by Dr. Bill Blank, MD
Published in Midwest Flyer – October/November 2020 issue
COVID-19 (COronaVIrusDisease19) first appeared in late 2019. Since then it has caused a pandemic. It is classified as a corona virus. Corona is Latin for crown. Under the electron microscope, it looks somewhat like a crown with thorns, thus the name. Its official name is SARS-CoV-2. SARS stands for Severe Acute Respiratory Syndrome.
Viruses are not alive. They are little pieces of genetic material, DNA or RNA, surrounded by a protein coat. They are quite clever. They attach to the surface of the cell under attack, penetrate and enter the cell. They, then take over the cell’s metabolic machinery and trick the cell into making thousands of copies of themselves. Eventually, so many copies are made that the cell often dies and the copies are released to attack other cells, either of the host or someone else.
COVID-19 is a respiratory virus. That means that it attacks the lungs. The major path of infection is by being inhaled. The infected person exhales into the atmosphere where it can be inhaled by someone else. In order to cause disease, there must be enough viral particles per cubic foot of air and enough air must have been inhaled. One CDC definition of close contact is being within 6 feet of an infected individual for 15 minutes. The infected person only exhales viruses for two weeks. That is the basis for the recommended two-week self-quarantine. Other viral diseases include Polio, Measles, Mumps, Smallpox, Chickenpox, Herpes, Rubella, Hepatitis, Influenza, and the Common Cold, which is caused by a different Coronavirus. Vaccines have been developed to prevent some of these diseases.
There are over 100 Coronaviruses, only a few of which cause human disease.
COVID-19 has caused so much trouble because it can cause serious illness and death and we do not yet have a specific, effective antiviral treatment for it.
The first antibiotic, Penicillin, was discovered in 1928. Antibiotics treat specific bacterial diseases. Since 1928, we have discovered and developed many antibiotics. We have developed very few specific antivirals. We’ve had some antiviral medication success with Herpes, HIV, Hepatitis, Influenza and Ebola. This leaves us with supportive and non-specific treatments for COVID-19. Dexamethasone, convalescent plasma containing antibodies to COVID-19, and Remdesivir, a broad-spectrum antiviral, have been somewhat helpful.
What will end the pandemic? Perhaps, when enough people develop herd immunity, either from having had the disease or a successful vaccination, the virus will be unable, statistically, to find enough new victims to continue the spread. Another possibility is that quarantining will be effective.
I think there is reason for hope. Our scientific research is highly developed and never has been better. Many research organizations are looking at various vaccine options. More than one approach may be successful. Some are already in testing.
Official weather forecasts started in 1860. Over the years, they have gradually improved. This success is due to improved technology, along with many more data points, including satellite and radar observations.
How long have we been trying to predict the course of viral pandemics? When this first started, we were unable to test anyone who wasn’t ill. We didn’t know and still don’t know how many people in the population have been exposed and had no symptoms or mild symptoms not requiring them to seek medical attention. Our lack of good data greatly decreases the accuracy of our forecasts. The last I read suggests that the death rate is now thought to be between 0.5% and 1.0%.
It doesn’t look like the pandemic will end until a vaccine has been developed and is widely available. In the meantime, there are two goals: First, not to become infected ourselves, and second, if we are infected, not to infect anyone else.
How can we best accomplish this? Avoid Close Contact. Stay at least 6 feet away from anyone who is sick or has symptoms. Wear a Face Mask in Public Places, especially indoors in confined places. Do your own risk assessment. If you are in an area which is crowded or people aren’t wearing face masks, leave and return later or go elsewhere. Wash Your Hands Frequently. Stay Home If You Are Sick.
As a pilot, in choosing your passengers, you are probably going to want to use the same criteria you use to decide who rides with you in your car. I am confident a vaccine will be found, but it will take time. Until then, be vigilant.
If, in spite of precautions, you do catch COVID-19, can you be certified?
The FAA recently notified Aviation Medical Examiners (AMEs) that they are evaluating the situation. If you have made a complete recovery, your AME should be able to certify you. If you were hospitalized, your AME will probably want hospital records, along with a current status report including pulmonary function tests. I don’t expect a definitive policy for quite a while as the FAA evaluates research results. Hopefully, few of us will need this. Meanwhile, stay healthy and fly safely!
EDITOR’S NOTE: William A. Blank is a physician in La Crosse, Wisconsin, and has been an Aviation Medical Examiner (AME) since 1978, and a Senior AME since 1985. Dr. Blank is a retired Ophthalmologist, but still gives some of the ophthalmology lectures at AME renewal seminars. Flying-wise, Dr. Blank holds an Airline Transport Pilot Certificate and has 5600 hours. He is a Certified Instrument Flight Instructor (CFII) and has given over 1200 hours of aerobatic instruction. In addition, Dr. Blank was an airshow performer through the 2014 season and held a Statement of Aerobatic Competency (SAC) since 1987.
DISCLAIMER: The information contained in this column is the expressed opinion of the author only, and readers are advised to seek the advice of others and refer to the Federal Aviation Regulations and FAA Aeronautical Information Manual for additional information and clarification.