We are a strange species indeed! Headlines around the world broadcast the news that the Coronavirus that has infected at least 250,000 people worldwide, while killing 217 people in the USA alone and over 10,400 people worldwide as of 20 March, 2020. At the same time, there are few headlines in the popular media about the influenza (flu) virus that has caused illnesses in an estimated 32 to 45 million people in the USA, leading to 14 to 21 million medical visits, 310,000 to 560,000 hospitalizations and 18,000 to 46,000 deaths from October 1, 2019 to February 22, 20201. Although the worldwide burden of influenza varies from year to year, the World Health Organization (WHO) estimated that seasonal influenza was associated with 250,000 to 500,000 deaths annually2, while the Global Influenza Mortality project (GLaMOR) estimated that there were 294,000 to 518,000 respiratory deaths associated with the influenza virus3. So, I am puzzled by people who ask me what I think about the risk of COVID-19 (Coronavirus disease 2019), caused by the new (or novel) Coronavirus, SARS-CoV-2 (also known as 2019-nCoV), when they also tell me that they have not had a flu shot (which would immunize them against at least three different types of influenza viruses: A/Brisbane/02/2018 (H1N1)pdm09-like virus, A/Kansas/14/2017 (H3N2)-like virus and B/Colorado/06/2017-like (Victoria lineage) virus) 4. Even though the new Coronavirus may turn out to be exceptionally deadly, it may never be anywhere near as deadly as the influenza virus. We just don’t know enough about this new Coronavirus. However, we do know about the influenza virus and how to protect ourselves from it. So, the goals of this article are to compare and contrast the influenza and SARS-CoV-2 viruses. I will start with a brief introduction of virology, or the study of viruses. This is followed by a description of how vaccines work and why they are necessary for public health. Next, there is a description of currently available antiviral drugs, along with some promising drugs that may become quite useful and effective, along with things that one can do to avoid becoming infected. Also, a promising new vaccine against the new Coronavirus will be described. Finally, the responses of the leadership and citizens in the USA and Mexico are compared and contrasted.

Introduction to Virology

Viruses are obligate parasites. They cannot live on their own, outside of a host (such as a human). They contain proteins such as hemagglutinin and neuraminidase in their outer shells. So, the H1N1 strain of the influenza virus has the first hemagglutinin and neuraminidase subtypes, while H3N2 has the third hemagglutinin and second neuraminidase subtypes. The SARS-CoV-2 virus has lipids in its outer shell, so soap is effective in killing (it dissolves the lipids). Viruses need a host to make their proteins and provide energy, as well as to make many copies of themselves. Whereas living cells have both DNA and RNA, viruses do not. They have either RNA or DNA, but not both. Viruses are often classified based on their genomes and how their messenger RNA (mRNA) is made. Viral genomes can be made of double stranded DNA (dsDNA), single stranded DNA (ssDNA), dsRNA, (+)ssRNA or (-)ssRNA. Some are classified as ssRNA-reverse transcriptase (ssRNA-RT) and others as dsDNA-RT viruses. That is, RNA or DNA inside the virus particles can be either + or – stranded. There is a + and – strand of DNA, arranged in a DNA duplex. The + strand codes for mRNA, while the – strand is complementary to the + strand and does not code for mRNA. Influenza viruses are type (-)ssRNA, while Coronaviruses are type (+)ssRNA. The RNA of (-)ssRNA viruses must be transcribed by the host’s RNA-dependent RNA polymerase to produce mRNA for the virus. On the other hand, the RNA of (+)ssRNA viruses is transcribed directly into the mRNA that the virus needs. In contrast, the HIV virus that causes AIDs is a ssRNA-RT virus. Its genomic material (RNA) must be reverse transcribed into DNA. This is called reverse transcription because normal transcription is when DNA is transcribed into mRNA, which is then translated into a protein. Reverse transcription is when RNA is first reverse transcribed into DNA. The DNA is then transcribed into mRNA, which is translated into proteins that the HIV virus needs to make copies of itself and spread throughout the body. One of the effective drugs that is used to treat HIV infections is an inhibitor of the reverse transcriptase enzyme that catalyzes the reverse transcription of the RNA in the HIV virus.

Viruses are also classified into different types, subtypes and strains. There are three types of influenza viruses. The most common hosts for Type A viruses are birds. However, Type A viruses can also infect humans and other animals. Type B viruses are almost always found only in humans. Although they have caused epidemics, they have seldom caused pandemics. Type C influenza viruses can cause mild illnesses, but do not cause epidemics or pandemics. An epidemic is a relatively sudden increase in the number of cases (as occurs during flu season in the Northern hemisphere). Epidemiology is the study of the distribution and causes of health-related states or events (including diseases), and the application of this study to the control of diseases and other health problems. In epidemiology, infectivity is the ability of a pathogen to establish an infection. More specifically, infectivity is a pathogen's capacity for horizontal transmission (how frequently it spreads among hosts that are not in a parent-child relationship). Incidence is a measure of infectivity in a population. A pathogen's transmissibility is its ability to pass from parent to child. Pathogenicity of an infectious agent is its ability to cause a disease. Virulence is the severity or harmfulness of a disease.

A pandemic is an epidemic that spreads across a large region, over many continents and possibly even worldwide. For example, there was a Spanish flu pandemic that started in 1918 and lasted through 1920, killing an estimated 50 million people worldwide. More recent flu seasons have not produced a huge increase in illnesses or deaths, unlike the Spanish flu of 1918. The WHO has declared that the COVID-19 outbreak is a pandemic. It is also an epidemic because the number of illnesses and deaths due to it have increased rapidly (from zero to many thousands). It has become an official pandemic because it has spread sufficiently throughout the world – even if it never causes anywhere near the number of illnesses or deaths as the flu virus. However, it’s also possible that SARS-CoV-2 will cause many more serious illnesses and deaths than even the Spanish flu of 1918. At this time, we just don’t know. One of the most important factors that determines the severity of a contagious disease is its reproductive factor, or R05. It is “the expected number of secondary cases produced by a single (typical) infection in a completely susceptible population”6. If it is greater than one (R0 > 1), the infectious agent can transmit its infection to secondary agents5 (other people in the case of SARS-CoV-2 or the influenza virus). If R0 is less than or equal to one (R0 ≤ 1), chains of secondary transmission will end5. Recent estimates of the R0 value for SARS-CoV-2, based on data from China are that it is between 2.5 to 2.9. The all-age fatality ratio was estimated to be 2.3%5,7,8. In comparison, the Spanish flu pandemic of 1918 had an estimated R0 of about 1.8 and a case fatality ratio of about 1 to 2%5. However, “these estimated numbers … are concerning, but such data alone do not enable expert assessment of continuing COVID-19 threat” 5.

Several important questions remain unanswered: “What society-based variables are different from, or have changed since, the SARS and MERS events? Which population areas will sustain R0 > 1 and what are the determinants of this degree of transmission? 5. The interactions between SARS-CoV-2 and the human population can be evaluated by the: “duration of viral shedding (time), titer of viral shedding (number of infectious particles released), duration of viral stability (environmental), and heterogeneity of viral shedding (e.g., “superspreaders”)” 5. Variables that affect mixing in society include: “people per area (densities), daily commuting (housing and workforce structure), close contact interactions (greater travel opportunities), and new behavior patterns (urbanization and greater mobility), among many others” 5. So, the value of R0 and the infectivity of SARS-CoV-2 will probably vary considerably from one community to another. A crowded city in the USA that is relatively uncontrollable may have a much higher infectivity than isolated communities that are sparsely populated.

Two measures commonly used for epidemiological surveillance are morbidity and mortality9. These measures describe the progression and severity of a given health event. Morbidity and mortality are useful tools to learn about risk factors of diseases, as well as to compare and contrast health events in different populations. Even though they are similar and often linked, morbidity and mortality are not identical. Morbidity is the state of being symptomatic or unhealthy due to a disease or condition. It is usually represented or estimated using the terms prevalence or incidence. Prevalence is the proportion of the population with a given symptom or quality. It is calculated by dividing the number of affected individuals by the total number of individuals within a specific population. It is usually a ratio or a percentage. Incidence, on the other hand, shows the frequency at which individuals within a specific population develop a given symptom or quality. It is calculated by dividing the number of new cases within a designated period by the total number of individuals within the population. Mortality, on the other hand, is related to the number of deaths caused by a disease or other event. It can be expressed as a rate or as an absolute number. Mortality usually is stated as a rate per 1000 individuals. It is also called the death rate. To calculation this rate, divide the number of deaths in a given time for a given population by the total population9.

One of the most important factors that affects the prevalence and morbidity of a virus (or other pathogen) is the mode of transmission. The influenza and SARS-CoV-2 viruses are stable outside the body. They are spread through contact between people – especially by coughing and breathing in the virus infected particles, by shaking hands with an infected person or touching a contaminated surface. So, coughing into one’s elbow (instead of one’s hand), avoiding crowds and wearing the proper personal protective equipment (for health care workers) can help prevent the spread of these viruses. In contrast, the HIV virus does not survive well when it is outside the body. So, one can not get the HIV virus from the saliva of a person who is infected or by sitting on a public toilet seat. Instead, it is spread primarily through unprotected sex and sharing contaminated needles.

One of the things that can make a novel virus especially dangerous is when it mutates in such a way that it can subsequently be transmitted from an animal to humans. For example, the H5N1 subtype of the bird flu (avian influenza) became a special concern for public health in 2005 because it could be transmitted from birds to humans10. It led governments to cull (or kill) millions of birds10. It may be possible to quarantine millions of people, but not millions of birds. Even though the 2005 bird flu pandemic ended, concern about newly mutated viruses continued. So, when it was discovered that SARS-CoV-2 was transmitted from an animal (possibly bats) to humans, it became a special concern.

So, the U.S. CDC (Centers for Disease Control) issues updates on the public health response to COVID-1911. They confirmed that person to person spread of the SARS-CoV-2 virus appears to occur mainly by respiratory transmission. However, we don’t know how easily the virus is transmitted between persons. Signs and symptoms of COVID-19 include fever, cough and shortness of breath. “Based on the incubation period of illness for Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS) Coronaviruses, as well as observational data from reports of travel-related COVID-19, CDC estimates that symptoms of COVID-19 occur within 2–14 days after exposure to the SARA-CoV-2 virus. Preliminary data suggest that older adults and persons with underlying health conditions or compromised immune systems might be at greater risk for severe illness from this virus” 11. Since sustained transmission of SARS-CoV-2 in U.S. communities is definitely occurring, the U.S. is implementing actions to slow its spread. This includes containing (isolating) communities like New Rochelle that have a higher incidence of COVID-19 cases, closing schools, restaurants and bars, while forbidding gatherings of over 50 people. Political rallies have ceased. People are being advised to stay home when ill and practice respiratory and hand hygiene11.

When cases of COVID-19 are found that aren’t part of a known chain of transmission, one should assume there are invisible chains of transmission12. There are probably many missed cases. More importantly, it tells us that our attempts to contain the virus have failed. Also, it can be very difficult to find these invisible cases and stop the spread. Epidemiologists realize that for every community-based case, there are many other invisible cases. In a well-prepared society (like South Korea), this leads to widespread testing of everyone who has symptoms or has been exposed to someone with symptoms. This usually leads to finding a lot more cases in the subsequent weeks. In a poorly-prepared society (like the USA), this leads to uncertainty, frustration and even panic buying of toilet paper and guns.

How Vaccines Work

Vaccines help the immune system develop an immunity and prevent a disease from occurring or at least limit its damage to one’s health12. Flu vaccines contain the surface hemagglutinin and neuraminidase proteins that are present in the different subtypes of influenza viruses. When these proteins are injected into the body, they act as antigens that initiate the immune response in our blood. That is, there are both red and white blood cells in human blood. Red blood cells contain iron and hemoglobin that bind oxygen (O2) and carry it throughout the body. There are three major classes of white blood cells: macrophages, B lymphocytes and T lymphocytes. Macrophages swallow up and digest bacteria as well as dead and dying cells. B-lymphocytes are defensive white blood cells that are made in the bone marrow. They produce antibodies that recognize antigens that are left behind by macrophages and subsequently prime or activate T-lymphocytes that are made in the thymus gland. When a person is first exposed to an antigen, it can take a few days or longer to make enough new T-lymphocytes to destroy all the viruses (or other infectious agent, such as bacteria) that have that antigen. If one has an effective immune system, he or she can usually develop an immunity to many infectious diseases even though they have never been vaccinated. For example, at least 98% of the people who have been exposed to the SARS-CoV-2 virus in China did not die. They must have had an adequately efficient immune system. In the process of developing an immunity, the body retains a few T-lymphocytes that are called memory cells. When the same person is exposed to the same infectious agent again later in life, the memory T-cells identify it and stimulate the B-lymphocytes to produce antibodies to attack and eliminate the virus, bacteria or other infectious agent. However, in people with a compromised immune system, it can be difficult or impossible to develop an immunity to a new virus or other infectious agent. So, elderly men as well as people with cardiovascular disease and/or diabetes have a higher risk of mortality caused by the SARS-CoV-2 virus. Interestingly, the mortality due to SARS-CoV-2 is almost zero for children aged 0 to 4 years, even though the very young do not have a fully developed immune system. In contrast, young children are more vulnerable to the influenza virus than older children and young adults. So, there is still much that we need to learn about the SARS-CoV-2 virus12.

Antiviral Drugs

European scientists have identified 31 existing broad-spectrum antiviral agents (BSAAs) that they say may represent candidates for repurposing against the infection13,14. BSAAs are small molecules that may inhibit different types of human viruses that exploit similar metabolic pathways and host factors so they can replicate inside cells. The advantage of repurposing a drug is that it we already know how to synthesize and purify it in large quantities. Moreover, such drugs have been shown to be safe during clinical trials. It is also possible that combining two or more such drugs could be very useful against viruses13,14.

In fact, the anti-viral drug Favilavir has been approved by the National Medical Products Administration of China to treat COVID-19, caused by SARS-CoV-2 infections16. Formerly known as Fapilavir, Favilavir was developed by Zhejiang Hisun Pharmaceutical. It was shown to be effective, with only minor side effects in an ongoing 70-patient clinical trial in Shenzhen, Guangdong province15.

A Promising New Vaccine

At the same time, new vaccines are being developed. The company called Moderna announced that it had shipped the first batch to the NIH’s National Institute of Allergy and Infectious Diseases (NIAID) for use in a planned Phase I study in the USA15. The study, “Safety and Immunogenicity Study of 2019-nCov Vaccine (mRNA-1273) to Treat Novel Coronavirus” (NCT04283461), is being conducted in Seattle, Washington and can be found on ClinicalTrials.gov. The open-label clinical trial is testing different doses of mRNA-1273. It will assess the safety, reactogenicity and immunogenicity of mRNA-1273, while establishing a safe and effective dose. According to NIAID, 45 participants will be enrolled into one of three cohorts (groups) and will receive an intramuscular injection of mRNA-1273 on Days 1 and 29 in the deltoid muscle. The participants will be followed through 12 months after the second vaccination (Day 394). The primary objective is to evaluate the safety and reactogenicity of a 2-dose vaccination schedule of mRNA-1273, given 28 days apart, across three dosages in healthy adults16.

We Are a Strange Species Indeed!

The global elite is insane17. They have inspired governments to hate other humans, while trivializing or ignoring the true threats to humanity: global climate change, nuclear weapons and pandemics. Total worldwide military spending was about $1.8 trillion in 201819. In the USA, the Affordable Care Act (ACA, or Obamacare) created a Prevention and Public Health Fund (PPHF) that was supposed to back “expanded and sustained national investment in prevention and public health programs” 19. In the Budget Act of 2018, $1.35 billion was cut from the PPHF, to be spread out over ten years. The current administration eliminated a key position (The Global Health Security and Biodefense directorate) that would have been involved in pandemic response. They also eliminated the National Security Council’s (NSC’s) Office of Global Health Security and Biodefense in May 2018. It was done to save money after the taxes for the richest people and corporations had been reduced. President Obama had created the unit in 2016 following an Ebola outbreak in West Africa19.

In contrast with the USA, Mexican President Andrés Manuel López Obrador, announced there would be a daily update about the virus each evening20. Those updates cover how many confirmed and suspected cases exist in Mexico, prevention measures, and global information. The President says he will not cancel his daily morning news conferences in the National Palace, usually referred to as las mañaneras20. In contrast, the over a year passed without a White House press briefing in the USA until just this week.

In contrast with the USA, Mexico and other Latin American nations have been relatively unscathed by COVID-1921. Still, they are increasing their efforts to stop or at least control its spread. “As of 13 March, according to the Pan American Health Organization, there had been 389 confirmed cases of COVID-19 in the Americas (excluding the United States and Canada), and five deaths” 21. Also, on 13 March, “Mexico’s Deputy Health Minister Hugo Lopez-Gatell told reporters that the spread of the Coronavirus coming from the U.S. is a concern and could result in action taken at the northern border to remedy it” 22. At the same time, some Mexican citizens are displaying an amusing sense of humor, “A wall is being built on our northern border and the USA is paying for it!”

In contrast, a small, but frightening minority of people in the USA have bought up almost all the toilet paper in the country. There are long lines outside gun stores. The customers say that they need the guns to keep other people from breaking into their homes and stealing their toilet paper. For now, in the USA, if a person calls his or her doctor’s office to tell them that they have a persistent cough, fever and shortness of breath, they will be advised to get a test to see if are infected with SARS-CoV-2. If the test is positive, they are advised to self-quarantine. If their symptoms become unbearable, they can call an emergency phone number (911), and an ambulance will be sent to pick them up and take them to a hospital. However, police are asking other people to stop calling 911 simply because they run out of toilet paper. It looks like the insanity of the global elite is trickling down into some parts of society in the USA.

Conclusion

In conclusion, we simply don’t know how dangerous the SARS-CoV-2 virus and COVID-19 are or will become. Governments and their health agencies are probably going to continue to err on the side of caution until we know much more. At the same time, they will continue to advise people to get a flu shot every year and hope that a vaccine against COVID-19 becomes widely available. We know that the flu shot (or vaccine) will NOT give you the flu. You might experience some of the symptoms that occur with the flu, but you will not be contagious. Even if you do get the flu some time after being vaccinated, the vaccine you received will limit the severity and symptoms. It could even save your life. In addition, governments and their health agencies are going to give similar advice on ways to keep you from becoming infected with either the flu (influenza) virus or the SARS-CoV-2 virus. Wash your hands regularly and thoroughly (for at least 20 seconds per washing). Don’t shake hands with other people – especially strangers. The Japanese and Koreans have a better custom – bow respectfully, but don’t touch the other person or shake hands. When you cough, cough into your elbow. At the same time, do things that can help boost your immune system. Get plenty of sleep and avoid stress, when possible. Don’t smoke, eat a healthy diet that includes plenty of fresh fruits and vegetables. Exercise regularly. Maintain a healthy weight. If you must drink alcohol, do so in moderation. Stay hydrated by drinking plenty of water. Stay vigilant, but don’t panic. When a vaccine comes available, get immunized. In the meantime, if you haven’t received the flu shot (immunized against influenza), you should get it as soon as possible and be sure to get it again next Fall. The flu shot will not keep you from being infected with SARS-CoV-2 virus, but it will keep you from being infected by the influenza virus23. You don’t want to become infected with both the influenza and SARS-CoV-2 viruses at the same time!

Finally, it’s very important that governments develop an effective plan to deal with future epidemics and pandemics. This should include investing much more money and resources into training and educating doctors, nurses and other health care workers, while building more hospitals. There is currently a shortage of qualified doctors and nurses even though we are not yet experiencing a public health crisis. Even though the Global Elite may show signs of insanity, they may soon realize that viruses do not discriminate based on one’s wealth or social status. A wise woman once said that billionaires will spend all their money if it is needed to get medical treatment to cure a deadly disease that they have. Perhaps the billionaires should use more of their money to help prevent and treat diseases, like the Bill & Melinda Gates Foundation does, before it’s too late24. I would like to finish by quoting one of my favorite authors at Wall Street International, Ellyn Kaschak25:

A stronger force approaches now, a higher power- Mother Nature herself. She has been trying for some time to alert her children to the very imminent destruction of the universe that she creates and that creates her each and every day. The entire planet is gravely ill and that illness may, indeed, be terminal. However, even “imminent” does not work on the ignorant, the greedy. They can continue to lie and deny because it is not yet happening in front of their own veiled eyes. The evidence is not clear enough for them and, as yet, carries no consequences discernible to them. Instead their guns, their greed and their prejudices remain central to them. They believe that they are winning a war that they are about to lose to an opponent that they cannot best. Here comes the mother of us all, Mother Nature, patiently working to get the attention of the would-be monarch and his minions. Mother knows best”25.

As she wrote in another article: “We Are a Strange Species”26.

Notes

1 COVID-19 Coronavirus Outbreak. Worldodometer, 20 March, 2020.
2 World Health Organization. Up to 650 000 People Die of Respiratory Diseases Linked to Flu Each Year.
3 Paget, J. et al. Global Mortality Associated with Seasonal Influenza Epidemics: New Burden Estimates and Predictors from the GLaMOR Project. Journal of Global Health, Volume 9, Article 020421, 2019.
4 World Health Organization. Recommended Composition of Influenza Virus Vaccines for Use in the 2019-2020 Northern Hemisphere Influenza Season. 2019.
5 Worldodometers.info/Coronavirus. COVID-19 Coronavirus Outbreak.
6 Jones, J.H. Notes on R0. Stanford University, 2007.
7 China CDC, Vital Surveillances: The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19)—China 2020.
8 Wu, J. T. et al. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet, doi: 10.1016/S0140-6736(20)30260-9 (2020).
9 Hernandez, J.B.R. and Kim, P.Y. Epidemiology Morbidity and Mortality. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020.
10 Bird flu 2005: The Ongoing Story. Nature News, 2005.
11 Jernigan, D.B. CDC. Update: Public Health Response to the Coronavirus Disease 2019 Outbreak — United States, February 24, 2020.
12 Landon, M. COVID-19: What we know so far about the 2019 novel Coronavirus, University of Chicago Medicine.
13 CDC. Understanding How Vaccines Work. 2018.
14 CDC. Genetic Engineering & Biotechnology News, 2020.
15 Andersen, P.I. et al. Discovery and Development of Safe-in-man Broad-Spectrum Antiviral Agents. International Journal of Infectious Diseases, 2020.
16 Pharmaceutical Technology China approves first anti-viral drug against Coronavirus Covid-19.
17 Burrowes, R.J. The Global Elite is Insane Revisited. Wall Street International, 8 November, 2018.
18 Moderna, NIAID Partner on Planned Trial of Coronavirus mRNA Vaccine. Genetic Engineering & Biotechnology News, 2020.
19 Robertson, L. et al. Democrats’Misleading Coronavirus Claims. Posted on 3 March, 2020.
20 McConnell, P. et al. Mexico, Latin America gear up for next phase of Coronavirus threat. 14 March 2020.
21 McDonnell, P.J. et al. Mexico, Latin America Gear Up for Next Phase of Coronavirus Threat. Los Angeles Times, 14 March, 2020.
22 Wade, P. Mexico Considers Border Restrictions as U.S. COVID-19 Cases Rise. Rolling Stone, 14 March, 2020.
23 Miller, A.M. Why you should still get the flu shot, even though it won't directly protect you from the Coronavirus. Insider. Accessed 16 March, 2020.
24 Bill & Melinda Gates Foundation. All Lives Have Equal Value, 2020.
25 Kaschak, E. La Corona or the Crown? What a Difference a Word Makes in the Trumpian Kingdom. Wall Street International, 10 March 2020,
26 Kaschak, E. Life and Death. We are a Strange Species. Wall Street International, 10 June 2018.