Credit: jchizhe / Adobe Stock
- A lot of hype surrounds vitamins and minerals for treating or preventing COVID-19, though little evidence exists.
- Vitamins C and D and zinc may help boost the body's response to the coronavirus, but likely only if you're deficient.
- Dozens of studies are currently investigating the potential use of these supplements on COVID-19 patients.
<p>Misinformation is rampant in regards to the novel coronavirus. In certain regards, this makes sense: it's <em>novel</em>. There's much to learn about treatments, immunity, and potential vaccines. While the virus seems overwhelming now, every pandemic has the same disorienting effect on the population. </p><p>Earlier this year, a cottage industry immediately emerged around supposed cures and interventions. Osteopath Joseph Mercola, who's built a vitamin empire while spouting numerous false claims, has <a href="https://cspinet.org/news/fda-and-ftc-urged-bring-enforcement-proceedings-against-joseph-mercola-false-covid-19-health" target="_blank">touted</a> at least 22 vitamins and supplements on his website that prevent and even cure COVID-19. Vitamin salesman David Wolfe peddles coated silver as a way to prevent coronavirus through "<a href="https://www.mediamatters.org/coronavirus-covid-19/author-david-wolfe-who-has-millions-social-media-followers-selling-coated" target="_blank" rel="noopener noreferrer">immunity</a>." </p><p>A strong immune system is important, during a pandemic and otherwise. The reality of immune-system building isn't sexy or highly marketable, but it is effective: eat a diet of balanced macronutrients low in processed foods and sugars; sleep seven to nine hours a night; hydrate regularly; move your body regularly; try not to stress out, and if you do, counter it with yoga, meditation, or breathing exercises. </p><p>The modern wellness industry cannot scale on basic science, however. And so we must endure false promises at every turn. </p><p>While lifestyle habits often lead to poor immune functioning, plenty of people suffer from genetic immunodeficiencies. As it turns out, this cohort could benefit from vitamins and minerals, especially if they're deficient. A <a href="https://www.sciencenews.org/article/coronavirus-covid-19-supplements-vitamins-what-we-know" target="_blank" rel="noopener noreferrer">recent report</a> investigates the efficacy of three popular supplements and their effects on COVID-19. For those lacking in vitamins C and D and zinc, a little boost could help.</p>
Can vitamin D help fight COVID-19?
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fefdc4c878af3febac545b6911ac1b66"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/Q2nXgeJSJrc?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Evidence for adding more of these vitamins on top of a balanced diet (and barring any deficiencies) is thin, however. Humans have long held a fascination with the idea that more is better. In the case of essential vitamins, it's all about balance. </p><p>A number of pro-vitamin D articles have been bouncing around social media. The argument: quarantining humans results in them not getting enough sunlight, which compromises their vitamin D levels. These opinion pieces are generally arguing against shutdowns, using this heavily-studied supplement as a wedge. </p><p>Vitamin D certainly helps your immune system. Deficiencies <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3308600/" target="_blank" rel="noopener noreferrer">are linked</a> to increased risk and severity of viral infections: "Interventional and observational epidemiological studies provide evidence that vitamin D deficiency may confer increased risk of influenza and respiratory tract infection." One <a href="https://eje.bioscientifica.com/view/journals/eje/183/5/EJE-20-0665.xml" target="_blank" rel="noopener noreferrer">study</a> has linked vitamin D deficiency to difficulties fending off COVID-19. </p><p>If your body produces enough vitamin D, however, you don't need more. As Susan Lanham-New at the University of Surrey in England, <a href="https://www.sciencenews.org/article/coronavirus-covid-19-supplements-vitamins-what-we-know" target="_blank" rel="noopener noreferrer">says</a> "If you have enough vitamin D in your body, the evidence doesn't stack up to say that giving you more will make a real difference." Since too much of this vitamin has a negative impact, you want to keep your levels around 600-800 IU per day. Spending <a href="https://www.healthline.com/nutrition/vitamin-d-from-sun#:~:text=Regular%20sun%20exposure%20is%20the,your%20skin%20is%20to%20sunlight." target="_blank" rel="noopener noreferrer">10 to 30 minutes outside a day</a>, a few days a week, is enough to satisfy requirements. Fish (such as salmon, trout, and swordfish) and fortified milk products also <a href="https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/appendix-12/" target="_blank" rel="noopener noreferrer">help you reach</a> these levels. </p><p>Thus far, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246103/" target="_blank">studies</a> have shown that people deficient in vitamin D could use a boost. There are currently over a dozen studies testing high-doses of vitamin D in newly infected volunteers. As no results have been published, the verdict is still out.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDY1OTA2NS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0Nzc3MjQ0NX0.PiFyT7pYtOPsQJoINHKgDrAX7YsPjpKzB2Pt5SaNfs8/img.jpg?width=1245&coordinates=0%2C57%2C0%2C57&height=700" id="6b67f" class="rm-shortcode" data-rm-shortcode-id="5dd77131200162dc029d045ec5a66b13" data-rm-shortcode-name="rebelmouse-image" />
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<p>Zinc has also been making the rounds, especially in conjunction with other treatments. If you regularly consume oysters, red meat, poultry, or beans, your body is likely sated. Taking zinc while you have a cold <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457799/" target="_blank">seems to help out</a> (provided you take it at the onset of the illness). Zinc lozenges <a href="https://bmjopen.bmj.com/content/10/1/e031662" target="_blank">don't fare as well</a>.</p><p>Zinc was on everyone's mind as an additive to hydroxychloroquine. While the latter treatment <a href="https://www.sciencenews.org/article/covid-19-coronavirus-hydroxychloroquine-no-evidence-treatment" target="_blank">didn't live up</a> to the hype, zinc supplementation <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2020.01712/full" target="_blank" rel="noopener noreferrer">bestows immune benefits</a> based on SARS research (which is also a coronavirus). At the moment, it <a href="https://www.ccjm.org/content/early/2020/06/08/ccjm.87a.ccc046" target="_blank" rel="noopener noreferrer">appears</a> that zinc reduces the duration of COVID-19, though not the severity of symptoms. Loading up isn't the best idea, as too much zinc <a href="https://ods.od.nih.gov/factsheets/Zinc-Consumer/#:~:text=Signs%20of%20too%20much%20zinc,the%20%22good%22%20cholesterol)." target="_blank" rel="noopener noreferrer">could cause</a> nausea, vomiting, stomach problems, and if taken for an extended duration, lower immunity. But if you start to feel sick, zinc might not be a bad idea. </p><p>Linus Pauling famously—some would say <a href="https://www.vox.com/2015/1/15/7547741/vitamin-c-myth-pauling" target="_blank">infamously</a>—touted the benefits of vitamin C. The two-time Nobel Prize winner went a bit overboard with his passion for this vitamin. That said, due to his work, vitamin C is now extensively studied (and sometimes overused). </p><p>The popular antioxidant provides an immune boost and reduced inflammation, both important when you're battling a virus. While you can take supplements, plenty of fruits and vegetables contain what you need. </p><p>Experts <a href="https://www.sciencenews.org/article/coronavirus-covid-19-supplements-vitamins-what-we-know" target="_blank" rel="noopener noreferrer">warn</a> that studies on vitamin C produce contradictory results. As an inexpensive intervention, upping your levels when you have a cold can't really hurt. A dozen or so studies are currently looking at the possibility of using vitamin C to treat COVID patients. As with the previous supplements, too much vitamin C produces unwanted side effects. In the coming months, researchers will have a clearer idea of its potential role in COVID-19 treatment. </p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a> and <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank" rel="noopener noreferrer">Facebook</a>. His new book is</em> "<em><a href="https://www.amazon.com/gp/product/B08KRVMP2M?pf_rd_r=MDJW43337675SZ0X00FH&pf_rd_p=edaba0ee-c2fe-4124-9f5d-b31d6b1bfbee" target="_blank" rel="noopener noreferrer">Hero's Dose: The Case For Psychedelics in Ritual and Therapy</a>."</em></p>
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Artificial intelligence model detects asymptomatic Covid-19 infections through cellphone-recorded coughs
The researchers trained the model on tens of thousands of samples of coughs, as well as spoken words.
31 October, 2020
Hector Vivas/Getty Images
Asymptomatic people who are infected with Covid-19 exhibit, by definition, no discernible physical symptoms of the disease. They are thus less likely to seek out testing for the virus, and could unknowingly spread the infection to others.
<p>But it seems those who are asymptomatic may not be entirely free of changes wrought by the virus. MIT researchers have now found that people who are asymptomatic may differ from healthy individuals in the way that they cough. These differences are not decipherable to the human ear. But it turns out that they can be picked up by artificial intelligence.</p><p>In a paper published recently in the <em>IEEE Journal of Engineering in Medicine and Biology</em>, the team reports on an AI model that distinguishes asymptomatic people from healthy individuals through forced-cough recordings, which people voluntarily submitted through web browsers and devices such as cellphones and laptops.</p><p>The researchers trained the model on tens of thousands of samples of coughs, as well as spoken words. When they fed the model new cough recordings, it accurately identified 98.5 percent of coughs from people who were confirmed to have Covid-19, including 100 percent of coughs from asymptomatics — who reported they did not have symptoms but had tested positive for the virus.</p><p>The team is working on incorporating the model into a user-friendly app, which if FDA-approved and adopted on a large scale could potentially be a free, convenient, noninvasive prescreening tool to identify people who are likely to be asymptomatic for Covid-19. A user could log in daily, cough into their phone, and instantly get information on whether they might be infected and therefore should confirm with a formal test.</p><p>"The effective implementation of this group diagnostic tool could diminish the spread of the pandemic if everyone uses it before going to a classroom, a factory, or a restaurant," says co-author Brian Subirana, a research scientist in MIT's Auto-ID Laboratory.</p><p>Subirana's co-authors are Jordi Laguarta and Ferran Hueto, of MIT's Auto-ID Laboratory.</p>
<h3>Vocal sentiments</h3><p>Prior to the pandemic's onset, research groups already had been training algorithms on cellphone recordings of coughs to accurately diagnose conditions such as pneumonia and asthma. In similar fashion, the MIT team was developing AI models to analyze forced-cough recordings to see if they could detect signs of Alzheimer's, a disease associated with not only memory decline but also neuromuscular degradation such as weakened vocal cords.</p><p>They first trained a general machine-learning algorithm, or neural network, known as ResNet50, to discriminate sounds associated with different degrees of vocal cord strength. Studies have shown that the quality of the sound "mmmm" can be an indication of how weak or strong a person's vocal cords are. Subirana trained the neural network on an audiobook dataset with more than 1,000 hours of speech, to pick out the word "them" from other words like "the" and "then."</p><p>The team trained a second neural network to distinguish emotional states evident in speech, because Alzheimer's patients — and people with neurological decline more generally — have been shown to display certain sentiments such as frustration, or having a flat affect, more frequently than they express happiness or calm. The researchers developed a sentiment speech classifier model by training it on a large dataset of actors intonating emotional states, such as neutral, calm, happy, and sad.</p><p>The researchers then trained a third neural network on a database of coughs in order to discern changes in lung and respiratory performance.</p><p>Finally, the team combined all three models, and overlaid an algorithm to detect muscular degradation. The algorithm does so by essentially simulating an audio mask, or layer of noise, and distinguishing strong coughs — those that can be heard over the noise — over weaker ones.</p><p>With their new AI framework, the team fed in audio recordings, including of Alzheimer's patients, and found it could identify the Alzheimer's samples better than existing models. The results showed that, together, vocal cord strength, sentiment, lung and respiratory performance, and muscular degradation were effective biomarkers for diagnosing the disease.</p><p>When the coronavirus pandemic began to unfold, Subirana wondered whether their AI framework for Alzheimer's might also work for diagnosing Covid-19, as there was growing evidence that infected patients experienced some similar neurological symptoms such as temporary neuromuscular impairment.</p><p>"The sounds of talking and coughing are both influenced by the vocal cords and surrounding organs. This means that when you talk, part of your talking is like coughing, and vice versa. It also means that things we easily derive from fluent speech, AI can pick up simply from coughs, including things like the person's gender, mother tongue, or even emotional state. There's in fact sentiment embedded in how you cough," Subirana says. "So we thought, why don't we try these Alzheimer's biomarkers [to see if they're relevant] for Covid."</p>
<h3>"A striking similarity"</h3><p>In April, the team set out to collect as many recordings of coughs as they could, including those from Covid-19 patients. They established a website where people can record a series of coughs, through a cellphone or other web-enabled device. Participants also fill out a survey of symptoms they are experiencing, whether or not they have Covid-19, and whether they were diagnosed through an official test, by a doctor's assessment of their symptoms, or if they self-diagnosed. They also can note their gender, geographical location, and native language.</p><p>To date, the researchers have collected more than 70,000 recordings, each containing several coughs, amounting to some 200,000 forced-cough audio samples, which Subirana says is "the largest research cough dataset that we know of." Around 2,500 recordings were submitted by people who were confirmed to have Covid-19, including those who were asymptomatic.</p><p>The team used the 2,500 Covid-associated recordings, along with 2,500 more recordings that they randomly selected from the collection to balance the dataset. They used 4,000 of these samples to train the AI model. The remaining 1,000 recordings were then fed into the model to see if it could accurately discern coughs from Covid patients versus healthy individuals.</p><p>Surprisingly, as the researchers write in their paper, their efforts have revealed "a striking similarity between Alzheimer's and Covid discrimination."</p><p>Without much tweaking within the AI framework originally meant for Alzheimer's, they found it was able to pick up patterns in the four biomarkers — vocal cord strength, sentiment, lung and respiratory performance, and muscular degradation — that are specific to Covid-19. The model identified 98.5 percent of coughs from people confirmed with Covid-19, and of those, it accurately detected all of the asymptomatic coughs.</p><p>"We think this shows that the way you produce sound, changes when you have Covid, even if you're asymptomatic," Subirana says.</p>
<h3>Asymptomatic symptoms</h3><p>The AI model, Subirana stresses, is not meant to diagnose symptomatic people, as far as whether their symptoms are due to Covid-19 or other conditions like flu or asthma. The tool's strength lies in its ability to discern asymptomatic coughs from healthy coughs.</p><p>The team is working with a company to develop a free pre-screening app based on their AI model. They are also partnerning with several hospitals around the world to collect a larger, more diverse set of cough recordings, which will help to train and strengthen the model's accuracy.</p><p>As they propose in their paper, "Pandemics could be a thing of the past if pre-screening tools are always on in the background and constantly improved."</p><p>Ultimately, they envision that audio AI models like the one they've developed may be incorporated into smart speakers and other listening devices so that people can conveniently get an initial assessment of their disease risk, perhaps on a daily basis.</p><p>This research was supported, in part, by Takeda Pharmaceutical Company Limited.</p><p>Reprinted with permission of <a href="http://news.mit.edu/" target="_blank" rel="noopener noreferrer">MIT News</a>. Read the <a href="https://news.mit.edu/2020/covid-19-cough-cellphone-detection-1029" target="_blank" rel="noopener noreferrer">original article</a>.</p>
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How do pandemics end? History suggests diseases fade but are almost never truly gone
Instead of looking forward, we should be consulting the past.
21 October, 2020
Andrew Redington/Getty Images
When will the pandemic end? All these months in, with over 37 million COVID-19 cases and more than 1 million deaths globally, you may be wondering, with increasing exasperation, how long this will continue.
<p>Since the beginning of the pandemic, epidemiologists and public health specialists have <a href="https://doi.org/10.1038/s41591-020-0883-7">been using</a> <a href="https://doi.org/10.1001/jama.2020.6585" target="_blank">mathematical</a> <a href="https://doi.org/10.1073/pnas.2006520117" target="_blank">models</a> to forecast the future in an effort to curb the coronvirus's spread. But infectious disease modeling is tricky. Epidemiologists warn that “<a href="https://doi.org/10.1038/d41586-020-01003-6" target="_blank">[m]odels are not crystal balls</a>," and even sophisticated versions, like those that <a href="https://doi.org/10.1101/2020.08.19.20177493" target="_blank">combine forecasts</a> or <a href="https://covid19-projections.com/" target="_blank">use machine learning</a>, can't necessarily reveal when the pandemic will end or <a href="https://covid19.healthdata.org/united-states-of-america?view=total-deaths&tab=trend" target="_blank">how many people will die</a>.</p><p>As a <a href="https://sc.edu/study/colleges_schools/artsandsciences/history/our_people/directory/nukhet.php" target="_blank">historian who studies disease and public health</a>, I suggest that instead of looking forward for clues, you can look back to see what brought past outbreaks to a close – or didn't.</p>
<h2>Where we are now in the course of the pandemic</h2><p>In the early days of the pandemic, many people hoped the coronavirus would simply fade away. Some argued that it would <a href="https://www.npr.org/2020/04/21/837348551/timeline-what-trump-has-said-and-done-about-the-coronavirus" target="_blank" rel="noopener noreferrer">disappear on its own</a> <a href="https://theconversation.com/coronavirus-may-wane-this-summer-but-dont-count-on-any-seasonal-variation-to-end-the-pandemic-136218" target="_blank" rel="noopener noreferrer">with the summer heat</a>. Others claimed that <a href="https://www.theatlantic.com/health/archive/2020/03/coronavirus-pandemic-herd-immunity-uk-boris-johnson/608065/" target="_blank" rel="noopener noreferrer">herd immunity</a> would kick in once enough people had been infected. But none of that has happened.</p><p>A combination of public health efforts to contain and mitigate the pandemic – from rigorous testing and contact tracing to social distancing and wearing masks – <a href="https://www.endcoronavirus.org/countries" target="_blank" rel="noopener noreferrer">have been proven to help</a>. Given that the virus has <a href="https://www.aljazeera.com/news/2020/09/14/which-countries-have-not-reported-any-coronavirus-cases/" target="_blank" rel="noopener noreferrer">spread almost everywhere in the world</a>, though, such measures alone can't bring the pandemic to an end. All eyes are now turned to <a href="https://time.com/5887199/coronavirus-vaccine-race/" target="_blank" rel="noopener noreferrer">vaccine development</a>, which is being pursued at unprecedented speed.</p><p>Yet experts tell us that even with a successful vaccine and effective treatment, <a href="https://www.theatlantic.com/health/archive/2020/08/coronavirus-will-never-go-away/614860/" target="_blank" rel="noopener noreferrer">COVID-19 may never go away</a>. Even if the pandemic is curbed in one part of the world, it will likely continue in other places, causing infections elsewhere. And even if it is no longer an immediate pandemic-level threat, the coronavirus will likely become endemic – meaning slow, sustained transmission will persist. The coronavirus will continue to cause smaller outbreaks, much like seasonal flu.</p><p>The history of pandemics is full of such frustrating examples.</p>
<h2>Once they emerge, diseases rarely leave</h2><p>Whether bacterial, viral or parasitic, virtually every disease pathogen that has affected people over the last several thousand years is still with us, because it is nearly impossible to fully eradicate them.</p><p>The only disease that has been <a href="https://www.cdc.gov/smallpox/history/history.html" target="_blank" rel="noopener noreferrer">eradicated through vaccination is smallpox</a>. <a href="https://theconversation.com/a-massive-public-health-effort-eradicated-smallpox-but-scientists-are-still-studying-the-deadly-virus-139468" target="_blank" rel="noopener noreferrer">Mass vaccination campaigns</a> led by the World Health Organization in the 1960s and 1970s were successful, and in 1980, smallpox was declared the first – and still, the only – human disease to be fully eradicated.</p><p>So success stories like smallpox are exceptional. It is rather the rule that diseases come to stay.</p><p>Take, for example, pathogens like <a href="https://www.sciencedaily.com/releases/2010/06/100617120718.htm" target="_blank" rel="noopener noreferrer">malaria</a>. Transmitted via parasite, it's almost as old as humanity and still exacts a heavy disease burden today: There were about <a href="https://www.who.int/news-room/fact-sheets/detail/malaria" target="_blank" rel="noopener noreferrer">228 million malaria cases and 405,000 deaths</a> worldwide in 2018. Since 1955, global programs to eradicate malaria, assisted by the use of DDT and chloroquine, brought some success, but the disease is <a href="https://www.who.int/malaria/media/world-malaria-report-2018/en/" target="_blank" rel="noopener noreferrer">still endemic in many countries of the Global South</a>.</p><p>Similarly, diseases such as <a href="https://www.who.int/news-room/fact-sheets/detail/tuberculosis" target="_blank" rel="noopener noreferrer">tuberculosis</a>, <a href="https://doi.org/10.1126/science/1109759" target="_blank" rel="noopener noreferrer">leprosy</a> and <a href="https://doi.org/10.1126/science.368.6497.1324-o" target="_blank" rel="noopener noreferrer">measles</a> have been with us for several millennia. And despite all efforts, <a href="https://ourworldindata.org/eradication-of-diseases" target="_blank" rel="noopener noreferrer">immediate eradication is still not in sight</a>.</p><p>Add to this mix relatively younger pathogens, such as <a href="https://www.nature.com/articles/d42859-018-00008-6" target="_blank" rel="noopener noreferrer">HIV</a> and <a href="https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease" target="_blank" rel="noopener noreferrer">Ebola virus</a>, along with <a href="https://www.who.int/health-topics/influenza-avian-and-other-zoonotic#tab=tab_1" target="_blank" rel="noopener noreferrer">influenza</a> and <a href="https://www.niaid.nih.gov/diseases-conditions/coronaviruses" target="_blank" rel="noopener noreferrer">coronaviruses</a> including <a href="https://www.who.int/ith/diseases/sars/en/" target="_blank" rel="noopener noreferrer">SARS</a>, <a href="https://www.who.int/news-room/q-a-detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov)" target="_blank" rel="noopener noreferrer">MERS</a> and <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-coronaviruses" target="_blank" rel="noopener noreferrer">SARS-CoV-2 that causes COVID-19</a>, and the overall epidemiological picture becomes clear. Research on the <a href="https://doi.org/10.1016/B978-012373944-5.00185-1" target="_blank" rel="noopener noreferrer">global burden of disease</a> finds that annual mortality caused by infectious diseases – most of which occurs in the developing world – is nearly one-third of all deaths globally.</p><p>Today, in an age of global air travel, climate change and ecological disturbances, we are constantly exposed to the threat of <a href="https://wwwnc.cdc.gov/eid/about" target="_blank" rel="noopener noreferrer">emerging infectious diseases</a> while continuing to suffer from much older diseases that remain alive and well.</p><p>Once added to the repertoire of pathogens that affect human societies, most infectious diseases are here to stay.</p>
<h2>Plague caused past pandemics – and still pops up</h2><p>Even infections that now have effective vaccines and treatments continue to take lives. Perhaps no disease can help illustrate this point better than <a href="https://www.visualcapitalist.com/history-of-pandemics-deadliest/" target="_blank" rel="noopener noreferrer">plague, the single most deadly</a> infectious disease in human history. Its name continues to be synonymous with horror even today.</p><p><a href="https://www.who.int/health-topics/plague#tab=tab_1" target="_blank" rel="noopener noreferrer">Plague</a> is caused by the bacterium <em>Yersinia pestis</em>. There have been countless local outbreaks and at least three documented plague pandemics over the last 5,000 years, killing hundreds of millions of people. The most notorious of all pandemics was <a href="https://www.livescience.com/what-was-the-black-death.html" target="_blank" rel="noopener noreferrer">the Black Death</a> of the mid-14th century.</p><p>Yet <a href="https://scholarworks.wmich.edu/medieval_globe/1/" target="_blank" rel="noopener noreferrer">the Black Death</a> was far from being an isolated outburst. Plague returned every decade or even more frequently, each time hitting already weakened societies and taking its toll during <a href="https://doi.org/10.1017/npt.2020.27" target="_blank" rel="noopener noreferrer">at least six centuries</a>. Even before the <a href="https://doi.org/10.1136/bmj.39097.611806.DB" target="_blank" rel="noopener noreferrer">sanitary revolution</a> of the 19th century, each outbreak gradually died down over the course of months and sometimes years as a result of changes in temperature, humidity and the availability of hosts, vectors and a sufficient number of susceptible individuals.</p><p>Some societies recovered relatively quickly from their losses caused by the Black Death. Others never did. For example, medieval <a href="https://utpress.utexas.edu/books/borbla" target="_blank" rel="noopener noreferrer">Egypt could not fully recover</a> from the lingering effects of the pandemic, which particularly devastated its agricultural sector. The cumulative effects of declining populations became impossible to recoup. It led to the gradual decline of the Mamluk Sultanate and its conquest by the Ottomans within less than two centuries.</p><p>That very same state-wrecking plague bacterium remains with us <a href="https://www.cnn.com/2020/08/08/us/second-plague-death-new-mexico-man/index.html" target="_blank" rel="noopener noreferrer">even today</a>, a reminder of the very long persistence and resilience of pathogens.</p><p>Hopefully COVID-19 will not persist for millennia. But until there's a successful vaccine, and likely even after, no one is safe. Politics here are crucial: When vaccination programs are weakened, infections can come roaring back. Just look at <a href="https://www.cdc.gov/media/releases/2019/s0424-highest-measles-cases-since-elimination.html" target="_blank" rel="noopener noreferrer">measles</a> and <a href="https://www.nytimes.com/2019/07/15/health/polio-pakistan-afghanistan.html" target="_blank" rel="noopener noreferrer">polio</a>, which resurge as soon as vaccination efforts falter.</p><p>Given such historical and contemporary precedents, humanity can only hope that the coronavirus that causes COVID-19 will prove to be a tractable and eradicable pathogen. But the history of pandemics teaches us to expect otherwise.<img src="https://counter.theconversation.com/content/146066/count.gif?distributor=republish-lightbox-basic" alt="The Conversation"></p><p><a href="https://theconversation.com/profiles/nukhet-varlik-1155360" target="_blank">Nükhet Varlik</a>, Associate Professor of History, <em><a href="https://theconversation.com/institutions/university-of-south-carolina-1755" target="_blank" rel="noopener noreferrer">University of South Carolina</a></em></p><p>This article is republished from <a href="https://theconversation.com/" target="_blank" rel="noopener noreferrer">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-pandemics-end-history-suggests-diseases-fade-but-are-almost-never-truly-gone-146066" target="_blank" rel="noopener noreferrer">original article</a>.</p>
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What does kindness look like? It wears a mask.
Northwell Health CEO Michael Dowling has an important favor to ask of the American people.
16 October, 2020
- Michael Dowling is president and CEO of Northwell Health, the largest health care system in New York state. In this PSA, speaking as someone whose company has seen more COVID-19 patients than any other in the country, Dowling implores Americans to wear masks—not only for their own health, but for the health of those around them.
- The CDC reports that there have been close to 7.9 million cases of coronavirus reported in the United States since January. Around 216,000 people have died from the virus so far with hundreds more added to the tally every day. Several labs around the world are working on solutions, but there is currently no vaccine for COVID-19.
- The most basic thing that everyone can do to help slow the spread is to practice social distancing, wash your hands, and to wear a mask. The CDC recommends that everyone ages two and up wear a mask that is two or more layers of material and that covers the nose, mouth, and chin. Gaiters and face shields have been shown to be less effective at blocking droplets. Homemade face coverings are acceptable, but wearers should make sure they are constructed out of the proper materials and that they are washed between uses. Wearing a mask is the most important thing you can do to save lives in your community.
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Coronavirus aggressively invades lung cells in chilling new images
The images were published in the New England Journal of Medicine and show how prolific coronavirus can become in a mere four days.
10 September, 2020
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<p>Even cast sterile monochrome, the pictures are spine shivering. At first blush, they appear to depict some unknown fungus devouring a sea anemone or maybe spider egg sacs infesting some poor soul's hair. But the actual subject is far too familiar these days. <a href="https://bigthink.com/tag/coronavirus" target="_self">Those pictures show novel coronavirus</a> in the microscopic flesh.</p><p><a href="https://www.nejm.org/doi/full/10.1056/NEJMicm2023328" target="_blank" rel="noopener noreferrer">Published in the New England Journal of Medicine</a>, the images offer an up-close and far-too-personal look at lung cells teeming with coronavirus. They were produced by Camille Ehre, an assistant professor at the University of School of Medicine's Marsico Lung Institute, and her team. They wanted to research how coronavirus occupied human airways and what happened to the inundated cells. And they vividly got their answer.</p>
Not exactly camera shy
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzg2MjU2MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0MDcyMzY5N30.P9-pN3720tOzXNrYTybx3X7qc_7ZO8ZdF15ztj5cgXA/img.jpg?width=1245&coordinates=0%2C52%2C0%2C52&height=700" id="dc41e" class="rm-shortcode" data-rm-shortcode-id="dd5152d7ead13cca82f0f19be988f538" data-rm-shortcode-name="rebelmouse-image" />Another image of novel coronavirus. This one shows the virions 10 times closer than the above image.
<p>To start, Ehre and her team exposed epithelial cells to novel coronavirus in a biosafe laboratory. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457445/" target="_blank" rel="noopener noreferrer">Epithelium tissues</a> are found at the barriers between the human body and the outside world, often lining the outer surfaces of organs and blood vessels. They serve many functions, including protection, fluid balance, particle clearance, and triggering immune responses. These functions make them important to the health and safety of our respiratory system.</p><p>The researchers took their epithelial cells from a bronchus, major airway passages by which air moves from the windpipe and into the lungs. The initial cells were taken from a transplanted lung and later grown in lab dishes. So, unlike your typical photoshoot or family portrait, this experiment remained ethically above board.</p><p>After exposing the cells to coronavirus, they waited for the infection to take hold. They then captured images of the epithelial cells with a <a href="https://serc.carleton.edu/research_education/geochemsheets/techniques/SEM.html" target="_blank" rel="noopener noreferrer">scanning electron microscope</a>, a device that uses a focused beam of high-energy electrons to produce images. They discovered a high density of virions—individual particles of the virus existing outside the host cell—had been produced and were swarming over the cells. In a mere 96 hours, virus production skyrocketed to reach a multiplicity of infection of three to one. That means there were three virions for each targeted airway cell.</p><p>"When we looked at these infected cultures under an SEM microscope, the most striking observation was the astonishing number of virions produced by a single infected cell," <a href="https://gizmodo.com/horrifying-images-show-how-the-coronavirus-ravages-our-1844946904" target="_blank" rel="noopener noreferrer">Ehre told Gizmodo in an interview</a>. "Some of these infected cells were so engorged with viruses that they rounded up and detached from the epithelium, giving the impression that they were about to burst."</p><p>The image at the top of this article shows the invasion at one-micrometer magnification. The tentacle-looking projections are <a href="https://medlineplus.gov/ency/imagepages/19533.htm#:~:text=The%20bronchus%20in%20the%20lungs,the%20bronchus%20and%20trap%20microorganisms" target="_blank" rel="noopener noreferrer">respiratory cilia</a>, hair-like organelles on epithelium that move microbes and other debris out of our airways. That spider-web looking stuff is mucus produced by goblet cells; it's used to trap microorganisms and protect the bronchus. Neither are effective against the locust-like plight of virions.</p><p>Above is the same scene but at 100 nanometers (10 times closer). From this all-too intimate vantage, you can clearly see <a href="https://www.oxfordreference.com/view/10.1093/oi/authority.20110803100316752" target="_blank" rel="noopener noreferrer">the peplomers</a>—those spiky protrusions on the virions' envelopes. These peplomers give the coronavirus family its name as they have <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus" target="_blank" rel="noopener noreferrer">a crown-like appearance</a> when viewed under such a high magnification—<a href="https://www.dictionary.com/browse/corona?s=ts" target="_blank" rel="noopener noreferrer"><em>corona</em></a> coming from the Latin for "garland or crown."</p>Protect your lungs, wash those hands
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="9626d989ee28bca36e49da0bbbc6c064"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/deJ3nZhK8KI?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>These images are a stark reminder of why COVID-19 infections can so devastate the human body. It's not only that our bodies serve as their viral birthing centers. It's that we're their all-in-one resource smorgasbord.</p><p>Because <a href="https://www.genome.gov/genetics-glossary/Virus" target="_blank" rel="noopener noreferrer">viruses can't reproduce on their own</a>, they have to inject their genetic material into host cells. They incorporate their DNA or RNA into a host cell's genome, and a bouncing baby virion is born, one that often kills the host upon release. It's basically the backstory of "<a href="https://www.imdb.com/title/tt0090605/?ref_=fn_al_tt_1" target="_blank" rel="noopener noreferrer" style="">Aliens</a>" at a Lilliputian scale, and should viral proliferation spread too quickly, even our immune-responsive Marines can't put up a fight. If enough cells are destroyed, the harm can affect the entire host organism—which now includes us.</p><p>"These images of SARS-CoV-2 infected cultures showing ciliated cells jam-packed with viruses releasing large clumps of virus particles make a strong case for the use of masks by infected and uninfected individuals to limit SARS-CoV-2 transmission," Ehre said.</p><p>They certainly do. Warnings about coronavirus in the abstract can make the case for physical distancing, shuttered schools, and wearing stifling makes while shopping. For a while. But as we've seen, people will eventually tire of their social sacrifices. Perhaps the idea of the above horror show occurring more closely to home will spur us to keep up the fight and listen to the experts for a while longer.</p>
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