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How the COVID-19 Coronavirus Attacks the Entire Body
Of course, the lungs and airways are the main focus of attention with the COVID-19 respiratory disease. Since the new SARS-CoV-2 pathogen mainly attacks the lower respiratory tract, infected persons who experience a moderate or severe course of the disease have a dry cough, shortness of breath and/or pneumonia.
However, there are now numerous indications that the new coronavirus also attacks other organs on a massive scale and can severely affect the heart, blood vessels, nerves, brain, kidneys and skin.
Several studies and papers from countries including the US, China and Italy suggest that SARS-CoV-2 also attacks the heart. The evidence is based not only on the significantly higher mortality of COVID patients with cardiovascular diseases and high blood pressure: Several studies have also shown that patients with severe courses of the disease often had elevated blood biomarkers released by destroyed and dying heart muscle cells. In many previously healthy patients, the virus infection has been shown to cause myocarditis, or inflammation of the heart muscle.
Whether the new coronavirus SARS-CoV-2 itself causes this damage to the heart or — as seems more likely — the harm is done by the immune reactions triggered by the infection remains to be seen. However, acute heart damage has also occurred in the past in some SARS and MERS patients, and these SARS-CoV and MERS-CoV pathogens are very closely related to the current coronavirus SARS-CoV-2.
During the COVID-19 disease, the lung is massively attacked, but the damage doesn't always stop there: Many recovered patients have presented partially reduced lung function as a late consequence. Chinese researchers have found a milky glass-like cloudiness in the lungs of some people who have recovered from COVID-19, which suggests permanent organ damage has occurred. Further investigations must now show whether the patients have developed pulmonary fibrosis, in which the connective tissue of the lung becomes inflamed.
This makes it harder for oxygen to reach the blood vessels, stiffens the lungs and makes breathing shallow and rapid. Respiratory disorders, shortness of breath and a dry, irritable cough are the consequences; physical performance decreases and even everyday activities become difficult.
Pulmonary fibrosis cannot be cured because the scarred changes in the lung tissue do not regress. But the progression of the condition can be delayed and sometimes even stopped if it is detected in time.
During the autopsy of deceased COVID-19 patients, pathologists at the University Hospital of Zurich discovered that in some of them the entire cell layer on the inside of the blood and lymph vessels (endothelium) of various organs was inflamed.
The researchers concluded that the novel coronavirus SARS-CoV-2 leads to a generalized inflammation in the endothelium via ACE2 receptors. This could lead to severe microcirculatory disturbances that damage the heart and cause pulmonary embolism and vascular occlusion in the brain and intestinal tract. As a result, multiorgan failure occurs, which can often lead to death.
In more than 80% of COVD-19 patients, a disturbance of the senses of taste and smell is observed. Such ageusia or anosmia occurs at the very beginning of the infection, and COVID-19 can be diagnosed early on the basis of these symptoms. This is because in a normal flu-like infection, which is triggered by adenoviruses, the olfactory and taste disorders occur only at an advanced stage of the disease.
This seemingly banal observation shows, however, that in many patients the nervous system is also affected by the novel coronavirus SARS CoV-2. This is because the olfactory nerve leads from the nasal mucosa through the skull bone directly into the brain. Researchers from Belgium found out that the nerve cells serve as a gateway for the virus into the central nervous system.
The earlier coronavirus infections MERS and SARS already showed a similar penetration of the viruses via the nerves into the brain. When a patient in Japan infected with the new coronavirus showed signs of epileptic seizures, he was diagnosed with meningitis caused by the new coronavirus, which had penetrated the central nervous system.
Researchers from Japan and China therefore fear that in some people, the pathogen penetrates into the brain stem and damages the respiratory center there. This might explain why older COVID-19 patients, in particular, sometimes stop breathing without having previously experienced massive breathing problems due to the lung infection. It is still unclear whether SARS-CoV-2 also causes or promotes strokes.
If COVID-19 patients with pneumonia need to be ventilated, this can also damage the kidneys. Acute kidney failure often occurs. Because pneumonia often causes a lot of fluid to accumulate in the lungs, patients are given a drug that removes fluid from the body. However, this reduces the blood supply to the kidneys, and they can no longer fulfill their cleansing function.
In addition, the blood coagulates faster in severe COVID-19 disease. As a result, blood clots can easily form, blocking the blood vessels and often also the kidneys. Small infarctions in the kidney tissue have been observed in numerous patients.
In about 30% of these patients, the kidneys are acutely restricted to such an extent that they require dialysis. It is not clear yet whether the kidneys heal after the patients recover or whether SARS-Cov-2 triggers long-term damage to the organs.
The novel coronavirus SARS CoV-2 also appears to cause visible damage to the largest organ of the human body, the skin. There are reports from several countries that COVID-19 patients showed significant skin lesions.
Small dermatological lesions on the feet have occurred particularly in children and young people. These purple patches resembled those caused by measles, chickenpox or chilblains. On the toes, the lesions usually resembled frostbite or formed reticular patterns, normally caused by blood clots in small blood vessels. Sometimes, however, marks, redness and hives-like rashes have also been observed on other parts of the body.
It is possible that the bluish discoloration of the skin is due to pathological blood clotting, which could also be caused by the novel coronavirus.
Reposted with permission from Deutsche Welle.
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Waste Mountain<p>The need for a dramatic increase in Australia's recycling capacity pre-dates the COVID-19 pandemic. <a href="https://www.abc.net.au/news/2019-12-27/where-does-all-australias-waste-go/11755424" target="_blank">Australians create approximately 67 million tons of waste a year</a>, and like in many wealthy countries, much of that was sent overseas. That all changed when China announced it was <a href="https://www.weforum.org/agenda/2017/10/china-has-banned-foreign-waste-so-whats-the-future-of-world-recycling" target="_blank">banning the import of a huge range of foreign waste</a> and recyclables. Soon <a href="https://www.weforum.org/agenda/2019/05/malaysia-flooded-with-plastic-waste-to-send-back-some-scrap-to-source" target="_blank">other countries followed suit</a>, and Australia was forced to look for alternative solutions.</p>
Biggest exporters of plastic. Statista
Waste Export Ban<p>Australia has adopted a strategy of taking responsibility for its own waste. Starting in January 2021, it is phasing in <a href="http://www.environment.gov.au/protection/waste-resource-recovery/waste-export-ban" target="_blank">bans on the export of different forms of waste</a>. By mid 2024, Australia's home-grown recycling industry will have to deal with an extra 650,000 tons of waste plastic, paper, glass and tires.</p><p>"As we cease shipping our waste overseas, the waste and recycling transformation will reshape our domestic waste industry, driving job creation and putting valuable materials back into the economy," federal environment minister Sussan Ley said in a <a href="https://uk.reuters.com/article/us-australia-waste/australia-to-set-up-132-million-fund-to-boost-recycling-following-export-curbs-idUKKBN247060" target="_blank">statement to Reuters</a>.</p>
Timeline for Australia's waste export ban. Australian Government
Trash Into Treasure<p>The benefits to the environment of boosting recycling rates are well known – less landfill, less plastic in our ocean, reduced need for virgin materials, and lower carbon emissions. The Recycling Modernization Fund initiative aims to divert more than 10 million tons of waste from landfill, part of an <a href="http://www.environment.gov.au/protection/waste-resource-recovery/publications/national-waste-policy-action-plan" target="_blank">overall strategy to reduce the total waste generated per person by 10%</a>, and push <a href="https://www.environment.gov.au/system/files/resources/7381c1de-31d0-429b-912c-91a6dbc83af7/files/national-waste-report-2018.pdf" target="_blank">Australia's total resource recovery rate from 58% in 2017</a> to 80% by 2030.</p><p>But like many countries, Australia is focusing on the economic benefits of better waste management as well.</p><p>"This will mean Australia converts more waste into higher valued resources ready for reuse locally by manufacturers and brands in their packaging and products," Rose Read, CEO of the National Waste and Recycling Industry Council, <a href="https://uk.reuters.com/article/us-australia-waste/australia-to-set-up-132-million-fund-to-boost-recycling-following-export-curbs-idUKKBN247060" target="_blank">told Reuters</a>.</p>
Green Jobs<p>The great potential of the circular economy to create green jobs is being recognized across the world.</p><p>In the UK, the Waste and Resources Action Program has launched a <a href="https://wrap.org.uk/buildbackbetter" target="_blank">six-point plan which it claims could add $90 billion to the economy, and create 500,000 new jobs</a>. Investment in the circular economy forms a significant part of the <a href="https://www.nytimes.com/2020/07/14/us/politics/biden-climate-plan.html" target="_blank">$2 trillion climate plan that Democratic candidate Joe Biden</a> is taking into November's US presidential election. And the <a href="https://ec.europa.eu/commission/presscorner/detail/en/ip_20_940" target="_blank">European Union has put its Green New Deal at the heart of its plans for recovery</a> from the economic shock of COVID-19.</p><p>The World Economic Forum's <a href="http://www3.weforum.org/docs/WEF_The_Future_Of_Nature_And_Business_2020.pdf" target="_blank">Future of Nature and Business</a> report identifies 15 systemic transitions with annual business opportunities worth $10 billion a year that could create 395 million jobs by 2030.</p><p>As is the case with Australia's Recycling Modernization Fund, a combination of private enterprise and government investment can offer ways to get people back to work by building a more environmentally sustainable economy.</p>
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By Andrew J. Whelton and Caitlin R. Proctor
In recent years wildfires have entered urban areas, causing breathtaking destruction.
Survivors left everything to flee the Camp Fire's path. Andrew Whelton / Purdue University
Wildfires and Water<p>Both the Tubbs and Camp fires destroyed fire hydrants, water pipes and meter boxes. Water leaks and ruptured hydrants were common. The Camp Fire inferno spread at a speed of one football field per second, chasing everyone – including water system operators – out of town.</p><p>After the fires passed, testing ultimately revealed widespread hazardous drinking water contamination. Evidence suggests that the toxic chemicals originated from a combination of <a href="https://doi.org/10.1002/aws2.1183" target="_blank">burning vegetation, structures and plastic materials</a>.</p>
Pipes, water meters and meter covers after wildfires destroyed them. Caitlin Proctor, Amisha Shah, David Yu, and Andrew Whelton/Purdue University
Dangerous Contamination Levels<p>Benzene was found at concentrations of 40,000 parts per billion (ppb) in drinking water after the Tubbs Fire and at more than 2,217 ppb after the Camp Fire. According to the California Office of Environmental Health Hazard Assessment, children exposed to benzene for a single day can suffer <a href="https://engineering.purdue.edu/PlumbingSafety/resources/Benzene-Levels-in-Water.pdf" target="_blank">harm at levels as low as 26 ppb</a>.</p><p>The U.S. Environmental Protection Agency recommends limiting children's short-term acute exposure to <a href="https://www.epa.gov/sites/production/files/2018-03/documents/dwtable2018.pdf" target="_blank">200 ppb</a>, and long-term exposure to less than <a href="https://www.epa.gov/ground-water-and-drinking-water/national-primary-drinking-water-regulations" target="_blank">5 ppb</a>. The EPA regulatory level for what constitutes a hazardous waste is <a href="https://19january2017snapshot.epa.gov/sites/production/files/2015-06/documents/tclp.pdf" target="_blank">500 ppb</a>.</p><p>In early 2019, California conducted contaminated water testing on humans by taking contaminated water from the Paradise Irrigation District and asking persons to smell it. The state found that even when people smelled contaminated water that had less than 200 ppb benzene, <a href="https://engineering.purdue.edu/PlumbingSafety/resources/Dissipatiion-of-Burn-Related-VOC-From-Water.pdf" target="_blank">at least one person reported nausea and throat irritation</a>. The test also showed that water contained a variety of other benzene-like compounds that first responders had not sampled for.</p><p>The officials who carried out this small-scale test did not appear to realize the significance of what they had done, until we asked whether they had had their action approved in advance by an institutional review board. In response, they asserted that such a review was not needed.</p><p>In our view, this episode is telling for two reasons. First, one subject reported an adverse health effect after being exposed to water that contained benzene at a level below the EPA's recommended one-day limit for children. Second, doing this kind of test without proper oversight suggests that officials greatly underestimated the potential for serious contamination of local water supplies and public harm. After the Camp Fire, together with the EPA, we estimated that some plastic pipes needed <a href="https://engineering.purdue.edu/PlumbingSafety/opinions/Final-HDPE-Service-Line-Decontamination-2019-03-18.pdf" target="_blank">more than 280 days</a> of flushing to make them safe again.</p>
Plastic pipes can be damaged by heat and fire contact. Andrew Whelton / Purdue University
Building Codes Could Make Areas Disaster-Ready<p>Our research underscores that community building codes are inadequate to prevent wildfire-caused pollution of drinking water and homes.</p><p>Installing one-way valves, called backflow prevention devices, at each water meter can prevent contamination rushing out of the damaged building from flowing into the larger buried pipe network.</p><p>Adopting codes that required builders to install fire-resistant meter boxes and place them farther from vegetation would help prevent infrastructure from burning so readily in wildfires. Concrete meter boxes and water meters with minimal plastic components would be less likely to ignite. Some plastics may be practically impossible to make safe again, since all types are susceptible to fire and heat.</p><p>Water main shutoff valves and water sampling taps should exist at every water meter box. Sample taps can help responders quickly determine water safety.</p>
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="9540d7e271306ed417112042a3efc9a4"><iframe lazy-loadable="true" src="https://www.youtube.com/embed/GnlrzI1wdAI?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
The Smell Test Doesn’t Work<p>Under no circumstance should people be told to <a href="https://www.waterboards.ca.gov/press_room/press_releases/2018/pr122418_voc.pdf" target="_blank">smell the water</a> to determine its safety, as was recommended for months after the Camp Fire. Many chemicals have no odor when they are harmful. Only testing can determine safety.</p><p>Ordering people to boil their water will not make it safe if it contains toxic chemicals that enter the air. Boiling just transmits those substances into the air faster. "Do not use" orders can keep people safe until agencies can test the water. Before such advisories are lifted or modified, regulators should be required to carry out a full chemical screen of the water systems. Yet, <a href="https://doi.org/10.1002/aws2.1183" target="_blank">disaster</a> after <a href="https://pubs.rsc.org/en/content/articlehtml/2017/ew/c5ew00294j" target="_blank">disaster</a>, government agencies have failed to take this step.</p><p>Buildings should be tested to find contamination. <a href="https://www.purdue.edu/newsroom/releases/2020/Q1/study-your-homes-water-quality-could-vary-by-the-room-and-the-season.html" target="_blank">Home drinking water quality can differ from room to room</a>, so reliable testing should sample both cold and hot water at many locations within each building.</p><p>While infrastructure is being repaired, survivors need a safe water supply. Water treatment devices sold for home use, such as refrigerator and faucet water filters, are not approved for extremely contaminated water, although product sales representatives and government officials may <a href="https://undark.org/2019/09/19/camp-fire-california-drinking-water-carcinogens/" target="_blank">mistakenly think</a> the devices can be used for that purpose.</p><p>To avoid this kind of confusion, external technical experts should be called in assist local public health departments, which can quickly become overwhelmed after disasters.</p>
<div id="71cf9" class="rm-shortcode" data-rm-shortcode-id="e059d199e8368d282a31601e372e4dda"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1204068265980547075" data-partner="rebelmouse"><div style="margin:1em 0">The Los Angeles City Council's Planning and Land Use Committee signed off on an effort to expand the city's fire-re… https://t.co/fP8Z8mUq7R</div> — IntlCodeCouncil (@IntlCodeCouncil)<a href="https://twitter.com/IntlCodeCouncil/statuses/1204068265980547075">1575907219.0</a></blockquote></div>
Preparing for Future Fires<p>The damage that the Tubbs and Camp fires caused to local water systems was preventable. We believe that urban and rural communities, as well as state legislatures, should establish codes and lists of authorized construction materials for high-risk areas. They also should establish rapid methods to assess health, prepare for water testing and decontamination, and set aside emergency water supplies.</p><p>Wildfires are coming to urban areas. Protecting drinking water systems, buried underground or in buildings, is one thing communities can do to prepare for that reality.</p>
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