WEBVTT - COVID-19 Chapter 14: Virology, Take 2 0:00:01.680 --> 0:00:04.040 My name is Patrick and I live in Orlando, Florida. 0:00:04.960 --> 0:00:07.000 In June of twenty twenty, both of my parents were 0:00:07.080 --> 0:00:11.080 hospitalized with COVID. It started with my mother. My mother 0:00:11.200 --> 0:00:14.520 was seventy two, active and in good health. She ran 0:00:14.600 --> 0:00:18.360 her own cosmetics franchise and practice yoga on a regular basis. 0:00:18.760 --> 0:00:21.720 Her only underlying condition was asthma, which was not severe. 0:00:22.760 --> 0:00:25.760 On June twenty fifth, she walked into the hospital complaining 0:00:25.760 --> 0:00:28.400 of shortness of breath, a persistent cough, and a fever. 0:00:29.360 --> 0:00:32.440 She was admitted and began aggressive treatment with high low oxygen. 0:00:33.720 --> 0:00:36.040 Due to COVID precautions, we were not allowed into the 0:00:36.080 --> 0:00:39.320 hospital and had to communicate with her through the phone. 0:00:39.440 --> 0:00:43.479 As the days progressed, her condition worsened. When she would cough, 0:00:43.640 --> 0:00:45.760 she would gasp for air as if she was drowning. 0:00:46.760 --> 0:00:48.680 We kept our phone calls with her shorts so she 0:00:48.720 --> 0:00:52.640 could conserve her oxygen. Eventually we told her only to 0:00:52.760 --> 0:00:57.320 use text messages. The hospital gave her convalescent plasma, but 0:00:57.360 --> 0:00:59.880 the treatment course was limited and it didn't seem to help. 0:01:01.040 --> 0:01:04.399 On July fourth, she was intubated with my mother on 0:01:04.440 --> 0:01:08.280 a ventilator. Any updates regarding her condition and prognosis were 0:01:08.319 --> 0:01:10.680 dependent upon the nurser doctor on the other end of 0:01:10.720 --> 0:01:14.680 the phone. The information regarding my mother's condition would change 0:01:14.720 --> 0:01:18.120 based on the person observing it. We closely watched her 0:01:18.160 --> 0:01:20.959 ventilator settings, and our hopes and emotions would rise and 0:01:21.040 --> 0:01:24.759 fall with the daily reports. However, there was no true 0:01:24.800 --> 0:01:28.560 guidepost with which to evaluate her progress. We were frequently 0:01:28.560 --> 0:01:32.000 surprised by new conditions, such as her being septic, a 0:01:32.080 --> 0:01:37.400 persistent pneumothorax, and the development of APHEB. On August sixth, 0:01:37.600 --> 0:01:40.679 after thirty two days on a ventilator, the hospital transitioned 0:01:40.680 --> 0:01:43.320 her to compassionate care and removed her from the ventilator. 0:01:44.360 --> 0:01:48.360 Thirty four minutes later, my mother died. Before she died, 0:01:48.520 --> 0:01:51.200 we saw the X rays of her lungs. Instead of 0:01:51.240 --> 0:01:54.120 the shadowy outline of two healthy lungs, it looked as 0:01:54.160 --> 0:01:57.840 if a family of spiders created an impenetrable web that 0:01:57.960 --> 0:02:02.040 showed as white lines criss crossed throughout the arc. My 0:02:02.160 --> 0:02:04.720 father was admitted to the hospital two days after my mother. 0:02:05.880 --> 0:02:08.080 My father has been disabled since two thousand and one 0:02:08.240 --> 0:02:11.120 after suffering a stroke which permanently compromised his balance and 0:02:11.240 --> 0:02:14.480 range of motion. He also suffers from heart disease and 0:02:14.520 --> 0:02:18.800 has frequent bouts of APHEB. Despite his medical history, my 0:02:18.919 --> 0:02:23.200 father's only COVID symptoms were a fever, diarrhea, and extreme exhaustion. 0:02:24.360 --> 0:02:27.000 After five days in the hospital, he was discharged because 0:02:27.000 --> 0:02:29.880 he did not need oxygen. However, he was still testing 0:02:29.919 --> 0:02:33.920 positive for COVID. The convergence of his mobility issues and 0:02:34.000 --> 0:02:36.120 exhaustion meant that he could not even sit up in 0:02:36.120 --> 0:02:39.640 bed and could not care for himself. We struggled to 0:02:39.639 --> 0:02:42.560 take care of him while wearing PPE to avoid exposure 0:02:42.600 --> 0:02:46.040 to ourselves. The same day my mother was intubated, we 0:02:46.120 --> 0:02:48.640 had to have my father readmitted to the hospital because 0:02:48.639 --> 0:02:52.640 the level of care he needed exceeded our capabilities. My 0:02:52.720 --> 0:02:55.679 father spent two more weeks in the hospital and survived. 0:02:57.040 --> 0:02:59.800 January twenty twenty one would have marked my parents' fiftieth 0:02:59.840 --> 0:03:04.440 way anniversary. Throughout this process, we struggled to obtain reliable 0:03:04.440 --> 0:03:09.040 and accurate information regarding my parents' conditions. Before my mother died, 0:03:09.120 --> 0:03:11.560 we were given the opportunity to come into the ICU 0:03:11.600 --> 0:03:14.480 and see her. The images from that day in the 0:03:14.680 --> 0:03:16.800 ICU have stuck with me more than those of my 0:03:16.840 --> 0:03:22.440 mother herself. The entire ICU was COVID patients. Each patient 0:03:22.520 --> 0:03:26.040 was on a ventilator and confined to their room. Outside 0:03:26.040 --> 0:03:28.120 of the door to each room was the IV poll 0:03:28.600 --> 0:03:33.080 with no fewer than six IV bags and pumps. The 0:03:33.160 --> 0:03:37.280 atmosphere was eerily silent. The only sound we heard were 0:03:37.320 --> 0:03:40.640 a faint beeping in the distance and the stifled sniffling 0:03:40.680 --> 0:03:42.960 of nurses who took turns sitting at the nurses station, 0:03:43.560 --> 0:03:47.040 quietly crying with their heads buried in their hands. It 0:03:47.120 --> 0:03:49.120 was clear to us that the doctors and nurses were 0:03:49.160 --> 0:03:51.640 trying to care for all of their patients, but they 0:03:51.640 --> 0:03:55.080 were continuously confronted by the dim, silent reality that most 0:03:55.120 --> 0:03:57.360 every person in the ICU would not go home. 0:04:00.040 --> 0:04:02.280 My name's Rachel and from our toil in New Zealand 0:04:02.400 --> 0:04:05.000 and my husband's My are both working education in Auckland 0:04:05.040 --> 0:04:07.920 and we have two young kits. I wanted to share 0:04:07.920 --> 0:04:09.920 the experience that I have at the moment living in 0:04:09.920 --> 0:04:13.240 a country which is essentially post COVID. We currently have 0:04:13.360 --> 0:04:16.479 no community cases of COVID in only fifty five cases 0:04:16.520 --> 0:04:18.960 in the country as of the eighth of December, which 0:04:19.000 --> 0:04:21.279 are all quarantined at the border, and there is the 0:04:21.320 --> 0:04:24.440 result of people coming back into the country. We went 0:04:24.480 --> 0:04:26.159 into lockdown with the rest of the world in March 0:04:26.800 --> 0:04:29.200 and the lockdown Level four lasted for five weeks and 0:04:29.279 --> 0:04:33.440 during that time we have very strict conditions. Only hospitals, pharmacies, 0:04:33.480 --> 0:04:36.680 petrol stations and supermarkets were open, and we were only 0:04:36.720 --> 0:04:38.960 allowed out of our house for one local walker day 0:04:39.480 --> 0:04:42.360 or for our designated shopper to go get groceries from 0:04:42.360 --> 0:04:45.720 the local supermarket. The idea was that we didn't put 0:04:45.839 --> 0:04:49.880 ourselves at risk anything that we did that might increase 0:04:49.880 --> 0:04:53.440 our chance of interacting with those outside our bubble. We 0:04:53.520 --> 0:04:56.520 just didn't go and then we went to level three. 0:04:56.600 --> 0:04:59.880 We are online. Shopping and takeaways were allowed for another 0:04:59.839 --> 0:05:03.320 fe few weeks and then by May, schools were open, 0:05:03.480 --> 0:05:07.120 businesses were pretty much back to normal. Our Prime Minister 0:05:07.240 --> 0:05:10.800 took the scientific advice that she received really seriously and 0:05:11.400 --> 0:05:14.279 we were rallied as a team of five million to 0:05:14.480 --> 0:05:18.120 protect each other in the United against COVID nineteen. Ashley 0:05:18.120 --> 0:05:20.720 Bloomfield was a Director General of Health and he did 0:05:20.720 --> 0:05:23.320 a press conference at one pm every day to update 0:05:23.360 --> 0:05:28.640 everyone on new cases and which clusters had new cases. 0:05:28.760 --> 0:05:32.800 And even though everyone not everyone agreed with lockdown. We 0:05:32.839 --> 0:05:36.520 had very few cases of people breaking it. People received 0:05:36.839 --> 0:05:39.760 government support and most people got paid at least eighty 0:05:39.760 --> 0:05:43.839 percent of their wage over lockdown, and our borders are 0:05:43.880 --> 0:05:48.480 still closed except for returning citizens in permanent residents and 0:05:48.600 --> 0:05:51.520 they have to undergo two weeks isolation in a government 0:05:51.560 --> 0:05:54.880 funded facility, which is a five star hotel until they 0:05:55.000 --> 0:05:58.880 give return three negative tests. So after that first lockdown, 0:05:58.920 --> 0:06:01.159 we had one hundred days with new cases, and to 0:06:01.240 --> 0:06:05.479 be honest, it really felt like that was that. But 0:06:05.680 --> 0:06:09.080 then we had one relapse where just an Auckland, the 0:06:09.120 --> 0:06:11.599 Auckland region went back into lockdown for three weeks when 0:06:11.640 --> 0:06:17.240 one family tested positive in the community and they were 0:06:17.279 --> 0:06:20.000 able to find out that that was somebody from quarantine 0:06:20.120 --> 0:06:25.520 who had delayed incubation period, so they came up positive 0:06:25.560 --> 0:06:29.080 once they were back in the community. And so contact 0:06:29.120 --> 0:06:31.120 tracing is a huge part of New Zealand's response and 0:06:31.160 --> 0:06:34.720 they now trace all cases genomically to help link the clusters. 0:06:35.240 --> 0:06:37.080 So COVID, is this a weird thing? Right now? We 0:06:37.120 --> 0:06:39.000 know it's out there, we did the work to eliminate 0:06:39.000 --> 0:06:41.080 it from the community, and there's this sort of peripheral 0:06:41.080 --> 0:06:43.800 awareness of it. Because we wear masks on public transport in 0:06:43.800 --> 0:06:47.360 case another case comes through quarantine, and we hear stories 0:06:47.400 --> 0:06:50.359 from overseas and it's by no means completely rosy, like 0:06:50.400 --> 0:06:52.479 it's hard for people with loved ones overseas and you 0:06:52.960 --> 0:06:56.400 can't fly into the country unless you have a spacebook 0:06:56.440 --> 0:06:58.320 to the managed isolation, so there are people that are 0:06:58.360 --> 0:07:01.400 missing out on coming home for Christmas. But we also 0:07:01.480 --> 0:07:03.440 go to concerts and have plans to travel with the 0:07:03.440 --> 0:07:06.440 New Zealand over summer and have big family Christmas celebrations, 0:07:06.480 --> 0:07:09.239 and we see what's going on, but we're not really 0:07:10.080 --> 0:07:12.520 part of that global narrative of quarantine and the ever 0:07:12.600 --> 0:07:16.120 present fear of in fiction or death for us here 0:07:16.160 --> 0:07:19.400 in New Zealand and instead because of how swiftly the 0:07:19.480 --> 0:07:21.560 government acts if there is a community case, we're sort 0:07:21.560 --> 0:07:24.280 of on edge. But it's very easy to forget in 0:07:24.320 --> 0:07:27.800 the day to day that it's out there, because our 0:07:27.880 --> 0:07:30.640 lives are back to normal so to speak. Okaids are 0:07:30.640 --> 0:07:33.320 at school, where at work, and apart from not being 0:07:33.320 --> 0:07:36.400 able to travel overseas, there's not a huge difference to 0:07:36.480 --> 0:07:41.120 how we live now compared to in February, but we 0:07:41.240 --> 0:07:44.960 do have that feeling of how lucky we are to 0:07:45.000 --> 0:07:48.520 be in this situation. So basically all that to say, 0:07:50.200 --> 0:07:51.520 there's a lot at the end of the title. New 0:07:51.560 --> 0:07:55.760 Zealand is proof that testing, contact, tracing, quarantine, and science 0:07:55.840 --> 0:08:00.920 and collective action can prevail, and hopefully we will and 0:08:01.000 --> 0:08:02.520 I've crossed the rest of the world as well. 0:08:46.920 --> 0:08:50.160 Thank you so so much for sharing your stories with us, 0:08:50.400 --> 0:08:53.439 and thank you also to everyone else who has written 0:08:53.440 --> 0:08:55.920 in to share your first hand account of how COVID 0:08:56.000 --> 0:08:59.720 nineteen has impacted you. We absolutely love hearing from you, 0:08:59.800 --> 0:09:03.600 and we feel like telling your stories is such an 0:09:03.600 --> 0:09:06.520 important reminder of how far reaching the effects of this 0:09:06.600 --> 0:09:07.480 pandemic have been. 0:09:08.240 --> 0:09:09.120 Yeah. 0:09:09.480 --> 0:09:13.520 Hi, I'm Aaron Welsh and I'm Erin Alman Updike and 0:09:13.559 --> 0:09:15.480 this is this podcast will kill you. 0:09:16.200 --> 0:09:20.160 Yeah, Welcome to our fourteenth I can't believe we've made 0:09:20.200 --> 0:09:20.640 it this far. 0:09:20.720 --> 0:09:21.240 Oh my gosh. 0:09:21.280 --> 0:09:24.840 I installment of our Anatomy of a Pandemic series on 0:09:24.960 --> 0:09:31.079 COVID nineteen. Today we are revisiting the virus itself, SARS 0:09:31.200 --> 0:09:35.080 COVID two, which we visited first many many. 0:09:34.840 --> 0:09:36.840 Months ago, many many months. 0:09:38.040 --> 0:09:42.480 So today we'll refresh you on what exactly this virus is, 0:09:43.000 --> 0:09:46.800 what new things we've learned about its transmission. We'll touch 0:09:46.840 --> 0:09:50.160 on some of the new strains or rather variants that 0:09:50.200 --> 0:09:53.200 you've probably been hearing about, and we'll talk about the 0:09:53.240 --> 0:09:56.480 different tests for COVID nineteen and how those actually work, 0:09:56.880 --> 0:09:58.480 and honestly, so much more. 0:09:59.040 --> 0:10:02.199 Again, there is a lot of great information in this episode, 0:10:02.280 --> 0:10:06.400 so get excited. I'm excited, But first, are you also 0:10:06.480 --> 0:10:09.559 excited that it is Quarantin any time? 0:10:10.080 --> 0:10:12.040 I'm always excited for quarantine any time. 0:10:12.360 --> 0:10:15.280 Absolutely? What are we drinking this week? 0:10:15.640 --> 0:10:17.680 We're drinking quarantin y fourteen. 0:10:18.160 --> 0:10:19.920 Oo. What a surprise. 0:10:20.880 --> 0:10:25.640 And in Quarantini fourteen we have lime juice, Lemon juice, rum, 0:10:25.880 --> 0:10:30.160 and Marischino liqueur. And we'll post the full version of 0:10:30.160 --> 0:10:33.360 this Quarantini as well as our non alcoholic plus burrita 0:10:33.480 --> 0:10:35.640 on our website. This Podcast will Kill You dot Com 0:10:35.679 --> 0:10:37.719 and all of our social media channels, so make sure 0:10:37.760 --> 0:10:38.520 you follow us there. 0:10:38.800 --> 0:10:42.319 Absolutely. Okay, let's see, we've got a little bit more 0:10:42.360 --> 0:10:45.319 business to cover, so we are still soliciting first hand 0:10:45.320 --> 0:10:48.200 accounts for this COVID nineteen series, and if you would 0:10:48.280 --> 0:10:51.319 like to submit your first hand account, head to our website. 0:10:51.320 --> 0:10:53.480 This podcast will Kill You dot Com and click on 0:10:53.559 --> 0:10:56.160 the COVID nineteen first hand tab on the top of 0:10:56.160 --> 0:10:58.800 the page, and that'll send you over to a Google 0:10:58.840 --> 0:11:01.840 forum where you can fill out some of the information 0:11:01.920 --> 0:11:04.800 for your first hand account. And once again, thank you 0:11:05.160 --> 0:11:07.520 so much to everyone who has submitted their first hand 0:11:07.559 --> 0:11:08.280 account so far. 0:11:08.960 --> 0:11:12.720 Yeah, we also are in the process of getting transcripts 0:11:12.760 --> 0:11:16.520 made yay for all of our episodes. This is long overdue. 0:11:16.640 --> 0:11:19.760 We're very excited. They will be available under the transcripts 0:11:19.800 --> 0:11:22.240 tab on our website This Podcast will kill You dot Com, 0:11:22.280 --> 0:11:25.000 So check back there or follow us on social media 0:11:25.040 --> 0:11:26.720 to know when they're all being released. 0:11:28.120 --> 0:11:30.800 And then there's just the usual business stuff. So we 0:11:30.880 --> 0:11:33.480 have a good Reads list, we have a bookshop affiliate 0:11:33.520 --> 0:11:35.800 account if you want to read more about any of 0:11:35.800 --> 0:11:38.640 the subjects that we mention and that there happens to 0:11:38.640 --> 0:11:39.400 be a book about. 0:11:39.840 --> 0:11:41.240 And we also have. 0:11:41.280 --> 0:11:47.600 Tons of incredible, amazing, beautiful, super cool TPWKY merch. Yeah 0:11:47.679 --> 0:11:49.760 we do, and you can find links to all of 0:11:49.800 --> 0:11:52.120 those things on our website This Podcast will kill You 0:11:52.160 --> 0:11:52.760 dot Com. 0:11:52.960 --> 0:11:55.240 How many times can we say the name of our 0:11:55.240 --> 0:11:56.480 website in this episode? 0:11:56.679 --> 0:11:59.040 My gosh, oh, my gosh. 0:11:59.280 --> 0:12:05.040 Oh. Anyways, let's get into today let's get into today. 0:12:05.200 --> 0:12:08.319 Yes, so our guest today is someone that you are 0:12:08.760 --> 0:12:12.080 likely familiar with because we talked with her all the 0:12:12.120 --> 0:12:15.880 way back in March for our first virology episode. Also, 0:12:15.960 --> 0:12:19.439 she's been like all over amazing, you know, up First 0:12:19.720 --> 0:12:21.920 and other podcasts. 0:12:21.960 --> 0:12:23.599 Super famous at this point. 0:12:23.360 --> 0:12:27.360 She's famous, and we think she's great. We thought she 0:12:27.440 --> 0:12:29.280 was great way back in the day. We still think 0:12:29.320 --> 0:12:32.040 she's great. So we wanted to ask her once again 0:12:32.640 --> 0:12:35.719 all about the virus and what we've learned. Yeah, we 0:12:35.800 --> 0:12:40.040 recorded this interview on December thirtieth, twenty twenty last year, 0:12:40.520 --> 0:12:45.760 last year, and so here she is. We are so 0:12:45.880 --> 0:12:49.960 thrilled to have back on virologist doctor Angie Rasmussen, affiliate 0:12:50.000 --> 0:12:52.760 at the Georgetown Center for Global Health, Science and Security, 0:12:53.120 --> 0:12:55.160 and she is going to answer all of our questions 0:12:55.200 --> 0:12:58.800 about SARS Kobe two, the virus that causes COVID nineteen. 0:12:59.200 --> 0:13:02.400 And we will let her introduce herself right after this break. 0:13:33.880 --> 0:13:35.959 I'm Angela Rasmussen or Angie. 0:13:36.320 --> 0:13:39.479 I am an affiliate and a virologist at the Georgetown 0:13:39.559 --> 0:13:43.160 Center for Global Health, Science and Security. Soon I will 0:13:43.160 --> 0:13:46.880 be a research scientist at Veto Intervac, which is the 0:13:46.960 --> 0:13:50.080 vaccine Research Institute at the University of Saskatchewan. 0:13:51.360 --> 0:13:54.560 Excellent, Thank you so much for coming on again. We're 0:13:54.600 --> 0:13:57.800 thrilled to speak with you. If you could kind of 0:13:57.880 --> 0:14:00.640 just help refresh our knowledge and tell us a bit 0:14:00.720 --> 0:14:04.560 about SARS CoV two, the virus that causes COVID nineteen, 0:14:04.760 --> 0:14:07.840 Like what kind of virus it is, maybe other viruses 0:14:07.840 --> 0:14:10.160 it's related to, and what that tells us about the 0:14:10.240 --> 0:14:11.920 virus and the disease it causes. 0:14:12.679 --> 0:14:16.800 Absolutely so, SARS coronavirus two, as the name implies, is 0:14:16.840 --> 0:14:21.160 a coronavirus. It is a beta coronavirus. So the Stars 0:14:21.240 --> 0:14:26.280 or the coronavirus family is divided up into three major branches, 0:14:26.840 --> 0:14:30.920 the alpha coronaviruses, the beta coronaviruses, and the gamma coronaviruses. 0:14:31.800 --> 0:14:36.320 SARS coronavirus two, like SARS classic, is a beta coronavirus, 0:14:36.360 --> 0:14:40.320 and it's also what's called the sarbeco virus. The Stars 0:14:40.440 --> 0:14:45.640 like beta coronaviruses, which is a subgroup of that particular genus, 0:14:46.680 --> 0:14:51.840 So it's most similar to SARS coronavirus classic. It's also 0:14:51.960 --> 0:14:55.920 related to MYRS coronavirus, which is another beta coronavirus, as 0:14:55.960 --> 0:14:59.520 well as to two of the common cold coronaviruses, which 0:14:59.560 --> 0:15:02.800 are also beta coronaviruses, and the other two common cold 0:15:02.840 --> 0:15:07.120 coronaviruses that circulate in humans are alpha coronaviruses. So it's 0:15:07.160 --> 0:15:10.720 part of this larger family called coronaviruses. And what all 0:15:10.720 --> 0:15:14.960 coronaviruses have in common is they have a single stranded 0:15:15.080 --> 0:15:18.880 RNA genome, so their genome, their genetic material, is encoded 0:15:19.320 --> 0:15:24.000 on one single piece of RNA, a single strand, So 0:15:24.080 --> 0:15:27.480 unlike our genomes, which are double stranded, DNA is just 0:15:27.560 --> 0:15:30.880 one strand of RNA, and it's what we call positive sense, 0:15:30.960 --> 0:15:34.160 meaning that if it gets into a cell, it can 0:15:34.200 --> 0:15:38.200 be directly translated into protein by the ribosomes, which are 0:15:38.200 --> 0:15:42.800 the organelles inside your cell that basically make proteins from RNA. 0:15:42.880 --> 0:15:46.720 And that's their normal function. So that's what coronaviruses have 0:15:46.760 --> 0:15:49.880 in common with each other. They all evolved at some 0:15:50.000 --> 0:15:54.960 point from a common ancestor coronavirus back in you know, 0:15:55.040 --> 0:15:59.760 ancient times, and now there's very diverse. They are very 0:15:59.760 --> 0:16:03.560 diver family. We probably only know a handful of the 0:16:03.600 --> 0:16:07.440 coronaviruses that are out there, and only a subset of 0:16:07.440 --> 0:16:12.479 those actually infect people, so people should keep in mind 0:16:12.680 --> 0:16:15.920 not to scare anybody, but stars coronavirus two is a 0:16:15.960 --> 0:16:19.080 sarbco virus, as I mentioned, and there are quite a 0:16:19.080 --> 0:16:21.840 few of those that have been found circulating in wild 0:16:22.000 --> 0:16:26.640 bat species, and not all of them can probably infect humans, 0:16:26.640 --> 0:16:28.880 but some of them may be able to. So there 0:16:28.960 --> 0:16:32.280 may be other coronaviruses out there floating around in the 0:16:32.320 --> 0:16:36.480 wild that may be potentially human pathogens, but we really 0:16:36.560 --> 0:16:38.640 don't know that much about that, and we I think 0:16:38.720 --> 0:16:41.320 really need to know more about that to prevent future 0:16:41.360 --> 0:16:42.520 pandemics from happening. 0:16:43.480 --> 0:16:43.600 Mm. 0:16:44.160 --> 0:16:48.280 Yeah, So now let's talk what has been all over 0:16:48.320 --> 0:16:52.240 the news lately, and that is strains. So in our 0:16:52.440 --> 0:16:55.920 earlier episode back in I think March, where we talked 0:16:55.960 --> 0:16:58.760 with you about the virology of SARS Kobe two, we 0:16:58.840 --> 0:17:01.400 asked a bit about a couple of the different strains 0:17:01.400 --> 0:17:04.600 that seem to have emerged at the time, calling the 0:17:04.760 --> 0:17:07.119 L and S strain, and we talked about what that 0:17:07.200 --> 0:17:11.040 might mean in terms of disease outcomes. And lately, a 0:17:11.240 --> 0:17:14.600 we have a lot more information about just overall strains 0:17:14.640 --> 0:17:17.720 of SARS Kobe two in general, and then in particular, 0:17:17.840 --> 0:17:21.720 there's been a lot of coverage about the one UK 0:17:21.880 --> 0:17:25.280 strain as it has been called in the news, that 0:17:25.320 --> 0:17:27.800 seems to have now popped up in the US, for instance, 0:17:27.800 --> 0:17:31.240 and popped up all over different countries, and there's some 0:17:31.320 --> 0:17:34.360 indication that it might be more contagious. Could you sort 0:17:34.400 --> 0:17:38.040 of just walk us through what this UK variant is, 0:17:38.240 --> 0:17:40.760 whether this appears to be a new strain, how different 0:17:40.800 --> 0:17:43.600 it is, and whether there are any you know, clinical 0:17:44.680 --> 0:17:47.800 outcomes that we are seeing in regards to the strain. 0:17:48.480 --> 0:17:52.879 Absolutely, So, before I get started, I'll say that, you know, 0:17:53.000 --> 0:17:56.720 even the use of the word strain is somewhat confusing, 0:17:56.760 --> 0:17:59.639 I think for people sometimes because it can be used. 0:17:59.400 --> 0:18:00.959 In a variety of different ways. 0:18:01.800 --> 0:18:06.119 So I tend to call the variant of variants because 0:18:07.040 --> 0:18:11.719 it's not really that different from all the other variants 0:18:11.720 --> 0:18:14.560 of stars coronavirus two that are floating around out there. 0:18:15.200 --> 0:18:21.120 It has I think twenty three different nucleotide substitutions or deletions. 0:18:21.640 --> 0:18:24.920 There are twenty three changes basically to the genome overall 0:18:25.520 --> 0:18:29.000 that make up this new variance, and that basically means 0:18:29.040 --> 0:18:32.640 that it's genetically different. But we expect all these variants 0:18:32.680 --> 0:18:35.520 to be circulating around anyways, because the one thing about 0:18:35.640 --> 0:18:38.119 RNA viruses that you can count on is that they 0:18:38.240 --> 0:18:42.239 mutate every time that they replicate. So this is a 0:18:42.280 --> 0:18:46.600 normal and expected thing to have different variants with different 0:18:46.640 --> 0:18:50.480 properties emerge. Whether there's strains or not is a matter 0:18:50.520 --> 0:18:53.400 of debate, just because sometimes when people say strain they 0:18:53.440 --> 0:18:57.960 mean something that's radically different, either genetically meaning that a 0:18:58.080 --> 0:19:01.680 much larger part of its genome is substantially different from 0:19:02.040 --> 0:19:06.720 the parent virus, or that it might be different immunologically 0:19:06.840 --> 0:19:10.360 meaning that you know your immune system will mount fundamentally 0:19:10.359 --> 0:19:14.000 different responses, make different antibodies to it. And we don't 0:19:14.040 --> 0:19:16.960 have any evidence that that's happening for this. So the 0:19:17.119 --> 0:19:19.399 L and S trains that we talked about, which feels 0:19:19.400 --> 0:19:22.560 like a million years ago, didn't turn out to be 0:19:22.840 --> 0:19:25.000 L and S. I think that the L and S 0:19:25.000 --> 0:19:29.800 stod for I think low, low disease or lethal. I 0:19:29.840 --> 0:19:31.679 can't remember what they stood for, but one was mild 0:19:31.720 --> 0:19:34.600 and one was more severe, and that didn't turn out 0:19:34.640 --> 0:19:37.920 to be true. That was probably just an artifact of 0:19:38.000 --> 0:19:42.560 the population sizes that they sampled. But this variant in 0:19:42.600 --> 0:19:45.600 the UK, which has the extremely catchy name of B 0:19:45.760 --> 0:19:51.200 one one seven is does appear to be more transmissible, 0:19:51.680 --> 0:19:54.680 and that's really based on a couple different lines of evidence. 0:19:55.280 --> 0:19:59.360 One is that it became very prevalent, very very quickly 0:19:59.600 --> 0:20:03.680 in the southeastern United Kingdom, and I should note that 0:20:04.200 --> 0:20:08.040 it didn't really necessarily emerge in the UK, but that's 0:20:08.080 --> 0:20:11.200 where it was first detected because their genomic surveillance program, 0:20:11.280 --> 0:20:14.960 where they're actually sequencing about ten percent of the viruses 0:20:15.040 --> 0:20:18.520 that they identify, and in terms of new cases, that 0:20:18.640 --> 0:20:21.240 made it very easy for them to track the sort 0:20:21.280 --> 0:20:26.080 of rapid takeover, if you will, of this particular variance, 0:20:26.240 --> 0:20:29.480 and it just became it out competed essentially all the 0:20:29.520 --> 0:20:33.680 other variants that were circulating in that population in about 0:20:33.720 --> 0:20:37.080 a couple of months, So that's really fast for a 0:20:37.119 --> 0:20:39.639 single variant to take over. So there was that evidence. 0:20:40.440 --> 0:20:43.840 They also observed that people who were infected with this 0:20:43.920 --> 0:20:49.040 particular variant had higher viral loads at the time of diagnosis, 0:20:49.040 --> 0:20:52.320 and that's a little trickier because people aren't usually being 0:20:52.359 --> 0:20:55.800 sampled every day and tested, and you know, during the 0:20:55.800 --> 0:20:58.560 course of a viral infection, your viral load will change 0:20:59.480 --> 0:21:01.919 as the viral replicating and then as it starts to 0:21:01.960 --> 0:21:06.199 be cleared so it's hard to say if that's the 0:21:06.240 --> 0:21:09.320 mechanism by which it's more transmissible, meaning that people who 0:21:09.400 --> 0:21:12.560 are infected with that are sheddy more virus, But that's 0:21:12.600 --> 0:21:14.720 what this preliminary data seems to suggest. 0:21:15.240 --> 0:21:17.920 And then yesterday I saw that they. 0:21:17.760 --> 0:21:21.720 Had released some data, some epidemiologic data about the secondary 0:21:21.760 --> 0:21:25.280 attack rate, and that basically showed that people who were 0:21:25.440 --> 0:21:28.240 infected with this were more likely to transmit the virus 0:21:28.240 --> 0:21:32.679 to others in their households or in their workplaces. So 0:21:33.400 --> 0:21:36.360 it does appear to be more transmissible. You know, we've 0:21:36.400 --> 0:21:40.040 now found it in the US in Colorado, it's probably 0:21:40.080 --> 0:21:42.160 elsewhere in the US. It's been found in I think 0:21:42.240 --> 0:21:45.600 twenty five twenty six other countries so far. So this 0:21:45.720 --> 0:21:52.119 variant has been emerging and has been spreading globally for 0:21:52.640 --> 0:21:54.680 a while now. We just hadn't picked up on it 0:21:54.760 --> 0:21:56.200 until the week before Christmas. 0:21:57.119 --> 0:21:57.919 Gotcha. 0:21:58.200 --> 0:22:00.800 And so if the mechan is by which it is 0:22:00.800 --> 0:22:05.040 more transmissible is a higher viral load or shedding more virus, 0:22:05.400 --> 0:22:08.359 does that have any sort of clinical outcomes as well? 0:22:08.359 --> 0:22:11.120 Like do we see more severe disease in people infected 0:22:11.160 --> 0:22:13.280 with this variant compared to other variants? 0:22:13.960 --> 0:22:17.760 So that hasn't been observed yet, and it doesn't appear 0:22:17.920 --> 0:22:24.520 that this variant results in increased pathogenicity or increased disease severity. 0:22:24.920 --> 0:22:27.040 You know, we don't know the mechanism by which it's 0:22:27.040 --> 0:22:30.680 more transmissible. That that viral load data is suggestive that 0:22:30.680 --> 0:22:33.320 that might be the case, but other people have shown 0:22:33.359 --> 0:22:35.720 that one of the mutations in the spike protein, which 0:22:35.760 --> 0:22:40.119 is in the receptor binding domain, binds ACE two, the 0:22:40.400 --> 0:22:43.359 receptor for the virus more tightly. It could have something 0:22:43.400 --> 0:22:44.959 to do with that. It could have something to do 0:22:45.000 --> 0:22:47.560 with increased fitness, which basically means that the virus is 0:22:47.600 --> 0:22:51.040 able to replicate to higher tighters. We don't know, but 0:22:51.080 --> 0:22:53.520 the good news is it doesn't appear to be associated, 0:22:53.560 --> 0:22:58.080 at least observationally with more severe clinical disease. And there 0:22:58.160 --> 0:23:01.240 is a mutation that inserts stop code on and to 0:23:01.359 --> 0:23:05.879 be ORF eight protein, and previously with both STARS coronavirus 0:23:05.880 --> 0:23:10.040 two and STARS, classic deletions in ORF eight have been 0:23:10.080 --> 0:23:14.240 associated with attenuation or making the virus less virulent. So 0:23:15.000 --> 0:23:18.520 it may be that this stop codeon and ORF eight 0:23:18.720 --> 0:23:21.760 has something to do with that might not, but people 0:23:21.800 --> 0:23:23.160 are investigating this now. 0:23:23.200 --> 0:23:24.480 But the good. 0:23:24.280 --> 0:23:26.760 News in the bottom line is that it doesn't look 0:23:26.840 --> 0:23:29.640 like this variant is more pathogenic. 0:23:30.680 --> 0:23:34.560 That is good news. I guess you mentioned that there 0:23:34.560 --> 0:23:37.080 are a lot of other variants kind of floating around, 0:23:37.119 --> 0:23:38.639 and I know that that's something that a lot of 0:23:38.680 --> 0:23:42.440 people have expressed questions or concerns about. Do we have 0:23:42.480 --> 0:23:45.399 any evidence of any other variants that do seem to 0:23:45.440 --> 0:23:49.960 cause more severe disease or even potentially affect different populations 0:23:50.080 --> 0:23:53.480