COVID-19 What you should know... and what to dismiss

by Jesica Levingston Mac Leod, PhD.

After reading and listening to a lot of COVID-19' hoaxes that friends have shared with me over the last few weeks, which broke my little virologist heart, I realized that it is not their fault believing fake information, but ours, as scientists for not correctly educating the public on this topics. Therefore, I hope this post helps to clarify and to educate the public about COVID-19.
First, let me tell you what a virus is, and what it is not... They are not bacteria, they are obligate intracellular parasites, as they need to infect a cell to reproduce. A virus requires the cellular machinery in order to reproduce, therefore, if you leave a viral particle isolated it won't multiply, and at some point depending on the type of membrane that covers/protects the genetic material, it will "die". Viruses are made of genetic material (in this case RNA ribonucleic acid), lipids (a type of fats that helps to keep the membrane structure) and proteins, some binding the RNA, protecting it, some for replication and regulation of the hosts' immune system and some in the viral membrane. The viral particles are quite sensitive to the environment, soap can destabilize/destroy the external membrane of the virus and therefore "kill it". I use quotation marks because there is a huge philosophical dilemma about calling viruses "living entities" or not and if you can kill them but destroying their structure. Contrary, bacteria can reproduce by themselves as they have the whole machinery to function independently of eucaryotic cells (human cells are eukaryotic cells) and have a way more sophisticated metabolism than the viruses

Can kids catch COVID-19?
Yes, people of all ages can be infected by COVID-19. A Chinese retrospective study showed that Covid-19 occurred in children, causing moderate-to-severe respiratory illness.
What do we know about the COVID-19 structure?
The whole virus has been sequenced, given that scientists have worked 24/7 to get this done, so we have the Wuhan seafood market pneumonia virus isolate Wuhan-Hu-1 complete genome is now available to compare with other viruses and follow up on anti-viral research. Similar viruses, members of the coronavirus family have been studied by virologists since approx 1970s.

What can you do to avoid being infected by COVID-19?
- Limit interaction with other people, avoid crowded places and gatherings.
- wash your hands, at least 20 seconds of old school soap and water washing are enough, hand sanitizer is good too, just be aware that it contains alcohol that can dry the skin
- Avoid touching your face, yes the virus can enter through holes other than your mouth and/or nose
- Use a mask if you are sick or taking care of a sick person (mostly for the placebo effect)
- If you have a deficit of vitamins, a multivitamin pill might help (again mostly for the placebo effect)
- Clean and disinfect regularly touched objects and surfaces using your regular cleaning products to reduce the risk of passing the infection on to other people.
- Be kind and have compassion: treat others as you would like to be treated, and take care of yourself as you would for a person you love.

What are the symptoms?
This is a tricky one because of the wide spectrum of symptoms recorded so far... most of the patients start with cold-like symptoms (fever, dry cough and difficulty breathing) and then it goes to a more intense phase of joint and muscle pain, sore throat, sneezing, congestion, and even pneumonia. The virus infects the lower respiratory tract and causes severe pneumonia (approx 10% of cases) and mortality in 3-5% of cases, mainly among the elderly and/or people affected by other diseases. One article that analyzed thousands of patients' records, reported that the main clinical symptoms of COVID-19 patients were fever (88.5%), cough (68.6%), myalgia or fatigue (35.8%), expectoration (28.2%), dyspnea (21.9%). Minor symptoms include headache or dizziness: (12.1%) diarrhea (4.8%), nausea, and vomiting (3.9%).

What does testing mean?
The main test consists of detecting the viral genetic material using a very sensitive technique called reverse transcription polymerase chain reaction (RT-PCR). They will take a nasal and/or mouth swap to collect some fluid that is then sent to the laboratory and it takes approx. 4 h to get a result. An Argentinian group developed a faster test based on CRISPR, it takes only 60 min to get a result, but it still under development.

How long does COVID survive on surfaces?
According to the latest research, still under review. it depends on the surface: the viable virus was detected up to three hours in the air, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel.

How long is the incubation period?
Guess what? it depends on your immune system and viral charge you got... generally around 4-6 days. A review of the Chinese clinical data reported an average incubation period of COVID‐19 is around 6.4 days, ranges from 0‐24 days. So travel restrictions to and from high-risk areas and/or 14 days quarantine of travelers coming from high-risk areas are recommended to prevent possible importation of COVID-19. This is why it is so important to stay home even if you don't have symptoms, at least for 14 days after you were in contact with a COVID-19 patient.

Is there a vaccine?
Not yet, and other vaccines don't work because the COVID-19 proteins won't be recognised by the antibodies that your body generated based on previous vaccines. The development of a safe and approved vaccine will take at least 2 more years.

Is there a treatment?
There are no specific treatments to date, but again, it depends on the severity of the symptoms and if by the "treatment" you mean just keeping the patient hydrated... Overall, no, there are no antivirals available yet and no, a big NO to antibiotic usage as they do not work, they only work for bacteria, and as we stated before viruses are not bacteria. Some vitamins, like Vitamin A have been shown to be important to maintain a healthy immune system in animal models, BTW, the Asian population has a general deficit of Vitamin A due to their diet. Importantly, you can get these vitamins from fruits and vegetables, and it seems they only work if you have a constant intake before you get infected.
Several drugs such as chloroquine, arbidol, remdesivir, and favipiravir are currently undergoing clinical studies to test their efficacy and safety in the treatment of COVID-19 in China.

Can you take ibuprofen?
The consensus is yes, you can. Some false claims were published in social media about ibuprofen. However, until we have more information about the effects of non-steroidal anti-inflammatory (NSAIDs), like ibuprofen, some authorities recommend taking paracetamol to deal with fever and pain. Paracetamol must be taken strictly according to the recommended dose because too much of it can damage the liver. If you are already taking ibuprofen or another  (NSAID) on the advice of a doctor, do not stop taking it without checking first.
https://sciencetechreviews.blogspot.com/2020/03/should-you-take-ibuprofen-if-you-have_18.html

How to boost your immune system for real?
A healthy lifestyle!
- Sleep at least 7 h every night
- Eat healthy (a plant-based low-calorie diet is ideal... but you know, life is too short eat dessert first)
- Exercise (from a walk to HIIT or dancing, get your heart rate up)
- Drink plenty of water (the 2 liters per day is under debate, but aim for 1.5 liters at least)
- Avoid stress, I know easy to say difficult to do. Breathing exercises and meditation can help.
- Be aware that viruses and bacteria are everywhere, including inside of you, and not all are bad.

Can you be re-infected?
We don't know. Probably not, based on previous knowledge on coronaviruses behavior, if the virus doesn't increase its mutation rate. There is one report of a potential re-infection in China and another one in Japan.

What wouldn't work?
- Probiotics intake during the infection, they showed very low activity.
- Vitamin C intake during the infection, it is not a shield!
- The 10 secs breathing test, is not a real thing!
- Ensuring your mouth and throat are moist and humidity myth... eh, nope. Although drinking water is always recommended, this claim is false. While staying hydrated by drinking water is important for overall health, it does not prevent coronavirus infection.
- Gargling with salt and won't work, because the highest viral load was found in nasal swabs.
- Cold weather and snow CANNOT kill COVID.
- Taking a hot bath does not prevent the COVID infection.
- There is no evidence from the current outbreak that eating garlic has protected people from the new coronavirus. Though, it is a healthy food that may have some antimicrobial properties
- Antibiotics are for bacteria, not viruses!
-So far, it can't be transmitted by cooked food

Is COVID-19 airborne?

Initially, COVID-19 was considered not airborne, because it can't be transmitted just by air but it needs large respiratory droplets. However, preliminary research (as it hasn't been peer-reviewed yet) reported the detection of COVID-19 up to 3 hours after aerosolization and can infect cells throughout that time period.

Please be kind and show compassion to others at all times! Big kudos to the scientist, doctors, nurses, and volunteers working 24/7 to treat patients, produce vaccines, tests, and treatments ASAP. Please help the ones in need and in risk groups during the lockdown. To paraphrase Brandon Sanderson: "the original plan for this article was to be short. It ends up being quite long. Ah well. That just happens sometimes. (Particularly when you are me)"

If you have any questions please post them in the comments and I will try to answer them ASAP.
Some ideas about what do to at home: read (you can get free books from the library, amazon, google and other websites), take an online course, learn a new language, cook, play board games and/or video games, workout, call your friends and family, meditate, try an online tour...

An electron microscope image of a coronavirus. Photograph: AP

Thanks Dr. Ilse Daehn for the edits.

Recommended links:
https://youtu.be/E3URhJx0NSw
https://sciencetechreviews.blogspot.com/2018/04/chasing-one-drug-to-rule-them-all.html
https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
Avril, Tom. “Coronavirus has shut down schools and events. Here’s why that helps, short- and long-term.” Philadelphia Inquirer. 8 Mar 2020.

“Coronavirus COVID-19 Global Cases.” Center for Systems Science and Engineering, Johns Hopkins University. Accessed 27 Jan 2020.

“Coronavirus disease 2019 (COVID-19) | Situation Report – 51.” World Health Organization. 11 Mar 2020.

Johnson, Krys. Assistant professor of epidemiology and biostatistics, Temple University. Email to FactCheck.org. 12 Mar 2020.

“Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19).” World Health Organization. 20 Feb 2020.

“Steps to Prevent Illness.” U.S. Centers for Disease Control and Prevention. Accessed 12 Mar 2020.

Weinberg, Abigail. “There’s a Facebook Coronavirus Post Going Viral Claiming to be From Stanford. Don’t Believe It.” Mother Jones. 11 Mar 2020.

“WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020.” World Health Organization. 11 Mar 2020.
“WHO Director-General’s opening remarks at the Mission briefing on COVID-19 – 12 March 2020.” World Health Organization. 12 Mar 2020.
World Health Organization Western Pacific (@WHOWPRO). “Q: Does drinking water alleviates a sore throat, does this also protect against 2019-nCoV infection? A: While staying hydrated by drinking water is important for overall health, it does not prevent coronavirus infection.” http://bit.ly/COVID19Mythbusters… #COVID19 #KnowtheFacts.” Twitter. 26 Feb 2020.