So, I misled you.  Sorry.

Instead of updating you with five articles on the SARS-CoV-2 virus, I find that I need six- for now!

What do we know about SARS-CoV-2

Where’s the viable treatment?

When can we feel safe?

The rush for a vaccine

Which Vaccine?

In particular, we have to scare all those less-than-[pick your noun] who believe they’ve “suffered enough”, that this COVID-19 is a “hoax”, or that it’s “summertime and the living is easy”, to pay attention.

And, in response to absolutely inane “We report so many COVID-19 cases because we test more”- two items.  1)  We don’t test more (nor do those tests yield timely results to protect our citizens) than other nations. And, 2) How many women are getting pregnant because they are taking pregnancy tests?

How about this answer to all those folks- Grow UP!

We can’t even contact trace!  Not only because we’ve starved our public health departments (you do realize that maybe 2.5% of ALL those bucks we spend on healthcare  is allocated to public health).  But, because we can’t get results from our COVID-19 tests in a few hours- or even a day.  The returns are running a week or more!  (You might not be surprised, but I was to find that there are more than 100000 cases of syphilis, about 600K of gonorrhea , and 1.7 million instances of Chlamydia right now.  The highest in three decades or more!)

Or, that when we found nursing homes to be risk factors (one is 19X more likely to contract COVID-19 in an enclosed space that outside),   TheDonald decided to relax nursing home inspections.  Not to mention what is going on in our jails and prisons!

We must socially distance.  Even with the loosened chains, we must choose who is a member of our “pod”, safe friends who follow the same rules we do with whom we can socially interface- albeit at safe distances.  (My Friday night dinners have dropped from having 6 to 10 friends to 2 or 3, from sitting side by side to using the polar opposites of my 8 foot dining table.  But, no one who has visited some 26 states is going to step foot in my home- with or without a face mask.)

Why am I worried?  Especially since I probably had a mild case of COVID-19, contracted when several of my friends who sat less than 2 feet away for hours on end succumbed to the disease?  Because a mild case (or more severe, possibly) may not leave me with sufficient immunity to stave off another case.  But, that’s not the norm.  You should know I’ve had the chicken pox four times in my life- from age 4 to while I was in grad school.

Moreover, we have NO CLUE as to who or why folks who contract the SARS-CoV-2 virus never really  recover.  Sure, they may lack the standard symptoms of respiratory failure, temperature,  etc.  But…

Many folks have lingering effects.  Fatigue (beyond the still tenuous chronic fatigue syndrome), shortness of breath (how would I know if that’s due to COVID-19 or my underlying issues?), racing heartbeat, achy joints, diminished (or vanished) sense of smell, foggy thinking (are we sure that TheDonald never tested positive for COVID-19?), and permanent organ damage (lungs, kidney, heart, brain).

Before you poo-poo this, you should recognize that there are v-e-r-y f-e-w long term patient studies.  (Of course that’s true- the disease has only been recognized for 7 months or so.)

But, consider this. 87% of some studied in Italy still had lingering symptomology 2 months after “recovering” from COVID-19.  (Gemelli Against COVID-19 Post-Acute Care Study Group,             Persistent Symptoms in Patients After Acute COVID-19). Or the US- Based (UK, Sweden are also part of this) COVID Symptom Study that allows folks to document their symptoms.  And, 10 to 15% of those self-reporting (albeit such self-reporting will be more likely to have those with worse symptoms be included) have never recovered- even if their initial cases were mild.

The problem is that the virus engenders inflammation, blood clotting, tissue disruption, plus direct attack on ACE2 receptors (to which the spike protein attaches)- and these receptors line the kidneys, lungs, heart, gut, nervous system of individuals.  No wonder there are complex and varied ongoing symptoms.  Especially when some of us “over-respond” to the virus- these excess inflammation scenarios end up appearing as if there’s an autoimmune disease- our immune system attacks our own cells.

Drs. Raul Mitrani, Nitika Dabas, and Jeffrey Goldberger have been examining patients who developed heart damage from COVID-19.  (COVID-19 cardiac injury: Implications for long-term surveillance and outcomes in survivors).  They postulate that troponin (an enzyme whose concentration balloons during heart attacks), raised in 20% to 30% of hospitalized COVID-19 subjects, is an indicator of cardiac damage (such as arrhythmia).  That may explain why more than 75% manifested cardiac anomalies 10 weeks post COVID-19 infection.

The good news?  Lung scarring (that prevails with SARS and MERS, other coronavirus) doesn’t seem so prevalent under COVID-19.  (This is not true if folks were maintained on ventilators- but that is probably not due to SARS-CoV-2 as much as to the trauma of the ventilator itself.)

All these anecdotals are why some long term studies are finally being effected. A group in the UK is going to follow 10,000 survivors for a year- and maybe up to 25 y.   300 adults to be studied long term in San Francisco to 2 years post COVID.

We have a lot to learn.

But we have to face the facts.  TheDonald is a comorbidity for COVID-19.  No, he isn’t the cause (at least not the proximate),  but with no federal coordination, no national response, he has arranged for the US to suffer from a  pandemic that puts the 1917 “Spanish” flu pandemic to the back rows.

The one fact we know for certain is the best approach is NOT to contract COVID-19 in the first place.