“Will my loved ones survive?”- Dr Shravan Verma explains what COVID-19 does to your body.
It has been a month since Singapore confirmed its first cases of COVID-19 and I have been busier than ever before. With so much yet unknown about the virus, I have seen people choosing to avoid clinics and instead opting to engage our house call services for a variety of reasons, including chronic care, elective procedures, and even medicine delivery. As the death toll from COVID-19 continues to rise beyond 2,200, with more and more countries reporting their first deaths, I can definitely understand why people are fearful of catching the virus.
But, how likely are you to die from COVID-19? I recently read a study by the Chinese Centre for Disease Control (CCDC), which found that you were most at risk if you are elderly or if you already have a pre-existing condition such as cardiovascular disease or diabetes. In fact, almost 80% of cases were said to be mild, with an overall death rate of 2.3%. But, I believe that the death rate might be lower, as it is difficult to know exact numbers at this stage of the epidemic, and experts believe there are many unreported cases.
So, what the study means is simply this — most people will recover from COVID-19. That said, I do think it is important to understand exactly what happens in your body if you contract the virus.
COVID-19 is a coronavirus, which is a respiratory disease that primarily attacks your lungs. Most patients report flu-like symptoms, including a fever, runny nose, sore throat, and cough, though there has been at least one confirmed asymptomatic case. It is less fatal than SARS, but it has been said to follow similar infection patterns.
The virus starts off by first rapidly invading the human lungs and killing off its cilia cells. Cilia cells work to keep debris and other foreign bodies out of our lungs, so killing it would cause our lungs to fill up with debris and fluid, resulting in pneumonia. This fluid in the lungs is how China is using CT scans to swiftly identify and isolate suspected cases.
Then, the immune system steps up, flooding the lungs with immune cells to try and fight off the virus and repair the damage. Usually, if your immune system is working properly, this process would only happen to infected areas in the lungs. But sometimes, the immune system gets confused and those cells end up attacking even the healthy lung tissue, causing even more damage and worsening the pneumonia.
I’ve heard people wonder if COVID-19 always leads to pneumonia. No, it doesn’t. New studies coming out of China suggest that the virus might behave more like influenza, infecting both upper and lower respiratory tracts. So, it is entirely possible that you might only have a runny nose and sore throat and none of the lower respiratory symptoms like shortness of breath.
Severe pneumonia can make it harder for your lungs to get oxygen out into your blood and to your organs, which is required for your body to function properly. Without oxygen, your body starts to shut down and that’s when you might have organ failure and eventual death. This is exactly why COVID-19 patients in the hospital in critical condition have been put on additional oxygen support.
But why does this put the elderly and those with underlying conditions most at risk? Firstly, our immune system weakens as we get older. Secondly, chronic conditions like heart disease and diabetes can make it more difficult for the body to recover from infections.
In fact, in the recent deaths being reported from several countries, these factors were mostly present. The second fatality from Hong Kong was a 70-year-old man who had underlying kidney problems and diabetes, while the first deaths from the Diamond Princess were a couple in their 80s. The man was reported to have bronchial asthma and a history of angina treatment.
That is not to say that if you’re young and healthy, you should not worry about taking precautions against the virus. Everyone should continue to practice good hygiene and stay at home if you feel unwell.
I’ve heard people wondering if the virus could mutate and potentially get worse. It is difficult to know for sure if it would mutate or die out. After all, the last reported case of SARS was in 2004, which means that it was successfully contained.
But, some experts do believe that the virus might mutate into something milder. Viruses aim to spread and cause disease to as many hosts as possible, and if it were pathogenic enough to kill its host, then it wouldn’t be able to do this. So, it is more likely that if it were to mutate, it would become milder so it can continue to propagate, just like influenza.
I do think that it is likely the COVID-19 threat will fade over time, though how long that will take is another question.
One of the biggest concerns I’ve had was from parents with young children, especially babies. After all, babies and toddlers have weaker immune systems than adults and there is some fear that the COVID-19, even if not fatal, might cause permanent damage.
What we’ve seen so far is that babies and toddlers can contract COVID-19 and successfully fight it off. This includes the 1-year-old in Singapore who is one of the fastest discharge cases in the country, as well as a 6-month-old baby in Vietnam. Both seem to be healthy and well with no indication of any lingering damage or negative effects. Similarly, in China, pregnant women who were found to have COVID-19 all successfully gave birth to healthy babies who did not have the virus. This suggests that the virus does not pass on from mother to child.
More importantly, a study of COVID-19 cases by the Journal of American Medical Association (JAMA) suggests that cases of young children actually contracting the virus is rare. This is actually similar to SARS, which did not infect many children as well.
It is difficult to know for sure what will happen next in our fight against COVID-19. Many people are holding out hope that it will die out quickly while others are resigned that it might last for at least a few more months.
I’ve also seen speculation online that Singapore might soon report its first fatality, with one of our cases being in very critical condition. While this is something I would never wish upon anyone, as a society, we do have to be prepared that eventually, it might happen. As I explained in this article, COVID-19 can be fatal, especially if you are elderly or are already suffering from underlying medical issues. What we must remember is to continue to keep calm even if fatalities are reported, because panic and chaos can do more harm than good in times of outbreak.
Let’s continue to respond to COVID-19 with empathy, love, and true Singapore Spirit.
This post was written by Dr. Shravan Verma, MD, Founder & CEO of Speedoc.