What if a COVID-19 Vaccine Is Never Developed?

What if a COVID-19 Vaccine Is Never Developed?

What if a COVID-19 Vaccine Is Never Developed?

Coronavirus is a whole family of viruses that have little spikes on the surface that look like a crown, which is how it got its name. You've probably heard of other sorts of coronavirus. There was the SARS coronavirus and the outbreak was in 2002. There was the MERS coronavirus, with an epidemic in 2012. And there are actually a lot of other types of coronavirus, but they don't have special names and they just cause the common cold. The virus we're dealing with is called SARS-COV-2 and the disease that it causes is coronavirus disease in 2019. Or COVID-19 for short. Bats are actually a natural reservoir for many viruses, so the virus can actually replicate inside the bat without making it sick and then the bat passes it on to other animals, and then finally that gets passed on to humans. And that is what happened in Wuhan, China. After the first person was infected, the virus got passed from person to person to person by people coughing and sneezing. Did you know that in just one cough it can spray 3000 droplets that can go all over the place? If you get smacked in the face by someone's cough, you can get a direct transmission of the virus. But if it lands in the air, the virus can land on a particle and stay floating there for up to 3 hours. If it goes on to a box, a cardboard box, it can last there for about 24 hours. And then if it goes on to plastic, it can be there for 2 to 3 days. So, let's say you get in touch with the virus and then you rub your face and then you get infected. What happens next? When the virus enters the body, it uses those proteins on its surface, the ones that look like a crown, to get into our cells. Those proteins are like a key that unlocks receptors on the outside of the cell. 

We believe that it's specifically the ACE 2-receptor on our lungs that the coronavirus is using to get inside our cells. Covid19 Virus, it then releases RNA, its genetic material, and it tricks your cells into making copies of the Covid19 virus. So, your cells actually become like a factory producing thousands of viruses without even realizing it. So, at the beginning when the virus is replicating, you don't actually have any symptoms yet. And this is called the incubation period. It's different for lots of different viruses, but in the case of SARS-COV-2, we think that the incubation period is 4 days. 4 Days where you've been infected and you don't have symptoms yet. As the virus was spreading, doctors in China started seeing more and more pneumonia and one doctor especially, as you know Doctor Lee wen Liang, concerned when he saw 7 to 8 viral illnesses that reminded him of the SARS in 2002. He immediately started telling his colleagues that he was concerned, but 4 days later the authorities told him to prevent spreading false comments. But the number of cases continued to grow and on January 9th China Central Television officially announced that there was a replacement coronavirus. At this point there were at least 50 people with pneumonia and the first fatality, a 61-year old man passed away. To complicate things Wuhan was a major hub for travel in China and it was less than 2 weeks away from Chinese New Year's when there's lots of travel and this huge celebration. By January 23rd Wuhan was officially in quarantine. Nobody in or out of the city at all. But unfortunately, 20 people had already given up the ghost from the virus. It seemed like every day we were hearing about new cases of SARS-COV-2 in different countries. It was sweeping the world and the World Health Organization labeled this outbreak a pandemic. So, what kind of symptoms are people actually presenting with? So, we're lucky that we've got information coming out of China to know what to prepare for and what to expect. So, the most common symptoms are fever, sore throat, cough, some shortness of breath. And we check out fever... people that are coming into the hospital, only about 43% of them had a fever. When they were within the hospital about 88% of them developed a fever. So, what that tells me is that if you don't have a fever, it doesn't guarantee that you don't have a coronavirus. Less common symptoms are nausea, vomiting, diarrhea in about 3-5% of people.

So that's what you need to watch out for Fever, cough, shortness of breath. And I know what your goanna says: ''But that sounds like the flu, that sounds like a cold!'' And you're absolutely right and that's what makes this so tricky. So, if you do get mild symptoms: Cough, fever, sore throat... What you should do is actually stay at home, don't panic and pick up the phone and call your health care provider, rather than going and sitting in waiting rooms and public transportation and spreading that virus everywhere. If you are quarantining yourself at home while you're sick but you live with other people, try to have like a sick room. And in that room, you try to stay there most of the time, you have your own dishes and utensils, try to use your own bathroom if you have that option. Just to prevent the other people in your house from getting sick. And the most important thing is to really be monitoring your own symptoms and seeing if anything is getting worse. So, see if you're getting really short of breath, if you're getting chest pain that's not going away or if you find you're getting really high fevers, you're getting confused or even having a blue-tinged lip. All of that would be signs that things are becoming quite severe and you should be going to the emergency department. Okay, I just want to say this one more time. For most of us if we get Covid-19 we're going to be okay. Don't panic, most folks can recover reception. We never need to even see a doctor or go to a hospital and you'll be just fine. We just have to watch out for those severe symptoms. But unfortunately, some patients do become critically ill, so let's talk about that. What's happening? What they develop is something called acute respiratory distress syndrome or ARDS. And this is a condition where the lungs develop so much inflammation and damage, that it becomes difficult to get oxygen out of the air through the lungs and into the red blood cells. There are actually lots of things that cause ARDS, things like sepsis or pneumonia, even pancreatitis. So, within the ICU, we're actually really conversant in the way to treat these patients. What you do is they often require intubation. So, a tube down the throat, much oxygen. Sometimes you need to paralyze and sedate a patient, even flip them over onto their stomach so that you can expand the lungs without injuring them and get more oxygen into the back of the lungs. It's a really involved process as you'll imagine and if that each one doesn't work, then you'll think about using extracorporeal membrane oxygenation. ECMO, a bit of a mouthful. And it's like a machine that works like lungs outside the body. So, the thought is blood gets pumped out of the body, the machine puts oxygen into it then the blood comes back to the body. It's actually really similar to a heart-lung bypass that they use in cardiac surgery. So, who's at risk for catching Covid-19? Well, the answer is everyone. It doesn't matter what age you are; you'll catch the coronavirus. What we see is the people who are most severely affected are the elderly and those who have underlying health conditions like heart disease, lung disease, Immunosuppression, diabetes. Those people go on to get a worse version of the disease. So, to place some real numbers thereon, in China about 78% of cases were people aged 30 to 69 and of these people about 20% of them had severe illnesses. So, it's definitely not just the elderly that are affected, but they are the ones who tend to have higher fatality rates. In the US we've seen that 8 out of 10 people that have passed away are over the age of 65 and in even higher proportion if you're over the age of 85. Although we know who is at risk, we don't actually know who is going to become critically ill and need life support. So, we all must do our part to stop the spread of this virus. So, I'm sure that you've seen these diagrams all over social media right now. Everyone talking about flattening the curve. So, the idea is that we want to slow the spread of the virus, but not everyone becomes sick at the same time. That way it doesn't overwhelm the hospital system, it gives us more time to come up with treatment and vaccinations. So, here's an example. Let's just imagine that people got on their minds that they all needed to buy toilet paper all at once. So, as you guys have probably seen, there's no more toilet paper. You can't find it anywhere and some people are left with no toilet paper. It's a disaster! The same thing is true for hospital beds and ventilator machines. 

We just want to make sure that people use them up slowly. And that means there will be enough for everyone and that it's not all used up at once. But I still hear people saying like: ''You know, if we're all gonna get the virus, why don't we just let it happen?'' The whole answer is that this happened in the past. We've actually seen this play out in the Spanish flu in 1918. So, if we look to history, we can see that Philadelphia took 2 weeks to actually put their social distancing plan in place. And we see this huge spike of deaths and fatalities that happened as opposed to St. Louis that put these measures in situ right off the bat and you'll see that that they had this nice flat curve. That is what we're aiming for. That's why we're working so hard to get social distancing in place now. For this to work, for us to really save lives, we need to all be in this together and there are 2 main things that we need to do. Number 1 is washing your hands really well and frequently. So that means 20 seconds of washing your hands, a long time by the way. It is about a happy birthday sung twice. Make sure you get your fingernails. Make sure you get between those fingers and the backs of your hand's number 2 is social distancing. So, there's been a lot of talk about this. This is 6 feet between you and anyone else or 2 meters, but it doesn't mean isolating yourself. So, make sure that you're reaching out to friends, family. We have this wonderful technology. You are not alone and don't let yourself get isolated. I know that it's a huge strain on families.

I know that there's a lot of financial demand and I just want to say thank you because what everyone is sacrificing is at a community level really helping in saving lives and it's inspirational to hear these stories. Should you be wearing a mask once you go outside? The World Health Organization says that if you are healthy and you have no symptoms, you don't need to be wearing a mask. It's only people who have symptoms: Cough, cold, fever. They should wear a mask or a healthcare provider who's looking after someone who has Coved should have a mask on as well. Personally, when I go outside, I'm not wearing a mask. I do wear a pair of thin gloves that I put on, so that if I'm touching doorknobs, then it doesn't get on my hands. And it reminds me not to touch my face as well because I'm pretty bad about that. And otherwise, I just come home and scrub my hands really well. So, treatments. As of now, there are no antivirals that have been proven to treat Covid-19. There are lots of other trials going on around the world and I'm really hopeful that we are going to come up with some great treatment options in the future. What about a vaccine? Scientists are working tirelessly to come up with a new vaccine. And progress has been fast, because China early was ready to sequence the genes within the virus and that they shared that with everyone internationally so that we will come up with a vaccine quickly.

From what I understand there's one in China and there's one in the US that are goanna be starting testing. But even with this fast progress, we're still looking at close to a year before they're gonna be able to distribute it to everyone. Okay? We have covered a lot of material. The most important thing at this point is each of us playing our parts: Washing our hands, keeping social distancing to stop the spread, slow it down, and flatten that curve. So, we don't overwhelm the healthcare system. I know this is such a difficult time. There's so much uncertainty and things are changing so quickly. And yet every day I look around and I see remarkable things. I see students who are bringing elderly people groceries so that they don't need to leave the house. I have seen a local distillery that has stopped making gin and instead is making hand sanitizer that they're giving out for free. And I've seen countless health care workers who are picking up extra shifts to relieve their co-workers who are getting quarantined.