9. Worst Case COVID

May 2, 2020 Minding Corona No Comments

May 2, 2020

Right

Is this worst case the future? I would go as far as saying that it is not an impossibility.

Please don’t read this text if you are weak at heart.

Numbers

Vaccination is still far away. Experts talk about at least a year before the population can be vaccinated in sufficient numbers to call it a go. A direct cure for COVID is also not evident. Sadly, an empathic wish for a cure will not make one.

The numbers from the labs in several countries show 4-5% of the population being immune at this moment. We need to attain 60-70% for herd immunity as the second option after vaccination. Anyone can calculate that this is 15 x the level we are at now. This makes for a worst-case of eventually 15 x more cases and deaths. The flattening of the curve is not flattening these numbers. We are at the beginning.

In Belgium, we see a total of 49.000 cases and 7.700 deaths at present. Before attaining herd immunity and if no vaccine or cure shows up, that means +/- 90.000 deaths in total. Meanwhile, people reach out for a restart of the economy shortly.

Worldwide, there are 240.000 deaths. Of the closed cases, 18% died. That is 7% of all known cases. Curves of total cases and deaths are today [from https://www.worldometers.info/coronavirus/]:

Note the presence of a straight line over the last month. With 3.4 million cases now, we risk going to x 10 or more in numbers of cases and deaths from COVID, worldwide, before vaccination day. Parts of the world are not as infected yet as are Europe and the US. This is not because those people have natural immunity. Latinos and blacks in the US are even more infected and have higher mortality than whites. Since the virus will be with us for a long time, new parts of the world may still become its victims. Due to several factors, the situation may become even worse there. Note that the situation is much worse now in Europe and the US than in China. Who would have thought so two months ago?

According to the Yale School of Public Health, the total COVID mortality may be substantially higher than official numbers are showing. They include people who died because of the epidemic but not from the disease. For instance, being afraid to seek medical treatment for unrelated illnesses. Reported levels of anxiety and depression are rising, which may contribute to increased death from suicide. Probably, the death counts will be revised upward as more reporting comes in. In the UK, the Financial Times estimated twice as many deaths from COVID than official estimates of England and Wales. People may die at home from a pulmonary embolism or heart attack in which the virus plays the role of a catalyst. Pulmonary failure may indirectly lead to failure of other organs, compounded with the result of general inflammation. It’s challenging to make an accurate analysis of such cases. Even without direct viral involvement, the stress from the social situation may play a substantial role in much sickness and mortality.

Add to this the collapse of economies, the surge of other diseases through poverty and lack of medical aid in parts of the world, the desperation, violence, etc. We may well be at the very beginning of this too.

Many countries are in lockdown. Some are reopening, but we don’t know whether this is sustainable. There is a clear risk of second and third wave after reopening. Many experts are confident in this. The choice seems to be between economic opening and certain surplus death toll, or less opening and economic disaster.

Virology – immunology

There is a huge difference between how people react to viral infestation. Most have little or no symptoms. The young are infected but don’t get ill (so much). First to think about is – again – the immune system which is, according to a massive amount of scientific insight, significantly influenced by psychological factors.

This way also, we don’t know how many people are already immune. These numbers appear to be much higher than expected. This shows that, besides the virus, other ‘mystery factors’ have a significant role to a higher degree than with other viruses. Such factors may be genetics or the psyche.

People who die from COVID generally don’t do so because the virus kills too many cells but because of their chaotic immune response. The latter deserves more attention.

We are looking at an enemy outside and how to ‘fight or flight.’ Vaccination/medication or lockdown/social distancing. This accords to the normal stress response as described in psychosocial literature. More recently, a third response has been added: the coming together and talk. Social togetherness, one way or another. In the COVID case, the stress response may be particularly relevant given the huge influence of stress on immunology. In another article, I call it the stress virus. It appears to have found a specific niche in stressed organisms. All elements of the enfolding story point to this.

Aftermath

After strong viral episodes from COVID, many get cured. Unfortunately, this is not the end of the mishap to any such person. Among other things, we know little about possible re-infection or even re-infection from inside as with some Herpesviridae leading to zona. ‘From inside’ in this case means that the virus may be hidden in one’s body after the first period of illness. Even after years, it may suddenly reappear. No contact with another infected person is needed.

Due to the high level of inflammation in the lungs, these remain scarred. Look at an inflammation of the skin and scarification afterward. This makes the lungs more vulnerable to several diseases in the future, going from other infections or re-infection with a new corona strain to an elevated risk of cancer.

Viral infections accompanied by strong inflammation are suspected precursors of autoimmune disorders. Multiple sclerosis is one such case. In this, there seems to be an interplay between virus, immune response, and inflammation forming a causal whirlpool. Note that with COVID, we see an extraordinary amount of inflammation. So, the elements are present. Other autoimmune-related disorders are rheumatic arthritis, inflammatory bowel disease, diabetes mellitus, psoriasis, systemic lupus, vitiligo, some thyroid diseases, and so on.

After viral infections, and also related to inflammatory processes caused by them, it is not uncommon to feel depressed or even get into a florid depression. In the COVID case, we already see people with neural symptoms. The virus is suspected to reach the brain in some patients. It is too soon to know the consequences.

More broadly, we may see the appearance of a new viral strain through mutation, another kind of ‘re-infection’ at society level. The new virus is like a cousin of the previous one. If the cousin is more infectious, even if not more deadly by itself, the chance is that a second wave leads to an even higher fatality at the population level, reaching those who were not infected by the first wave. Improbable? It happened in 1918 with the Spanish flu. The first wave was like a strong typical flu, affecting many people. Then one mutated strand – the cousin – of the virus appeared, being much more deadly than the previous one. People were kept working because of the war effort. Soldiers were displaced en masse for the same reason: war. After four years of war, populations were not in good shape. The stage was set for a second wave that killed, nearing the end of the war, more people in a few months – mainly in September and October of 1918 – than the whole World War itself. And now? 2020. There are four million reported cases. For sure, many more people are infected. There is by far no herd immunity. No vaccine. The virus is not contained. Stress as before. People are put to work again because of the ‘war effort,’ being at present the economy. I find this immensely dangerous.

Of course, it is advisable not to get infected. But within the herd immunity scheme, the statistical risk is unavoidable. In case no more deadly strain appears, one can only hope to be between the 30 to 40% of eventually uninfected people. In the narrowest sense, this is about ‘me or you.’ The very rich might go and sit on their private islands and wait for herd immunity – or vaccination – then come out again. An insane dystopia.

In my view, the best to-do is to positively boost the own inner defense, including the immune system. Thus, one can diminish inflammation, the risk of dying and of any aftermath and, maybe, also the level of infectiousness, saving time for others towards vaccination day, hopefully somewhere in 2021. There is no magic involved in this. There is no wonder cure. Nevertheless, any immune support is welcome. More generally, inner strength, as is referred to in the last two characters of AURELIS (a project I’m working on for years already).

Scientifically, we know pretty well that the human mind has a significant effect on the immune system. A possible positive effect is evident, although less scientifically investigated in experimental studies, due to the difficulty of organizing such studies. Elements in this difficulty are operational (the study itself), ethical, and financial. Perhaps, this time of COVID can enforce a breakthrough in research. At this moment, as far as I can see, there is no sign that this breakthrough is happening.

We are developing tools and are trying to involve financial partners, as well as scientific cooperation, to make this possible.

More specifically, we are developing psychological support through an app containing mental exercises and additional how-to and informational background. The app is applicable in any situation of acute stress with a risk to ‘drown in a whirlpool of different elements.’ One such situation is coronavirus + stress (acute upon chronic and in the broadest sense) + inflammation. Another applicable situation may be that of the caregiver. Even more, a caregiver who gets infected.

This version of the app will be for free, for all, forever, soon available as the ‘Aurelis’ app. One can look at it as a key to open the door towards the space beyond. The key by itself may seem irrelevant. Its quality is all-important to reach the goal. This is about subconceptual processing or ‘autosuggestion,’ the subject of my Ph.D. and book, and the driving force, in openness, of what lies otherwise hidden behind the placebo effect and empathy. We have a lot of experience with this in many domains. We want to give as much support as possible within the app. With A.I. means, stepwise developing the A.I.-driven coaching chatbot Lisa, we can go much further. In this, we have a lot of know-how available, and we also know how to accomplish it effectively. We do lack resources.

As said in the beginning, this text is not to be published. It could provoke unnecessary panic. Nevertheless, well, we need to be serious about this, unfortunately, very serious. If you see any way to help, please do.

In short, pointing out:

The situation is even direr than is generally thought at this moment.
We entered an era that will last much longer. Also in time, we are at the beginning.
There is a substantial immunological influence, not only on the amount of people getting ill but also on the degree of illness.
There is a considerable influence of the psyche on immunology.
This should be investigated much more deeply and realistically than is the case at present.
The knowledge that we gain – and already have to a relevant degree – may be brought to bear in practical tools and other means.

We should not fight against the virus but fight for a better future. This includes anything related to this viral disease.