr Mark Holliday

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