Kelly McGrath, MD

“Isn’t the coronavirus just another common cold virus?” “I don’t think I have risk, so why should I care?” These are some of the questions asked in our community about Covid 19. While no one wants to be controlled by fear, it is important to understand the unique features of the coronavirus causing Covid 19 and the actions we can take to reduce the risk for ourselves as well as those in our community.

Some may ask why this virus is so much worse than some of the viruses we typically encounter. The coronavirus that causes Covid 19 is a particularly formidable virus. It is not just another “common cold” virus and far exceeds the impact of the usual seasonal influenza virus. Everyone understands that the coronavirus has altered our world in ways that almost no one could have predicted just 8 months ago. What many do not understand is why this virus, in particular, has had such an impact on our social lives, school, work, economy and, for some, our personal health.

One way in which this virus, unfortunately, has set itself apart from other viruses is with its large and ever-increasing death toll. Just in the United States alone, according to the Johns Hopkins coronavirus data source, there have been 167,253 deaths. While it is true that many of those who have died have had other common conditions such as high blood pressure, obesity, diabetes, cardiac conditions and advanced age, many have had none of these conditions and were previously healthy. This unpredictability for severe disease or death should have everyone on guard. Also, Influenza and common cold viruses tend to wane with the seasons.  This summer shows clearly that Covid does not play by that rule and does not wane with the seasons. It is a year round foe.

This virus also is a heavy weight when it comes to the tools it has had its disposal. When we are infected, viruses use their genetic code to hijack the machinery of our cells to produce more viruses and advance the infection in our bodies or spread infection to other people. They use either DNA or RNA which are molecules that carry the genetic code. The coronavirus is an RNA virus. However, in comparison to other RNA viruses, it has many more genes packed into its genetic blueprint. For example, rhinoviruses which cause the common cold have about 8000 base pairs for their genetic code, the HIV virus has just fewer than 10,000, the influenza virus has around 12,000 while the SARS-CoV-2 virus that causes Covid has a whopping 29,900 base pairs! That is about three times the amount of genetic code as the HIV virus that causes AIDS. This extra genetic material is part of what makes Covid so formidable. This Coronavirus has the genetic blueprint for a special “proofreading” tool to ensure when our cells are infected that they make powerfully accurate copies of the virus to infect other cells and other people. Most viruses do not have this mechanism. This extra genetic code in the coronavirus also has unique mechanisms to help hide the virus from our immune system until the infection is in full force.  Other viruses typically do not have this trick.

Other ways in which the coronavirus is different than some of the viruses we commonly encounter is its ability to cause other disease processes. Even in Covid survivors, the coronavirus can increase the tendency of our blood to inappropriately form clots. As a result, it increases the risk of blood clots in the lungs of patients as well as the risk of stroke – even in younger patients. Early evidence also shows significant effects on the heart that appear to last well beyond the infection and may be permanent. This can create chronic shortness of breath and other heart-related issues. There is evidence also that, even among Covid survivors, the coronavirus can cause blood vessel inflammation, kidney failure, mental health symptoms, impaired brain function and may even increase the risk of developing type 1 diabetes. These are not conditions that are seen with “common cold” viruses.

The virus causing Covid 19 is a powerful foe. It can have serious effects in any of us despite risk factors. The encouraging news is that we can significantly reduce our risk by just following some simple measures. These include good, frequent hand washing practices or use of hand sanitizer. Wearing masks is a key step for our own health as well as those in our community. Masks reduce the risk of inhaling droplets containing the coronavirus. Importantly, even if we do inhale some droplets containing the virus, masks reduce the amount of virus that we inhale which has been shown to decrease the severity of disease if we do get sick from the virus. Avoiding close contact with others, frequent cleaning of surfaces and covering coughs and sneezes all help to protect us and others. We are hopeful that there will be a vaccine available early in 2021. Until that time, the best ways to protect ourselves from this powerful virus are within our control and the collective control of our community.