There are more than one hundred ways an RNA molecule can be chemically modified after it is synthesized. The functions of many of these modifications, collectively referred to as the epitranscriptome, are largely unknown.

Here’s the problem with medicine and our genome. We are toddlers, tinkering with a system we barely understand. In much the same way as anyone capable of reading can consume a book on calculus, comprehending what actually stands in the book is another endeavor entirely. We’ve opened the book on the human genome and with our basic comprehension and reading skills we now feel we are qualified to fiddle around with the building blocks of life.

Nothing could be more irresponsible.

Our limited knowledge, coupled with a voracious appetite for exploration and profit, has opened Pandora’s box, and there is no putting the genie back. The pandemic, origins aside, was the key to propelling mRNA technology into the world. Tech that companies like Moderna and others had invested billions of dollars in developing. In point of fact, Moderna’s entire business structure, worth billions, was built on the hopes of mRNA succeeding.

Until the pandemic struck, things looked bleak for both Moderna and mRNA. the treatment had encountered numerous hurdles, no the least of which was the CDC, who restricted the use of untested mRNA technology in trials to end of life patients. If you’re at deaths door, risk becomes irrelevant. Delivery mechanisms (a substance to carry the mRNA into the cell) were another aspect no one in the industry had been able to resolve. Yet, suddenly in 2020, miraculously, a working mRNA Covid treatment was developed in record time.

Not just one, but two, a product from Moderna and another from Pfizer/Biontech. Now call me skeptical, but I have a really hard time believing in miracles, no matter how much money you throw at something. It turns out the miracles came at a heavy price, and unfortunately there does not seem to be a ceiling to this price, as more and more patients report an ever increasing number of side effects from the mRNA vaccines.

As icing on the cake, late last year Moderna conveniently announced an mRNA treatment for heart conditions, the irony of which cannot have been lost on hundreds of thousands of people who’ve suffered heart damage from the first round of mRNA “approved” treatments. You cannot make this up and watching the narrative unfold over the last three years has been nothing short of jaw dropping.

mRNA, in this authors opinion, holds massive promise, possibly 20 years down the line, as a tool to effectively combat diseases like cancer on a genetic level. Why 20 years? Well it is going to take us that long to truly grasp the far reaching implications of tampering with our bodies internal clock. Twenty years of cautious science, uncovering dependencies between systems and how all the dots connect. Right now, we can barely crawl, and yet we are attempting to run. It is costing people their lives.

Altering the human genetic code

Strictly speaking, mRNA vaccines, if they adhere to their licensing protocols, cannot interact with human DNA. DNA based Covid vaccines can, so if you’re worried about having your DNA changed, vaccines from Janssen and others are of far more concern. mRNA cannot alter DNA as far as we know and based on our current understanding of cellular traffic. If you have time and the inclination, an article I wrote in 2021 explains the flow of traffic inside a human cell and like any traffic system, there are rules. RNA affecting DNA is a no-no.

That being said, there are very few hard and fast rules in nature that aren’t, on occasion, broken. Spillage occurs, much like a drunk driver who accidentally ends-up driving against oncoming traffic. So can mRNA do this? It is possible. However unlikely, the contamination of DNA cannot be ruled out. If your goal was to alter our DNA, you would rather opt for a DNA-based vaccine.

mRNA can however effect changes within our bodies on a cellular level, and in many ways, this poses far more risk than DNA manipulation. How? Well, take for instance the Covid vaccines, designed to interact with our ACE2 receptors, receptors that the SARS-COV2 virus targets. It turns out that certain organs within our bodies are more susceptible to having these receptors activated. The testes are a perfect example and reduced semen motility after inoculation with Pfizer BNT162b2 has now been clinically proven as a side effect.

What we don’t know about mRNA therapy

Rather than espousing the risks carried by an unproven medical technology at a cellular and genetic level, I’ve opted for listing a few of the unknowns. Possible effects and interactions with mRNA, other medicines and more. It’s possibly worth mentioning at this point that I believe the technology has huge potential, both for medical advances against disease and for exploitation.

Lets start with mRNA and HIV therapies. This group was not represented in the mRNA Covid clinical trials and we have no idea of the potential interactions between the two therapies or how mRNA will impact HIV in the host. There is prior knowledge of the flu vaccine, for example, waking up HIV and exposing it to the immune system; but it has been unclear whether that was only happening in flu-specific T cells, a known place where HIV hides. Now new evidence suggests mRNA has the ability to wake latent HIV.

mRNA and it’s effects on nursing mothers and infants was completely ignored in the original trials, despite this group being an established part of a vaccine cohort in trials. We know now that mothers can pass the spike protein through their breast milk to the nursing infant.

A growing body of evidence now suggests that there is in fact a large degree of risk to nursing infants from the mRNA vaccine, risk that in some instances results in cardiac related damage or death and new research just published in Jama now recommends mothers do not breastfeed for two days after receiving the mRNA vaccines. This is what they discovered.

Of 11 lactating individuals enrolled, trace amounts of BNT162b2 and mRNA-1273 COVID-19 mRNA vaccines were detected in 7 breast milk samples from 5 different participants at various times up to 45 hours postvaccination.

Sadly, too late for most mothers, many coerced into the vaccine. We have no idea what the long term medical implications are for the infant, and yet, President Biden and the CDC website still suggests vaccinating 6 month old children, effectively doubling their exposure.

The impact of mRNA on a fetus is also largely unknown, yet we still recommend pregnant mothers be vaccinated, showing no regard for the safety of the fetus. Some emerging data suggests a dramatic increase in stillbirths and miscarriages, where causality is ascribed to lockdowns and lack of access to proper medical care, while an overwhelming spate of recently published research suggest no short term dangers exist to the fetus.

Again, none of this research was done prior to the mRNA being administered in 2020, it is all post 2021. Did we simply get lucky, telling pregnant women there was no risk, when in point of fact, we had no idea? Time will tell.

The untested impact of mRNA on Cancers. Cancer patients were underrepresented in the original Covid trials. While some may argue that as most of Moderna’s work done on mRNA leading up to the so called Covid “vaccine” was based around developing cancer treatments, mRNA poses no risk to this group, the opposite may in fact be true. Cancer cells are responsive to mRNA therapy. What we don’t know is if mRNA therapy intended for a different target, say Covid, will awaken dormant cancel cells.

• New research shows patients with hematologic (cancers of the blood) malignancies appear less likely than those with solid tumors to have detectable immune responses and this extends to patients undergoing chemo.
• This paper in Nature on Cytokine release syndrome in a patient with colorectal cancer after vaccination with BNT162b2

Children as young as six months are the latest guinea pigs in the global clinical trial underway for mRNA technology. Ethically and morally inexcusable and sanctioned by the FDA, CDC and President Biden, you are told it is safe to inject your children with the Covid “vaccines” when in point of fact, we have absolutely no idea about the long term impacts and the trials used to justify the treatments in children are nothing short of laughable and will serve as an embarrassment to science and medicine for generations to come.

Adverse events, and the unknown. With a list of Serious Adverse Events (SAE’s) as long as your arm, all the Covid vaccines, including and especially those utilizing mRNA, came with risks, most of which were down played. Damage to your heart, Myocarditis and Pericarditis (for which Moderna conveniently had another mRNA therapy in the pipeline, released recently), blood clotting, Bells Palsy, the list goes on and on. While we are rapidly discovering the many unknown short term side effects for some of mRNA therapy, we still have no idea of the long term SAE’s. Two questions arise.

Are these effects, both immediate and long term, the result of the mRNA based delivery or the actual spike protein generated by the treatment. Only time and honest research will answer this question satisfactorily and it is one that must be put to bed as new flu shots, cancer treatments and more are rolled out on the back of mRNA technology. All regard for long term, established safety protocols have been thrown out the window.

Unintended consequences and the complex interactions of cellular based medicines on an organism as complex as the human body cannot be calculated, accounted for or anticipated, at least not yet. We have gaps in our knowledge on a biological level and only a minimal understanding of the toys we are tinkering with. if we have no qualms enforcing this on pregnant women, that in itself should give us pause for thought.

The risks for cancer patients in remission is another topic of debate, after recent reports that mRNA has triggered latent cancer cells to resume growth.

What we are discovering about mRNA Covid Therapies, post treatment

A recent study from Cleveland Clinic highlighted a fear that has been raised by a few medical outliers who chose to speak out against the “vaccination regimen” at risk of professional ridicule. Focusing on the bivalent vaccine, it reported a worrying trend. With every successive booster, the patients risk of contracting Covid actually increased.

The risk of COVID-19 varied by the number of COVID-19 vaccine doses previously received. The higher the number of vaccines previously received, the higher the risk of contracting COVID-19 (graph below)

You can view the full results of the Cleveland Clinic study by following this link. Now while there may be certain problems with this study pertaining to their cohort, their findings are substantiated by findings from two other studies.

Breasts Cancers seem to be on the upswing. Evidence continues to emerge about axillary lymphadenopathy following COVID-19 vaccination and it is now a recommendation that women undergo a breast screening, post vaccination. It is known that the Pfizer vaccine can cause swelling of lymph nodes, often suggestive of breast cancer. However, any enlargement of lymph nodes can potentially indicate cancer, so this symptom should not be ignored.

This creates an ideal environment for misdiagnosis. Ensure your doctors and health providers know you’ve been recently vaccinated, but make sure you a properly screened and that the swellings are not merely dismissed out of hand because of your recent vaccination.

People with gastrointestinal conditions (GI) should be carefully monitored after vaccination for Covid 19, according to a paper published on PubMed entitled Gastrointestinal Complications of COVID-19 Vaccines. Their patient experienced post-vaccination acute diverticulitis and colon micro-perforation following a Moderna booster dose.

Sperm motility in men should be monitored in patients who have received multiple boosters and want to start a family. There appears to be a direct correlation in the reduction of sperm motility and the number of mRNA vaccines administered to a patient. Whilst recovery takes between 10 and 14 days after a second does, research does not exist for third, fourth or fifth doses. You can read the paper, entitled Covid-19 vaccination BNT162b2 temporarily impairs semen concentration and total motile count among semen donors here.

Of course, this above mentioned list of issues is in no way comprehensive, that would require nothing short of a book, but rather is provided to highlight certain ongoing issues.

Getting to the heart of mRNA’s problems

Sudden Death and the hashtag #DiedSuddenly follow you wherever you go on Twitter and other social media platforms. Cardiac related issues experienced by healthy teenagers and young adults are on the increase and many prove fatal. These incidents are matched by the number of videos of people of all ages dropping from an apparent stroke, most performing the same macabre contortions before collapsing to a mostly unknown fate.

To exacerbate mRNA’s headaches, it is being forcibly administered to patients without their consent in hospitals where the patient undergoes surgery. Some hospitals still refuse life saving medical interventions like organ transplants if the patient is not “vaccinated”. A global spike in excess deaths, up by hundreds of percentage points in some countries over the last two years also demands an explanation and vaccines are seen as the most likely culprit.

It would seem that even if mRNA survives it’s rocky introduction to humanity with no further serious long term adverse events, its reputation will have been seriously damaged, perhaps even irreparably. A little ironic justice metered out for the damage it has inflicted on the reputation of actual vaccines.

A spate of Happy Coincidences

If you believe in them. Personally, I don’t, but actually separating fact from fiction around mRNA’s sudden meteoric rise to fame is rapidly becoming an improbable task, as the tangled web surrounding it continues to become more complex. Rather than trying to unpick it, I’ve opted for listing a few interesting, and often overlooked, facts surrounding mRNA in the last three years and earlier.

1. The National Institute for Health (NIH) and Moderna developed the Moderna vaccine in partnership, with patent rights, US Patent Application No. 62/972,886 entitled 2019-nCoV Vaccine filed in June of 2020, residing with the NIH.
2. NIH, alongside the National Institute for Allergies and Infectious disease (NAIAD) and Moderna have researched coronaviruses, like MERS and SARS, for several years, and signed a contract in December of 2019 that stated “mRNA coronavirus vaccine candidates [are] developed and jointly owned” by the two parties.
3. Since 2015, the National Institute for Health (NIH) and the National Institute for Allergies and Infectious disease (NIAID), knowingly provided funding to a specific group of American scientists and their institutions and businesses to perform Gain of Function (GOF) research, despite a moratorium.
4. The publicly stated intent of these scientists, working under the auspices of Peter Daszak, Ph.D and EcoHealth Alliance, Inc was to develop a more infectious version of the coronavirus and to achieve their ends they chose a Chinese scientist working out of a laboratory in Wuhan, China.
5. EcoHealth Alliance is a non-profit group that has received millions of dollars of U.S. taxpayer funding to genetically manipulate coronaviruses with scientists at the Wuhan Institute of Virology.
6. During this period, Dr Anthony Fauci was director of NAIAD and Dr. Francis Collins director of the NIH. Jointly they controlled about 10 billion dollars of funding annually, placing them in a position to control and distort the public Covid narrative.
7. The same Peter Daszak of EcoHealth Alliance interfered on numerous occasions with investigations into the origin of the SARS-COV2 virus, creating a narrative contrary to a manufactured laboratory origin for the virus. For those with time and intent, the full list of EcoHealth Alliance emails released under Freedom of Information, can be found here.
8. Dr Fauci, in September of 2022 and only days away from retirement, as a parting gift to EcoHealth Alliance from the NAIAD, awarded a $653,392 grant to the company to analyze “the potential for future bat coronavirus emergence in Myanmar, Laos, and Vietnam.” This despite the company’s failure to produce records pertaining to Wuhan and their involvement in the GOF research undertaken there on their behalf.

In closing, I have no compunctions about leaving you with my impressions of the duplicity of pharma, governments and regulatory bodies foisting unproven medical technology down our throats and sadly, there is no defense that can be raised by any of the parties involved that would excuse their actions.

Hindsight is offered in part to offer comfort to the those who are now being held accountable. It’s easy, they claim, to criticize now, after the facts. That, of course, is complete and utter nonsense. Anyone with a grain of common sense able to follow something to its logical conclusion knew months into the pandemic that we were being manipulated, cajoled, coerced and prepared for amass vaccination campaign. Everyone with an inkling of medical training knew that mRNA was a potential horror story waiting to unfold, and yet, here we are, two years later, recommending we now “get the kids”.

It is the betrayal by science, the community in general and the professionals who undertook oaths to protect their patients that is perhaps the most saddening part of the pandemic shambles. It is this betrayal that will impact medicine for generations to come. “Trust me, I’m a doctor,” the punchline to a pandemic joke coming soon to a stand-up venue near you.

Part 4 of the Covid Files. When is a vaccine not a vaccine?

The post The Covid Global Clinical Trials for mRNA. Thank You for Participating appeared first on Medika Life.

During six weeks, we will examine all the aspects surrounding the last three years and the draconian and, at times, absurd manipulation of the media to convey a narrative that, it turns out, had little to do with your health and well-being. We’ll examine the demise of critical science, which some would argue is already long gone, but the pandemic brought it home. Covid shots and tech (mRNA) will be placed under a critical microscope and the origins of the virus that brought the world to a standstill will be discussed.

Make no mistake; if you’ve been jabbed against Covid, then you’ve been coerced into participating in the largest global medical trial ever undertaken. Good science weighs risk/benefit alongside risk/risk – the risk of the disease alongside the risk of the treatment.

Medika Life stands for objective science and exchange – proper critical science undertaken with the goal of improving lives. By that, I refer to sound critical science undertaken to improve lives, science that is open to criticism and uncensored peer review. Cautious science, designed to protect and save lives – to do no harm. A path that science currently, under the duress of politics and profit, has forsaken. Sometimes, science cannot be – should not be – rushed.

Take vaccines as an example, life-saving routine treatments critical to the safety of our children and treatments we would administer with little thought to safety. During the last two years, the “labeled” Covid vaccines have damaged the credibility of what vaccines are in many people’s minds – therapies that prevent disease and its transmission. Credibility that had taken generations to build. Ironic if you consider that the Covid products were nothing more than the equivalent of the flu jab and never a vaccine.

Each article in the coming weeks will examine a range of issues based on real hard data and facts, including the validity of the treatments (vaccines), mRNA technology, lockdowns and masks, virus origins, the actual reality of Long Covid – is it the result of long-term damage from the virus, reaction to the virus combined with the vaccine or another clinical pathway. What of people who have survived the so-called “Sudden Death” syndrome and more?

Read Medika Life and enjoy access to the most comprehensive analysis of our post-Covid lives. For more than two years, Medika has questioned numerous aspects of the pandemic, including mandates and the “vaccination” of children and healthy adults.

Facts have emerged subsequently to support these views and we’d like to provide you with an authoritative range of articles to refer to that are properly referenced and contain actual facts. Our goal is to get people thinking. Questioning is not a crime. It leads to new ideas and innovations.

Here is a list of reading to look out for. The links to these pieces will be activated as they are published and you are welcome to reach out to us with questions and suggestions.

• Welcome to The Covid Rabbit Hole: A dystopian maze filled with deception and misdirection.
• The Covid Global Clinical Trials for mRNA. Thank you for Participating.
• When is a vaccine not a vaccine?
• On the Origin of Covid, with apologies to Darwin
• Covid’s Elephant in the Room
• Sudden Death, Pure Bloods, Myocarditis and more.
• Lockdowns and Mandates, Politics, Medicine and Orwell.
• The Demise of Freedom of the Press and Censorship.
• Is Long Covid a real thing?
• Learning to trust again in a post-Covid society?

The post The Covid Files: A Series Separating Pandemic Fact from Fiction appeared first on Medika Life.

What role has GOF played in all of this? Therein lies the crux of the debate, it either had everything to do with the virus or nothing or has perhaps contributed to it. There is evidence in favor of each of these scenarios, both for and against. Even science and its practitioners are divided on the topic and laypeople around the globe interpret a rambling cohort of random and often incorrect “facts” to arrive at their own conclusions. 

This discussion doesn’t relate to the SARS-CoV2 virus or its origins. It is solely about Gain of Function research. Are there risks associated with it, what are those risks, and is the scientific community justified in continuing to do the research? Is there sufficient evidence to suggest a global ban on this type of research?

We thought we’d play devil’s advocate, posing both sides of the argument for and against the discontinuation of GOF research. To start us off, let’s establish exactly what Gain of Function research entails.

What is Gain of Function research, exactly?

Gain-of-function research refers to the serial passaging of microorganisms to increase their transmissibility, virulence, immunogenicity, and host tropism by applying selective pressure to a culture. So in other words, in layman’s terms, it’s about creating something nastier, tougher, and more deadly than the original by manipulating it in a laboratory.

Why would we want to do this? Aside from the obvious answer of weaponizing disease, there are a number of very valid scientific reasons for this research.

Also, to be clear, associating Gain of Function research as being mutually exclusive to influenza or coronaviruses is patently wrong. The field is immense and it is totally imprecise to equate GOF studies only with influenza transmission experiments. Virology is founded on adaptation approaches, and these have broad utility because they provide phenotypic evidence of a genotypic change when combined with a discriminatory biological assay.

Gain of Function studies are mostly applied in virology (to viruses) and have revealed many details regarding the biological mechanisms behind virus transmission and replication. Obviously, everything we can learn about the enemy is useful. How a virus evolves is a key part of our strategy to defeating it, developing vaccines, and knowing where to watch out for potential vectors. Gain of Function allows us a window into this world.

The high replication and mutation rate of viruses commonly leads to escape mutants, lineages that have acquired changes to their genome that lessen or eliminate the affinity of natural or vaccine-induced antibodies towards the virus, while not notably lowering survival. Most people now associate these words and terms with SARS-COV2 and its mutations and discussions about its origin.

Most mutations a virus acquires aren’t helpful to virus function, but in some cases mutation can both enhance virulence and allow better immune escape. For example, early studies regarding the E484K mutation of the spike protein of severe acute resSARS-CoV-2 suggest that affinity towards the ACE2 receptor, the target of the virus, is enhanced, while neutralization by serum antibodies sourced from patients having recovered from wild type SARS-CoV-2 are evaded more effectively.

In simple terms, the virus evades our natural immunity by developing new ways of attacking us and these include “hiding” by not triggering signals our immune system has trained itself to look out for. Influenza is an excellent example, returning year after year with a new book of tricks, and boom, you’re down with the flu again.

Gain of Function allows scientists to encourage these mutations in a laboratory setting where they can study the process and figure out ways of keeping our medicines and vaccines one step ahead of the curve. The potential for unearthing an as yet unknown key to controlling viruses may very well lie in the pursuit of this research.

So before we plow ahead let’s clear the air. 

This article refers only to Gain of Function research in terms of its applicability to enhancing dangerous pathogens. 

Sounds really cool, where’s the problem?

And Gain of Function really is. One of the reasons we’ve been able to develop vaccines so rapidly for Covid, Moderna had a working model ready to go in a month, is thanks in no small part to GOF research. So there are clear and easily defined benefits to the research. There are, however, also very distinct dangers involved that we cannot afford to ignore. 

Without being dramatic, pursuing this line of research without properly ensuring its safety, could lead to an extinction-level event. Us being the species we wipe out. It’s an unlikely, but not impossible consequence.

In 2012 a paper was published in Science by Herfst et al., titled: Airborne Transmission of Influenza A/H5N1 Virus Between Ferrets. The group had genetically modified the A/H5N1 virus (Avian influenza) by site-directed mutagenesis and serial passages in ferrets, creating a strain that was airborne transmissible in ferrets.

This demonstrated that it was possible for the avian influenza virus to become airborne and that the strain was sensitive to certain antiviral drugs. The paper raised many concerns regarding the ethics and safety of creating such a virus. The risks of accidental or intentional malicious release caused the USA administration under Barack Obama to halt funding for gain-of-function research relating to influenza, SARS, or MERS in 2014. 

In 2016, under questionable advice from the National Science Advisory Board for Biosecurity (NSABB), the NIH overturned the moratorium on GOF research and resumed funding research, including projects run in Wuhan 

The dangers of Gain of Function lie on a number of fronts and it is these we will explore in-depth in this article. Our aim is to provide as balanced a discussion as possible on the topic. Here then a quick overview of what we will look at.

Laboratory Safety: Can we ensure that research and viruses and other organisms used in Gain of Function research stay where they are supposed to stay. In the confines of a laboratory? History tends to suggest no. How do we secure these facilities, keeping in mind they are global and subject to various different regulatory bodies, to ensure lab leaks do not occur? Can we human-proof them?

Military Engagement: Discover something deadly or set about building it and every single military complex on the face of the planet perks up its ears. Biological weapons are the most deadly, untraceable, and easily dispersed weapons on the planet. When every single human can act as a potential vector for spreading a virus, you can simply build it (or steal it), release it and sit back and watch.

Corporate Agendas: There’s a thin line here between conspiracy and corporate greed, but this is still a hugely valid concern, particularly now that we have the basic parameters for a global pandemic established, thanks to SARS-CoV2. As companies like Microsoft, Amazon, Google, The Gates Foundation and other large corporates dip their toes into Healthcare, we’d be well-served to remember these organizations serve their shareholders and the gods of capitalism. Our well-being is not on their checklist for global domination.

Laboratory Safety and Gain of Function Research

This is, on a personal level, where my largest concerns lie. These concerns are motivated by the following factors, all of which can and may contribute to the potential leaking of a deadly pathogen from a laboratory, and I am not alone. In 2014 scientists calling themselves the Cambridge Working Group urged caution on creating new viruses. In what may have been prescient words, they specified the risk of creating a dangerous virus.

“Accident risks with newly created ‘potential pandemic pathogens’ raise grave new concerns,” they wrote. “Laboratory creation of highly transmissible, novel strains of dangerous viruses, especially but not limited to influenza, poses substantially increased risks. An accidental infection in such a setting could trigger outbreaks that would be difficult or impossible to control.”

The human element

The most secure systems in the world are all subject to this one, flawed cog. The human one. Whether by intention (disgruntled or “bought” researchers) or accidental (overworked, momentary lapses of concentration) this risk can only be removed by isolating and automating processes completely. 

This could potentially be achieved by robotic automation, where robotic arms and machines can perform experiments in total isolation, without the need for a human to breach the working environment. Obvious drawbacks still exist to this system, including the need to physically introduce cultures into the secured environment, prohibitive costs for many facilities, and extending the time required for processing research. 

Automation still doesn’t overcome the major problem associated with this kind of research, that of human involvement. Smuggling out a pathogen remains a constant possibility, with many people within a facility having access to Biosafety Level 4 laboratories. The accidental infection of laboratory technicians also remains a very real risk.

The slow and painful dismantling of accepted dogma also poses a huge risk. We have only now, in the last few months accepted a massive body of evidence supporting the fact that coronaviruses can move about freely in the air, like the measles virus. They become aerosolized and don’t require water droplets. Six feet isn’t an obstacle, neither are walls and doors, so our so-called secured facilities may very well have been built on flawed science.

What we thought was sufficient protection for certain viruses simply wasn’t. It’s a simple mistake, but a fatal one based on 80-year-old research, and our inability to freely question accepted scientific dogma poses a very real risk in fields that deal with potential pandemic-capable pathogens.

How often do pathogens escape their laboratory confines? This is a question we can attempt to answer by looking back at the incidents listed over the last few decades. It is of course entirely possible that many have been covered up, particularly those originating from off-grid laboratories run by the military and other government agencies.

The paper referenced above makes for interesting reading and has this to say on the 1977 H1N1 virus that mysteriously resurfaced after a 20-year absence.

Public awareness of the 1977 H1N1 pandemic and its likely laboratory origins has been virtually absent. Virologists and public health officials with the appropriate sophistication were quickly aware that a laboratory release was the most likely origin, but they were content not to publicize this, aware that such embarrassing allegations would likely end the then nascent cooperation of Russian and Chinese virologists, which was vital to worldwide influenza surveillance.

The most plausible reason for a Chinese or Russian laboratory to thaw out and begin growing a c1950 H1N1 virus in 1976–77 was as a response to the US 1976 “swine flu” program, which resulted in a program to immunize the entire US population against H1N1 influenza virus. It was clearly a rational response for other countries with virology capabilities to explore making their own H1N1 vaccines. Thawing available frozen stocks of the virus was necessary because H1N1 was no longer circulating. 

Modern commentators have begun to articulate this connection between the 1976 Swine flu immunization program and the 1977 H1N1 re-emergence:

“Perhaps an even more serious consequence [of the 1976 swine flu episode] was the accidental release of human-adapted influenza A (H1N1) virus from a research study, with subsequent resurrection and global spread of this previously extinct virus, leading to what could be regarded as a ‘self-fulfilling prophecy’ epidemic.”(Zimmer 2009)

SARS, the laboratory escape artist 

SARS has not naturally recurred since 2003, but there have been six separate “escapes” from virology labs studying it: one each in Singapore and Taiwan, and in four distinct events at the same laboratory in Beijing.

• The first escape was in Singapore in August 2003, in a 27-year-old virology graduate student at the National University of Singapore. He had not worked directly with SARS, but SARS was present in the virology laboratory where he worked with West Nile Virus (WNV). Investigation showed that his preparation of WNV was contaminated with the SARS virus and that this was the likely origin of his infection.
• The second escape was in Taiwan in December 2003, when a SARS research scientist fell ill on a return air flight after attending a medical meeting in Singapore Dec 7- 10.
• On April 22, 2004 China reported a suspected case of SARS in a 20-year-old nurse who fell ill April 5 in Beijing. The next day it reported she had nursed a 26-year old female laboratory researcher who had fallen ill on March 25. Still ill, the researcher had traveled by train to her home in Anhui province where she was nursed by her mother, a physician, who fell ill on April 8 and died April 19. The researcher had worked at the Chinese National Institute of Virology (NIV) in Beijing.
• Several Chinese and international groups investigated the outbreak at the NIV and identified in retrospect two additional SARS laboratory infections at the NIV that had previously gone unrecognized and had begun in February 2004.

Foot and Mouth Disease, Pirbright, England 2007

Foot and Mouth Disease (FMD) is a veterinary disease that affects primarily cloven-hoofed domestic animals (pigs, sheep and cattle). It has been eradicated in North America and most of Europe. It is highly transmissible, capable of spreading through direct contact and even through some prepared meats (sausages, airline food), on boots of farmworkers (or tourists’ shoes: that’s why there’s that question “have you visited a farm” on the re-entry customs checklist coming into the USA), and even by aerosol spread.

Two separate instances were recorded in 2007 of the virus escaping a facility in Pirbright tasked with producing vaccines against FMD for the veterinary industry. The outbreaks cost the UK an estimated 200 million pounds and the damage to the livestock and meat industry was substantial.

As an aside, in the US, previous law had banned it on the continental US, so FMD virus was only held in the USDA Plum Island facility off of Long Island (in a facility originally built in the 1950s for anti-animal BW work). Currently, a replacement facility under the Department of Homeland Security (DHS), the National Bio and Agro-Defense Facility (NBAF) is under construction in Manhattan, KS and will become the new home of this incredibly infectious and highly transmissible virus. It seems we don’t learn our lessons.

It is clear that accidents occur in laboratories. To suggest they don’t is both dishonest and disingenuous. The question we need to be asking now is given the current chaos on the heels of the Covid Pandemic, can we afford any new accidents? Although there is no concrete evidence to support the laboratory leak in Wuhan, it cannot completely be dismissed yet either.

Can scientists and science assure us there will be no future mishaps? The answer to that has to be no. So there remains a risk, a global risk. The question we then need to ask is this. Do the benefits we are afforded by GOF research justify the potential risks?

The Military and Weaponizing Diseases

GOF serves two purposes in this setting. It allows for the creation of more deadly pathogens and it allows scientists to study the way in which these pathogens can be combated. This is where the lines of ethical arguments, safety, and practical enforcement become blurred.

This technology is comparable to the nuclear capability of a country. If we stop all GOF research, how are we then able to protect ourselves against rogue states that do not comply with a global ban on GOF research? Biological agents are undoubtedly the new preferred weapon of choice for many countries for very obvious reasons.

• Biological agents can decimate a targetted population whilst leaving all infrastructure unharmed.
• The cost of developing these agents is minimal in comparison to say for instance a nuclear arsenal, or an ICBM platform.
• The nature of the weapon makes its covert development far simpler to achieve.
• Countermeasures or vaccines can readily be introduced to protect a local population.
• Militant groups can seek to secure these agents through financial incentives, or simple theft from laboratories that do not engage sufficient security protocols.

Clearly, if you have no compunction about wiping out millions of innocent lives, a biological agent is your weapon of first choice. This is not lost on governments across the globe, and each government engages in its own clandestine efforts to stay up to speed in the virus wars. Their tool of choice is Gain of Function.

By restricting GOF research to military laboratories, you restrict the potential risks of theft. You cannot remove this risk completely, as again, we are dealing with human beings, but you can ensure the risk is dramatically reduced. The flipside of this coin isn’t that great though. The military is not renowned for transparency and the regulation and safety monitoring of these facilities by impartial external agencies would prove nigh on impossible.

Additionally, the focus of military financed research will lean heavily toward the weaponization of the viruses it studies. To sanction this is comparable with strapping a load of dynamite to your back and tossing lit matches over your shoulder. 

It’s a catch 22 and irrelevant of what the global scientific community decides about GOF research, you can rest assured that military agencies across the globe will continue irrespective. The genie is out of the bottle and we cannot put it back. Many find themselves uncertain as to whether we should even try and from a military perspective, the argument of preparedness holds water.

Corporate greed and that thin line in the sand

Welcome, all our conspiratorial compatriots, to the juicy bits. Supposition and wild conjecture based on rumor, possibility, and the public whipping post, to which we have all bound ourselves with the unbreakable bonds of capitalism. Our scrambled financial history of Keynesian economics and Friedman has bred financial behemoths, monsters controlled by individuals rather than governments, and therein lies our problem.

These companies, owned by individuals like Bezos, Gates, Zuckerberg, and others are driven by one singular purpose. He who dies with the most wins. While there are considerable donations made and charitable organizations founded, the motives and ambitions of these individuals remain the subject of intense debate. Covid has presented and highlighted the next frontier. Healthcare. And the respective owners of the monsters are falling over each other to get to the front of the queue.

If you think large corporations would be discouraged by killing off a few million people to conquer a single global market, think again. If you had to remove all the unhealthy, disease-causing, potentially toxic and carcinogenic items from your local supermarket chain’s shelves, you’d probably be left with a single shelf of produce. American consumers are being fattened and slaughtered by large businesses. It’s been happening for decades, and most consumers never realize it.

So the question here boils down to this. Who is the more evil? Your local Costco or a large corporate who decides to “manage” a future pandemic? If you’re killing your customer over two decades using fat-laden poisons or in two months with a designer virus, there really isn’t any difference, is there.

The Gates Foundation has already spread its reach into the WHO, vaccine trials, and development, and yes, Gain of Function research. Bill Gates, without a single shred of medical or scientific training relating to these fields, is dictating global health policy or attempting to. He is not alone. The fortunes to be made from global vaccines are not to be sneezed at and arguably, all you need is a product that caters to a demand. 

How you set about creating that demand is where the issues arise. 

Before you dismiss this as a flight of fancy, remember the world you are I now live in. One that in January of 2020 would have seemed like a dystopian fairytale, had you described it. We have to assume the worst of manipulative corporations that have ALL profited hugely from the pandemic. Allowing them potential access to gain of function research is in my humble opinion, a terrible idea.

Back to reality and today

Where does all this leave us? It’s an almost foregone conclusion that the term Gain of Function will become a household name over the next few months as we ramp up our (what I believe to be futile) efforts to track the origin of SARS-CoV2. The virus may or may not present its origin when it and science meet in a mutually agreeable place at a date of its choosing.

The role played by GOF research will remain at the forefront of the discussion and its very presence in the discussion, whether it is eventually shown to be complicit or not, should sound a warning call to both science and those that seek to protect our societies. Laboratories across the globe are currently engaged in GOF research. Even now as I write this, many will be rushing ahead on projects and multi-tasking, all too aware of the ax that now dangles above the neck of GOF.

This in itself presents additional opportunities for laboratory breaches. 

We’ve been having this discussion for a while now. This 2015 article in Nature entitled “Gain-of-function experiments: time for a real debate” highlights just how long we’ve been debating the benefits of GOF research and also provides an excellent defense for the technology. In the article the author frames the problem as follows; (PPP refers to Potentially Pandemic Pathogens)

Creating PPPs — a subset of GOF experiments involving creation of novel, virulent, transmissible viruses — is one of these approaches. Unlike other GOF experiments, the creation of PPPs entails a unique risk that a laboratory accident could spark a pandemic killing millions. The question is not whether to carry out research on PPPs or to do nothing; it is whether to have a portfolio of approaches to defeat viruses without creating a pandemic risk, or whether to include PPP experiments in that portfolio. For example, we should decide whether devoting our limited resources for flu research towards PPP creation experiments — which are expensive, often underpowered, low-throughput and often poorly generalizable5, and which create pandemic risk — is better than using those resources to enhance the rest of the portfolio for flu preparedness.

We need to sit down as a global community and address Gain of Function now. Scientists need to produce a foolproof design, perhaps an enhanced version of BSL4, for future experimentation that all but eliminates the risk of escape and we need to ensure that any changes are implemented and rigorously policed. Organizations like the National Science Advisory Board for Biosecurity (NSABB) have proven themselves hopelessly unsuited to either determining risk or monitoring facilities.

An independent body, divorced from the role of science, needs to be established to monitor global GOF research involving PPP. The question now is who that would be and the World Health Organization is clearly not a candidate. They have proven themselves, over the duration of the pandemic, to be woefully ill-equipped to either address the demands of new emergent science or to cope with the dynamics of imminent threat. To date, they’ve been hugely non-commital on what they refer to as dual use research of concern (DURC).

All in all, it’s a series of events that will require a level of cooperation beyond anything we’ve been able to achieve over the course of the pandemic and that may prove to be its undoing. We may just simply resort to bans or moratoriums on a country-by-country basis that restrict GOF research on anything that could remotely be considered an end-of-days pathogen.

The research scientists rushing about their laboratories trying to force five years of research into an ever-narrowing window may already have seen the writing on the wall.

I’ll leave you with a quote from David A. Relman, from the 2015 Nature article referenced above. Do click on the referenced article in the quote.

More than twice a week in US laboratories, there is a ‘possible release event’ or a ‘possible loss event’, even if we look only at select agents — some of the most dangerous pathogens. For every 1,000 lab-years of work in BSL-3 laboratories in the United States with select agents, there are at least 2 accidental infections.

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Washington University School of Medicine announced a new clinic specifically targeting patients who recovered from Covid-19 but continue to suffer from a wide range of symptoms. Covid Long Haulers in St. Louis and the surrounding area will have access to top-notch care in this multispecialty service line.

The Care and Recovery After COVID-19 (CARE) Clinic recognize people with long Covid presents with diverse issues and complications. Patients often complain about problems in the heart, lungs, kidneys, brain, blood, insomnia, sleep, and mood disorders. To facilitate care coordination, the CARE clinic has access to specialists in Cardiology, Endocrinology, Gastroenterology, Hematology, Infectious Disease, Nephrology, Neurology, Occupational Therapy, Physical Therapy, and Pulmonology.

The team of specialists addresses each patient’s needs by providing a comprehensive individual assessment. Referrals, testing, and recommendations are coordinate from the central hub of the CARE Clinic.

The St. Louis Washington University CARE Clinic will schedule patients with Long Covid symptoms who have had a confirmed positive case of COVID-19 by a nasal swab test, a saliva test, or a blood antibody test.

Washington University is not the only institute launching post-Covid care clinics. The National Institute of Health (NIH) announced a new initiative to study the causes of the post-Covid condition. The influx of a $1.15 billion investment in new medical research funding will hopefully open the doors to preventative steps and, ultimately, treatment options.

Scientists continue to learn more about persistent symptoms after a Covid-19 infection. Popular terms for the condition include “long Covid” or “Covid long haulers.” The CDC uses the more descriptive term post-COVID condition to cover the set of post-infection signs and symptoms experienced more than four weeks after infection with SARS-CoV-2.

We know that SARS-CoV-2 enters the brain and causes inflammation. Scientists in Bethesda, Maryland, published a paper in the New England Journal of Medicine evaluating the brains of people who died from Covid-19. They noted inflammation and evidence of leaky blood vessels in the postmortem brain tissue.

Despite these findings, we do not know the specific reasons the virus causes persistent symptoms in some patients. Long Covid symptoms appear in some patients with severe Covid disease and those with mild or asymptomatic infections.

The CDC lists common symptoms of post-Covid complaints.

• Tiredness or fatigue
• Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
• Headache
• Loss of smell or taste
• Dizziness on standing
• Fast-beating or pounding heart (also known as heart palpitations)
• Chest pain
• Difficulty breathing or shortness of breath
• Cough
• Joint or muscle pain
• Depression or anxiety
• Fever
• Symptoms that get worse after physical or mental activities

FIGURE. Self-reported symptoms at the time of positive SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) testing results and unresolved symptoms 14–21 days later among outpatients (N = 274)* — 14 academic health care systems,† United States, March–June 2020

A recent study published in the Lancet evaluated patients six months after hospital discharge. Approximately 75% of the 1,655 hospitalized COVID-19 patients in Wuhan, China, continued to have at least one symptom six months after discharge.

Another Lancet study evaluated the neurolgic and psychiatric outcomes in 236 379 Covid-19 survivors six months after infection. One third met criteria for a neurological or psychiatric diagnosis within six months of infection. Anxiety, depression, muscle pain, substance abuse and insomnia were the most common reported conditions.

Patients in St. Louis and the surrounding area with post-Covid condition symptoms can find more information here.

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Two days ago, the professor who teaches at the University of Hamburg, released a 100-page report that he personally prepared on the alleged origin of the SARS-CoV-2 virus. In the report he makes the following claims, claims that he openly states are not based on scientific certainty, but rather deductive logic and circumstantial evidence. 

According to Prof. Wiesendanger and the 100-page report (available here on Research Gate) he has released, he has come to the following conclusion.

“both the number and quality of the circumstantial evidence point to a laboratory accident at the virological institute in the city of Wuhan as the cause of the current pandemic.”

He bases this claim on the following statements. (the statements below are reproduced from swprs.org)

No intermediate host animal has been identified that could have facilitated the transmission of SARS-CoV-2 pathogens from bats to humans. ergo, the zoonotic theory as a possible explanation for the pandemic has no sound scientific basis.

The SARS-CoV-2 viruses possess special cell receptor binding domains combined with a special (furin) cleavage site of the coronavirus spike protein. Both properties together were previously unknown in coronaviruses and indicate a non-natural origin of the SARS-CoV-2 pathogen.

Bats were not offered for sale at the suspected fish market in the center of Wuhan city. However, the Wuhan City Virological Institute has one of the world’s largest collections of bat pathogens, which originated from distant caves in southern Chinese provinces. It is extremely unlikely that bats from this distance of nearly 2,000 km would have naturally made their way to Wuhan, only to cause a global pandemic in close proximity to this virological institute.

A research group at the Wuhan City Virological Institute has been genetically manipulating coronaviruses for many years with the goal of making them more contagious, dangerous, and deadly to humans. This has been documented in the scientific literature by numerous publications.

Significant safety deficiencies existed at the Wuhan City Virological Institute even before the outbreak of the coronavirus pandemic, which have been documented.

There are numerous direct references to a laboratory origin of the SARS-CoV-2 pathogen. For example, a young female scientist at the virology institute in Wuhan is believed to have been the first to become infected. There are also numerous indications that as early as October 2019, the SARS-CoV-2 pathogen spread from the virological institute to the city of Wuhan and beyond. Furthermore, there are indications that the virological institute was investigated by the Chinese authorities in the first half of October 2019.

Taken on their own, these claims would be easy to dismiss, but bundled together they make a very convincing case for pointing to the laboratory in Wuhan as the most likely source of the outbreak. It’s a very serious allegation with far-reaching implications if it is true and it, therefore, warrants serious attention.

As to Motivation

Why would a respected nanotechnology expert with an incredibly long and illustrious career suddenly branch out into a field he openly admits to having no experience in? Why would he risk his career by publishing a controversial report that is clearly not evidence-based on a hugely controversial topic he knows nothing about? It’s the first and most obvious question and one that we cannot answer with certainty, but we can speculate.

There has been growing concern in medical and scientific circles about “Gain-of-Function (GOF)” research. Essentially, this research focuses on weaponizing viruses or exploiting the virus to make it more lethal to its human hosts. In scientific terms, the research seeks to increase the pathogenicity of a virus. There are elements within the scientific community who are almost militant in their desperation to stop this type of research and with good reason.

Arguably, being able to pin a pandemic on this type of research would stop it in its tracks, but to achieve that you would need to conclusively prove that the Wuhan laboratory was engaged in GOF research, that they had access to a coronavirus, that they were able to successfully increase its pathogenicity, and finally, that they accidentally or otherwise, released the virus into the human population.

That’s a tall order, particularly after the WHO inspectors on the ground in China released a statement just ten days ago in which they urged scientists to dismiss theories about a laboratory as the origin, stating the possibility was ‘extremely unlikely’. Our professor has however apparently been working on his report for over a year, so the timing of the WHO advisory may simply have been an unfortunate coincidence.

Let’s look now to the claims made, and examine them individually.

Fact or Fallacy

‘the zoonotic theory as a possible explanation for the pandemic has no sound scientific basis.’

We won’t waste much time on this. Suggesting that simply because an agent has not yet been located for the transmission, that one does not exist, is simply flawed logic. The theory of animal to human transmission does have precedence and that is why it must be explored to its conclusion. We are a long way from that point.

a special (furin) cleavage site of the coronavirus spike protein indicates a non-natural origin of the SARS-CoV-2 pathogen

Again, flawed logic, from someone who should know not to confuse correlation with causation. Simply because no previous instance exists doesn’t imply the virus was manufactured by humans, nor does this allow us to make any other inferences. You could argue aliens developed it, based on the same logic, so sorry, but no. Strike 2.

It is extremely unlikely that bats from this distance of nearly 2,000 km would have naturally made their way to Wuhan

In 2012 a coronavirus was discovered in bats living in a mine in Mojiang in China, some 1200 km’s (not 2000 as claimed) from Wuhan. Labeled RaTG13 by scientists, the virus was the closest know version of a coronavirus to be discovered in animals. It wasn’t, and still isn’t, the SAR-CoV2 virus. We still haven’t found the carrier, if it originated in animals, as is currently suspected by the majority of scientists.

WHO scientists have also highlighted in their recent report that contact between bats and people in the Wuhan area is uncommon.

The fact this is the currently preferred theory doesn’t preclude all others and science has been known to be wrong before, ask Galileo. So while we can agree that bats may be ruled out at a later date, it still doesn’t point conclusively to the laboratory as the source. It merely rules out bats as the likely source.

The Wuhan City Virological Institute has been genetically manipulating coronaviruses for many years with the goal of making them more contagious, dangerous, and deadly to humans

It’s interesting that the publication lists no links to the ‘numerous reports documented in the medical literature that it refers to. The Wuhan Institute of Virology did in fact have access to the coronavirus and it would have engaged in research on the virus. Given the purpose behind the Institute, it would be foolish to claim otherwise and the Institute has never denied possession of the coronavirus (not the SARS-CoV2 strain). 

They have however repeatedly insisted that there were no safety lapses that could have resulted in any virus escaping from the laboratory. The institute is home to the China Center for Virus Culture Collection, the largest virus bank in Asia and which preserves more than 1,500 strains, according to its website.

Are there occasional safety issues at the laboratory? Probably, but it is unlikely they occur in the P4 wing of the institute. Safety protocols are extremely high and adhered to meticulously in areas where many of the highly lethal viruses scientists are working with, are potentially fatal if contracted. These institutes are also subject to international oversight and there is a regular presence of foreign scientists at this, and other similar institutes.

The takeaway

There is no substance to any of the professors claims and it is our opinion that he should retract his conjectural report.

Scientists are highly skeptical of Dr. Roland Wiesendanger’s, and he openly admitted to ZDF, a German newspaper, that the report was not based on science, but merely designed to spark public debate. While no one can, at this point, claim with complete certainty that the laboratory in Wuhan was not involved in the origins of the pandemic, the opposite is equally true, and to engage in this kind of false news is professionally disingenuous and suggest alternate motives.

We’d like to suggest to the professor, that abusing scientific publications for the purposes of “sparking public debate” is in fact highly questionable. We would further argue that accusing a foreign power and your foreign compatriots of unleashing a pandemic they “engineered” is both irresponsible and dangerous, particularly if your allegations are based on circumstantial evidence. Allegations, that are, in effect, baseless.

We were under the impression the professor dealt with science and evidence-based conclusions. Clearly, this is no longer the case. May we respectfully remind him, that if he continues to attempt to emulate Sherlock Holmes, he has not yet exhausted the impossible, and so, cannot begin to claim the improbable. His current course of action does a disservice to both science and his profession and will serve only as fuel for future conspiracy theories.

Not happy with our simplistic public-facing breakdown. Let’s see what an expert in Covid research says on the topic. A Medika Life author and SARS-CoV2 researcher, Julian Willett, MD adds his voice.

Dr. Roland Wiesendanger is a PhD physicist and lacks medical qualifications. His personal research is not medical related (https://pubmed.ncbi.nlm.nih.gov/?term=roland+wiesendanger). Expert opinions on topics tend to be from those who have extensive experience in a given discipline. His claims make being an expert even more important (especially firm scientific evidence is further required). The WHO and its health team, made up of physicians, physician-scientists, and scientists all specializing in medical topics and often virology have deemed that it is extremely unlikely that the virus came from a lab.

I personally am a physician-scientist investigating COVID-19 genetics, for my Ph.D., both the virus’s genetics and the human genetics associated with the virus. I trust the WHO’s findings and agree with the responses to Dr. Wiesendanger’s points by the author of this article. There are already increased hate crimes done against those of Asian ancestry due to it publicly arising first in Asia. Such a work by Dr. Wiesendanger utilizing baseless claims only provides fuel to such hate.

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In March, as the Southern Hemisphere braced for winter flu season while fighting COVID-19, epidemiologist Cheryl Cohen and colleagues at South Africa’s National Institute for Communicable Diseases (NICD) set up a plan to learn from the double whammy. They hoped to study interactions between seasonal respiratory viruses and SARS-CoV-2, which causes COVID-19. Does infection with one change a person’s risk of catching the other? How do people fare when they have both?

But the flu season — and the answers — never came. NICD’s Centre for Respiratory Disease and Meningitis, which Cohen leads, has logged only a single flu case since the end of March. In previous years, the country’s surveillance platforms, which capture a sampling of flu cases from doctors offices, hospitals, and clinics, have documented, on average, about 700 cases during that period, Cohen says. “We’ve been doing flu surveillance since 1984, and it’s unprecedented.”

There are a number of factors that may have affected the 2020 influenza season. Masks, for one. More focus on hand hygiene and the disinfection of household surfaces, and then, social distancing. Add to that the closure of schools, children are the major engine for influenza transmission, and you can see possibly why the seasonal flu is having a hard time.

There is another reason though, and it has to do with viruses in general. They seem to prefer healthy hosts.

Viruses exhibit really strange behavior that we don’t as yet fully understand. When a new strain emerges, older viruses will often go into a phase of inactivity. It’s almost as though they are able to assess the landscape of potential hosts and realize they offer slim pickings. Scientists don’t fully understand this mechanism or what drives it.

Anecdotally, where I find myself currently ensconced in a remote village in the Philippines, Covid-19 is a rarity, almost no cases have presented. Here, the common flu virus is still alive and well, doing the rounds, and our rainy season brought with it all the usual flu encapsulated miseries.

So does this mean that traditional influenza will be back when the coronavirus runs its course? Possibly. We just don’t know enough about viruses to be sure. There is an alternative scenario though. One that becomes more likely with each passing day.

The possibility that this particular coronavirus, which is, don’t forget, a member of the family of influenza viruses, sticks around. Permanently. That our new term for flu becomes Covid. That we are already in the midst of a really terrible “flu” season that we’ve simply chosen to intentionally ‘mislabel’.

What supports this potential outcome?

The SARS-CoV-2 is an influenza virus with a twist. Its symptoms, when you first start feeling the effects of being infected, are initially indistinguishable from regular influenza. That’s why we need to rely on tests before we treat Covid-19 patients.

I take issue with articles like those issued by the WHO that seek to underline the differences between the regular influenza virus and SARS-CoV-2. This simply increases the public perception that we are dealing with something that’s not an influenza virus. Surely the time has come to admit that despite the severity and transmissibility of SARS-CoV-2, it is nothing more than a really aggressive influenza. A new breed of “flu”.

If your body fails to destroy the virus, that’s when things take a turn for the worse and when SARS-CoV-2 shows its true colors. It possesses an array of tools, a viral box of tricks, if you will, that regular “old school” influenza can only dream of.

Although it follows the conventional flu virus by using our nose and mouth to gain access to our bodies, that’s pretty much where the similarities end. Initial symptoms that appear flu-like are actually a precursor or warning for what can and does follow in some people. Unlike influenza, which pretty much limits itself to cardio and pulmonary attacks, the SARS-Cov-2 virus uses our bloodstream to transport itself to every organ and orifice of our bodies.

From your little toe to your brain, everything you own is fair game for this virus and there is emerging evidence that even those who don’t develop severe Covid-19, still sustain damage to their lungs and, perhaps, even other organs. We are only just starting to understand the long term impacts on survivors.

We use the term “influenza” to describe a whole range of viruses that cause respiratory like symptoms in their hosts. The coronavirus is part of this family, and while your organs, brain, and circulatory system are all at risk from it, it is still the lungs that are most likely to sustain serious damage from Covid-19, If it walks like a duck and quacks like a duck, even though it may have grown a few new feathers, it’s still a duck. Just a far more dangerous duck.

Viral Evolution

To have a context for the severity of influenza pandemics it might be helpful to know the death count of a typical flu season. Current estimates for the annual number of deaths from influenza are around 400,000 deaths per year. Paget et al (2019) suggest an average of 389,000 with an uncertainty range 294,000 from 518,000.

This means that in recent years (pre-Covid) the flu was responsible for the death of 0.0052% of the world population — one person out of 18,750. It is a number so negligible as to pay it no heed, which is exactly what flu became to us. A negligible concern. Unless you were old or suffered from a related condition that made contracting influenza potentially deadly, catching flu was simply an annoying part of life for most. Millions, possibly billions, were infected each year.

The interactive graph below shows our increase in life expectancy since the 1830s.

If the 1918 “Spanish Flu” pandemic estimates of 50 million deaths published by Johnson and Mueller are used, it implies that the Spanish flu killed 2.7% of the world population. If it was in fact higher, as the report suggests— 100 million— then the global death rate would have been 5.4% of the global population in 1918, estimated to have been around 1.8 billion.

In 2020, with over 140 million recorded births globally, you can see how even the 2 million deaths from Covid-19 cannot impact this curve. We have become too prolific and the old adage, “safety in numbers” may very well no longer count in our favor. Our proclivity for breeding and increased numbers merely offers viruses an untold wealth of opportunities.

Interestingly, as the graph shows, 1918 was the last time the world’s population experienced a contraction. In the last century, we’ve faced other influenza pandemics, but all have paled in comparison to the 1918 outbreak.

• The Russian Flu pandemic of 1977–78 was caused by the same H1N1 virus that caused the Spanish flu. According to Michaelis et al. (2009) around 700,000 died worldwide
• According to a WHO publication the “Hong Kong Flu” (1968–1969) killed between 1 and 4 million people
• Estimates for the death toll of the “Asian Flu” (1957–1958) vary between 1.5 and 4 million.
• Two decades before the Spanish flu the Russian flu pandemic (1889–1894) is believed to have killed 1 million people.

Viruses don’t just disappear. Take the H1N1 variant. Fifty years after the Spanish Flu pandemic, it was back. Reduced deaths can easily be attributed to our access to antibiotics, a relatively new medical tool to combat infections, and improved hygiene protocols. By the late seventies, we understood the nature of the enemy we were facing and how best to neutralize it.

So is the coronavirus flu, or isn’t it?

Yes, it is and no, it isn’t. In the strict sense of viral lineage, it is not an influenza virus. Both are enveloped, single-stranded RNA viruses, and both are encapsidated by nucleoprotein but there are fundamental differences between normal flu viruses and SARS-CoV2, notably the following;

• Polarity. The influenza virus is comprised of 8 single-stranded negative-sense, viral RNA segments. SARS-CoV-2 has single-stranded, non-segmented, positive-sense, viral RNA.
• Influenza viruses rely on the collaborative functions of 2 viral surface proteins, haemagglutinin (HA) and neuraminidase (NA) to enter and exit host cells. SARS-CoV-2 is covered in spike (S) proteins that facilitate invasion of host cells. S proteins bind to the host cell receptor, angiotensin-converting enzyme 2 (ACE2)
• Scientists also point to the different strains of Influenza viruses and the single strain of SARS-CoV-2. It is, however, early days and the mutations of the virus are now in evidence.

There is a very real possibility that SARS-CoV-2 will replace older influenza strains by establishing dominance in the host population (us). Failure to acknowledge this may be one of the reasons we’ve mishandled the pandemic so badly in terms of information and disseminating “need to know” details to the public. Trying to classify it as anything other than a new deadly strain of influenza may very well have hurt our efforts to contain it.

Rather than reclassifying it as its own deadly disease, we need to consider expanding our classification of influenza viruses to include it.

Yes, it is far more deadly than conventional strains of influenza, but as we’ve discussed, that doesn’t change its origins and nature and at some point, we may have to face the one glaring and unpleasant fact we’ve been avoiding.

The SARS-CoV-2 virus has supplanted influenza strains, replacing H1N1 and other common strains. and is now, officially, here to stay.

We need to deal with this unpleasant reality, adjust the public perception of the virus, and call a spade a spade. The virus will not magically disappear at some point in the near future. Everything we know about it suggests otherwise. It is mutating, frequently and rapidly and we are not going to simply wake up one morning to a world that is free of SARS-CoV-2. That is a pipedream and needs to be removed from the publics’ mindset.

SARS-CoV-2 is here to stay and we have to start working with that knowledge as the basis for our plans for the future. Medically, scientifically, economically, and as societies. We need to open up our world again and at the same time implement enforceable mandates for effective (not the current tea strainers we use) masks and social distancing.

Vaccines make up an integral part of our limited arsenal, but it is critical that they do not cause us to become complacent, that would be a false currency, given the nature of the virus and protection can be transient.

We need to start learning to co-exist with the new enemy, as we can no longer afford to try and “sit it out”. The virus doesn’t need to pay a mortgage our feed its children. We do and there are workable solutions we can implement to achieve this. We need to be addressing these now and with urgency.

SARS-CoV-2 has established itself as the top dog, and other common influenza strains will now take a back seat, waiting for it to show weakness. Perhaps in ten years, perhaps in fifty. When the opportunity presents, these “old familiars” will return, possibly exhibiting new tricks their years of isolation may have enabled. H1N1 is proof of their longevity, patience, and resilience.

We are directly responsible for many of these changes in viral behavior and viral evolution. Our drugs are not without impact on the viruses and we should never lose sight of the fact that for each countermeasure we deploy, viruses possess the ability to evolve and respond in kind. We need to be hyper-vigilant as our use of new technologies simply amplifies this risk.

Viruses have evolved and co-existed alongside us and our fates are, like it or not, inseparably intertwined.

We may also be dependant on viruses in ways we don’t yet fully understand. Our genetic code is in part comprised of bits of viral DNA amassed over generations, some of which are beneficial to our survival. This symbiotic relationship shouldn’t be ignored in our efforts to eradicate them. We need to examine ways of controlling and negating their impact on us as a species, rather than seeking to destroy them.

In our haste to counter, we may unleash a new strain that is far less tolerant of human life. To date, we’ve simply been lucky. We need to responsibly engineer our way to more good fortune and find ways to sustain this incredibly complex relationship in relative safety till we fully understand it. Only then can we seek to alter it.

So to re-examine our opening question again, you do know someone who contracted influenza this season, only it’s Covid-19, not the “normal flu” virus we would far rather have bumped into. It’s fair to say, considering this, that globally, the outlook for the 2021 “flu season” just became really bleak. It’s going to be a killer unless we act now to negate the impact of the SARS-CoV-2 virus. That means all of us, on the same page, acting cohesively and responsibly.

Spread the word. Killer flu on the loose! Get your flu (covid vaccine)shot, mask up and mind the gap.

The post Covid is Never Going to Be Over. We Need to Plan Accordingly appeared first on Medika Life.

A new paper published in the medical journal JAMA offers more encouraging news for pregnant women. Researchers at the University of Texas Southwestern Medical Center in Dallas published a study titled Pregnancy Outcomes Among Women With and Without Severe Acute Respiratory Syndrome Coronavirus 2 Infection.

The results show that 95% of women who tested positive for Covid-19 during pregnancy had no adverse outcomes. Five percent of infected women experienced severe complications such as pneumonia and respiratory distress.

This study also showed a low rate of newborn infections (3%) consistent with our previous reporting. Previously published data from the PRIORITY Study(Pregnancy Coronavirus Outcomes Registry) showed babies born to Covid-19-positive women do well with no increase in negative metrics such as low birth weight, difficulty breathing, apnea, or respiratory infections through the first eight weeks of life.

Based on current scientific understanding of Covid-19 infection in pregnancy, there is no evidence at this time indicating pregnant women are more at risk for severe illness from Covid-19 than the general public. In general, viral infections in pregnancy can lead to poor outcomes in mothers and newborns.

Pregnant women have a suppressed immune system and experience changes in the way the respiratory system functions. These physiological changes are essential but put pregnant women at a higher risk for respiratory problems when they contract other similar viruses such as MERS, SARS, influenza, or pneumonia.

This paper from UTSW adds to the growing body of medical evidence that most women who contract Covid-19 will do well. The authors acknowledge the scientific consensus that viral infections place pregnant women at risk but highlight the low number of sufficiently powered, large-scale studies conducted to accurately assess the specific risks associated with SARS-CoV-2. The purpose of this study was to address this gap in scientific research.

This large urban county health system’s research compared outcomes in 252 SARS-CoV-2-positive and 3,122 negative pregnant women. The data was collected from March 18 through August 22, 2020. The study population included 2,520 Latinx (75%), 619 Black (18%), and 125 White (4%) women. The statistical analysis controlled for variables such as age, parity, body weight, and other medical conditions.

The study found SARS-CoV-2 positivity was more common in Latinx women, accounting for 90% of the cases. Latinx women make up 75% of the 12,000 women delivering at UTSW.

Thirteen women (5%) developed severe respiratory complications requiring interventions, and one patient developed venous thromboembolism.

There was no difference in preterm birth rates, preeclampsia, C-section rates, or stillbirth in women with Covid-19. This data is further supportive evidence that pregnant women who test positive for Covid-19 and their newborn babies have a low risk of developing severe symptoms.

This study also evaluated the placenta for evidence of pathological changes. Scientists have been concerned the viral illness could lead to placental vasculopathy and inflammatory infiltrates. Pathologists studied the placentas of patients infected with Covid-19. This study found the majority were not affected by the virus.

NIH research indicates that in utero mom-to-baby transmission is rare because the placenta is missing key components the virus needs to enter the fetal circulation, namely ACE2 receptors and the TMPRSS2 enzyme. Both the ACE2 receptor and TMPRSS2 are present in the placenta but only in tiny amounts. The low levels likely explain why SARS-CoV-2 is unlikely to cross the placenta from mom to baby.

How do pregnant women protect themselves from Covid-19?

We all must do our part to prevent the spread of the virus. Pregnant women should follow the same global recommendations:

1. Wash your hands with soap and water for at least 20 seconds.
2. Use hand sanitizer containing at least 60% alcohol.
3. Avoid touching your face.
4. Practice social distancing.
5. Cover your mouth if you cough or sneeze.
6. Clean your cellphone and household surfaces.
7. Avoid travel.
8. Wear a mask when out in public.
9. Get your flu shot.

Adhikari EH, Moreno W, Zofkie AC, et al. Pregnancy Outcomes Among Women With and Without Severe Acute Respiratory Syndrome Coronavirus 2 Infection. JAMA Netw Open. 2020;3(11):e2029256. doi:10.1001/jamanetworkopen.2020.29256

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Little did they know their luncheon would lead to a clash between personal liberty and a 19th-century philosophy concept called the harm principle.

All in their 70–80’s, the women have varying degrees of health conditions. Diabetes, hypertension, asthma, and a cancer survivor sat at the round table inside a restaurant, enjoying a meal together.

The friends reconnected by reminiscing and sharing stories from their decades-long friendship. They hugged and returned home.

A few days later, the first in the group mentioned she tested positive for Covid-19. She did not call to warn the others or to recommend testing and quarantine. She casually mentioned her illness in passing.

She is a Covid-19 denier. She believes Covid-19 is real, but it is not the big deal the liberal #fakenews media portrays it to be. The pandemic did not deter her lifestyle.

She proudly sang in the choir at an evangelical Megachurch, where thousands of maskless worshipers celebrate their faith each week. She hosted her 30-person Sunday school inside of her home throughout the pandemic. She wondered aloud how she could have caught Covid-19.

She did not acknowledge she exposed her lifelong friends to a potentially deadly infection.

Luncheons, weddings, family barbecues, and other get-togethers serve as a reminder that our life choices now determine others’ fate. We may be socially isolated, but our lives are more connected than ever. Our decisions affect other people more than ever before. Our expression of personal liberty may impinge on the health and well-being of our loved ones.

“A person may cause evil to others not only by his actions but by his inaction, and in either case, he is justly accountable to them for the injury.” — John Stuart Mill.

Freedom to Do Whatever We Want vs. Others’ Rights Not to Suffer

Our world requires a collective effort to navigate through the pandemic. Each of us must make sacrifices to squelch the viral scourge.

Not all Americans share pandemic beliefs. The diversity of opinions are an inherent aspect of being an American. Historians will determine who is right and who is wrong. In the present, we each must make decisions about how we live our day-to-day life.

We are living in Pascal’s Wager.

Any of us may be asymptomatic carriers of SARS-Cov-2. Each of us may spread the virus before symptoms began and inadvertently pass the infection to another person.

Covid-19 is spread through person-to-person contact via respiratory particles. Breathing, talking, sneezing, and coughing spread large droplets. When we gather in groups, each of us is only as safe as the least compliant person.

We have two disparate choices:

1. The utilitarian approach follows nonpharmaceutical interventions such as social distancing, hand hygiene, and wearing a face mask. Individuals make a small sacrifice for the greater societal good. Wearing a mask is the easiest thing we can do to slow the spread of coronavirus and save others’ lives. Masks are an act of kindness towards others.
2. The deontological approach focused on personal freedom. In order to preserve individual liberty, one disregards precautions recommended by scientists, epidemiologists, hospitals, The Center for Disease Control, The World Health Organization, The Joint Commission, The American Medical Association, and The National Institute of Health.

Applying the Harm Principle

How do we reconcile the idea of honoring personal liberty while ensuring we limit the potential of hurting other people?

19th-century philosopher John Stewart Mill espoused the concept of the harm principle. This idea proposes people should be free to do whatever they want unless their actions cause harm to others.

Applications of the harm principle are evident throughout society. We respect the freedom of speech, but it is illegal to yell fire in a movie theater. People are free to drink alcohol but not drive a car while intoxicated.

Covid-19 deniers and skeptics are expressing individual freedom, but they are causing harm to others. Personal liberty does not include making others sick or possibly killing them.

I wear my mask to protect you. You wear one to protect me.

The United States has 6.8 million confirmed Covid-19 cases so far. There are over 31 million confirmed cases worldwide. 200,000 Americans are now buried in coffins. We have to do better.

We are living in dangerous times. SARS-Cov-2 does not care about our opinions or where we get our news. It infects and kills without considering its victim’s political views.

Covid-19 is a nonpartisan pandemic, but both political parties are deeply entrenched in their Covid-19 beliefs. We owe it to ourselves to pause for a moment of self-reflection asking, “What if I am wrong?”

We each should consider the possibility that our actions may be harming others. Until a vaccine or an effective treatment is available, the safest course of action is for every American to live as though we are all asymptomatic carriers.

One of America’s founding fathers famously said, “Give me liberty or give me death.” Our country celebrates an individual’s right to live life as they choose, but a functional society asks each person to consider the potential for harm to others.

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Coronaviruses are a large family of viruses that usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. However, three new coronaviruses have emerged from animal reservoirs over the past two decades to cause serious and widespread illness and death.

There are hundreds of coronaviruses, most of which circulate among such animals as pigs, camels, bats and cats. Sometimes those viruses jump to humans—called a spillover event—and can cause disease. Four of the seven known coronaviruses that sicken people cause only mild to moderate disease.

Three can cause more serious, even fatal, disease. SARS coronavirus (SARS-CoV) emerged in November 2002 and caused severe acute respiratory syndrome (SARS). That virus disappeared by 2004. Middle East respiratory syndrome (MERS) is caused by the MERS coronavirus (MERS-CoV). Transmitted from an animal reservoir in camels, MERS was identified in September 2012 and continues to cause sporadic and localized outbreaks.

The third novel coronavirus to emerge in this century is called SARS-CoV-2. It causes coronavirus disease 2019 (COVID-19), which emerged from China in December 2019 and was declared a global pandemic by the World Health Organization on March 11, 2020. To date, at the time of this articles publication, it has infected more than 8 million people globally and killed over 400,000.

COVID-19, MERS & SARS

In January 2020, a novel coronavirus, SARS-CoV-2, was identified as the cause of an outbreak of viral pneumonia in Wuhan, China. The disease, later named coronavirus disease 2019 (COVID-19), subsequently spread globally. In the first three months after COVID-19 emerged nearly 1 million people were infected and 50,000 died.

The Centers for Disease Control and Prevention (CDC) developed a test to diagnose COVID-19 in respiratory and serum samples. The National Institute of Allergies and Infectious Diseases (NIAID) also is accelerating efforts to develop additional diagnostic tests for COVID-19. These tests are helping facilitate preclinical studies and aid in the development of medical countermeasures.

NIAID COVID-19 research efforts build on earlier research on severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), which also are caused by coronaviruses. MERS is a viral respiratory disease that was first reported in Saudi Arabia in September 2012 and has since spread to 27 countries, according to the World Health Organization. Some people infected with MERS coronavirus (MERS-CoV) develop severe acute respiratory illness, including fever, cough, and shortness of breath.

From its emergence through January 2020, WHO confirmed 2,519 MERS cases and 866 deaths (about 1 in 3). Among all reported cases in people, about 80% have occurred in Saudi Arabia. Only two people in the United States have tested positive for MERS-CoV, both of whom recovered. They were healthcare providers who lived in Saudi Arabia, where they likely were infected before traveling to the U.S., according to the CDC.

Infection with SARS coronavirus (SARS-CoV) can cause a severe viral respiratory illness. SARS was first reported in Asia in February 2003, though cases subsequently were tracked to November 2002. SARS quickly spread to 26 countries before being contained after about four months. More than 8,000 people fell ill from SARS and 774 died. Since 2004, there have been no reported SARS cases. 

Research evidence suggests that SARS-CoV and MERS-CoV originated in bats, and it is likely that SARS-CoV-2 did as well. SARS-CoV then spread from infected civets to people, while MERS-CoV spreads from infected dromedary camels to people. Scientists are trying to determine how SARS-CoV-2 spread from an animal reservoir to people.

Characterizing MERS and COVID-19 Disease

Since the emergence of MERS coronavirus (MERS-CoV) in 2012 and SARS-CoV-2 in 2019, NIAID scientists have advanced their understanding of how the viruses cause disease, focusing on developing animal models of disease and on countermeasures such as diagnostic tests and vaccine candidates. Research by NIAID scientists and others demonstrated that MERS-CoV and SARS-CoV-2 use their spike (S) protein to enter cells and initiate infection. After entering the cell, the viruses delay usual immune system responses, allowing the infection to gain a foothold. By the time the immune system responds, the infection has progressed and becomes much harder to fight.

Scientists also have characterized different strains of MERS-CoV and can determine through tests how those strains affect different animals. They also are studying how the form of the virus—liquid or aerosol—affects its stability. Using a monkey model of MERS, researchers have learned how the virus causes disease in people. For example, scientists at NIAID’s Rocky Mountain Laboratories (RML) demonstrated in a monkey model that clinical signs of MERS appear within 24 hours of infection. They also found that the virus causes disease deep within the lungs, leading to pneumonia. NIAID-funded researchers also have established several mouse models of infection that have been critical in developing MERS-CoV medical countermeasures.

A research group at RML also has developed a rhesus macaque model of SARS-CoV-2 to study COVID-19. The model mimics mild- to-moderate respiratory disease in people, including signs of pneumonia seen in an X-ray; this also is an important diagnostic feature in human patients. They also learned that the virus causes disease in the lungs, and that virus is shed from the nose, throat and rectum in a pattern similar to virus shedding in COVID-19 patients. The scientists are using this model to evaluate treatments and preventive vaccines. 

About Covid-19

COVID‑19 is the new respiratory disease spreading around the world and it is caused by a coronavirus. COVID‑19 is short for “coronavirus disease 2019.”

The virus is thought to spread mainly between people who are in close contact with one another (about 6 feet) and through respiratory droplets produced when an infected person coughs or sneezes.

• People are most contagious when they are the sickest. But those who don’t have a lot of symptoms can still pass the virus on to others.
• There is currently no vaccine or cure for COVID‑19 but researchers are working to find one.

What are COVID‑19’s symptoms?

The most common symptoms are very similar to other viruses: fever, cough, and difficulty breathing. Common symptoms of COVID‑19 are changing as more is learned about the disease.

The most common symptoms of COVID-19 are fever, dry cough, and tiredness. Other symptoms that are less common and may affect some patients include aches and pains, nasal congestion, headache, conjunctivitis, sore throat, diarrhea, loss of taste or smell or a rash on skin or discoloration of fingers or toes. These symptoms are usually mild and begin gradually. Some people become infected but only have very mild symptoms.

Most people (about 80%) recover from the disease without needing hospital treatment. Around 1 out of every 5 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart and lung problems, diabetes, or cancer, are at higher risk of developing serious illness.  However, anyone can catch COVID-19 and become seriously ill. 

People of all ages who experience fever and/or  cough associated withdifficulty breathing/shortness of breath, chest pain/pressure, or loss of speech or movement should seek medical attention immediately. If possible, it is recommended to call the health care provider or facility first, so the patient can be directed to the right clinic.

Who is at high risk for COVID‑19?

Everyone is at risk of getting COVID‑19, but some people are at a higher risk of serious illness.

Asthma (moderate-to-severe)

Moderate-to-severe asthma may put people at higher risk for severe illness from COVID-19.

Actions to take

• Follow your Asthma Action Plan.
• Keep your asthma under control.
• Continue your current medications, including any inhalers with steroids in them (“steroids” is another word for corticosteroids).
• Know how to use your inhaler.
• Avoid your asthma triggers.
• If possible, have another member of your household who doesn’t have asthma clean and disinfect your house for you. When they use cleaning and disinfecting products, have them:
  • Make sure that people with asthma are not in the room.
  • Minimize use of disinfectants that can cause an asthma attack.
  • Open windows or doors and use a fan that blows air outdoors.
  • Always follow the instructions on the product label.
  • Spray or pour spray products onto a cleaning cloth or paper towel instead of spraying the product directly onto the cleaning surface (if the product label allows).

Why you might be at higher risk

COVID-19 can affect your respiratory tract (nose, throat, lungs), cause an asthma attack, and possibly lead to pneumonia and serious illness.

Chronic kidney disease being treated with dialysis

Chronic kidney disease being treated with dialysis may increase a person’s risk for severe illness from COVID-19.

Actions to take

• If you are on dialysis, you should NOT miss your treatments.
• Contact your dialysis clinic and your healthcare provider if you feel sick or have concerns.
• Plan to have enough food on hand to follow the KCER 3-Day Emergency Diet Plan for dialysis patients in case you are unable to maintain your normal treatment schedule.

Why you might be at higher risk

Dialysis patients are more prone to infection and severe illness because of weakened immune systems; treatments and procedures to manage kidney failure; and coexisting conditions such as diabetes.

Chronic lung disease

Chronic lung diseases, such as chronic obstructive pulmonary disease (COPD) (including emphysema and chronic bronchitis), idiopathic pulmonary fibrosis and cystic fibrosis, may put people at higher risk for severe illness from COVID-19.

Actions to take

• Keep taking your current medications, including those with steroids in them (“steroids” is another word for corticosteroids).
• Avoid triggers that make your symptoms worse.

Why you might be at higher risk

Based on data from other viral respiratory infections, COVID-19 might cause flare-ups of chronic lung diseases leading to severe illness.

Diabetes

Diabetes, including type 1, type 2, or gestational, may put people at higher risk of severe illness from COVID-19.

Actions to take

• Continue taking your diabetes pills and insulin as usual.
• Test your blood sugar every four hours and keep track of the results.
• Make sure that you have at least a two-week supply of your diabetes pills and insulin.
• Follow the sick day guidelines for people with diabetes.

Why you might be at higher risk

People with diabetes whose blood sugar levels are often higher than their target are more likely to have diabetes-related health problems. Those health problems can make it harder to overcome COVID-19.

Hemoglobin Disorders

Hemoglobin disorders such as sickle cell disease (SCD) and thalassemia may put people at higher risk for severe illness from COVID-19.

Actions to take

• Ask your healthcare provider about telemedicine or remote healthcare visits, and know when to go to the emergency department.
• Work with your healthcare provider to manage medications and therapies for your disorder (including hydroxyurea, chelation therapy, blood transfusions, and prescriptions for pain management) and any other health condition you may have (such as diabetes, high blood pressure, and arthritis).
• Try to prevent vaso-occlusive episodes or pain crises by avoiding possible triggers.

Why you might be at higher risk

Living with a hemoglobin disorder can lead to serious multi-organ complications, and underlying medical conditions (such as heart disease, liver disease, diabetes, iron overload, kidney disease, viral infections, or weakened immune system) may increase the risk of severe illness from COVID-19.

Immunocompromised

Many conditions and treatments can cause a person to have a weakened immune system (immunocompromised), including cancer treatment, bone marrow or organ transplantation, immune deficiencies, HIV with a low CD4 cell count or not on HIV treatment, and prolonged use of corticosteroids and other immune weakening medications. People who are Immunocompromised

Actions to take

• If you are immunocompromised, continue any recommended medications or treatments and follow the advice of your healthcare provider.
• Call your healthcare provider if you have concerns about your condition or feel sick.

Why you might be at higher risk

People with a weakened immune system have reduced ability to fight infectious diseases, including viruses like COVID-19. Knowledge is limited about the virus that causes COVID-19, but based on similar viruses, there is concern that immunocompromised patients may remain infectious for longer than other COVID-19 patients.

Liver disease

Chronic liver disease,  including cirrhosis, may increase risk for serious illness from COVID-19.

Actions to take

• Take your medications exactly as prescribed.

Why you might be at higher risk

Severe illness caused by COVID-19 and the medications used to treat some severe consequences of COVID-19 can cause strain on the liver, particularly for those with underlying liver problems. People living with serious liver disease can have a weakened immune system, leaving the body less able to fight COVID-19.

People aged 65 years and older

Older adults, 65 years and older, are at higher risk for severe illness and death from COVID-19.

Actions to take

• Take your medications for any underlying health conditions exactly as prescribed.
• Follow the advice of your healthcare provider.
• Develop a care plan that summarizes your health conditions and current treatments.
• Prepare yourself to stay home for long periods using this checklist.

Why you might be at higher risk

Although COVID-19 can affect any group, the older you are, the higher your risk of serious disease. Eight out of 10 deaths reported in the U.S. have been in adults 65 years or older; risk of death is highest among those 85 years or older. The immune systems of older adults weaken with age, making it harder to fight off infections. Also, older adults commonly have chronic diseases that can increase the risk of severe illness from COVID-19.

People who live in a nursing home or long-term care facility

Many cases of COVID-19 in the U.S. have occurred among older adults living in nursing homes or long-term care facilities

Actions to take

• Carefully follow your facility’s instructions for infection prevention.
• Notify staff right away if you feel sick.
• Ask your caretakers about the actions that are being taken at your nursing home or long-term care facility to protect you and your loved ones, including if and how they are limiting visitors.

Why you might be at higher risk

The communal nature of nursing homes and long-term care facilities, and the population served (generally older adults often with underlying medical conditions), put those living in nursing homes at higher risk of infection and severe illness from COVID-19.

Serious heart conditions

Serious heart conditions, including heart failure, coronary artery disease, congenital heart disease, cardiomyopathies, and pulmonary hypertension, may put people at higher risk for severe illness from COVID-19.

Actions to take

• Take your medication exactly as prescribed. Continue angiotensin converting enzyme inhibitors (ACE-I) or angiotensin-II receptor blockers (ARB) as prescribed by your healthcare provider for indications such as heart failure or high blood pressure.
• Make sure that you have at least a two-week supply of your heart disease medications (such as those to treat high cholesterol and high blood pressure).
• People with hypertension should continue to manage and control their blood pressure and take their medication as directed.

Why you might be at higher risk

COVID-19, like other viral illnesses such as the flu, can damage the respiratory system and make it harder for your heart to work. For people with heart failure and other serious heart conditions this can lead to a worsening of COVID-19 symptoms.

Severe obesity

Severe obesity, defined as a body mass index (BMI) of 40 or above, puts people at higher risk for complications from COVID-19.

 Actions to take

• Take your medications for any underlying health conditions exactly as prescribed.

Why you might be at higher risk

Severe obesity increases the risk of a serious breathing problem called acute respiratory distress syndrome (ARDS), which is a major complication of COVID-19 and can cause difficulties with a doctor’s ability to provide respiratory support for seriously ill patients. People living with severe obesity can have multiple serious chronic diseases and underlying health conditions that can increase the risk of severe illness from COVID-19.

What about COVID‑19, pregnancy, and newborns?

At this time, pregnant women reportedly have the same COVID‑19 risk as adults who are not pregnant. There is also no clear evidence that a fetus can be infected with COVID‑19 in the womb.

Pregnant women are known to have a higher risk of severe illness when infected with viruses from the same family as COVID‑19 and other viral respiratory infections. This is why pregnant women should take extra precautions to not get COVID‑19. Avoid those who have or who have been exposed to COVID‑19. Wash your hands often. Practice physical distancing. Clean and disinfect frequently touched surfaces daily

• During this time, it’s normal for care providers to change some prenatal visits to telemedicine.
• Ask if your delivering hospital has changed any rules, like if you’ll be asked to wear a face covering while giving birth or if there is a new visitor policy.
• Most babies born to people with COVID‑19 are not affected. However, once the baby is born, it is at risk for infection. New parents should take the same precautions to protect themselves from illness as pregnant women.
• So far, COVID‑19 has not been detected in breast milk. If you are sick, including with COVID‑19, wear a cloth face covering and wash your hands before each feeding. If pumping milk, do not share your pump with anyone else. Wash your hands before expressing milk or before touching the pump or bottle parts. Follow recommendations for cleaning the pump and parts after each use. If possible, have someone who is not sick feed the baby.
• Stay in touch with your care team if you feel sick or develop COVID‑19 symptoms.
• Pregnancy and postpartum can be stressful, and COVID‑19 can add to feelings of uncertainty, stress, anxiety, or depression. Talk with your care provider if you are feeling overwhelmed. Seek help if you are in crisis and feel like you may harm yourself or your baby.

When should I see a doctor?

Knowing when to see a doctor can keep medical care available for those who need it most.

Most mild symptoms can be treated at home. The most up-to-date way to assess your best next steps is to complete our Screening Tool.

• If you need to see your doctor, call the office before you go. Many physicians’ offices are doing virtual visits. They will tell you what to do based on your location.
• Testing is limited-availability across the country and is currently being prioritized for healthcare workers, emergency medical service providers, police, and other essential workers, so please consult your doctor for availability in your local area.
• If you develop emergency warning signs, call emergency services. Emergency warning signs include: severe, constant chest pain or pressure; extreme difficulty breathing; severe, constant lightheadedness; or serious disorientation or unresponsiveness.

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