• Arwa Hanin Elrayess

Why Some Are More At Risk Than Others: Surprising Facts You Didn’t Know About COVID-19

During a time of great economic vulnerability and political instability, the coronavirus (also known as COVID-19) has forced us all to the edge of our seats.

Unsurprisingly, the media, as well as governmental officials, have been quick to jump to conclusions.

Chinese internet chat rooms have speculated that the virus was manufactured in America to damage the Chinese economy, whilst a U.S. Republican Senator, with presidential ambitions, has suggested that it was spawned by a bio-weapons program in a government laboratory in Wuhan.

And even though these conspiracies seem overly far-fetched, the virus does display a strangely specific trend in the groups it targets.

Collected data has shown that males, those above the age of 35, the sick, the elderly and (surprisingly) Asians are at a higher risk of contracting the disease, and/or dying from it.

But data is never black and white and can always be manipulated to show things that it may not necessarily mean. So, in this article, I wanted to verify, or debunk, some of the widely advertised claims, by seeing if they had any scientific basis.

However, the terminology can become quite confusing, so here’s a simple breakdown of everything you’ll need to comfortably understand this article:

Moving on...

Simple science: what COVID-19 is, and how it infects us...

COVID-19 is the third known coronavirus disease after SARS and MERS that normally exists in animals but can infect humans.

The virus has a single strand of RNA, which contains all the necessary information for it to replicate and survive. This strand is surrounded by a layer of surface proteins.

Like all other viruses, COVID-19 cannot replicate or survive on its own. So, using its layer of surface proteins, it connects to ‘receptors’ on specific living cells, like a puzzle piece. Then, using the functions of these living cells, the virus begins its life cycle: replicating itself and infecting other cells.

Although the virus is more commonly spread through bodily fluids, recent studies have shown that it can survive on non-living surfaces for up to 9 days, meaning that you can catch the disease from coming in contact with ‘contaminated’ objects.

How does it kill us?

Unlike other forms of viruses, COVID-19 is capable of invading deep into our lungs.

Scientists have predicted that this is due to the virus attaching itself to something called ‘ACE-2 receptors’ found on the outer layer of certain cells, which complete the viruses’ puzzle piece.

These receptors are present in ‘ciliated epithelial cells’ located in the upper and lower airway of the lungs, as well as in cells that reside in the alveoli and produce lung-lubricating proteins.

When the virus connects to these vital cells, in severe cases, pneumonia is caused. Severe lung damage from pneumonia can result in acute respiratory distress syndrome (ARDS), which in turn can cause septic shock.

ARDS and septic shock are the main causes of death from COVID-19.

The Science Behind ‘Superspreaders': Are they real?

News sources have been advertising a phenomenon called the ‘coronavirus super-spreaders.' (Individuals who have been able to infect tens of people in just a matter of days.)

And although this sounds like something straight from a science-fiction novel, there are fairly simple explanations behind it.

For example, some people, through no fault of their own, produce larger-sized respiratory droplets when they speak, breathe or talk. The size of these droplets can largely affect how they travel through the air, and how likely they are to reach, and infect, another person.

Similarly, your social relationships (how many people you meet a day and come in direct contact with) can certainly increase the number of people you may infect.

And even though genetics, previous strength of immunity and the level of exposure to the virus can also increase how many people you infect, the term “superspreaders” is misleading and unhelpful.

At the moment, there isn’t any evidence to suggest there is a variation in how people spread COVID-19.

In simple terms, it’s not the person, it’s the situations they are placed in on a day-to-day basis.

Why Are Elders More At Risk Than Children?

In many outbreaks, it’s the elderly and the very young who are particularly vulnerable.

But that trend doesn’t seem to hold up with this coronavirus.

Instead, there are fewer confirmed cases and outbreak-related deaths in children than expected.

Unfortunately, we still don’t know exactly why that is.

But, some scientists have predicted that it may be because the virus is unable to replicate in children as well as in adults. Or that children have immunity, from previous and related infections.

What we can be certain of, however, is that there is a threshold.

Below the age of 35, we're seeing practically zero cases, and a death rate of 0.2%, compared to a significant number of deaths from the ages of 40-80.

Here is the link to a full chart, comparing the rate of death in different age groups.

As of today, the only reasonable explanation for this is the declining health and underlying illnesses in older individuals.

Why Are Those With Underlying Illnesses At A Higher Risk?

While less than 1 percent of people who were otherwise healthy died from the disease, the fatality rate for people with cardiovascular disease was 10.5 percent. That figure was 7.3 percent for diabetes patients and around 6 percent for those with chronic respiratory disease, hypertension, or cancer.

This may be due to the overproduction of 'cytokines.'

In healthy patients, immune cells in the vicinity are recruited to eradicate the virus when it reaches their airways.

However, some—especially the elderly and sick— have dysfunctional immune systems that fail to keep their immune response in check.

This could cause an overproduction of immune cells, leading to a ‘cytokine storm’ often associated with a lot of really severe inflammatory disease conditions like pneumonia, shortness of breath, inflammation of the airways, and so forth.

The risk may also be higher in diabetics as diabetes causes chronic inflammations. These inflammations prompt a low, but sustainable, production of those same cytokines.

Why Males Are More At Risk Than Females, and Why Asian Males Are Most At Risk:

Of course, stating that ‘males are more at risk than females’ is a bold claim that completely depends on the percentage of both genders which have been exposed to this virus.

However, data has repeatedly shown that, while the infection rate among men and women is the same, the death rate among men is 2.8% compared with 1.7% for women.

And there may be scientific evidence as to why.

The ACE-2 receptor needed for COVID-19 to infect us is found more prominently in male alveolar cells than females, making it easier for the virus to infect cells deeper in the lungs of males.

What’s even more unusual is that Asians have a higher level of 'ACE-2' expression in their alveolar cells than the white and African American populations.

This may explain why the virus has a wider, and more vicious, infection rate in Asian countries, compared to infected European or African ones.

Nevertheless, the increase of cases in Asian males, and males in general, may also be due to the larger number of male smokers compared to female. An estimated 47.6% of Chinese males smoke, compared to only 1.8% of Chinese women.

Women also generally mount stronger immune responses than men.

In Conclusion...

Ultimately, at this rate, some scientists have predicted that by the end of 2020, 40%-70% of the World’s population will encounter Covid-19.

80% of those infected will show mild symptoms. Out of the remaining 20%, 17% will show more severe symptoms and survive, whilst the remaining 3% will be at risk of death.

Despite this, however, COVID-19 should not bring our lives to a standstill.

Health organizations and officials have repeatedly advised against panic and stress since all that will be achieved is instability amongst communities.

Instead, the best thing you can do to keep yourself, and your loved ones, safe it to simply stick to the basics. Such as: washing your hands, coughing into your sleeves and keeping away from close contact and crowded areas.

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