IN any war, it is best to know one’s enemy well to have a better chance of survival. We must know all we can about our invisible adversary, SARS-CoV2 virus, the cause of the current COVID-19 pandemic, in order to defeat this virus. As of 7 a.m., Wednesday, April 1, it had infected almost a million and killed more than 50,000 worldwide in 203 countries, including 188,881 cases in the USA with 4,066 deaths, 81,554 in China, with 3,312 deaths, and 2,311 in the Philippines, with 96 deaths. The numbers and fatalities are still going up. It is suggested that 30 percent or more of the world population could be infected before this pandemic ends. WHO estimates the average mortality death to be 3.4%, and 15% for those admitted to the hospital.
Viruses are not alive
What is a virus? Contrary to conventional knowledge, viruses are not living microorganisms like bacteria, so the virus is not “alive.” It is actually a protein molecule (DNA) covered by a protective layer of lipid (fat), which when absorbed by the cells of our ocular (eyes), nasal (nose) or buccal (mouth) mucosal lining, “instantly changes its genetic code (mutate) and rapidly converts itself into an aggressor and multiplier cell,” then replicates superfast in a host (in animals, in the case of COVID-19, like bats, which was transmitted to humans in Wuhan, Hubei, China) and massively attack and damage the main target: the lungs (resulting in pneumonia, which is the final killer).
The virus is unable to “survive” on its own, without a host. It is totally dependent, a parasite, which decays on its own outside of a living host. On surfaces, this protein molecule will lose its potential activeness (destroyed) within a period of time (see list below), depending on the material of the surface.
We can destroy and inactivate the molecule by damaging/altering its DNA thru handwashing with foamy soap and water (preferably warm, since it hates temperature beyond 23˚C or 73˚F) for at least 20 seconds, and drying our hands well since it loves moisture. It is also destroyed by disinfectants: at least 70% alcohol; diluted chlorine bleach (5 tbsp per gallon water); likely by UVC light, which damages its DNA to disable replication; by anti-SARS-CoV2 medications (the old anti-malarial drug Hydroxychloroquine, with Azithromycin for the pneumonia), a combo still being clinically tried; and prevented with a vaccine, now being developed.
The foam that forms when we wash our hands with soap and warm water (heat melts fats) cuts, destroys, and dissolves the protective fats around this very fragile virus, breaking and dispersing the protein molecule on its own, inactivated. The same good effect happens when we wash our face or take a shower.
SARS-CoV2 virus on surfaces
Recent studies have suggested that the SARS-CoV2 virus remains active on various surfaces for different length of time:
From the time an infected person coughs or sneezes, the trajectory of the virus-loaded droplets stay in the air for up to 3 hours, and thereafter settle on the ground within about 6 to 10 feet, depending on the air flow or wind. It is best not to do dusting or shake clean clothing, which will spread the virus more. Use damp cloth to clean the floor, to limit the virus from flying around.
On copper and wooden surfaces, it stays active for up to 4 hours. On cardboard and paper, this virus could survive up to 24 hours, and about 2 to 3 days on ATM machines (screen and keypad), likewise on plastic and metal surfaces. It is unclear for porous material, like clothing and textile, but it is suspected that the virus may be absorbed by the fiber and the virus dies more quickly than on hard surfaces.
Since the virus does not survive well when the temperature is above 73˚F (23˚C), when the summer months arrive in the sun belt States and in other countries, the hot season might mitigate the spread of the virus somewhat. Since the SARS-CoV2 virus is new, we still have a lot to learn about it.
New speedy testing
At the behest of President Trump, the FDA had fast-tracked the approval for countless labs to develop tests for COVID-19. He announced recently that Abbott Lab had developed lightning-fast and accurate instant “point-of-care” molecular test that can be performed in doctor’s offices, hospitals, etc., which will yield positive results in 5 minutes and 13 minutes for negative test, on the spot. This brilliant test was launched on April 1. This good news should not make us overly confident and careless. The mnemonic COVID strategy we coined below is still the best tactic we have against COVID-19 to save ourselves, our loved ones, and the elderly.
UVC light: Anti-viral
Since UVC light was found to be effective in damaging the DNA of viruses in past MERS/SARS epidemic and pandemic, it is reasonable to suspect that UVC light could also be effective in destroying the SARS-CoV2 virus. All medical centers have been routinely sterilizing their OR and ICUs, etc. using UVC light for more than a century, after it was invented in 1801. Many have been trying it these days to sterilize the much-needed Personal Protective Equipment (PPE) for our medical front-liners, like masks, eye wears, gowns, gloves, etc., which are in low supply. In Italy 50 physicians have died from COVID-19, six in the Philippines, and countless around the globe, including in China, Spain, and Iran, among others. Caution: UVC light is injurious to the skin (burns and potential skin cancer) and to the eyes (cataract formation). Use only on empty rooms.
HydroxyChloroquine + Azithromax
Following President Trump’s request, the FDA has reluctantly allowed the off-label use of Hydroxycholoquine (used for decades for malaria, lupus, arthritis, amebiasis), for trial use for COVID-19 patients. Added to treat the COVID-19 pneumonia, is Azithromycin, a previously approved antibiotic. Some initial reports are very encouraging, especially from France. The next question is whether hydroxychloroquine could also be effective for prophylaxis, to prevent infection by this virus, especially those physicians and other front-liners, the unsung heroes putting themselves in harm’s way in this pandemic, who are directly exposed to COVID-19 patients day in and day out, like my own four children and three sons-in-law, who are treating patients without adequate PPE to protect them.
Convalescent serum
The serum from recovered virus patients in past pandemics, including in the 1918 Spanish Flu that killed about 100 million, MERS, and SARS, showed that their (serum) contained a lot of antibodies that could be transfused to those infected with the virus to help them fight the infection successfully, in an otherwise helpless situation. The regimen is now used as an adjunct therapy for COVID-19 patients.
ECMO for severe COVID-19
The use of Extra-Corporeal Membrane Oxygenator (heart-lung machine used routinely in open-heart surgery) is an option among those with COVID-19 pneumonia that is not responding to standard ventilator, which are in serious short supply even in the U.S. The ECMO acts as an artificial lung to keep the patient’s blood oxygenated. There are indications, restrictions, and limitations of this treatment.
To end COVID-19, practice COVID
The best tool we have to end this deadly pandemic faster and sooner is this common sense personal behavioral modification DIY strategy – Fight COVID-19 with COVID: Cover face to scratch, sneeze or cough; Omit non-essential travels; Voluntary quarantine; Intensive handwashing; Distancing.
Potential threat
A clinical report from China says the SARS-CoV2 virus was found in the saliva of recovered patients 39 days after the pharyngeal swab was negative and positive in feces up to 13 days afterwards. The question is whether those who had recovered and had tested negative are truly virus-free and non-contagious. The other is, is the virus also spread by fecal contamination? Studies are ongoing.
Our unsung heroes
While we who are able to stay home on self-quarantine are safe, front-liner physicians, nurses, allied healthcare and other hospital personnel, first responders of every kind, put themselves in harm’s way, exposing themselves to the killer virus 24/7, stepping out of their comfort zone in the name of selfless service to their sick fellowmen. Even their families at home are at a higher risk. They are our unsung heroes. At least 50 physicians treating COVID-19 patients in Italy have died from COVID-19, six physicians in the Philippines (the youngest in her mid-30s), and unaccounted for numbers in China, Spain, Iran, Korea and the U.S.
There is one thing, individually, we can do to help them: STAY OUT OF THE WAY. Stay home and avoid getting infected and spreading it to others, especially to the elderly, majority of whom have health issues. Let us not be the carrier of the virus and the courier of death.
Once again, unless someone at home had tested positive, a clean and well-ventilated home is the safest sanctuary against COVID-19 and other infectious diseases. Young people can also die from COVID-19. Among the youngest ones who died so far were ages 12, 17, 24, and 26 years old.
The young man on the beach teeming with people during his summer break two weeks ago saying on TV “It’s my civil right to do what I want with my body and enjoy,” is obviously stupid and a greater threat than the virus to the public and especially to freedom and democracy. He has the right to kill himself but not others.
Gear up when outside
If we have to go out to a grocery store, drug store, or for other essential matters, let us put on gloves, mask, and a cap, observe distancing, and wash our hands properly and frequently. We must not touch the mask either. Having a healthy dose of paranoia (medical vigilance) during this deadly pandemic is also helpful to protect ourselves and our family. Our invisible enemy is out there killing humans rapidly, including the young.
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Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, a Health Advocate, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. Websites: philipSchua.com and FUN8888.com; Email: [email protected].
