What do we know now? [Video]

At the beginning of the COVID-19 pandemic, ACS Reactions turned on their usual content to provide reliable information about the coronavirus of the experts. One year later, they went to some of the experts again and asked, “What do we know now that we were not then?”

Video transcript:

So I’m in week 3 of self quarantine, and now we’re in week
(dramatic music)
47!

Last year we talked to a bunch of experts about what was then a new coronavirus. A virus that has since killed nearly 500,000 people in the US and more than 2 million people worldwide.

Today we are going to look again at some of the experts and ask what do we know now that we did not know then? And how will the information help us in the coming months or years?

(clear music)

(laughingly)

Sorry.

(laughingly)

Sorry, continue.

At the beginning of the pandemic, we all wondered when we would get a vaccine so that life could become normal. I called virologist Dr. Ben Neuman, who has been studying coronaviruses for decades. And I asked him what do scientists need to know to create a vaccine?

He said that it is critical to have an in-depth understanding of the proteins that the virus allows in our cells. Fortunately, we already know a few important things about this coronavirus because a similar 2003 caused the SARS outbreak.

[Dr. Neuman] Okay, so the SARS coronavirus has a protein on the outside called the vein protein. And it’s going to affect the ACE2 on the outside of a lung cell.

[Sam] Researchers also knew this EARS-CoV-2 would not be able to infect ACE2 cells without a co-receptor. The co-receptor modifies the peak, activating it essentially so that once it binds to ACE2, it can infect the cell.

(cash register bells)

At the time, they suspected that the co-receptor was probably a protein called TMPRSS2.

[Dr. Neuman] Since then, we have learned all the other TMPRSS proteins, because if there is a two, there is a lot more, (laughs). I think they rise to 11 or 12, and it seems that at least half of these infection can be supported.

[Sam] SARS-CoV-2 can use a bunch of these TMPRSS proteins that are available everywhere. Brain cells, lung cells, heart cells, cells in your stomach. So you would think that all these cell types can become infected.

[Dr. Neuman] People expected much more direct infection of the heart, much more direct infection in the brain. The evidence for both is not yet particularly strong.

[Sam] There are some reports of patients with heart inflammation or symptoms in other parts of the body, but the direct infection by the virus seems quite rare. After a year, it is clear that it mainly infects our lungs, but it is not clear why.

Then why does it matter? Why should we care about this? We already have some vaccinations against SARS-CoV-2.

Well, you saw the news. There are other variants of SARS-CoV-2 emerging, and if this virus mutates to the point where current vaccines are no longer effective, we will have to redesign it.

And if we want to do that, it’s critical that we understand this virus as deeply as possible.

Meanwhile, some of these emerging variants may be more transferable. Which means wearing a mask is more important than ever. Early information about masks, at least in the US, was confusing. So in April, we spoke to an expert to get a straight answer.

N-95 better than surgical mask, better than cloth mask. But if you take into account what your real risk and needs according to population are, a cloth mask is totally good for the general public.

[Sam] And it turns out, right?

[Dr. Soe-Lin] I’ve always said that the three, my three favorite words in the English language, are not like ‘I love you’, they are ‘you were right’. (laughingly)

[Sam] There are now dozens of studies showing that cloth masks work, but that does not mean that all cloth masks are the same.

This is what we’ve learned so far: multilayer cloth wire masks block 80% of all breathing drops of the person wearing the mask and more than half of the small droplets and particles.

Even the small particles that do get through do not move that far. The effectiveness of some cloth masks is even similar to surgical masks.

And we learned that masks not only protect other people, but also protect the person wearing the mask. It may seem obvious now, but early in the pandemic we did not know it.

[Dr. Soe-Lin] I did not think it would be so effective. I just felt a little desperate at first that we had nothing. So I thought, you know, all the primary literature has shown that this is going to be an effect of 20%. I thought, well, 20% is better than nothing. You have to take it. I did not think it was going to sweep like that.

With these new variants of SARS-CoV-2, which may be more transmissible, some European countries require people to wear medical masks in public.

This is a rapidly changing situation. So keep an eye on CDC guidelines. We left a link in the video description. Either way, it’s clear that masks work. Social distancing work. But there was another recommendation that we should start early.

[Dr. Soe-Lin] Do you remember that they still said, “Wash your hands”?

[Sam] Yes.

[Dr. Soe-Lin] I mean it’s important to wash your hands, but you have to wash your hands anyway, but I wish we could wash our hands from this epidemic. I mean, it’s not even fully appreciated how aerosolized this virus was.

[Sam] Soap was the thing at the beginning of the pandemic. Our first COVIDeo, get it? COVID E O. Our first COVIDeo was about the chemistry behind the way SARS kills SARS-CoV-2.

These surfactants can actually wedge first into the lipid bilayer, lipophilic end, and when this happens, the virus will break apart. (crackling sound)

[Sam] Soap does kill the virus. It has not changed. It was just that at the time we did not realize that we were spreading this virus almost exclusively through the air.

[Sam] Dr. Soe-Lin was right. Masks are an excellent way to prevent infection. But what do we do for someone who does get infected? Last year in May we looked at medicines that can block the SARS-CoV-2 infection, or stop it before it gets really bad. These drugs are called antiviral drugs.

Every time you take a drug that is in people, there is always a hope that you can revive it for something else. And sometimes drugs can affect more than one virus, even if you developed it for Ebola. So people said, let’s test it.

He’s talking about a drug you may have heard of. This is called Remdesivir.

[Sam] In the fall of last year, the NIH concluded that Remdesivir works quite well. It seems to shorten recovery time, and it may help prevent progression to worse versions of COVID-19. But here’s the problem.

[Vincent Racaniello] Its main effect is to block virus reproduction. And this is not your problem once you’re in the hospital. Your problem is that you have an excessive immune response which also causes all these problems in your lungs and other organs.

It’s one of the things we learned that you, this disease, initially have a viral infection in your upper channel, which lasts maybe ten days, but then you have this immune response that causes incredible diseases.

And so they give Remdesivir to people who are hospitalized. And by that time, an antiviral drug is not needed. It’s too late. At that point you do not need any antiviral drug, you need to dampen your immune response.

[Sam] Once you are at the point where you need to go to the hospital, SARS-CoV-2 had a lot of time to repeat and spread. And most of it has been cleared up by your immune system, which is now too hard.

You do not die from SARS-CoV-2, you die because of the reaction of your immune system to it. So yes, Remdesivir can help prevent the virus from recurring, but in severe cases of COVID, the virus really is no longer the problem.

[Dr. Neuman] Say the virus is like a stick of dynamite and say the disease is like an avalanche. The stick dynamite starts it. But you know, what the antiviral drugs do is they try to stick the little fuse on the dynamite.

Once it has blown, the deluge comes, whether you like it or not. And you know, you can pour all the water you want on the remnants of the dynamite, but that’s not going to stop the avalanche, yeah.

And so we have nothing that can delay – … the immune response down.

[Sam] This is such a great metaphor. Andrew, did you catch it?
(laughingly)

– Sorry.

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