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Local doctor discusses why some become ill with COVID-19, die

By BILL BARKSDALE

Special to the Democrat

This is the second part of an interview with Dr. Kenneth Stubbs of Internal Medicine and Associates of Natchez.

Q: What is Covid-19 and why do some people become very ill and succumb to the virus? 

A: This is a brand new virus and we are learning more about it every day, every hour. The guidelines we suggest today may not hold true tomorrow, and that’s the nature of what we are all dealing with. World-class virologists, epidemiologists are frantically working on this every day.

We hope at some point there will be new potential therapies that may help those infected, but vaccines are probably 18 months away because of how thoroughly vaccines are tested.

Covid-19 originated in animals, and it made a jump to humans, probably around September of 2019. There were some genetic mutations in the virus that allowed it to bind to human proteins.

To date, we believe that the virus attaches itself to chemical receptors that are found in the respiratory tract. The virus is toxic to the lung tissue, causing damage and inflammation. 

In the small subset of people who get extremely ill or die, it appears that our own immune system also plays a part in that respiratory distress. Our bodies have a natural response to viruses. When our bodies detect a virus, cytokines (small secreted proteins) are deployed to fight it.

The current thinking is that in some patients, too many cytokines are released, a phenomenon known as a cytokine storm. A cytokine storm itself causes more damage to the lungs, increasing respiratory distress. It is the cytokine storm, going unchecked, that can lead to Acute Respiratory Distress Syndrome and which can then be fatal.

The cytokine storm also can damage other areas of the body. For example, it can suddenly drop your blood pressure very low. That is why persons with previous respiratory conditions or low immunity seem to be more at risk than others.

Q: Why does the virus seem to spread so quickly?

A: The best thinking today is that it spreads quickly because there is no herd immunity that we know of (a term used to describe common immunities that human communities have built up over time.) We don’t have answers about the degree of herd immunity, tests need to be developed to fully answer those questions.

In the first few weeks of dealing with Covid-19, it seemed that younger people were not affected by it. We now know that is not true. This virus can infect anyone at any age, and the experts now believe 25% of those infected are asymptomatic.

Q: What can we do to help?

A: Because this particular type of corona virus has not been here before, it has infected a lot of people all at once. Which is why all of us are pleading with the public to put mitigation in place. Mitigation means to physically isolate yourself, distance yourself at least 6 feet when you have to be out in public, continually wash your hands, don’t touch your face, and above all: if you are coughing, sneezing or think you may be in the least bit sick, don’t go anywhere. Everyone for now should absolutely stay home. Don’t go out, don’t spread this bug, because many people will get it, and it will overwhelm the health care system.