Wednesday, April 08, 2020

REFLECTIONS ON COVID-19 SO FAR

There is a body of thought that suspects disease is not an entity that crawls around looking for something to infect, but more likely a malfunction of relationships, contexts that are destructive, actions that invite trouble.  The idea is almost instantly corrupted to what individuals want the world to be like for themselves to be more comfortable, but there is a valid sense in which a disease (dis-ease) manifests when there is opportunity, which means that if you can find where the knot in the process has developed, it’s possible to untie it, which may relieve difficulties that had seemed unrelated.

This set of reflections is in part a reaction to a vid by Sam Vaknin.  I would post a link to his vid but it has since disappeared.  I suspect that much public thought is being “managed”.  Sam — who is Israeli and has a mixed background of medicine, physics, psychiatry, and getting in trouble — expressed bafflement about our current pandemic.  He approaches the world through math, mostly, and compared this virus version to flu, another corona virus.  He finds that the fatality rate is higher for flu, the rates of infection are not that different.  The main diff seems to be that covid-19 came in one big onslaught, but flu is just going along all the time at lower levels.

Choosing flu is rather arbitrary since there has been a sequence of exotic viruses that sweep through populations.  The media has seized on ebola, so deadly that it can hardly travel because victims die quickly, MERS, SARS, H1N1, Zika.  Most of the new ones come from our growing edge of population pushing into areas that were previously isolated, like jungle, and eating or otherwise interacting with the animals there.  I don’t know the origins of constant viral persistence like sdt’s, tuberculosis, and so on.  The one I’m most likely to get is toxoplasmosis, from cat poop.  But it hurts mostly pregnant women, going to gestating brains.

Flu is a parasite virus.  All viruses are parasites because they enter complete cells with their own RNA and convert the cell to their own uses.  Necessarily, the success of the virus depends or varies according to the kind of cell it invades.  There is enormous variation in cells and they fight back with their immune systems, some of which are in the cell and others in their medium, like blood or lymph.  

In fact, I’ve read one suggestion that since it is suspected that the vector for corvid-19 is large bats like fruit bats, which eat many things and have developed formidable immune defenses, the virus that developed in them has to be able to survive such immunity.  People with weak immune systems may succumb, or maybe the war between immunity white cells and the virus are so violent that it kills the host animal.  Investigators have noted that people have less immunity to natural troublemakers like those found in dirt, but may have overdeveloped problems with “autoimmunity” so that the immune system attacks some of their own cells.  I have a tendency towards autoimmunity, despite or because of the amount of dirt I’ve ingested over the years.  

Statistically, flu and some other viruses are “worse” than this Covid-19.  The number of infections, the depth of infection in individuals both in numbers and in individual consequences, the kind of symptoms, the number of deaths, the number of recoveries, the contagiousness, are all only provisionally guessed at, since there is no universal testing program and not enough tests.  But it does appear that some people catch it, have no symptoms, and need no special treatment.  Especially children.

There are demographic consequences, statistically, because people who are stigmatized and neglected by poverty are already at risk to infections and tend to have much worse consequences from co-morbidities.  It is also a distinct different between a flu that comes around now and then, and this covid-19 that crashed down on us all at once, exceeding our capacity to take care of people.  Looking at the system then, we realize it has become concentrated in big hospitals, has starved out the local hospitals, and dependent on just-in-time provider systems.  We’ve let our warehousing literally rot.  We’ve taken our health system for granted and therefore ignored it, even fired the people who were originally charged with monitoring our readiness.  WE LET THIS PANDEMIC HAPPEN

Obvious symptoms are dramatically like Darth Vader remotely strangling people who annoy him.  Remember how he holds out his hand at them and they fall back clawing at their collars?  Failure to get enough air into the lungs and through the walls of the organs into the blood stream is a problem that causes a lot of struggle on the edge of death.  Treatment is semi-brutal — forced breathing.  First high oxygen air, next intubation so a pump can push air.  I presume there are drugs meant to help the cells of the lung walls.

Heart attacks kill because a heart cannot pump oxygen through the body.  Cyanide kills because the molecule replaces oxygen in the blood so that though it circulates it cannot carry the oxygen.  Suffocation, circulation and choking prevent air intake.  The death of Elvis from inhaling a bottle cap and the death of Mama Cass from a bit of ham sandwich stuck in her throat show how vulnerable the air passages are to being blocked.

Researchers immediately began working to map the genome of this virus (which is only genetic material that cannot be expressed except by hijacking a complete cell and using its machinery.)  No one has said anything about what cell the virus hijacks — does it act differently if it grabs a blood cell than it does if it gets into a muscle cell?  

Our technical means are almost capable of tracing every step from how the virus touches the cell to how it gets inside and what it grabs to change which DNA is used.  How does it direct the creation of more virus instead of settling down to peacefully live there?  We use viruses to send our gene splicing chemicals into a cell, but people don’t normally die from it.

Two other variables might get into the story.  One is the number and kind of pre-existing breathing disorders, including those that are deliberate inhalants like smoking or antihistamines, or those that are from things like stoves that produce particles or the general toxicity of places with a lot of air pollution.   Consequences for lungs are in lead in gasoline, particulates from asbestos,  volatiles in liquids or glues that are deliberately “huffed”, out-gassing from new fabrics or furniture.

Demographics about nutrition, medical care, and income all affect general health more than we’ve admitted in the past. These differences put an emotional and political valence on the statistics and actualities, things like ambulance service, local hospitals, proportion of docs to patients, make a major difference in consequences.  Since they are locally supported with occasional help from governmental bodies or NGO’s, they vary.  The religious bodies, like orders of nuns who used to sponsor medical care, have withdrawn.

We are all living much longer than we used to and are much more willing to devote major money to maintaining people in special care nursing homes, even when they are comatose and near death.  This means more vulnerability — or if you’re cold, which Vaknin claims as an attitude — people die who in past times would already be dead, often by pneumonia — infection of the lungs.  

This is different from the failure of muscles to pump the movement that causes air intake.  This earlier paralysis was the way that infantile paralysis killed.  Forced breathing at that pandemic was in an iron lung which left the head outside and functioning.  This is different from the frightening tube (intubation) that prevents communication in order to deliver air, which is an attack on one’s identity and ability to relate to others.

We have been devoted to the “germ theory” that blames and attacks microbes that endanger us, but we have not looked so much as the changes in ourselves over the years.  Human genomes continue to mutate but also our assumptions about how to live can change radically.  Solitary or group settings, exposure to different kinds of people, travel — esp. flying, but also in cars — can be bits on the scales.  Breathing has a mechanical aspect that distracts us from the kind and quality of the air until we taste it, smell it, or choke on it.

Does this water feel warm to you?

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