 I wanted to share with you something this funny. This is a fellow in Dublin who I came across on Twitter and he does adaptations like the Blunt song You're Beautiful and he changed it to sing You're Too Close and he sings it with passion and so I wanted to suggest if you want to have some fun with it, check him out on Twitter and hear some of his songs. Let's see. I'm going to talk about scientific aspects of this principally and I have a friend, he's a physicist that I've known for many decades and we always communicate about scientific things and he actually did some analysis of the mess we're in and I just wanted to show these quickly. One reason I'm bringing him up is because he has told me when I speak I tend to try to cram a semester into an hour so I'm going to try not to do that today. I only have 25 slides. Here's another of his analyses and curve fitting and he used a Kermak-McKendrick model which is used in epidemiology and world meters info is a good source for how bad things are at the moment. We are over a million now of known infected cases and the slide is self-explanatory. This is one other thing I want to put out here and it's on my profile as well that I made a PDF and it's on my Google Drive of the slides I'm going to show. I'm trying to get back here and I'll paste it in. And to anyone that like to look at my slides in more detail they're welcome to. The slides often will have more information than one could hope to cover in a proper amount of time like we have but you can go if you're interested and examine the points I make. I try to make the slides as much standalone as possible. Once again I'd like to emphasize I think this is a really important way of thinking of slides. A virus that is David Baltimore classification from 1971 is a remarkable individual and it was just at the right time when people had broken the basically the genetic code and figuring out how molecular biology drives life and it only made sense to switch over from trying to organize phylogy of viruses which are things but they still are part of biology so they try to associate them by morphology and their antigenicity and their behavior and yes DS stands for double strand SS for single strand. The type of virus we're talking about here with the SARS-CoV-9 it's actually CoV-2 I'm really screwed with semantics at times. Phil pointed out in our last talk that SARS-CoV-2 is the current accepted name for this virus and COVID-19 is the term for the disease and I really hadn't paid attention to that but I think that's valid and so at any rate I have it mistyped in there and I apologize for that it's because my brain works but this is a type 4 virus it has a long single strand in positive sense of single strand of RNA it goes just under 30,000 bases and positive sense means that just like messenger RNA it's read from the five prime end to the three as soon as it gets into the cell it can be fed by the ribosomes and have some translation going on. I want to point out also that type 5 or RNA viruses but they're negative sense or anti-sense type arrangements and both of these kinds of viruses require RNA polymerase and that plays into some of the potential treatments for this so keep that in mind one of the well-known type 5 viruses is the Ebola virus or Ebola-like viruses which come from fruit bats so quit eating bats quit eating bush meat roadkill and so at any rate let me go into the next slide here I love bats actually I think they're very cool and I never heard them if I come across one I protect it or I'll rescue it and put it someplace where it's up high enough that it can fly down it needs at least a five feet clearance on a drop to be able to get into flight so I think that bats are likely to be maligned and they eat all these nasty little bugs that may be more trouble to you if they bite you especially with the climate change and malaria progresses northward I don't eat anything that's a vertebrate really I think they're a little too closely related genetically now in the terms of structure the coronavirus a helical meaning it's alpha shaped it wraps a helix of RNA it's a long single strand the the alternatives are having circular strands or having fragmented strands and there are viruses which have fragmented strands now it seems to me it would be much more difficult for a virus to be successful with a fragmented strand having a single package that's like mailing your taxes in one page at a time it's a good chance you'll have one not get there or not getting the right place it just seems to me it's amazing that fragmented viruses could make it but I'm going to talk about mutation rates with these viruses these are the largest of the RNA viruses these corona viruses they're larger than they're supposed to be in a sense uh they have uh you know well let let me let me get back to this uh because I want to have a little bit of discussion to make before I start talking about how the genome replicates itself but there's a by lipid bilayer which is like an envelope that's around this the nucleocapsid is the RNA helix and it's covered with or encased in these n proteins in proteins there are three other kinds of proteins of interest in our particular virus we want to talk about the spike protein that everybody's been hearing about in the news stand to watch the news I've actually gotten to where I'm watching 30 rock some with Tina Fey and Alex Baldwin just escaped the membrane protein or M protein and the E protein or envelope proteins the spike membrane and E proteins are all really in the envelope and extend through the envelope really uh in in most cases uh so uh let's see I'm going to the next slide is this uh created a creative commons slide I came across that's pretty good although it has uh I would not pay much attention to the hemagglutinin esterase dimer part uh but it shows this helical spiral inside this spherical capsule and it has n proteins on it and there's what's called this matrix which is this little space between that and the envelope and which is worth talking about a little bit because all this has to get opened up and the genome has to be made available to the ribosomes in the victim cell or host cell in the envelope there which you see is is kind of marked as a red uh stolen structure from probably the Golgi process um maybe some from the cell membrane uh has the M protein senate uh which are probably the most important team in having this thing work to be able to replicate itself inside the cell and the um uh E proteins are envelope proteins as I guess the bottom of this list on the right there you see that and then the spike protein which is again real important the S protein which is really quite interesting it's um it's three monomers it's a trimeric uh and each monomer of the spike protein has um uh two subunits and that's important in terms of how the attack on the cell takes place um I came across all kinds of beautiful uh cryo electron microscopy uh images of these uh spike proteins in particular and uh well pretty much every aspect of these uh infections you can imagine those require a lot of work and um I think there's something you might want to look at on your own uh I was thinking I got I started to go crazy because there's so much I'd like to have included but it's too much well the the mitochondria have circular DNA in them uh and uh RNA polymerase as well but at any rate those are all various organelles uh or small uh functional units in the cell this is a slide I'm not going to say a lot about except this uh glycoprotein M uh drives the assembly of the coronavirus when it has to get put together which then end up budding uh into the lumen of the uh ERGIC there's this uh these little organelles which are viral induced uh um tubular vesicle structures that's the endoplasmatic endoplasmic reticulum golgi intermediary compartment and M is the most abundant of these uh envelope proteins E is the least abundant but it's really critical for having a good output of the virus um yes is uh kind of the last thing that goes on there and it uh is um it it yields a virus that is armed and dangerous and uh so let's see I again this slide would be one that you might want to look at again in uh PDF and this one too I don't want to go into this too much except that if you take the E gene uh from the coronavirus genome you won't get much production of virus growth and particle formation there are studies that involve creation of viral like particles vlps just like back when I talked about um HPD or human papillomavirus and the vaccines being viral like particles that were created um um and by nucleosynthesis really uh uh from the uh uh genome but are free of any genetic material but they self-assemble uh one of the points I'd make in this kind of thing having a self-assembled um uh viral particle uh without the S spike I really question how effective that would be for a vaccine because it's enveloped it's sort of like you get a letterbomb uh bringing back on unabomber you know you open up the envelope that's when you get the surprise you know the envelope really conceals the dangers of this thing okay let's see let me go on here so first off I would like to point out there's this innate immunity and I it's another one of those aspects that's too much to talk about here but I have some slides in a bit about um uh the ACE2 or angiotens it should be angiotensin converting enzyme um uh two is what most people would call it um angiotensinogen is the precursor but ACE2 receptors it hasn't except today's uh activation site on that uh it's a domain on that receptor that works to activate angiotensin and one reason why even though I wonder why would they have that in the cell A who is A but why would that be in the cell most of these things have functional structure function sense that you can draw from it along this end the borderline it's sort of a vascular organ it's in a sense it's part of the vascular system it's every drop of blood in your body goes through your lungs from the right side of the heart uh to um get uh gas exchange uh carbon dioxide gets to come out along with the garlic you ate and um uh you get to absorb oxygen into your hem uh in the red blood cells and uh so it makes sense really uh physiologically that you would have receptors that would have actions that would cause basal constriction for instance as angiotensin does so that's why you have them in the lung you got them in your endothelium of your blood vessels and your kidneys and all over uh so attachment is the first step then the uh virus has to get taken in uh generally thought by endocytosis but I don't think that is necessarily 100 percent in terms of I think there are times when the whole thing may just roll in but this thing has to get uncoded most of the research of the research papers you read about this they gloss over uncoding they'll say after uncoding and that's the only time you'll hear that mentioned uncoding is actually a more complicated process than that and it's really important if you can't do coding of the virus or if it doesn't get uncoded then uh the RNA is not going to be exposed to your um um translational machinery the ribosomes and the virus won't succeed um and then there's biosynthesis which I'm going to talk about it's a beautiful strategy in a sense that uh this uh thing can be interpreted as I don't think it was created by intelligent design or anything but I think that one can in perceive why it works the way it does uh and make sense of it um finally maturation when the viruses get viral particles variants get assembled and then necretion uh uh the cell which leads to further infection of other cells okay I don't want to deal with this a lot I did want to show you some cryo electron micrographs of the ACE2 cells there are two types of epithelial cells in the alveoli there's a type one which are kind of like cobblestones they're squamous in their shape and you might have might have heard of squamous cell carcinoma that just means squamous is just a morphologic description but those are living cells that are spread out thin and they are important especially to diffusion um they're just a barrier between the human where the air is and the uh peristitial fluids and the capillaries that are branching off the pulmonary artery pulmonary artery is um from the right side of the heart is deoxygenated blood and the pulmonary vein draining to the left side of the heart is oxygenated oxygen rich kind of a little twist on what you usually think about peripheral circulation but any rates uh this has an interesting aspect it has a pore here that they happen to catch uh where there's a little arrow on that upper left and I think it's marked here on these other uh slides in these um cryo EM or cryo electron microscopy images they do thousands of beams on different angles and they get a lot of data and they can crunch the data and create algorithm algorithmically create the images and they can make them any color they want anything um if there's a uh mathematical difference in the data so a lot of people involved in this have information technology computer backgrounds they're not biologists um at the start of it um okay okay despite protein it's a trimer it has uh each trimer has two subunits one interesting point there's only 76 similarity between the amino acids of the S protein in our current um um severe uh acute respiratory um uh syndrome cov2 and the original SARS epidemic back in 2002 and 2003 it's really remarkable to me that you can have that much difference in the amino acids and still have um uh same target receptor now the exact binding domain receptor binding domain on the target is uh different significantly from the original SARS as well but they're still the same overall molecule um anyway when this uh and and HACE2 you might see that abbreviation H it just means for human um as it can be from all kinds of uh origins um when this spike protein hits it has to be split this thing's a switch blade you can think of the S as uh S for switch blade uh this has energy stored in it and when it has a there's a kinase a protonase action that takes place i'm going to tell you about in a second when it and gets attracted it basically uh draws into the target uh receptor by van der Waals forces um this um action of protease action or makes the um uh S the one and S2 split apart um causes a uh change let's see if i got something about that um uh in the S1 domains so the S2 is over it's kind of splits and it's still attached there and the S1 then has is free to have its blade come out in a sense like a switch blade it and it it's you know when you have messenger RNA um getting translation of um into uh peptides you can have chaperone molecules that will lead around the peptide to keep it from folding up uh prematurely because if that's tertiary structure the shape of an um a protein uh and that's what gives it its action it's enzymatic action and um if it folds up too early to get into a knot basically think of it that way so these chaperone molecules will gather around it and it uh terminates translation and finishes making the peptide the primary structure of the protein and the chaperone molecules there's several of them maybe wherever it needs to be uh goes to a barrel shaped it's often described structure called chaperone which is a machine it's a molecular machine and it goes this whole assembly goes into there the peptide goes into that and there's um some uh phosphorylation um involved in energy action um to shape the protein and then it's ejected in its or in its tertiary form so i don't know if you knew about that but that's pretty cool uh in a sense this um s2 subunit is a chaperone for s1 uh nobody actually that i read uh described it like that but it's the same sort of thing it protects it and keeps it in a kind of a native form until it's ready for action and uh so i won't go on about the rest of this i i i always hated to have a situation where you just read slides uh so any rate you get cleavage of the um spike and um the um s1 adheres to the um ace2 receptor which is shown here from cryo electron microscopy derivations and at the top of this uh in orangish is or coronavirus uh spike protein attached and um the cryo em is so cool it can show changes in conformation there's kind of a generally an open and a closed conformation for the ace2 receptor so it changes um its configuration and um the um receptor its thought gets taken into the cell by endocytosis is probably the easiest way to describe it here's another picture i didn't want to deal a lot with this but see it has a neck and this linkers and a tm means the transmembrane part and the um other parts up out uh on the outside of the cell membrane very receptive to um molecules um and this shows different configurations it's really just extraordinary and that was would have loved to see this when i was a kid uh wasn't possible but if you're really young you don't know how good you got it all the things you could see these days okay this is uh also another thing i wanted to give information for people that want to dig a little further but um uh generally the transmembrane serine codease 2 um at this top of the slide talks about the coding gene for that uh and diseases with that enzyme are associated with influenza it activates and uh promotes the um intake of uh influenza viruses at times but also it's related to prostate cancer processes and prostate prostate cancer but at any rate this enzyme is in the host membrane and near the ace um receptor and it punches the uh spike protein and uh is involved in leaving the dimer uh of the spike protein monomers there's three monomers in each or a dimer or have two subunits and so the it uh cleaves each of those into two subunits so that the active one s1 can uh on in tight and intimately with the um molecules the ace 2 inhibitor and or the ace 2 receptor and um uh then uh it's felt that the s2 promotes the cell membrane starting to get sucked in and alter its shape and take in the virus i think there's a lot to be learned about how this really takes place it's still a vague um explanation for how the virus gets in so um this is just some more about this serine protease um uh enzyme that's a host enzyme and it's a transmembrane enzyme in uh human cells that's involved in the proteolytic cleavage of the spike bico protein so let's look at that in the uh pdf if you're interested and i guess i wanted to emphasize the um um ability the SARS-CoV uh virus to get out and this is undoubtedly true as well for the SARS-CoV 2 um depends on m membrane protein the e envelope protein and protein um all three of those have to work together and um this makes reference to the one study about creating viral like particles to study how this thing assembles um in a bit i have a diagram that may hey here we are okay this is going to be um interesting i think the i didn't um there were there were a lot of diagrams uh that i could have chosen i figured this was as good as any but uh what i didn't um show in this or it doesn't show in this is uh after the attachment and entry um this tends to be in a vesicle is the way it's described and then the vesicle um uh merges with the lysosome which has proteolytic enzymes and degrades molecules it's a way the cell protects itself and um uh it's acidic and that uh environment uh promotes the encoding and also the removal of the n protein from the RNA so you get an uncoated air positive strand single 29k plus you know between 20 a 30 000 basis of RNA uh that uh are there to party and um there's one other thing i'll say about this the um the ace two uh the um type one epithelial cells i said were uh like cobblestones the type two which was what i showed you in that um diagram a little bit before that uh bryoem they're more sphero spheroidal or uh cuboidal uh traditionally they were regarded were called cuboidal and that may become an obsolete term but they have all kinds of function they're very difficult to study and they take them out and they try to culture these you can do a lot of things by culturing cells but they one of their jobs is to repair damage and they will tend to differentiate into type one cells if there's a there's a problem say i'm here to fix things uh the other thing is they secrete surfactant interesting aspect of this this thing has a golgi process you know wonder what is this kind of cell have a golgi process well it's secret surfactant surfactant is what helps keep the airways from sticking shut or it makes it easier for them to open up for air to get in and uh it's sort of like soapy as opposed it reduces surface tension almost to nothing and it's a type of proteins especially um and those kinds of things are um produced and uh secreted through the golgi process and uh the pore that you saw in that one cell that i pointed out might have been uh surfactant a bubble of surfactant that was in an envelope being emptied into the environment now these surfactants there's surfactant a b c and d and c is unique to these type two epithelial cells in the alveoli in particular but these surfactants can act as part of the innate immunity in addition to their functions they can also kind of bind up um bad actors there's over 100 common types of molecules that are not associated with human physiology that the innate immunity seems to have some level of recognition for and it can have these kinds of molecules get tagged and it facilitates actions like these wandering macrophages which are these phagocytic cells that um in the interstitium and also in the lumen of the alveoli and they're the ones that get full of uh soot and carbon and tar when you smoke you know if somebody who's smoked for years and years and they have an autopsy to see the lungs look pretty black and disgusting um and uh if you see an autopsy i've seen some unpleasant things i guess is one way to say it but they see an autopsy on a child the lung tissue is uh generally pink and clean looking so any rate um uh i wanted to mention the innate immunity it's an important part of this and that's another aspect about why do some of these people um hardly have symptoms and don't even get sick they may have the virus and shed some but they control it it could be that the way their um innate immunity is working is better and being able to that pharmacologically uh might be another strategy for dealing with rendering this virus less lethal um so anyway back to this back to this diagram shoot i'm going way way over i'm sorry i'll try to uh tell me to shut up when when you need to well tell you what when you uh uh finished with talking about the disease part what i'll do is go back and yeah it is interesting and uh i find it interesting i have a biochemistry background and so i'll go back and tell them a little bit about what we're doing you've talked about the virus and about the disease and our presentation is both on the science part and on society and if you guys don't mind sticking around a little bit uh we'll we've got some really good presentation here so go on go go full go ahead dr. Hendricks and and i have a few slides i'll save for the last if we get enough time to come back to about the uh put you know treatments that have been touted in the news and that sort of thing and what might work and what might not but uh in any case um if you look up here in the upper left hand corner in this nicely organized uh infected cell you have this long positive strand RNA and these this is really fascinating these just like messenger RNA produced in the nucleus there's uh uh processing of of RNA processing that goes on in the nucleus of a cell so that messenger RNA gets capped at the five prime end and it also has a three prime poly A tail or adenosine tail um these messenger RNA like molecules from the virus also are capped they have some untranslated uh sequences and then a start codon generally messenger RNA always has a start codon aug a u g for methionine which is a sulfur containing amino acid um so that's that tells the uh well that's that's the part of the uh messenger RNA that gets taken up by the ribosome to start with and it goes from there and then um has a progressive uh reading and translation uh going down by codons or three nuclear like uh bases at a time that matches up and hooks up amino acids so okay this messenger RNA gets in there from the virus not something you want and then uh it gets translated straight away by this and the cytoplasm by ribosomes you do have three ribosomes floating around the cytoplasm and it um creates uh this coronavirus's superpower which is a 16 unit sub uh 16 subunit protein complex it creates 16 non-structural proteins nsp in a way of translation that's frame shifting it's called it has two-thirds of the genome is used for this uh it starts off with the uh one a um part of the genome and then it has a loop or a knot as described in various ways and the uh translation shifts to the one b uh um part and so it makes I think about well but probably over 30 percent um uh of um one a uh transcript product and and uh then the rest is a one a one b hybrid it's a peptide from two parts of the messenger RNA I'm calling it messenger RNA it's a message from the virus that has those those have proteolytic activity inherently that chop these up into 16 products and they they form this complex and this is where I'm talking they this thing has superpowers uh it has um by the way polycystronic means that uh it has uh you know conserved arrays of domains in coding more than one uh one product um in per strand or per length that it uh reads um so whereas messenger RNA from the nucleus codes for one protein normally unless it's screwy um or the machine is not working right but uh this this is more complicated than that so at any rate it produces this uh this kind of two peptide products that break its break themselves up into 16 pieces make a complex and it has an RNA polymerase it's a non-structural protein 12 RNA polymerase there's a helicase which means it can um open up uh a double uh nucleic acid strand like a double stranded RNA which occurs transiently in this process it has a messenger RNA capping uh activity in non-structural protein 14 and 16 and it's also got this extraordinary thing where it can proofread when it and that's in in non-structural protein 14 especially if non-structural protein 10 uh is there with it and it can keep the messenger RNA from getting screwed up what happens this messenger RNA once it makes these this super molecule or the super complex of molecules that somewhere in there we should find a way to kill this sucker uh it goes and does a couple things it reads the entire uh original genome from the five strand to the three uh is uh five prime to three prime end and makes a replica in a negative sense and from that replica this same complex because it has all these multifunctions can produce two things it um and well first off it goes from making it it has a reverse transcriptase um so that it it uh reads the negative sense RNA and makes a replica of the original positive sense strand RNA now it's error rate in this happening and uh Sturgy I think you talked about that uh synergy I'm sorry uh you talked about that a little bit ago this this thing makes a lot of mistakes it actually has a potential for a high mutation rate um and um a mutation rate so high that um some calculate that it should not be able to have more than 15,000 bases or it's twice the size it should be or it will say it'll have so many mistakes it'll just be an epic fail um but it has this XO ribonuclease that can detect if there's a mismatch when the negative strand RNA is being replicated to make the original genome again and it can excise and replace and fix it so this thing can self-repair its mistakes it's really pretty amazing that's that's pretty much unique to these coronaviruses and uh then the other big thing about this from that negative strand it produces um all these uh subgenomic uh positive strand RNAs and I won't get into it too much it does this by its second big thing it does it by discontinuous transcription meaning it can get a common leader from they put a leading sequence on and then jumps to the gene that's to translate and from those come um structural proteins um and um so basically you have uh structural proteins non-structural proteins um and uh so 16 non-structural proteins have activity the um uh structural proteins uh or think of four of them right now uh to make the housing for the genome uh well anyway this thing ends up as these uh uh proteins get uh uh produced in the rough into plasmic reticulum uh installed that's where the uh end protein is made and it's made first and it uh is attracted to its own RNA and coats it so the um genome the whole genome gets that's that 130 k ram uh 30 k um uh strand uh gets coated with n proteins that's that helical nucleoprotein and uh then this thing ends up in the er g i c or this uh virus induced uh tubular vesicular structures that are between the rough endoplasmic reticulum uh and the bulgy process bulgy process is sort of like a packaging center in a sense well the um capsid molecules tend to get uh um assembled uh and the envelope uh gets assembled uh uh further i guess the capsid is really the the end protein around the uh helix i misspoke there but the uh end this uh these little vesicles in the cotton they're described as um double walled uh vesicles they're kind of unusual and they're associated with these infections and inside those are where envelope ends up on these uh things and the um uh the uh protein um viral proteins that are associated with the envelope are on there and the spike gets added in the um sort of last step and it gets extruded by budding and then it's out uh um feeling single and one to mingle as james brown once said so um that's how this happens and the reason i wanted to go through all that is because when i listen to the news it's like so simplistic and people are saying yeah why don't they just make the vaccine to this or you know give um quinine derivatives or you know some uh simplistic idea and you got to know what you're dealing with i mean that's like uh you know uh walking into someone else's culture and country and uh i'll put your feet up on the table and expecting uh well uh you're not going to win out too well so you kind of understand what you're dealing with and how to beat it and uh you find strategies by studying what it does and seeing its weak points and there are so many places where you might be able to interrupt vital steps in viral production or slow it down so if you can just slow it down it's like flattening the curve in an individual then the immune system has time to uh clear the virus and one other thing is uh this uh thing that kills people particularly this cytokine storm cytokines like interferon as these molecules that were first discovered around 1957 uh that are promoters or inhibitors of infection and motors of infection can get so revved up they cause destruction uh and destructive processes in the lungs like filling them up with fluid so uh i'll stop there and uh i've got a little bit more let's see my next slide is yeah i'll come back to this so i thank you for indulging me on this now that was good and that's why we've got you here Dr. Hendricks is uh because so people want to know what uh we know uh it's not an unknown thing it's very different from some of the other pandemics that we didn't know enough about uh now uh there's a little bit of Murphy's law uh that is you're using the same script on your slight protector as i am so uh i'm going to go back to the first one you're you're at about 17 or 18 i think so i'll be able to catch you back up here but let me go back to number one here and bring mind forward for just a second and then you'll you can uh bring them in again on what they can do and and what researchers are doing and stuff like that okay so um one of the things we're trying to do today is to talk to you about both science and society from a science perspective at least as far as the pandemic goes uh Dr. Hendricks has uh very uh in very much detail very ably told us about what this is and uh what i'd like to do is talk a little bit about what's happened so far and then uh what's what is happening and then uh Dr. Hendricks will talk a little bit about what researchers are doing and about um what researchers are doing and then what we can all do to help and then i'll do a little bit of speculation from a science standpoint about what will happen next and we'll open up to questions now the way we work in here is we've been doing is that if you haven't been to science circle welcome and you can feel free to comment at any time in chat uh that's one of the advantages of having a world like this okay so let me talk a little bit about um what we what has happened so far if you look at the um slide here it's a little busy but uh it it's all happened in a very short period of time back in december of course uh chinese uh alerted the world health organization as they um as everyone should and then identified this is not just a cluster of pneumonia cases but a new coronavirus um a new coronavirus and then the first death occurred on uh january 11th in the first cases outside of china shortly after including the u.s. on as early as january 20th and then the first death outside of china and then uh one of the milestones uh kind of infamous milestone was the deaths surpassed saw one um on 9 february now the issue with that is if you look at sars and mers which are also corona viruses is that they had a much higher uh death rate when you have viruses and dr hendrix can back me up on this but when you have pathogens like this with high death rates they usually don't transmit quite as far uh because the people who have them either die or survive um but this one's kind of insidious because the flu uh virus um has a much much much lower death rate uh than this and then the mars and mers and sars and we talk about Ebola of course that's really really uh lethal and so as far as the timeline goes you could read it up there as far as um uh thing when things spiked outside of um china uh italy and other countries decided to do a lock down even before it was declared a pandemic and china as i'll show you here uh as as one model as early as 19 march and continuing uh has no or at least reported no new local infections but now we're up to as far as a couple days ago a million cases worldwide so let's take a look at this from a perspective in other words um what is what is this different than any other time we've had a pandemic well pandemics of course have been around for thousands of years if you look over to the left you might have to zoom in but the idea is those little fuzzy balls show the number of deaths in pandemic in world history uh the biggest being the bubonic plague or black death and then smallpox um and then the spanish flu which is the uh influence of 1918 and then other plagues as you see um i'm not making light of the number of people who've died there it's been enormous a number of people who've died but uh the uh where it says you are here down here the tiny little dot is comparison to uh plagues over uh the centuries okay however one of the things that's very different is dr hendrix has demonstrated that in a century we've learned an enormous about uh enormous amount about these viruses and how they spread and such like that but we really haven't changed a lot as people okay we simply forgotten because there's not a lot of people that are over a hundred years old and so if you look on the right you can read it as well as i can but if you look on the right that could have been written today that was a department of health uh bulletin by city of new york back in 1918 and um the SARS-2 COVID-19 disease is not influenza but it's a pandemic it's contagious and basically they're telling the people a hundred years ago exactly what they're telling us today so if we look at if we look for example at yes and that and that's part of the problem in other words when you see numbers um when you see numbers they're part of the problem too so to speak let's take a look at this uh slide for for a second is essentially this is what is going on right now today and then i'll talk a little bit about this and then i'll hand it over to dr hendrix again is uh it was just reported that the uh in the united states that we've gone over 300 000 so this is actually just i did this this morning so you can see how fast things are progressing and you can see that by the curve down there at the bottom left but essentially we were over a million cases that were worldwide these are the uh number of cases in different parts of the world and but you will also notice that there are differing numbers that have recovered uh based on when we started testing and when uh different countries um enacted different practices we'll talk a little bit about that okay so let me give you back to dr hendrix for a second what he will do if you will please talk a little bit about unless you um have some other slides on the virus itself talk a little bit about this is what's happening let's take a look a little bit about uh perhaps things that we might be able to uh do or what researchers are doing i'll give you back to uh dr hendrix can you hear me yeah let me let me get my slide one back there because i'm gonna have a great i want to show a couple more i'm gonna have to show you there we go go ahead that was fast very slick yeah i've been doing this for a while um the uh i gave a comment here about uh denzel washington john goodman movie fallen which i thought was really eerie and uh i saw it was eerie as a physician and someone who is very scientifically oriented um this um uh spirit and it was doomed to exist without form without life of its own but it could take over people and make them do horrible things and uh then uh jump to another person and that person that had been its victim suffered the consequences of whatever actions it created and it was so much like an infection uh so i think you might find that an interesting movie to see just metaphorically um this virus is horrible in that um so many people are able to tolerate it and go about the business while shedding it and um i think it also may be more durable than we had expected and i would let's say so many thousands of pictures of the chinese spraying in office buildings and hallways and people sitting around but still spraying some kind of a disruptive agent in streets with huge plumes of spray which i wonder if it was alcohol mist uh something to disrupt this virus this they they it suggested me they knew this thing was much more deadly and dangerous than uh um we had been uh led to believe there was also kind of disappointing you know it was a researcher in um texas who wrote a sounded like a summary article that was put out around the 20th of january in which he talked about the wuhan uh china virus and he said several times this is not a serious danger to americans not of serious concern to americans unless you've been to wuhan and um my response to that was uh i think i typed this to barrigan yesterday is boy johnny did you back the wrong horse you know that was a really bad judgment one point i want to make about that is that even people that are well grounded in the science of this um this sounds like uh one of um socrates uh arguments about people over judging themselves uh and thinking because they're good at one thing they're good at everything uh also i would cite dirty harry uh clenice would say and a man's gotta know his limitations uh you gotta remember what you know and what you don't really know and anything that seems uh um too easy or um uh there there's gonna be a lot more behind it and people that might be behind it might be uh doing some of this for political reasons or whatever you gotta really be suspicious and uh question even the stuff that comes out that seems really solid and valid they get changed with long-term consensus one of the aspects about science is that consensus can change and we always talk about you know peer reviewed and based on objective collection of data and especially in control and experimental groups when possible and that sort of thing and then reaching a consensus among informed people but uh it's really quite complex process so beware of quackery you know there's a i couldn't find out what the organization is it's a uh some um um science uh organization that has government funding that's giving 50 million dollars to bander built university and to duke university to evaluate if taking um this um chloroquine um uh prophylactically may protect uh healthcare workers uh and they're gonna do studies they got 50 million dollars to do studies on this i can't help from wondering if this is somebody trying to protect uh somebody from their own consciousness uh because it's natural to grab its straws uh but in real leadership you know you know just go out and sell false hope and uh misdirect people and there's so many people that are uh have such limited uh ability to assess what they're doing this is a sad story i thought but i kind of blame it on leaders going out there and shooting off their mouths about stuff they don't understand the one place where the chloroquine might be beneficial is it supposedly helps inhibit the action of lysosomes and lysosomes are felt to be important in the encoding of the virus so you'll see people saying well since the chloroquine may help decrease or lessen the efficiency of encoding of the virus so why not use it oh the reason not to use it of course these people in this story here i didn't read it to you but you can read it yourself um they were afraid of getting sick and they didn't know a lot and they just saw a word and didn't investigate it and they're probably elderly probably watch fox news um and which doesn't help uh just to be blunt um yeah is they use the wrong form uh you know it's just freaking sad uh here are complications associated with chloroquine now as an otolaryngologist uh i didn't see a lot of people who'd use chloroquine chloroquine derivatives some use of it has been made in people with um arthritis in the past as well as for preventing uh some of the stages for malaria development um present it blocks the development inside red blood cells but agranulocytosis that means your bone marrow stops working bone marrow stops working you stop making white blood cells and red blood cells if that's really extreme um um pernicious anemia or uh uh severe anemia and agranulocytosis where you have no immune system and that's kill you hepatotoxicity burning the damaging the liver myopathy damage the muscles neuropathy damage of neural function um as an otolaryngologist i have seen patients that had neuropathy in terms of hearing loss hearing loss is associated with quinine it has ototoxicity and affect brain function rednopathy so this isn't a benign drug and i heard on the news uh people that should have known better um yeah maybe i shouldn't point i'm pointing i'm shaking my fist i'm doing more than pointing my finger i heard people on the news saying uh chloroquine it's a safe drug we know a lot about it well it's not trivial they made it sound like it's trivial and that also misleads people into thinking well i'm gonna take it like a damn to aspirin okay uh the hiv cocktail there was actually a good study uh done wasn't huge huge but a pretty reasonable number of people a couple hundred people in two groups experimental in a control group uh that got um uh part of the hiv cocktail and uh it didn't seem to have any benefit and plus it caused some people more trouble so it didn't stop viral replication um and they don't know if it reduced the viral replication but it they couldn't detect a significant difference in the um outcomes um on the other hand i'd told you about and the top here is again from the david baltimore classification of viruses back in 1971 that everyone should be using uh and type four and type five are both RNA viruses and so they require RNA polymerase and um remdesivir rdv uh has effect on inhibiting RNA polymerase um and there's an RNA dependent RNA polymerase in the uh um super protein 16 subunit protein complex that uh arises from the initial translation of this SARS-CoV-2 so this might make sense to give it a real go um and um putting more money into that might um might help uh and also showed some potential for activity uh against Middle Eastern respiratory syndrome or MERS so MERS is related to the current pandemic and just one way to look at this uh remdesivir has a structure where it's got this um purine attached to a um five ring um sugar and uh it's uh analog to adenosine remember adenosine if uh whenever you drink coffee and you get your caffeine your caffeine is uh uh acting a bit like an adenosine uh analog and keep your brain fooled that you aren't fake and uh rested uh so this is how these analogs work then they can uh displace uh processing of other medications i also would point out you see uh at about um two o'clock on this figure on the left um oh isn't smart enough to figure out how to move the laser uh so i would point it out otherwise there's a laser associated with this screen that was given me but that's c n with three links to it that is called cyanide that's a cyano group cyanide and um that's okay if it's in an organic bun like that that's uh but here's an interesting uh opponents to this uh but what happens is the uh complex tends to take this up and gets blocked and uh gets jammed it as they might say in popular culture it jams the mother and uh so transcription uh stops because it thinks it has an adenosine as it's making RNA and it's got this thing so i think that's an interesting potential there it is with a 3d uh model that uh um i guess it's on prochem um that i got that but um at any rate this also is used an ebola which is a type five uh RNA virus with an in negative sense but it depends on RNA polymerase um so that's one i think i would keep my eye on and uh i would stop at that i guess uh we've gone well over i wanted to share this with you this uh uh yeah i've got to shut up this uh was shared with me by my physicist friend so so would you like to add hi yeah let me uh uh bring us back to um some of the things we're talking about except i'm gonna have to go back to let's see we're using the same script for a slide so hang on a second okay there was a bit of chat going on um in the audience and um let's take a look at this one for a second because there was a couple things that people were mentioning the first thing to remember is when you look at numbers any kind of numbers like that statistics is um numbers are only good as the data in other words one of the things i mentioned in chat was if you look at this it represents about 181 out of 195 nations there are a number of nations tiny little nations of the pacific and otherwise that it's probably likely that they did not have any cases yet because there's some of the least uh well it could be and that's exactly right uh max and there's a lot of reasons for that some of the little nations in the pacific it's there's some of the least visited places on earth and so it's very possible that uh those numbers are correct on the other hand there's at least two nations you can look these up i don't need to be putting names in here i told you i told um in chat that basically we decided not to mention names but we can mention what is happening and possible reasons why and there are at least two major countries that are not have no official cases because uh for a lot of reasons hey what you're looking at here is just the confirmed cases in other words the ones that have been tested in countries where tests have not existed in or been late coming into the ballgame in countries where the political leaders have decided that it won't it wouldn't look good to have the numbers that are correct all of that stuff uh you will not find them on this board also in countries where perhaps the infrastructure the health structure the other things um are not designed to be able to do this and reporting and testing and uh that sort of stuff so you'll see you'll see a number of countries on here so this is only as good as the information that we have on there right now well yes and there's a lot of speculation about that Dr Hendricks may be able to say something about that about that temperature in other words there's a lot of people there's some people that are basically saying oh hey hey this is like flu it can go away in the summer but i would not count on that what i can tell you is a few other things uh that that we do know about this here is one of the things we do know is that um why are we we need to all know why we're staying in the house or why we're being locked down and one of the reasons we're doing that is this idea of flattening the curve the idea of flattening the curve is purely uh so that the number of deaths per day and total number of deaths cannot overwhelm the health system otherwise we really will be back in 1918 because essentially there won't be enough medical staff and enough supplies in order to do the testing or care for people and the doctors will be forced to make decisions about life and death about you know who lives and who dies i heard about i was listening to that on the news and nobody wants to say nobody wants to say well this person has so many years to live and this person doesn't or whatever and try to make those sorts of uh judgment calls so if we all follow the guidelines or in some countries are able to enforce the guidelines if we all follow the guidelines what you'll see is um a flattening of the curve now what that means is two things one is that we can keep the number of cases per day down to an amount that the health care system can support that the other thing is it gives us time to study it gives us time to try to find ways to combat this thing and eventually to have a vaccine although that's not going to occur anytime soon uh and therefore total deaths reduced now what that also means and i noticed some people were talking about getting back to work and all that stuff like that um that's a decision is it your life or your money um this may take a while well how long is a while well we can take a look at that from a scientific standpoint and here again if i could predict the future man i would uh that would be excellent uh however common let's take a look at this these graphs up here is um and you're correct uh there gone is that a lot of countries have tried this a little differently and you can see uh by these graphs exactly what's happening in different countries over let's take a look at the one over on the right one of the things you're looking at is you're looking at some of the countries that do or did do testing and also uh if you want to call it collectivist countries in other words the countries that um do look out for other people instead of just themselves and you'll see there the number of cases and the days since the first confirmed cases and you'll see that their graphs are very different from graphs that are over on the left you can also see on the far left about what there actually is an end to this in other words um and partly herd immunity you excuse me herd immunity and other factors look over on the left for example what you see is the dark areas on the left are where there are a lot of cases reported uh during that day so for example you'll see of course that it started in china but what's happening in china while china was able to and the people are a collectivist society that basically look after others before they look after themselves they agreed to go in isolation for nearly two months um i can i don't know whether the us has that kind of willpower to actually be in isolation for two months um and in consequence and like dr hendricks was saying is that they took other measures and consequently look at what happened over a period of time uh they are down to where as people are saying in certain areas of china they are trying to get back to some sort of normal uh schedule now there is an instance and you've seen it in the news where there may be a slight second wave and they've been tackling that uh in other words people coming back to china from other places and people being out to work which means that we have to continue to be vigilant about this not even talking about whether this might come back next year you'll also see same thing with south korea that uh tested virtually everybody tracked virtually everybody everybody wore masks everybody was um you know very careful about what was going on and it went up and then it went considerably further down uh other cases if you look at up on the top are not so i would say fortunate except we actually have a choice now in italy which was one of the very first countries to lock all 60 million people down shortly before it was even called a pandemic you'll actually see that the cases are starting to reduce however the longer you go on this the first cases for example in the united states were in january the longer you go without uh taking actions the longer people go uh where they're still holding corona parties and uh big church sessions and going to the beach and whatever the longer that sort of behavior uh continues the bigger the curve and the more deaths and um cases there will be and the more chance we are to overwhelm uh the hospitals now how how long might this last well there are ways of taking a look at this i can't predict the future but for example let's take a look at this on the left that is the i i mentioned what people were talking about a hundred years ago which is essentially what they're talking about today on the left is 1918 this is not the flu of 1918 but it's a pandemic and so things sometimes happen similarly on the left you will see a two month now where are we right now obviously the curve shows that we're headed up we're not plateauing we're not heading down uh it's as people say it's going to get worse uh but look at over on the left it extended for about two months period look over on the right that is china's experience with that you also see that it was about a two month period in other words if people behaved and did what they're supposed to do and yes of course it's going to impact all our lives just like 1918 impact is economically impact is socially impact us in in every way possibly uh but look over over on the right so you can either have and look on the left and that's kind of uh what has happened in the past and what's happening uh today uh with at least one country so really it boils down to what do you want what's your value is it people is it uh money is it uh you know sports you name it um that's what what it comes down to we'll so we'll see you know come back in two months and we'll give another presentation and see what actually happened okay that's kind of my uh presentation and if I I'll turn it back over to dr uh Hendricks if you'd like or we can have some questions can you hear me I have just a couple quick comments um first off uh epidemiologically the most reliable way to track this right now is by deaths uh deaths from coronavirus um uh rather than new cases new cases with it being politicized as it is um is possibly not going to hold up and it's reviewed in the future uh the the statistics or the dynamics won't uh be consistent um but to a larger degree new deaths and cumulative deaths are pretty reliable parameters of where we are and it will be for later since we haven't done adequate testing in the United States at least um it's easier to identify deaths than new cases I think deaths from this um but uh there would be some um um errors in that as well uh you can imagine um eventually there will be serum tests for the presence of antibodies to see uh how much of the population has immunity um IG IG and IGM types systemic immunity um and um then you might be able to um kind of back uh calculate uh what the death rate of this is but um whatever the the death rate is um the new cases would be uh likely a um uh a constant multiple of that um also if you have a country like Hong Kong uh or especially uh uh in uh Taiwan um they never uh dismissed their um professionals and investigative agencies and the systems they had set up to deal with SARS so when this came along and they were all right on it and um their numbers are quite good uh uh the um um there's it's so much just out there it's like trying to see who has their feet wet when you've had a flood uh at this point uh I live in a small rural town here and we've had uh 20 cases now and uh nobody comes here so uh there are also comorbidities associated with the deaths uh and um you know there's been plenty spoken of that uh but there were comorbidities associated with a lot of the influenza deaths in 1918 and 1919 um particularly there was a homophilus influenza uh bacterium type of pneumonia it was a secondary bacterial infection for which they really didn't have a treatment except supportive treatment uh but you end up with this nasty stuff going on in the lungs and um get debris and fluid and the innate immunity and the systemic immunity uh overall gets uh compromised and uh you can get uh opportunistic infections and hemophilus uh influenza bacteria was uh not uh rare uh so uh it that was called Pfeiffer's Baxillus um that had been described in uh by a German um investigator back in the 1800s and of four years until 1930 when Schof demonstrated with the um Brookfelt uh what was um Burke something I can't think of the word uh filter that filters out bacteria that they could still have a um uh an infectious filtrate um so that something smaller than bacteria were causing uh the uh infection the primary infection but up to 1930 there were a lot of people that thought that the 1918-1919 flu was all because of Pfeiffer's Baxillus because so many of them when they had autopsies they they looked at it on their microscope uh saw a Baxillus so thing is now with um people closed in and not readily going to go to the doctor and not able to if they want to and if they go to the ER they're going to be sitting there for a long time and um I think that you're going to have potential for people having uh comorbid uh infections that could be treated uh getting a run on things before they get treatment uh because the system is getting overwhelmed and you have um places like Alabama I think is a place that would be interesting watching uh understand Alabama's got a uh shelter in place uh stay indoors order but it starts Monday so uh what I see in average ordinary day-to-day people who are not into science or don't like to watch the news and understand things uh they're not incompetent in their day-to-day life but when they have a thing like that the government says okay as of Monday you know that means they party and then weekend right before it so they're still spreading it they have super spreaders and super spreading events there was a tragic case in um Washington of a um coral conductor who sent out emails to over a hundred people that uh he said well I'll be here if you want to come to practice and they came and they had a super spreader event and something like uh almost 70 people got infected and a couple of died so that'd be terrible to live with but um once this is out there and um the lack of control is just one of the worst things about it um I it's almost as as as ridiculous as when you have starvation as we've seen anybody who's lived very long has seen areas of the world where there was horrible starvation and uh people of all ages including newborns and children starving to death because of war and bad leadership and the differences uh in this case the virus doesn't care about your affiliation within societal tiers uh it goes opportunistically anywhere it can and we're all connected so um I I think one one last comment is real quickly the United States particularly has been about the only place where you have this okay Bergen's got it there uh these conspiracy theorists going on with nonsense and people oppositionally just disbelieving any authority or any sensible measures and sometimes healthy uh South Korea or the uh patients or individuals who and then they would explain to them and they say okay okay I understand I went along with it that's what I've read um I wasn't involved in those discussions but I was impressed by the fact that they were just down to earth and you know not deluded by oppositional disbelief of everything maybe people think that being oppositionally cynical gives them empowerment when they don't really have a sense that they know anything uh but that is a great weakness in our society's ability to deal with crises like this so that's all I have to say okay so one thing we can't one thing that's uh positive about all this is that we as individuals can do something can do uh stuff uh to both protect ourselves our family and to protect others uh are there any questions or you've got a doctor in front of you are there any questions about what you can do okay there you go uh about what masks do what they don't homemade masks I mean all of that sort of stuff I got uh that's the positive thing we all have a we all have a decision to make about whether we can stop this debt and its tracks and only have the cases that are now or whether we continue to spread it and continue to have increased deaths and uh a decreased economy due to that would you like me to address that yes please tell us how we just as individuals can uh do our part I think we should have all been wearing masks yesterday uh anytime you step outdoors really um every time you speak you are shedding molecules and particles and uh um leaving a little mist in the air and um um you know I've told people take your walks in the day daylight because ultraviolet light will kill uh anything dependent on nucleic acids uh within seconds uh in good strong daylight but uh if everyone were wearing a mask a lot of the viral shedding would be stopped um and also everyone washing hands and learning not to touch their face I noticed yesterday um a suggestion that everyone should wear masks was made by the burdened administration of the United States but the um POTUS said well I'm not going to wear one you think some reason you think of all these world leaders and uh uh dictators and uh he just couldn't see it and so um I think the eyes too yes uh if you don't wear glasses something to cover your eyes um sunglasses or something idea if you're working with um um patients you need to have goggles really and you need an N95 mask um I think uh right now just if you've got any kind of cloth mask or if you can fashion one then uh um it it may be effective simply because it will capture the droplets and that may be splattering from your breath and your voice uh in real time uh uh neural wonder uh neuro wonder uh so glasses and face shield uh and that's again with working with patients where your healthcare worker at risk but simply just having a population that's willing to observe um uh general um guidelines for the greater good uh uh whether they want to or not uh and uh or whether it uh insults their political sensitivities or not uh could save us and uh some may not have liked some of the comments I made but you know the problem why we're here is because nobody especially people that are afraid of losing their jobs or whatever it is is will are willing to speak truth to power that we're not willing to stand up and it's it's the water slowly heating to a boil and the frogs cook so I don't apologize for anything I said I was really I was restrained so but I do thank you for um uh the honor of speaking to you and uh sharing what I know about this and what I think uh we're up against and uh there it is any more questions otherwise we will bring this to a conclusion there was one question one question about hydrogen peroxide as far as cleaning non-porous surface areas how advanced is this virus it's got so many of the features that are typical coronaviruses um uh it's just has some um qualities that make it very infectious um and yet um tolerated by people so they can spread it uh unknowingly and this is not the common cold so what would you say we can I mean we could wear masks and such but what would you say about uh cleanliness at home as far as viruses in other words there's certain surfaces which it can stay on I've read copper about four hours and cardboard perhaps a day and such but if we do have surfaces at home just what can we use there we go um hydrogen peroxide approved by uh EPA um do you know of any other things that we could do personally uh alcohol it's recommended to be 80 percent uh I think even if you had nothing but whiskey which probably about 45 alcohol it'd be better than nothing but uh high concentration alcohol would be useful you need to be where there are the uh in the United States the FDA is going after people who are marketing stuff as disinfectants uh and hand sanitizers when uh they're not effective and don't even have alcohol in them uh they have essential oils or something like some kind of marketing ploy uh their scams um but uh if you've got nothing else it's hot sudsy water lots of suds um like from dishwashing detergent will um disrupt the high lipid content of the um envelope of the virus there was another question about vinegar although I understand that that's probably not very sick uh I'm not sure how that would work what do you think um I would go with soap over vinegar and um then drying uh any any surfaces that you've washed it may be days before you can really rely on them being free of viable viruses anything that produces good suds emulsifies uh fatty stuff like viral envelopes so I would think most any any sudsy soap like bar soap included would be useful okay one other important thing that people are looking at is that particularly when we have a lot of recoveries is that uh is there any known information about whether recovered people are immune I know that there are some trial cases with perhaps serum from people it's not the first time they've ever done this sort of stuff it was done back in late 1800s even yeah in those days they used horse serum sometimes and they got serum sickness from reactions um uh I would not be too keen on having other people's serum uh administered to me but um uh I guess um in um uh a desperate situation one wouldn't question it but the feeling is mostly that um antibody infusion uh from cooled antibodies uh would be uh most effective early in an infection and early in an infection most of the people are still being watched they're not uh you know you really can't tell who's going to go downhill okay and uh what about in other words the idea of the herd immunity of course that doesn't easily happen until you have enough vaccinations but is there any is there any evidence whatsoever about people who are who have contracted this and recovered whether they are immune from getting it again you know actually there were some projections by people looking at the mutation rate of this and the antibodies to the spike protein are probably key and your body being able to um contain and destroy this virus before it infects you a second time um the rate of um of uh at which the mutations occur um are not so great they they they projected that a vaccine would probably have several years of um of several meaning two or three uh may have uh that long of life of usefulness but it may be like the flu virus where you have to upgrade the vaccines you can have multi-valent vaccines for you might end up with different strains of this uh uh same virus uh because it does have a mutation rate and an error rate in its replication uh yeah that proofreading uh um exoribonuclease uh is really a killer with this if somehow we could inhibit that it would help turn the virus into duds anything else that the audience wants to share any more questions thank you max okay then we'll call it today everybody uh be safe out there um share what you know with others and but don't share the virus thanks everyone