[This blog is being updated as more information comes in-last update was on 3/4/20].
- The Coronavirus is lethal, but not likely as lethal as the Spanish flu Pandemic of 1918
- Chinese physicians have several trials ongoing using stem cells to treat the disease
- Early results look very promising in curing the critically ill
I was trying to figure out how I would write about Coronavirus in the blog as I have some things to say, then Chinese doctors made it easy by using stem cells to cure several people on their death beds. How did that work? Is this a real thing?
Coronavirus is in the news now every day, but to quickly review, it’s a severe form of the flu. Its scientific name is COVID-19. ‘CO’ stands for ‘corona,’ ‘‘VI’ for ‘virus,’ and ‘D’ for disease. The name Coronavirus is really medical slang as that’s just the virus type, but that’s also the name of usually much milder flu bugs.
We’ve had lethal flu viruses before with the most notable being the 1918 Spanish Flu Pandemic. This was an influenza virus that had a 2-3% mortality rate and that killed an estimated 30 million worldwide (1.7% of the world’s population). That number is hard to compare to today because this was before ventilators, anti-viral, drugs, or modern life support and even before the widespread use of oxygen.
This virus seems to have originated in China and we’ve had other flu bugs that have come out that area including the “Bird Flu”.That bug was far nastier than the Spanish flu, with the H5N1 variant having a mortality rate of 60%, but it was also much harder to spread so there were under a thousand cases reported.
Coronavirus is much more like the Spanish flu than bird flu in that it’s easily transmitted and more lethal than the typical flu, but nowhere near as lethal as bird flu. How lethal is still being figured out. If we take the most recent published data from China, the mortality rate is 2.3% (1). But that’s likely an overestimate, as most cases are so mild that they never seek medical attention. Hence, that rate was calculated based on known cases that were seeking medical attention and were tested. From that same paper, the health worker infection and death rate may be more accurate, as most of these people were under constant surveillance and received supportive care immediately. That rate was 0.3%. For comparison, the average influenza virus has a mortality rate of 0.05%.
Like the flu, Coronavirus hits the elderly the hardest. Remember, these numbers are likely way over-estimated. Only 0.2% of 10-39 year olds died, double that for people in their 40s, six times that for people in their 50s, 18 times that for people in their 60s, and death rates in the 8-14% range for people 70 and older.
Here’s a great discussion of how the death rates for Coronavirus are likely wildly inflated. Bottom line, more accurate data on case fatalities from the only awful natural experiment that exits, the Diamond Princess cruise shows a fatality rate of 0.85%. All of the people that perished were over 70, which is much more typical for standard influenza. In addition, the ability of the virus to spread was again, not that impressive. So while this bug is nasty, it’s likely not the middle-aged killer that the media has been making it out to be.
Form this article:
“This all suggests that COVID-19 is a relatively benign disease for most young people, and a potentially devastating one for the old and chronically ill, albeit not nearly as risky as reported. Given the low mortality rate among younger patients with coronavirus—zero in children 10 or younger among hundreds of cases in China, and 0.2-0.4 percent in most healthy nongeriatric adults (and this is still before accounting for what is likely to be a high number of undetected asymptomatic cases)—we need to divert our focus away from worrying about preventing systemic spread among healthy people—which is likely either inevitable, or out of our control—and commit most if not all of our resources toward protecting those truly at risk of developing critical illness and even death: everyone over 70, and people who are already at higher risk from this kind of virus.
This still largely comes down to hygiene and isolation. But in particular, we need to focus on the right people and the right places. Nursing homes, not schools. Hospitals, not planes. We need to up the hygienic and isolation ante primarily around the subset of people who can’t simply contract SARS-CoV-2 and ride it out the way healthy people should be able to.”
Could Stem Cells Help?
This morning I came across a report from the South China Morning Post that reviewed the case of an elderly woman in the ICU in China. She had been there for two weeks and her organs were clearly failing, so the Chinese doctors got approval to use stem cells that had been culture expanded in the lab. After the first two treatments and within days she was able to get out of bed and then after the third injection, she was able to leave the ICU and was found to be COVID-19 negative. [Big thanks to a reader who has since found the published study which is here].
Another study is underway in Hunan province using similar stem cells and the doctor there was quoted as observing similar results. All of the doctors are saying that it’s time to throw the rule book out the window while they try to use anything they can to save the severely ill.
Are These the Same Stem Cells as My Chiropractor or Naturopath Offers?
NO. Per the article, the type of cells used in the first patient were isolated from umbilical cords and then grown in the lab. Meaning these were cells that were confirmed as highly viable and functional as this was tissue taken from the OB Ward directly into the lab to be isolated and grown. It was NOT the non-viable tissue being sold and promoted as umbilical cord-derived “stem cells” here in the US. Those products, based now on the research now from many labs, actually contain dead and non-functional stem cells.
How Could Stem Cells Work?
What often kills people with the flu is the massive inflammatory reaction in the lungs. This causes swelling and reduces the ability of the lungs to oxygenate tissues. Real stem cells are very good at the short-term reduction of inflammation. In addition, stem cells have been shown to be antibacterial and anti-viral (2,3).
Should We Panic?
NO. My best, educated guess is that COVID-19 is not as lethal as the 1918 Spanish flu. Whether that’s because of improvements in medical care or because it’s actually less virulent, we won’t know for some time. However, it’s still a bad virus that has the potential to kill people. On the other hand, you also need to understand that about 400,000 people a year die of the typical flu. The number of deaths reported to date for COVID-19 are a tiny fraction of that number.
I read an interesting back and forth discussion on Vox with a WHO researcher who spent time in China that’s both comforting and concerning. On the one hand, COVID-19 doesn’t seem to spread like the typical flu, where you would usually find 20-40% of an entire population testing positive for the flu. Instead, only the close associates of COVID-19 patients showed transmission. That’s VERY GOOD news for this not becoming a world-wide pandemic like 1918. On the flip side, Chinese death rates may not transfer to many other countries as they employed sophisticated medical technology that many countries don’t have in volume. For example, they used blood oxygenator machines in the most severe cases. Hence, the Chinese became experts at managing the disease, eventually getting the outside Wuhan death rate at low as 0.7%.
The Near Future
We will likely see a spike in US cases this next few weeks, but much of that will be due to the fact that the CDC test for COVID-19 had issues and the FDA is now allowing local hospitals and universities to start testing. Hence, we have been under testing and thus underreporting the number of COVID-19 cases here.
The good news is that it’s March and flu transmission is reduced in April and May because nicer weather brings more people outside where it’s harder for viruses to spread. So I would expect worldwide cases to begin to drop by late April. By summer, hopefully, this flu season is mostly over.
In the meantime, we may see a short-term recession while the US undergoes selective areas of quarantine. We may see more telecommuters decide to stay home and online delivery services like Amazon and the rest will do well for a few months. Factory production may be off in the first and second quarters but should roar back by the third quarter.
What can you do to protect yourself and your family? I had this conversation with my son this weekend. Wash your hands 10-15 times a day. Stay out of crowded spaces. Buy some hand sanitizer (this is getting sold out quickly). You don’t need a face mask. If you’re elderly and retired, stay indoors this month. Listen to the recommendations coming out of the CDC.
Here’s a good image of what happens when you use different hand washing techniques:
Light is bad (bacteria) and darker is better. The CDC is saying that proper handwashing should be at least 20 seconds with soap!
You can also make your own hand sanitizer by buying aloe vera and combining it with 99% isopropyl alcohol (rubbing alcohol) at 1/3 alcohol to 2/3rds aloe vera. It needs to have a final alcohol content of at least 60%. You need to cover your hands thoroughly and then allow the alcohol to dry for hand sanitizer to work, as that’s how it kills bugs. Don’t squirt it on and wipe your hands.
Could this Be a Stem Cell Tipping Point for the Incurable?
One of the interesting things at play here is that patients with lethal and incurable diseases have been making a push for being able to use experimental stem cell treatments for at least the last decade. Their arguments have largely fallen on deaf ears. However, if it turns out that culture-expanded stem cells can cure COVID-19 rapidly, we may see another push to get these therapies to the bedside in weeks and not years. That could be very good for all of those patients with lethal diseases, as it brings the issue of allowing patients who will die anyway to be able to try anything that helps to the forefront of the average American’s mind.
The upshot? Don’t panic! COVID-19 will likely be in the news for the next 1-2 months and it may put a big temporary dent in the economy and our lives during that time. However, it’s also being very much overhyped by the media to sell eyeballs to advertisers. In the meantime, we could see culture-expanded stem cells become a treatment for severe cases, moving the issue to the forefront of allowing dying patients to try whatever they want.
(1) Chinese Center for Disease Control and Prevention CCDC Weekly. The Epidemiological Characteristics of an Outbreak of 2019 Novel
Coronavirus Diseases (COVID-19) — China, 2020. Vol. 2. No. 8. http://weekly.chinacdc.cn/fileCCDCW/journal/article/ccdcw/2020/8/PDF/COVID-19.pdf
(2) Alcayaga-Miranda F, Cuenca J, Khoury M. Antimicrobial Activity of Mesenchymal Stem Cells: Current Status and New Perspectives of Antimicrobial Peptide-Based Therapies. Front Immunol. 2017;8:339. Published 2017 Mar 30. doi:10.3389/fimmu.2017.00339
(3) Yang K, Wang J, Wu M, Li M, Wang Y, Huang X. Mesenchymal stem cells detect and defend against gammaherpesvirus infection via the cGAS-STING pathway. Sci Rep. 2015;5:7820. Published 2015 Jan 16. doi:10.1038/srep07820