 Hi everybody, Dr. O here. I wanted to kind of update everyone on where we're at with the coronavirus now known as COVID-19 since the last time we talked about it in class. I also receive a lot of questions via email, text, social media, so I wanted to sprinkle in some of the more frequently asked questions that I've seen and see if I can offer some insight. I'm not your medical doctor, this is not medical advice. These are just people asking me for my opinions and I'm going to share it here. I mainly want to talk about, so it's going to be a little bit long here, but I mainly want to talk about social distancing, why it works, why it's important, et cetera. We'll talk about the virus, we'll talk about some of its relatives, we'll talk about where viruses like this come from, will it happen again, all these types of things. So let's go ahead and dive in. So we first started talking about this new virus in class. It was only a problem in Wuhan and clearly that has changed. We'll talk about maybe how we missed some things there in the beginning, but here's the most recent information that I've seen over a quarter million confirmed cases and over 10,000 dead. So let's dive in. So why did this take us by surprise? So when we first talked about it in class, I said, let's not be concerned about it at this point, knowing what we knew then, I think that was still very fair, but things have changed. First of all, every new infection takes us by surprise. We can't know when or where they're going to strike, but what was so unique about this virus that allowed it to grow out of control? Part of it was our human error, a lack of testing, where there wasn't enough testing in the beginning, where there hasn't been enough testing now. We don't even know the actual scope of what's going on with SARS-CoV-2 virus and the COVID-19 disease. So we thought it was just another SARS and SARS was terrible, but SARS was something that was able to be contained and for multiple reasons that hasn't been the case here. That's one of the biggest reasons why this was surprising to see how it kind of grew out of control. One of the biggest differences, and we'll talk about this more later, is that this virus is easily spread by asymptomatic people. Its closest relatives, SARS and MERS, are primarily spread by sick people. And it's so much easier to contain a disease if you know who has it and who can spread it and you can quarantine them and contain them. Not the case when the huge majority of infections are mild and you have people that are asymptomatic that are still possibly spreading the disease. This virus, the SARS-CoV-2, also lives on surfaces longer than its close relatives. We'll talk about more. It's aerosol droplets stay in the air longer. So you're looking at a virus, we assumed it was a virus that didn't live on surfaces very long, didn't stay in the air very long, and we knew who was capable of spreading it. But now we know that asymptomatic carriers can be spreading it. People are spreading it before they're showing any symptoms. It can stay in the air, in these small aerosol droplets for maybe three hours. And it can survive on surfaces longer than its close relatives. So for all of these reasons, this thing is just transmitting itself around the globe in a way that its cousins, SARS and MERS never did, never could. So let's talk about social distancing. The idea that keeping away from other people is one of the best ways to flatten the curve, as you can see here. Now what I think about this personally, so I've been in the house all week. So it's been five days since I left the house. My wife has to go to the hospital and work, but me and the children have been home and we're doing our best to flatten the curve with social distancing. But I don't think it's not for me, right? It's certainly been uncomfortable and a nuisance for me and I'm moving all my classes online. So it's been a lot of work and it isn't something that I'm really enjoying. But when I look at it, I realize it isn't about me. So I'm not super concerned about me, I mean, I could certainly get sick, I could certainly get very sick, but I'm not concerned about me. I'm not even super concerned about Oliver, right? And my children, because for reasons we'll talk about later, with really no one under the age of nine or nine or under dying at this point. When I think of social distancing and what we're doing as a family is we're trying to protect the elderly, we're trying to protect my in-laws that watch Oliver when I'm at work, we're trying to protect immuno-compromised people. And I think really, really important thing is we're trying to protect the entire healthcare system, so we'll come back and talk about that later. So when people talk about how this is a nuisance and it's disrupting their lives and we're blowing this out of proportion, you have to realize that you can't think about you, I'm healthy, my kids are healthy, I'm not worried about this. What we're trying to do is we're all trying to stop the spread of this virus that maybe you would be fine, but your neighbors wouldn't be. Your child's kindergarten teacher wouldn't be, et cetera, et cetera. So this really is, we're all doing this for the greater good. That's I think that's a very important point to make. Here's a really good example. If you go read this article, I strongly recommend it. They do a comparison of Philadelphia and St. Louis during the Spanish flu outbreak in 1918 that killed 600,000 Americans, potentially 50 million people around the globe. This is just a great, great example. You see this chart here in Philadelphia, they had a parade and 200,000 people came to this parade. At the same time in St. Louis they were closing churches and closing theaters and doing what they could do to distance themselves from each other, closing schools. And you'll see what happened here. After this parade, we're 200,000 people clustered together. Every single bed in all 31 hospitals in Philadelphia were full. And thousands of people died because they clustered together. So if you're complaining about the fact that they've canceled the NBA and NCAA tournament, just think about it. This type of thing were to happen again. So St. Louis really was spared the worst of the Spanish flu in 1918 because of social distancing. So there's an example of where it has worked in the past. And again, it may be it isn't about you. Maybe this is more of a nuisance to me than a protective thing for me. But this is what I'm primarily thinking about. I'm my wife, my stepdaughter, they're part of the healthcare system. My students, but the primary reason to social distance at this point and flatten this curve, in my opinion, besides saving individual lives, is to make sure that our healthcare system doesn't get too overburdened. The mortality rate of this disease is quite a bit lower if you live in an area where your healthcare system can handle the load of new patients that we're looking at. So here's some information here. In the U.S., there's about 2.8 hospital beds per 1,000 people, very, very low. So there's, and like it says there at the bottom at any given time, about 68% of our million hospital beds are full. So we have 300,000 hospital beds available. And who cares that number a little bit higher, a little lower, doesn't matter. Another way to look at it, there are 95,000 intensive care unit beds in the United States. There are 160,000 ventilators. So how many patients can we have that are seriously ill before we're out of beds? We're obviously already running out of PPEs. We're out of beds. We're out of ventilators. This is already happening in New York. They're sharing ventilators between more than one patient. So another way to look at it is, even if you don't have older in-laws or older parents to care about, we have to keep the healthcare system from being overburdened. Because if we're running out, if our healthcare workers are all getting sick and we're running out of equipment and running out of beds and we can't care for people, then more people will die. So you staying home, you distancing yourself from other people could potentially be saving someone's life, even if all you're doing is keeping our healthcare system from being too burdened. All right. Is there a downside? I'm definitely, I think social distancing is what we need to be doing just so you know, but I want to talk about one potential downside. We do need to reach herd immunity for this disease, for this virus to become just an endemic thing that only causes small problems or maybe to go away. We have to reach herd immunity, which means we have to reach a point where the huge majority, 70% of more people are immune. And the best way to do that, please hear me out, the best way to do that is to let this disease just run through our country and kill who it's going to kill, expose everybody and whoever's left standing is now immune and now we have herd immunity. That's the best way if you're trying to reach herd immunity the fastest. But if you're trying to keep people safe and keep people from dying, then social distancing is a better idea. And we let this disease slowly trickle through the population so we don't burden our healthcare system too much and less people die. But the reality is it will take longer. So the downside to what we're doing right now in flattening this curve is that maybe this will take three years before we can reach some level of herd immunity. But that's a phenomenal trade-off. I'm just trying to explain the biological downside to what we're doing. But I don't think it's a bad idea in any way, shape or form. This is a very common question I see. Are coronaviruses new? So the reality is no, not even close. I always like to say that you've probably not had the coronavirus, right? SARS-CoV-2 that we're talking about. But you've definitely had a coronavirus. And that's because there are four coronaviruses that cause the common cold. They actually cause 20% to 30% of all the common cold. So if you're more than a few years old, statistically speaking, you've had a coronavirus infection. But not SARS-CoV-2, the coronavirus we're talking about now. So they are not new. They've been with humans a very long time. And then over the last couple of decades, we've seen some new variants of coronaviruses show up. So this is actually the seventh coronavirus. We have the four that cause the common cold. Then let me show you this here. We have SARS and MERS. So SARS stands for Severe Acute Respiratory Syndrome. That's be the SARS virus. And then MERS is Middle Eastern Respiratory Syndrome. So SARS and MERS are closely related to this COVID-19 that we're dealing with now. And then you see this a comparison here with the flu. So the R0 or R sub-zero you see there is, in normal situations, how many people are gonna get infected by every sick person? So one thing you can see here is that COVID-19 does have a higher R0 or R sub-zero than the flu, but it's actually lower than SARS. And then MERS was quite a bit lower there. The case fatality rate, the mortality rate, we're looking at somewhere between 0.25 and 4%. We don't know at this point with COVID-19. Notice that SARS and MERS are both higher. Let's go ahead and look at those. So MERS has by far the highest fatality rate of these three coronaviruses, but you pretty much only got it if you were elderly or had some sort of comorbidity. Healthy people didn't get it. So it was really hard to get, but if you got it, there was a very high likelihood you were going to die. SARS was relatively easy to get, but it was primarily healthcare workers that took the brunt of it because they knew when it was spread. It was spread when people were very, very sick. So that number is pretty high, but it was only happening when people were sick. So other than healthcare workers, it wasn't running through populations the same way that COVID-19 is. COVID-19 has a lower R0, but for the incubation period of four to 14 days where people are asymptomatic or have very mild illness, they could still be spreading the disease. So I think that's what makes this an especially dangerous organism if you're looking at infectability, right? Or how quickly it's traveling around the globe. The other thing to note here is that, especially comparing it to the flu, it isn't just a bad flu. The flu certainly kills people. The flu has killed more Americans than by far than COVID-19 has, but look at the hospitalization rate. About 20% of people end up in the hospital, 15 to 20% somewhere in that ballpark, whereas with the flu, that's a much, much lower number. So lots of people are gonna be hospitalized. Thankfully, only a small percentage of them are going to die, but still worth noting. All right, so this is not new. Just so you know, this is a new or novel version of the coronavirus, but coronaviruses are not new. So why is SARS-CoV-2 so infectious? I picked this article here from the journal Science to talk about because the main issue that I see is that people are spreading it when they don't know they're sick or else they have a very mild illness. 81 to 84% of people that actually have SARS-CoV-2 infection are either asymptomatic or have very mild condition. So for a few days, maybe you've had a little bit of a cough, you just don't feel great, you think it's just a cold, but you're out, you're out there spreading it. So the biggest number here from this article was that undocumented or unknown infections were the cause or source of 79% of the documented cases. So most people getting this disease are getting it from people that either didn't know they had it or had such a mild illness that they weren't concerned about it, but they were still out and they were still spreading it. With SARS, if you were sick, you were quarantined, you were taken out of the population, you were contained, and you weren't spreading it to other people except for healthcare workers, sadly. In this condition, people are going to work, they're going to school, they have no idea that they're carrying this very, very dangerous virus because for them, it's a mild illness or they're asymptomatic. So to me, that is the number one reason. And when people ask me about why this is so much more infectious than we thought, it's the reality that you could easily be spreading this disease before you know you're sick. All right, another question that we hear, obviously a ton is, is COVID-19 really that bad? Like I'm not worried about it, it's not going to kill me, et cetera, et cetera. Well, the three key factors that I look at here is age. So clearly, as you can see here, this is with the COVID morbidities, but the older you are, the more likely you are to die. So no one, no one niner under has died. And I'll show you some age related stuff in just a little bit. But as your age goes up, your risk of dying goes way up. So age is a very big factor. Number two, we have your comorbidities or preexisting medical conditions. So cardiovascular disease, diabetes, lung disease, high blood pressure. These are all going to things that are going to make this organism that much more dangerous. And the third one is where you live is your healthcare system overwhelmed? So here I'm in South Dakota at this point, there are 14 cases, anyone that's infected there or that has a documented case is being well taken care of in other parts of the world and other parts of the United States. The healthcare system is so stressed that is there a bed for you? Can they actually take care of you? Can they, do they have a ventilator for you? These types of things. So I think those are the three key factors. When you ask me, is it really that bad? I would say for you as an individual, how old are you? Do you have these comorbidities or preexisting conditions? And how stressed is the healthcare system in your area? I mean, I've heard just the things that are happening in New York are alone already make me very, very thankful that I live somewhere where we're not seeing that at this point. I've also been specifically asked about pregnancy. Again, I don't think we know the answers. I haven't seen any evidence that being pregnant increases your risk at all or even that this virus increases your risk for preterm birth, but I have to assume it does because the flu virus and things do. So I can't point to any evidence that pregnancy is something that makes this worse, but I'd have to believe so. Again, just my personal opinion, I haven't seen the evidence to support that or refute it. Why should I worry I'm young and I'm healthy? This is another thing that's really surprising people. So as you can see here, CDC data shows that nearly 40% of hospitalizations are people aged 20 to 54. Now they're not gonna die. They're gonna be hospitalized. They're gonna fill up. They're gonna disrupt the healthcare system. They're gonna fill up all these hospital beds. They're going to survive. They're gonna be very, very ill. So if you're young and healthy, if you're a young 30-year-old, you still got a really good shot if you get this disease that you end up hospitalized. And you probably will survive, but will the person next to you because they're running out of resources taking care of you? That's why I keep going back to the same thing. We are all doing our part to protect everyone by not getting this disease. Even if you think you're young and healthy and you can handle it. What is the actual mortality rate of COVID-19? This is something we talked about a lot in class a few weeks ago. As you can see here, they're estimating huge ranges because we don't know the answers yet. You only know this when you look back and you do blood analysis and all sorts of testing and looking backwards to figure out how many people actually had the disease. But I wanna talk about why you don't know because I already showed you a chart. Here's how many confirmed cases. Here's how many deaths. Don't we know the case fatality rate or mortality rate? No. The range that they give here is between 0.25 and 3%. It's a huge range and they're even saying that it's probably gonna be on the lower end. So even though if you run the math, I ran the math today, the numbers I showed you earlier in this presentation would have put the mortality rate at 4%, about 4% of people that are confirmed cases died. But the number is gonna be lower than that. Mainly because you have a disease that while it can be fatal and causes hospitalizations in 15 to 20% of cases, 80% of people have mild illness. So how many of those people never got diagnosed? Never went in. They just thought they had the cold. They had a mild enough illness where they just wanted to stay home. So they're not in the system. So if you look at the numerator, which is the number of people that have died, we know how many people have died or at least a really close number, divided by the nominator, which would be the total number of cases. The total number of cases is probably much, much bigger. Like here in South Dakota, there's a backlog. They're out of tests. There's only 14 positive cases, but there's like 270 that are pending. And we have no idea how many more are out there. And that's just here in South Dakota. It's much worse than other places. So I think if you ask me where it's gonna end up, I say it's gonna end up at one or even under one is where I think it'll end up. But that's just kind of my gut feeling based on the fact that there's probably been a lot, lot, lot more people infected than we actually knew. All right, so why are children safe? So the reason I put safe in quotation marks up there is because they still get the disease. And it's, but it's unknown why they're not dying. So you see the numbers here, no fatalities, nine and under, 0.2% for 10 to 19 years old. That's awesome, right? This is the biggest silver lining. Like if this disease was killing kids, I would be terrified. Anyone that knows me, knows how much I care about. Oliver and my stepchildren and how terrified I would be. And I cannot be objective when it comes to my own son. So this is really the biggest silver lining and the biggest, the biggest good news so far with this disease. But as far as why, I cannot really give you an answer. I've researched and researched this. They just don't understand it. So they get it, but they're not dying. I think the two best hypotheses I've seen so far is one is that maybe their young immune systems aren't developed enough or at the point where they can develop what are called immunopathologies. So where your own immune system creates these cytokine storms that could be doing a lot of the damage. That is potentially one reason. The other thing that I've seen is that maybe their lungs are not the kind of environment, usually these coronaviruses like SARS and SARS-CoV-2 here. They hit you once and then you start to feel better and then they hit you a second time and that's when they kill you. Potentially these young lungs are just not the environment where that second wave comes through. Those would be my two best guesses as to why children are not dying, but thank God they're not. All right, is it a good thing that 80% or more of infections are mild or asymptomatic? It is great for them, right? If I'm gonna get it, I want to be mild or asymptomatic, but it's bad for controlling the spread to other people. For all the reasons you said before, the majority of the cases are people getting it from other people that don't even know they have it because they have no symptoms or very mild symptoms. So it's very hard to flatten that curve we keep talking about if people don't know they're sick. It was much easier to control SARS because people had to be sick to be spreading the disease. We know with SARS-CoV-2 here, COVID-19 that they don't have to be. So it's hitting this from all angles here just to give you a complete picture. This is great news for those individuals but very bad news for spreading the disease, right? The last time we went to the store to get some more food, no one was coughing, no one was visibly ill, but we have no idea what was being spread and by whom because so many people don't have symptoms or have very mild symptoms. All right, is SARS-CoV-2 hard to kill? So I put kill in parentheses there because that's quotation marks, sorry. Good thing I teach biology because you can't kill a virus, they're not alive, right? We inactivate viruses which people use the word kill, I could care less, but if they're not, right? They're envelope viruses. So another piece of good news here is these viruses are very fragile. The envelope viruses are the weakest of the viruses, they're the easiest to kill or inactivate, alcohol, hydrogen peroxide, your quaternary ammonium compounds we talk about in class. Soap, soap can disrupt this lip and envelope and destroy these viruses. So they are not hard to kill. The key is to get them killed, get them inactivated while they're on services or while they're on your hands before they get in you because once they get in you, that's where they're gonna cause a problem. So I just showed some alcohol here, but really there's a long list of things that will kill slash inactivate SARS-CoV-2. That is not the biggest concern. I think personally soap will do just a fine job because soap will disrupt the lipid membrane and that lipid envelope. So no, not the answer here is no. Seen this question a few times is using disinfectants making SARS-CoV-2 worse? When you think about resistance, right? So using chemicals and things becoming resistant. I'm using more concerned about this with bacteria than am viruses. With viruses, it's absolutely true that they can develop resistance, especially to antiviral drugs. HIV is a great example. One of the reasons that we use combinations of drugs is because if you throw any one drug at a virus like HIV, it will mutate around it. But that's gonna be more on the treatment end. As far as using hydrogen peroxide, using alcohol, is that leading to resistance? I don't think that's a big enough deal to be concerned right now. You should be washing your hands and disinfecting way more than you think at this point because we're trying to flatten this curve. Let's worry about that down the line. But I'm certainly not saying that what we do isn't leading to resistance, but I just don't think this is something we should be too concerned about now as long as, unless this virus were to mutate, to where it no longer had a lipid envelope, anything that disrupts those lipids should still do a very, very good job of inactivating this virus. To face masks help, I question whether to even talk about this or not because there's conflicting information and then also I think there's a reason why the message is that we shouldn't be using them. But I do it here. The average person touches their face about 23 times an hour. So one of the main benefits of wearing a face mask if you were to wear one and it's fitted and you wear it properly is for it to keep you from touching your face. But if you're wearing one that's improperly fitted and you're fiddling with it all the time or you're constantly popping it off to eat or drink or do different things, you might be touching your face more. So in that case, you definitely wouldn't want to be using a face mask. So who should use one? I think that if you're sick, the evidence is clear that if you're sick, wearing one is a really, really good idea. And then healthcare workers that are gonna be knee deep in this need them as well. So I'm glad the messaging has been not to wear them that you don't need to wear them. But I cannot say that they wouldn't protect you. If they were properly fitted and you were using them correctly, I definitely can't say that they wouldn't help you to some extent. But we can't steal them from the people that need them. So if we're taking so many of them and hoarding them and people that are perfectly healthy are wearing them when they're walking down the street and then a healthcare worker doesn't have one or someone that's sick doesn't have one, that's a huge problem. So that's why I'm glad the messaging has been don't worry about face masks, but at the same time, I can't say that they're not doing you any good just so you know. All right. Can you catch it twice? Seen this multiple times as well? I know there was a case where they thought that happened. At this point, I would say no. I don't know if there was a testing issue or what there was with that case, but to catch it that quickly a second time, I don't think so. Now, is this mutating? Yeah, I mean, viruses mutate. This shouldn't mutate in the same ways like the flu virus does where it mixes and matches genes, but it's mutating and changing along the way. Could it reach the point where it mutates enough where it becomes something else? Yeah, absolutely, absolutely. But the main thing I wanted to talk about here, so I don't think that you're gonna get it now and get it again in 14 days, but one thing I find pretty interesting, the research done on SARS and MERS has shown that immunity doesn't last very long. So this might be the kind of thing where even if you got it and you were immune seven months, eight months, a year, year and a half down the line, I can't guarantee you still will be. And it doesn't, nothing to do with mutation. It's just the immunity from fighting off this infection doesn't seem to last. And I can't say that for this virus for sure, or just looking at the best evidence we have from those relatives, SARS and MERS. This also might be a problem with vaccines though. If you create a vaccine, will we have the same issue where the immunity just doesn't last very long? Don't know, but as for now, if you were to ask me personally, again, not medical advice, if you were asking me to catch it twice, I would say no. What's next for this virus, SARS-CoV-2? It could disappear like SARS basically has. It could become a more mild endemic disease. A lot of times that happens when a new virus shows up, it causes a real, real big problem. And then it settles in and maybe infects our nasal passages and it just becomes this mild endemic thing that's constantly with us possibly. It could disappear and then pop up occasionally, maybe after every generation or so when the last generation that was immune has moved on past adulthood, maybe it'll kind of pop back in like that potentially or it could get worse because of some mutations that make it worse. So honestly, I have no idea but it's gonna constantly be changing and mutating and these are all potential things that could happen. Good question though. Will something like this happen again? The answer is absolutely yes. As you can see, I put this bat here because the bat coronavirus, that's believed is what created this SARS-CoV-2, bat coronavirus and it's not just bats but the reality is that according to the World Health Organization, over 60% of all human diseases are zoonotic or zoonotic, which means they used to be animal diseases that jumped into humans and 75% of all new diseases that have been discovered in the last decade are these zoonotic or zoonotic diseases. So as long as we live near animals that have viruses, bacteria, et cetera, as long as we continue to encroach on their habitats and spread our reach on this planet, we have no idea we're gonna come into contact with. We have no idea what the next bat in the rainforest is carrying or the next animal here, next animal there. We have no idea what's gonna happen when we eat exotic animals or we go to places where humans aren't normally at. So this is that if you wanna live in close proximity with animals and you wanna consume them and you wanna continue to spread our reach on this planet, we are gonna bump into organisms we've never seen before. And some of them are gonna take a liking to human beings and that's what's gonna happen. So do not think this is the last time that we'll ever have this spillover event where an animal virus finds its way into human beings. It will definitely happen again. Why are they worse? Why are new diseases worse? Well, think about it, no one's immune to it. There's certainly no herd immunity protecting us as a group. There's no immunity at all. So when a new virus or a new organism jumps into humans it has just a heyday because of that because there is no protection. We also didn't know about it. So there's no vaccines, no drugs, et cetera, which is what we're seeing now. Then over time. So let's say this virus decides to stick around. It should evolve towards mildness. So over time I think that these organisms they kind of find a happy medium where they can infect us and they can occasionally cause problems but we constantly give them a home and give them an environment, a way to pass on their genetic material. Wiping us out isn't good for them either. So this is generally what happens. When a disease first jumps into the human population it's nasty and then it should become more mild as we move forward. That's again, my best guess. We will have to wait and look back from the future and find out. When will there be a vaccine? People talk about a vaccine a lot. I know there's been some, the trials are already starting and that's great. But if there was a vaccine, I mean let's sort this way, there's still not a vaccine for SARS and that was from 2002, 2003. If there's a vaccine 18 months to two years is like a, would be like a record pace. So hopefully they can do it and hopefully we have it. But if you want to actually fully test a vaccine it's gonna take a ton of money and a ton of time. So don't expect a vaccine to save us here in the next few weeks. That's just not reality. Why don't treatments exist already? Well, specifically this virus is brand new but it has relatives, right? So if we continue to do research on SARS and MERS and we made some good progress in those areas then potentially we'd have something to work with. But funding in those areas dried up. I mean, so you think about it, SARS basically disappeared. There's no money in it. So the research that was being done to combat SARS and look for vaccines and look for treatments, the funding dried up because pharmaceutical companies have to make money and there just wasn't any money in the area. So we need more research funding and we have to continue to do research funding. I think it's clear after this one that coronaviruses are gonna continue to be a problem. So I hope that research funding towards studying coronaviruses and looking for the next new one will continue to go and we won't forget about this, right? It's kind of like I heard someone say the other day that, because obviously lots of people aren't very happy with vaccination but this is something we're talking about all the time. So someone was asked if there was a SARS-CoV or COVID-19 vaccine will people take it? And they said this year they would next year they wouldn't, right? We cannot afford to forget about this and what's going on right now and the cost in human lives and the disruption in our lives. We have to remember that. As far as the treatments they're studying all there's dozens and dozens of studies being done looking for treatments. They're looking at potentially some anti flu medications anti Ebola medications might be working. Lots of cool things happening. Maybe you had somebody ask me a question about convalescent serum. So the idea that antibodies from someone that's recovered could help someone. Certainly that's used in many diseases including Ebola. Convalescent serum is an option but it basically takes one person to save one person. So as far as ramping that up it would have to be some sort of an antibody therapy and they're working on those. So I certainly hope that there's treatments coming in the very, very near future. Was SARS-CoV-2 made in the lab? This is one of the questions I've been asked the most. There is no evidence to support that if you actually look at the evolution of this virus it certainly doesn't look like anything that a human made. I always like to say that Mother Nature did not need our help to make this virus. So I see no evidence to support that. Just have a little fun before we quit here. What are the best toilet paper alternatives? I have no idea. But the toilet paper thing I have students telling me that all the yeast has gone from their stores could be used least yeast for one of our labs. Like clearly this is something that is big. My wife's been calling it a panicemic and hoarding all the toilet paper is part of it. So I actually don't know where we use wipes in my house but I just wanted to kind of leave you with a little bit of a smile hopefully. So from a teaching standpoint what should we learn from this experience? Well, one of the biggest things I've been telling students is everything we're doing now we should be doing anyways to protect ourselves from the flu, right? So we're actually already doing we should. If you look at, I mean were people not washing their hands before? Were people not doing these kind of things? So we're doing what we should do every flu season is something that I'd like to keep in mind. Number two, we have to invest in research. If you have money share it when we have to invest in more research before this happens again. And I've already mentioned, right? As long as humans are gonna be consuming exotic animals and they're gonna be moving in the new habitats the reality of these kinds of things are gonna happen is there. So keep that in mind. And then lastly, just this idea of the globalization of disease, right? This was a problem over there wherever over there is, right? We don't care about diseases that are over there but there's no such thing as over there anymore. Now you actually have people that are bringing this virus back to China because of travel. So globalization means that we all have to be concerned about all these diseases especially ones that are contagious like this. Okay, so those are just my thoughts and I think I've answered all the major questions that students or anybody else has asked me. So just, you know, not medical advice just my personal opinion. I hope this brings you up to speed and we can get out of our homes pretty soon because we've dealt with this thing, we've conquered it. And so, all right, I hope this helps. You have a wonderful day. You blessed.