Coronaios, One Year Later – What We Have Learned, What We Still Don’t Know

December 31, 2019 – December 31, 2020. A year after China’s first official announcement about the emergence of a new mysterious virus, which mainly affects the respiratory system causing pneumonia. A time that has already cost the lives of more than 1.8 million of our fellow men and has brought many changes to the lives of everyone else, many of which are here to stay.

This time, among other things, he pushed the limits of scientists; in fact, it forced them to overcome them. And indeed very quickly, as evidenced by the shorter time compared to any other time required both to decode the DNA of the new coronavirus (the Chinese published its genetic structure on January 21 and three days later they presented it in full) and to start the first human vaccine trials (in just 67 days, when H1N1 required 89, Ebola 164, and SARS 323).

The dark sides

However, despite the tremendous efforts made and the undoubted achievements, still today some important aspects remain that remain “dark” for researchers and, consequently, for all of us, “common mortals”. “We have learned a lot, but to the point where we know everything in detail, we have countless miles to go.” It is something that microbiologists and public health professionals have been working on for decades, “Maureen Ferrand told CNN, Assistant Professor at the Rochester Institute of Technology.

The effort is now focused on solving these mysteries, something that is seen as the free shot at the “invisible enemy” who declared war on us. And the effort will continue, even if it is known that there are other things that science has not yet answered, such as the animal that Ebola “jumped” from some 40 years ago.

1. Origin of the virus

   Despite conspiracy theories, the vast majority of scientists agree that, as CNN notes, “Covid-19 is due to a coronavirus, a type of virus that is responsible for everything from the common cold to SARS “. However, according to Deutsche Welle in their analysis, “it is not clear exactly when and where the virus was transmitted from animals to humans.” Transmission from a bat to an intermediate host, possibly an Asian raccoon, and then to humans is considered the possible source of the pandemic. “But although the” home “was initially estimated to be on the market in the Chinese city of Wuhan (which became the first to be severely quarantined), a study published in the Lancet magazine in January showed that a third of the first patients had no relationship or direct contact with that market.There is now evidence that the virus has been present in various parts of the world since the end of the summer of 2019, such as in the US. , But also in Italy, where it was detected in samples collected in September this year.

2. How it is transmitted

   While there is no doubt that transmission is – and easier and faster than the so-called “seasonal flu” – from person to person, there is no complete picture of how it is primarily done. Nor, of course, for the exact moment when a “carrier” can spread the virus. Many scientists also believe that transmission is mainly due to droplets that are emitted from coughing or sneezing, which means that ordinary masks can also protect effectively. Others argue, however, that aerosols, which are particles with a much smaller diameter and which can linger in the air for hours over long distances, bear a greater responsibility, as even their transmission is accelerated by air conditioning units. This is why the use of at least disposable surgical masks is recommended, while at the same time, there is a resurgence of interest in air sterilization systems, with ultraviolet radiation technologies, photocatalytic oxidation and (controlled) ozone use. However, research on the process of transmission and infection continues, along with research on strains resulting from mutations (expected and normal).

3. Symptoms and complications

   To date, several studies and publications have been carried out on the population groups that more easily “catch” the coronavirus (different blood groups, residents of the North or South, etc.), but also with the symptoms that usually accompany it. There are statistics, for example, that show that people with underlying diseases, the elderly, blood group A and men are relatively more likely to become infected, to show severe symptoms, but also complications. However, this is not a law. That is why a letter published in the Annals of Internal Medicine in November referred to the case of 60-year-old twins who were diagnosed and hospitalized, but while one was discharged in two weeks without further adventures, the other had to be admitted. in the ICU and intubated. Symptoms are also known to vary from case to case, without anyone being able to explain what determines which will occur: a simple cough and / or shortness of breath, high fever and / or severe headache, loss of smell and / or taste. , diarrhea and / or bone pain?

4. Treatment and drugs

   The bottom line is that there is currently no fully effective and certified drug for the treatment of Covid-19 patients. It is well known that doctors in hospitals and ICUs continue to develop and use various “cocktails” of preparations, using the experience they acquire over time and the cases they handle. It is known that in recent months, a number of substances that presented themselves as “miracle workers” did not confirm his reputation. Hydroxychloroquine, for example, has been shown to be ineffective and potentially dangerous, dexamethasone is still in doubt, azithromycin has “limits”, and WHO has recommended that remedesivir not be used in hospitalized patients. At the same time, there is a heated debate about monoclonal antibodies, which come from patients who have been cured, developed in the laboratory, and administered to boost the immune system. Many cite its high cost (around $ 1,000 per dose) and the difficulty of mass production to justify its low availability; others argue that they could prove to be free saviors and ICUs, saving many lives.

5. The duration of the disease and immunity.

   Not a few have found and reported “remnants” of Covid-19 even for several weeks after being judged “clean.” For example, according to a study published in the British Medical Journal in August, 10% of patients had symptoms, sometimes mild, sometimes more severe, up to 12 weeks after testing positive. Also crucial is the question of how long a person recovering from Covid-19 shows immunity (thus retaining the proper and competent antibodies) or whether and to what extent it is possible to get sick a second time “under the hood” or become a carrier of the virus. The evaluations of doctors and scientists also vary in this sense, some speak for a few months and others go up to one or more years. Something similar happens, of course, with vaccination and artificial immunity. It is no coincidence, after all, that none of the companies that produce formulations, not even those that have already received the corresponding approvals, risk giving guarantees for a specified period of immunity.

6. Vaccination

   Undoubtedly, the subject that has been dominating lately and is expected to dominate all of 2021. And here the (reasonable) questions are many. Although the question of serious side effects (for all types of vaccines) is probably not raised by serious scientists, the same is not the case with the rate of efficacy and protection, the number of doses needed, the time interval between them and several plus. The rush of governments and companies to give approvals and start the process, under the enormous pressure of cases and deaths, often generates confusion and doubt – at the same time that it is butter on the bread of all kinds of “sprinkles”.

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