 Jay, we're back. We're live on Jay Fidel. This is ThinkTech. More specifically, the issue and subject of the day, in many days to come, CoronaWatch. And with us today, we have Sarah Winaker. She's a geneticist, which I think is really important for us in our understanding of what's going on with coronavirus. Hi, Sarah. Thank you for joining ThinkTech this morning. Thank you, Jay. Thank you for having me on your program. So exciting to talk about a geneticist. I remember, for example, when this first started happening, or at least coming to our attention in January, I was kind of surprised to find that the Chinese had already developed, already identified the genome for the virus. That was pretty quick. And I wanted to ask you, how did they do that? And how do they do it so quickly that they have it in their back pocket anyway? And finally, all about that, what good is it to have the genome? Doesn't seem to be doing us much good right now. Yes, a lot of questions there. The genome of this particular virus is actually quite small, as are genomes of just about all viruses. And so they're really quite quick to sequence. We can sequence a human genome in just a few hours. So that part is simple. The reason that it's important to know that is the sequence that is, is that will help to provide a foundation for developing a vaccine. So we need to know what we're dealing with, what kinds of proteins and antigens and so forth that this virus can make, that we can ultimately develop either antibodies or vaccines for. Is it fair to say that we really can't do a vaccine within that year or 18 months that Dr. Fauci talks about without having a genome? Well, certainly having the genome gave us a head start because historically, we've had to not we personally, but scientists have had to actually isolate the virus and figure out what we're working with. But we're one step ahead already knowing the sequence and vaccines normally take a good two to five years to develop. So even this 12 to 18 month turnaround is, I wouldn't say optimistic, but realistic as well. So in terms of, in terms of discovery, a question is very provocative question we talked about for the show began. Is it possible that this is a weaponized virus that say somewhere in Wuhan or near Wuhan that was a laboratory, a Chinese laboratory that was working on this as a weapon? Yeah, I know that that that's been bounced around that sort of it's it's rumor. Some people are calling it a conspiracy theory. I think there's a paper just recently published in Nature Genetics that kind of put that theory to rest that it could not in all likelihood have been genetically engineered. The reason is twofold. First of all, if a scientist were to try to model what aspects of the virus would make it very virulent by using computer modeling, they would not have landed on actually what is making this virus so virulent. And secondly, yes, this virus does have differences in the DNA compared to other types of coronaviruses, but viruses mutate naturally. Their natural evolution is to mutate and avoid surveillance by the immune system. Viruses mutate about a million times faster than human DNA does. One question that came up is we have had like 50 shows about coronavirus. You should look at our website thinktecawaii.com. Anyway, one question came up in connection with earlier epidemics such as the Spanish Flu 1918-19. Without a vaccine, without any significant medicines to cure the flu, it evolved out. It mutated out or it seemed to mutate out. It stopped functioning. Maybe you could say that at some low level it continued from then till now. Viruses come and go and all that and maybe in large part they stay around. But is there the possibility that this virus, that coronavirus will sort of mutate to a less virulent model and then the epidemic goes away mysteriously? I suppose that's the case, but it certainly is to the virus's benefit to not mutate in that direction. Viruses are really outliers in terms of biological entities. They're not living organisms. They're not made of cells. They don't create their own energy. They can't move and they can't replicate on their own. They've got to have a host organism. So it is not to their benefit to become less virulent. In terms of the flu, we have a lot of different strains of influenza. One strain caused the Spanish Flu and there have been multiple different strains. That's why we need to get a vaccine every year for the flu because we're combating different variants. Well it seems traditionally we've never really, maybe with the exception of Ebola, we've never really created a vaccine that will work and I'm wondering what the natural pattern is and also I'm wondering if all this interest in the virus now, scientifically, could result in a medicine or an approach to put it all to bed forever, in order to learn enough about this kind of virus, a corona or something related, so that we never have to worry about it again. Humanity is freed from the chains of this ongoing and sometimes repeating, sometimes very aggressive virus. Right. So yes, there are all sorts of novel types of vaccines that are being developed and coronaviruses, you're right, are a class of virus. So one theory is that we could use a sequence from sort of the backbone that's common to all of these viruses and hopefully develop a vaccine against that. That would be interesting because it, you know, it might change the population of the world. In other words, there wouldn't be these devastating epidemics from time to time and people who would otherwise die would live and so forth. But you know, you said something earlier, Sarah, that I'm really interested in thinking about this. You know, in a case of a bacteria, you know, it's easy. We know what the bacteria wants. It wants to feed, it wants to grow. It's like a person. It has a purpose in attacking you. But the virus, it's not as clear to me that the virus is, you know, it has a purpose in attacking you, that it benefits by attacking you. And I see it as this really dark, wicked thing that just kills for the sake of killing. And yet, you know, there's no grand scheme here. There's no leadership. They just go around the world and they hit so many people. And it's really, it's like it's a statement of evil. It makes the bacteria look innocent somehow. Yeah. Well, they are, they are very, you know, nefarious things, because they can only survive, they can only replicate by infecting a host. And so, you know, their concern is to replicate and reproduce. So I don't think that they're, you know, obviously don't have a thought process, but their, their intent is not to kill. Their intent is to replicate and make copies of themselves. And in so doing, yes, they cause disease and they kill. It also strikes me that they've been around for a long time. I mean, if you know, you think of the creation of the world, the evolution of the world, back when we were swimming in the ocean. And, you know, they were there, weren't they? The viruses were there. They were, they're an essential part of the, what I'm going to call it, the biological infrastructure of the world, the ecology of the world. They've always been there with us as we evolved, they evolved. And so am I right? Yeah, it's, it's, in a way, it's hard to determine that because viruses, unlike almost every other life form, don't leave a fossil record. They're too small. They don't exist on their own. They die if they're not within a host. So we can't really determine, you know, which viruses were present and when. Which is an assumption that we make. So what's the, what's the, you know, what's the logical concept on how to, how to deal with them, how to make a vaccine? I mean, they're, you know, they're, you know, back when, back in the, well, in the Spanish flu and before, they were giving the blood of a survivor to someone who's just getting a disease and the thought that there was something in that, and we know now that would have been, if anything, antibodies, and the antibodies of the survivor would help you. Is that always a way of vaccine work? And then the other possibility, and I know nothing about this, is that you find, you find virus that will create a non-destructive illness like dead virus or almost dead virus. And then you give the person a very low level of illness and that helps the person develop antibodies. And then, and then he or she can, can resist the disease. I don't know if, is that the current thinking? Is that the modern thing? How do we see vaccines these days? We don't, taking blood from an individual that's been infected with this virus, yes, that individual will have developed antibodies. And, and maybe in the short term, I know Dr. Anthony Fauci has talked about this, that one possibility is to, you know, take plasma and blood from individuals that have been exposed. But that is a very, you know, costly, lengthy process. And we don't know if there's, if it's how effective it's going to be. The, you know, more effective vaccines will be developed, as you say, by identifying which aspects of the virus, which particles will trigger our natural immune system to develop antibodies. And so whether that's, you know, a protein, a fragment of RNA or DNA, or sort of an inactivated virus, that's the more common way of developing. What about the notion of the lipid, the lipid covering of the particle? You know, I mean, people say, that's why you wash your hands, because the soap and water combination will make the lipid inert, rather, it will tear through the lipid. It will, you know, create a fissure in the lipid. And the particle will then be exposed to things that make it inert. So isn't it possible to take some kind of soap on a molecular level, you know, some kind of solvent to an alcohol, whatnot, and get to every particle or sufficient number of particles, you know, to tear through them and make all the viral particles inert? Right. So yeah, virus is really just made of either RNA and DNA, and it's got, in this case, an envelope that consists of proteins and lipids. Soap also contains lipids, and that's why it's so effective, because the lipids in the soap will intermingle with the lipids in the individual area, and essentially destroy it. However, once the virus, and that works great, and everyone should be doing it, it works great on surfaces, on your hands, but once the lipid's inside the cell, we can't access it with soap. That will destroy the, the, the, our cells as well. Okay, so that wouldn't work. Yeah, yeah. You know, another, another, thank you. I'm just thinking, I actually went, I went to the long drug store, and I, and I, I caught a pharmacist, and I, I asked the pharmacist, what does it take to dissolve lipid oil? And she said, as you suggested, other oils, you know, are away, I mean, solvents are away, but other oils are away, like the soap, the oil and soap, too. The other, the other question that springs out of this, though, is, is that, you know, okay, so I got one particle, somehow it got on me, and somehow I touched my mouth, my nose, my eyes, you know, and it got into my, into my body, one particle, just one. Am I worried about one particle, or is this the kind of thing where up to a certain, you know, trigger point up to a certain critical mess, I'm not at risk. And after that, then I am, is that the way it works? I think it's probably more the latter. You know, we do have two components of our immune system, we have like a natural immune system that, that it is nonspecific. It kicks into gear whenever we encounter any kind of pathogen, like a virus or bacteria or whatever. And that, that's our just nonspecific immune system where we, you know, initially we can develop a fever, which actually helps to kill the virus. We get inflammation, weakness, because it takes a lot of energy to, to ramp up the immune system. So if we, if there are very few viral particles, our innate immune system, you know, will likely be able to, to take care of that. But once, once the system becomes overwhelmed with, you know, a threshold level of viruses, then, then we get sick. What's the point of overwhelmed though? In other words, how do I know I passed the trigger point? Is it that's when I develop symptoms? Is that what happens? In other words, I go through that whole list of symptoms, they start popping up in me. Then I know that I've been overwhelmed. And I'm in another, another chapter, so to speak, of the development of the particles. Yeah. I mean, that, I mean, this, this particular infection has, has very, very specific symptoms, as you know, with, you know, fever and cough. And then the shortness of breath results from the fact that this virus has mutated to develop a very strong affinity for a particular receptor on the lung cell. And that is when people's, you know, really, the people that have had, you know, either failure or severe illnesses is, is because the virus has attacked the lining of the lung, and we cannot get enough oxygen into our bodies. I'm not sure that answered your question. No, I'm, yeah, I'm, yeah, I'm just, I'm wondering, you know, there's a sequence of symptoms. And I don't know which one, the first one is probably something like sniffles or so throat. The cough and then the fever. And then some difficult breathing. And you know, many, many people, as I'm sure your other guests have said, don't exhibit any symptoms or can exhibit just one or two of these. So it's, it's quite variable. But once, once somebody comes short of breath, that's, that's where it's becoming critical. One point of great interest to me is the sense that these viral particles are like all around us in our world in a, in a city which is having an epidemic. I say city, because somehow I think that cities are more, more, you know, more the target than say rural areas. But so I see, I see them everywhere, little particles jumping up and down all over on every surface and waiting for you to pick up a few. And then you pick up a few, you don't wash your hands. And before you know it, you know, you're, you're into this process of having them replicate until the point where they, they, they got you. Is it true? I mean, do you, do you see it that way when you walk around and look at the world? Do you see little particles all over? Do you see that? I think that we've all parted to, to kind of visualize the world like this. And, you know, I was sort of thinking the other day, gosh, if there's just some way we could tag these, so that they could be visual to the, you know, visualize. It would be in good shape. But, you know, the bulk of transmission is really through coughing and droplets. It does, you know, it does exist on surfaces and that's why we need to wash our hands constantly. And certainly not shake hands or touch, you know, individuals that could have been exposed. But yeah, it's, I think we're all a bit, I don't want to say paranoid, but very wary. It's a very situation. You know, a lot of, a lot of products have popped up. Some of them I'm sure are scams. But one of them is this notion of the, the ultraviolet light. And they say, and I did a little looking through the, you know, the internet on this, they say that this is used in hospitals and they will reel this robotic device into a room and close the door and shines the ultraviolet light all over the room and presto digital, no more virus. Is that real? Oh, and then you see these things for 20, 30, 40 bucks, where you can buy it and you can run it over a surface. And they say that it will, it will kill all the virus in that on that surface. Is this a true phenomenon? Well, I don't know. I hadn't heard this. I don't know how effective it is against viruses, but I do know that UV light does induce DNA breaks and DNA mutations. So, you know, it does have the potential to sort of incapacitate the, the viral genome, and therefore it would not be infectious any longer. I would have to look into that further to see how you know what's interesting. Let's assume just assume with me now. I mean, this is not science. This is speculation that if you can get an ultraviolet light to kill the particles or, you know, make them inert somehow by virtue of light, then you're really talking about light now. And if you're talking about light, you could, you know, do do variation on that theme and shine the light on a given surface. And now you would see the particles colored, oh, let's say orange. And so where something appears to have little specks of orange or little patches of orange, then the light would have identified them. And you know that surface is contaminated. That's logic. What do you think? Well, again, another good idea, although viruses are so small that it's sub microscopic. So even so, unless you had a huge, you know, conglomeration of these viruses on the surface, you still wouldn't be able to see a single virus or 10 or 1000 viruses. So you're better off using the old soap. Well, our lives are certainly going to change here. But you know what, one thing that I, one thing that I see is imagine a sort of a wheat field, maybe a dry wheat field, and there's a little fire burning and the fire sweeps across the wheat field. And most of the grain is burned. Some may survive, but most is burned. And I see the world as a target for this kind of thing. It's magic, if you will, is that it can spread so quickly. And you know, you can't even see it happening, but it happens everywhere. And it's more contagious than any, am I right? Anything we've seen in the past in terms of a global phenomena. But you know what strikes me is that this burns through the wheat field and it kills or rather it infects X percentage of the people predictably around the world. It also kills X percent and it spares X percent. And once we know more about it, we'll know how this, you know, this global, you know, fire in the wheat field thing works. How do you see that? How do you see the wheat field in this kind of context? Yeah, I think, you know, now that we are so interrelated globally that this, I don't want to sound like a doomsayer, but I think that this will continue to be an issue because of, you know, densely populated cities and global travel. Yeah, we are going to have waves of this sort of thing. And this virus itself could even mutate once we develop a vaccine. It could, it may well mutate so that this particular vaccine would no longer be effective. The good news is that at least thus far, since we've been able to identify the virus since December, we haven't seen mutations in the virus. So it seems to be at least thus far pretty stable. But I think that's an interesting analogy. Yeah, so you can make it more virulent. You can make it less virulent. I mean, it could become by its own, which I find interesting because say one particle of this virus, okay, is in deep Siberia and the other is right outside Rome, just for example. Yeah. So if we say, if we say that the one in Siberia has mutated to be more or less virulent, but the one in Italy doesn't know, it has no communication, it's so far away, it's never going to be able to pick up the change by itself. So are you saying that the mutations can happen on a geographical level and not spread the same way that the virus itself is spreading? Yes, it certainly would happen on a geographical level because it's not like a population wide change in the DNA. These mutations just crop up in individual viruses. And that's precisely what happened with this current virus is that the sort of hook on the outside of the envelope that connects to the receptor in the lung cell, that is the portion of the virus that mutated. So that occurred somewhere close to Wuhan, which is a geographical area. So yeah, it's geographic dependent. By the way, is that great? Go ahead. I was just going to say is to the virus's benefit to become less virulent so that the virus itself, because if the virus is quite virulent, infects the cell, makes thousands and thousands of copies, then it bursts the cells and destroys the very host that it needs. So it's to the virus's benefit to sort of lie low and create a less virulent kind of process. So what we have now is a kind of irrational, mean kind of virus. But on the other hand, it's in terms of the way it interfaces with humanity, it's brilliant because it can travel so fast and hit so many people. Would you compare that to the process of evolution itself? You know, once in a while, you have a phenomenon that is so virulent that it can hit many more people. And there's a mistake there. It's kind of psychopathic. It's a psychopathic brilliant virus. And you know, that's kind of scary because at the end of the day, humanity will still exist. And so will the virus. So if you were going to do trials on this, you know, with a likely candidate or a series of candidates for a vaccine, how do you do that? How do you do the trials without hurting anybody? But at the same time, you know, trying to find a successful candidate that will work. Right. So that's one of the reasons why it does take so long. You don't go from developing potential vaccine that you don't go immediately into humans. It's got to be tested first in what we call tissue culture in the laboratory. So like on human cells in tissue in the laboratory and then moved into animals, animal models, and then to very low doses in human beings to see, first of all, is it safe? Is it doing, you know, we don't want to cause more harm than good. So that takes quite a long time to, you know, just, you know, to evaluate the safety of any particular vaccine. And then the doses are incrementally increased. And then we start looking at a frequency. Is it triggering the immune system to attack the virus or not? So we've got to determine that it's safe. Secondly, we have to make sure it's efficient. Okay, then once we've checked all those doctors, then we've got the issue of ramping up the manufacturer of the vaccine to, you know, worldwide availability. So it's a long process. Yeah, I just, I wonder, you know, if you take the national conversation on this, there's some people who say, okay, let's speed it up this time. Let's take some chances. But what are the risks in moving too early? What could happen if we don't go through the whole trial sequence? Are you asking what is the risk of going into humans too early? Yes. Yeah. Well, one thing is it could overwhelm the immune system to the extent that our response to the vaccine is worse than the virus itself. So if, say, we, you know, generate a fevers of, you know, astronomical levels that could cause a lot more harm than good. So we've got to take it one step at a time. I know that it will be expedited. And the hope is that, you know, we can identify some antiviral medications to at least, you know, treat or tamp down the symptoms of the viral disease before this vaccine is available. Yeah. You know, one possibility, logical possibility that hits me is if you go too early, is it possible that the punitive vaccine would encourage, would stimulate the virus to mutate? That is precisely why viruses mutate because they do want to avoid the immune system. You know, this is not a thought process on the part of the virus, but just in natural evolution, if they do then develop a mutation that allows it to kind of evade attack by antibodies, then, you know, then we've got a new disease that we're dealing with. Yeah. That would be scary. Well, more scary. It's scary enough already. The other thing is, I wanted to ask you, what about these drugs that have been talked about, you know, the ones that go from malaria and so forth? Is there any value there? Just, it seems, it seems really disconnect. You take a drug that has something to do with malaria and say, oh, this, this will help you. And it's like, you know, there's a couple three that the president has talked about, other people have talked about. Daniel Day Kim, one of the actors in Hawaii 5.0, said he recovered using those. He recommends that, or at least he says consider it. And I wonder if that's just pie in the sky, or is this real medical genetic reason to use those drugs? Yeah. Well, there's certainly, I mean, I think there is reason to use them, but we, we, you know, we need to establish, you know, the efficiency, the effectivity of these, of these medications. There are a whole class of medications, you know, the hydrochloroquine that you just mentioned. There is another one that's already been through clinical trials and safety, safety trials for, for the flu. And then, and then another one. Tamiflu. Yeah. Another, no, Tamiflu won't work for this virus. Okay. But another drug called Remdesivar will hopefully work for this virus. And another one I just read about today involves inserting a different type of nucleotide. So it basically inserting into like getting a different nucleotide into the viral genome so that it can't replicate. So they're, they're not, they're quite a number like of different antivirals that could potentially help treat this disease until we do have a vaccine. I have a feeling that, you know, although we talk about it in the United States, the research may be going on elsewhere, like in Germany, for example, or in, or in Asia. And, you know, it may, it may pop up there as a success there. Maybe we don't have the same kind of FDA requirements to know it's easier to do it. The other thought is that most of, most of the drugs on the market today are made outside the US. So when you get to the manufacturing stage, we may have to rely on other countries to manufacture for us. Yeah. That's, that's right. They're people working worldwide, certainly, certainly in Europe and in China and, you know, throughout the world, different laboratories and companies and scientists, you know, attacking this from a multi-pronged approach. Are you working on it actually, Sarah? No, I am not working on it. I work on a number of human genetic diseases, not viral diseases, helped identify the genes for dwarfism and Huntington's disease and muscular dystrophy. And so my focus really has been on human genetic diseases, so hereditary diseases. I certainly know a lot about genetics, of course. Of course. Can you tell, before we go, can you tell us about your book? Yeah. I wrote a work of fiction. I've written lots and lots of scientific articles, but a number of years ago I actually was diagnosed with ovarian cancer. I'm completely fine now, but at the time I thought, okay, I'm going to take on a new challenge and write a mystery novel. So it's a mystery thriller about a forensic geneticist in Iceland that uses the national DNA database to solve crimes, including that of her young brother that disappeared and she ends up in a world of trouble. And it's called double-blind, which is scientific term, double-blind the Icelandic manuscript murders. I've got to see it. I visited Iceland last year and I've got to see it. Yeah. There's not any about Iceland. Sarah Winiker, a geneticist who has helped us understand so many aspects of coronavirus. Thank you so much for appearing on Sync Tech, Sarah. Thank you, Jay. It was a pleasure. Aloha.