Welcome back, head banging homebodies! I have returned with another list of disease-themed metal to cradle your cochlea, in hopes to teach some epidemiology along the way. Like many of us, you may be experiencing a perpetual state of melancholy the likes of which can only be matched by the droning, downtempo, despondent din of doom metal. This playlist has 10 songs, about an hour long – which is quick for a doom metal list, and it veers into sludge and stoner metal territory at times. At the bottom of the article, you will find a glossary of bolded terms. This is the second part in a series. if you missed part one, check it out here.
The Plague by Holy Serpent
Last time, we pointed out some of the differences between COVID-19 and the plague: COVID-19 is a respiratory disease caused by a virus, while plague was a vector-borne disease caused by a bacterium. However, an interesting interaction can occur between pandemics, even those caused by different pathogens centuries apart. For example, susceptibility to HIV is influenced by a human mutation called CCR5-Δ32, which arose around 2,500 years ago. Some research suggests that this mutation was selected for through repeated epidemics of either bubonic plague or smallpox in Europe. A group of researchers are conducting a study to find out whether the variation we see in symptom severity in COVID-19 has a genetic underpinning, and maybe we’ll learn if this pandemic has a historical precedent.
The Strain by Beastmaker
On March 3, a publication suggested that there were two strains of SARS-CoV-2 circulating, calling them the S strain and L strain, and claimed that they vary in their infectiousness. Two days later a debate ensued, and since this claim has been largely debunked by the virology community. This points out how rapidly the process of science communication moves in the context of this pandemic, and how difficult it can be to tease apart reliable and unreliable sources.
Inhale by Krypts
We are hearing a lot of talk about masks in the news: under what circumstances they are effective, how often you should wear them, whether or not the government can force you to wear them, etc. New research how shown that infectious SARS-CoV-2 particles can survive in aerosol form for up to 16 hours. That is, it can remain airborne and potentially infect people via inhalation. All the more reason to follow CDC guidelines and wear a mask in public whenever possible.
Laboratory of Nightmares by Hooded Menace
Although everything may seem like a chaotic nightmare right now, laboratories studying COVID-19 are under strictly regimented protocols to ensure the safety of researchers. In fact, working with any infectious agent falls under designations called biosafety levels or BSL, of which there are four. BSL-1 and BSL-2 laboratories can be found in nearly every hospital and university. BSL-3 laboratories work with microbes that can cause potentially lethal diseases like tuberculosis, SARS, MERS, COVID-19, and West Nile Virus. BSL-4 labs work with potentially lethal, aerosol-transmitted diseases with no available vaccine or treatment like Ebola, Marburg Virus, and Rift Valley Fever. There are currently 13 BSL-4 labs in the US, including the CDC, many using positive pressure suits, airlocks, and thorough decontamination techniques. Oh, and speaking of laboratories, here is some new evidence to remind you that SARS-CoV-2 was not created in a laboratory in China.
Lyssavirus by Cough
A playlist inspired by a pandemic of respiratory disease must include a song by Cough. Lyssavirus is the group of viruses that includes Rabies. Although Rabies virus and SARS-CoV-2 are different in many ways, they are both single-stranded RNA viruses, which means that their genetic code exists on a single strand of nucleotides (the “alphabet” that makes up the genomes of all of life on Earth). Viral RNA can be rapidly encoded into proteins in the host cell, though coronaviruses and Lyssaviruses achieve this goal with different molecular machinery. RNA viruses have exceptionally high mutation rates, and historically many have worried about their risk as candidates for the next global pandemic.
Coma by Grief
In severe COVID-19 cases, patients have such a hard time breathing that they are put on ventilators which move air in and out of the lungs mechanically. Before the use of a ventilator, patients are put under a medically-induced coma which can last many days and potentially have long term effects (see description for song #9).
Doldrums… by Sourvein
Doldrums: a period of inactivity or stagnation. That seems to describe many of our lives right now. For those of us that were not deemed essential workers, we have either been working from home or have been laid off for weeks on end. Days seem longer, and it is difficult to find motivation. One of the underlying causes of this malaise is moral fatigue. This phenomenon has traditionally been applied to emergency medical professionals, who are faced with a seemingly never-ending deluge of high intensity, highly emotional decisions that have a profound impact on wellbeing. Now, our lives have changed in countless ways and mundane daily decisions feel like moral quandaries. Activities likes grocery shopping, visiting family members, and using public transit are riddled with fear and uncertainty. Many people spend hours daily thinking about death rates, family members in high-risk categories, and the uncertain future of employment and public events. This is exhausting, and can cause fatigue, anxiety, and reduced productivity.
Queen of Sickness by Acid King
The first human coronavirus was identified and described by Dr. June Almeida in 1964. Dr. Almeida was a virologist and pioneer in using a technique called electron microscopy to visualize viruses. Apparently, her original publication describing the first coronavirus was rejected “because the referees said the images she produced were just bad pictures of influenza virus particles.” She and a group of researchers coined the term coronavirus because of the crown or halo surrounding the viral particles in the micrograph.
Healing Process by Servants of the Mist
Due to shortages in testing, we currently don’t know the exact recovery rate for patients with COVID-19, but it is likely over 97%. Overall, that sounds like good news, and it is certainly better than the recovery rates of SARS in 2001 and MERS in 2012. However, death is not the only outcome to fear. COVID-19 can cause debilitating morbidity, and patients that recover from severe disease can be left with scarred lungs, prolonged inflammation that can leave patients at greater risk of heart attack and stroke, and delirium that can lead to long-term cognitive deficits. Patients with extreme symptoms that are placed on ventilators can have even more hurdles to recovery.
Return Again by Forming the Void
How or when will we return to normal? There are protests across the USA to “re-open the country” because many populations appear to have passed the peak of their infection curve. Prematurely removing interventions like social distancing, however, may simply release a giant wave of susceptible hosts back out into a well-mixed population and incur a second wave of infection cases. This will likely send us right back into reactionary social distancing, probably with more restrictions than during the first wave. A 2007 study found that similar pattern played out in the 1918 Flu Pandemic. There is no way to predict precisely how long we need to engage in social distancing, but Erin Mordecai, a disease ecologist at Stanford, and her team developed an interactive model for testing the effects of interventions like social distancing on disease dynamics. Go check it out, throw on a good playlist, and find out for yourself!
SPREAD THE MUSIC, NOT THE VIRUS!
The preceding was a guest post from Nick Keiser, an assistant professor of behavioral disease ecology at the University of Florida. His lab studies how animal behavior influences infectious diseases in animals like spiders, ants, mites, and flies. Follow him on Twitter at @HiDrNic for more metal-laden disease content.
Glossary
Biosafety level: A four-tiered system for assigning safety regulations for laboratories studying infectious agents of disease.
Electron microscopy: A technique used to visualize structures with magnifications up to 10,000,000x. Unlike traditional light microscopes, electron microscopy uses a beam of accelerated electrons to visualize structures.
Moral fatigue: An overwhelming feeling of powerlessness in response to a long series of moral decision-making, often resulting in fatigue, anxiety, and reduced productivity.
Morbidity: Illnesses or debilitations associated with a disease.
RNA Virus: Viruses whose genomes are encoded with RNA, which can be translated into proteins in the host cell more rapidly than DNA viruses.
Selection: The process by which alleles (produced by mutations and other genetic processes) become more prominent in future generations. If a mutation confers some benefit, that organism may produce more offspring than a competitor that lacks the traits associated with the beneficial mutation.
Strain: A genetic variant of a microorganism like a virus, which can have different characteristics like virulence, transmissibility, and mechanisms for evading host resistance.
Vector-borne disease: A disease caused by parasites that are transmitted between hosts by a vector, often biting arthropods like mosquitoes, ticks, and fleas.
