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Coronavirus: Perspectives and Woad Is Me

2019-nCoV

Image by Jay Javier (flickr/cooey), CC BY-NC-ND 2.0

The latest coronavirus, which was officially declared this past New Year’s eve, is actually the third one of its kind. The first coronavirus was the severe acute respiratory syndrome (SARS) outbreak in 2002; the second, the Middle East respiratory syndrome (MERS) in 2012. While coronaviruses are responsible for the majority of common colds, these three are distinct because they were transmitted to us from another species.

This outbreak is suspected of originating in bats and was first labelled 2019-nCoV—short for novel coronavirus (novel, because it’s a new strain never before seen in humans). The World Health Organization (WHO) has updated the name to COVID-19. [Here, I’ll use the names interchangeably, either based on the source or for prosaic flow.]

Because this is a new virus, we lack historical data. So any conclusions drawn from what we do know seem to evolve in real-time; and the statistics discussed here may soon be revised. However, let’s get some perspective on current statistics.

99%

Ninety-nine percent of global laboratory-confirmed cases have occurred in China, based on WHO Situation Report-27 dated 2/16/20.

All other cases seem to have been exported from China. So, travel within China or contact with someone who has traveled within China is the biggest risk factor. While “contact” is a loose term, based on six degrees of separation, at least all the U.S. cases tested by the CDC seem to fit the risk profile. Specifically, 5% of the U.S. cases were found to be positive for COVID-19.

[Update, 2/18/20: According to the WHO Situation Reports, there was an almost 38% jump in global cases from 2/16/20 to 2/17/20. The large increase is attributed to a less restrictive inclusion criteria that now adds clinically diagnosed cases rather than just the laboratory-confirmed. Therefore, the new numbers are more conservative. The 99% statistic remains valid.]

3%

The fatality rate for 2019-nCoV is 3%.

This rate is less than that of the other coronavirus outbreaks. SARS and MERS had death rates of 10% and 40%, respectively; and those outbreaks barely put a dent in our memory. This too will pass. But to be fair, as the world actively responds to the ongoing outbreak, that rate can change by significant degrees.

1.4-5.5

Another value to look at is the basic reproduction number, R0 (“R naught”). This is the average number of people that a contagious person can be expected to infect. For 2019-nCoV, R0 ranges from 1.4-5.5. Generally, an R0 >  1 increases the risk of an epidemic. But to put it into perspective, the MERS R0—that had a death rate of 40%—was less than 1.

SARS had a similar R0 range of 2-5.

SARS 2.0

COVID-19 is similar to SARS in that they invade our cells via the same receptor protein, ACE2. So, the current assumption is that they will behave the same. This assumption is supported by their similar R0 values.

Based on the pathogenetic similarities between COVID-19 and SARS, there is speculation that we may benefit from SARS prevention measures.

During the SARS outbreak in 2002/03, Traditional Chinese Medicine hospitals in China were using woad root (Isatis indigotica) for the treatment or prevention of SARS. The clinical basis was that woad root is a well-established anti-viral in Chinese medicine. However, it is important to note that the resolution of SARS should be mostly attributed to the quarantine measures taken and not to some superherb.

While woad root has historically been a strong and effective anti-viral, novel virus strains present new ball games; especially viruses that adapt and evolve quickly like SARS did, and possibly COVID-19. That’s not to say it isn’t worth putting woad root to the test, but that the primary focus should be on standard prevention, monitoring yourself and others, testing suspected infections, and quarantining confirmed cases.

Standard Prevention:

    • Wash hands frequently
    • Avoid touching eyes, nose, mouth
    • Covering mouth if coughing or sneezing
    • Trying to stay at least 3 feet away from known cases of infection [Update, 3/17/20: prior to COVID-19, and at the original time of this post, the consensus standard for social distancing was 3 ft. The recommended distance has since been extended to 6 ft.]

After the primary focus has been met, woad root is definitely a candidate for an added layer of defense, or as an integrative treatment. It has a long history of use in Chinese medicine for viral infections.

Scientifically, the major chemicals in woad root are phenylpropanoids, alkaloids and organic acids. The most active ingredients appear to be clemastanin B (CB) and epigoitrin. While none of the compounds or individual chemicals have been shown to kill a virus directly (in vitro), they do inhibit virus multiplication and attachment.

Viruses cannot survive on their own. They need to attach to our cells before invading them, then splice into our DNA * after entering. After reprogramming our “software,” * they can replicate and build an army to seek and destroy more of our cells.

[* Correction, 2/18/20:

Coronaviruses are RNA viruses and do not enter the nucleus of the cell where our DNA resides. They use the components within the cytosol to replicate. For viruses that do enter the nucleus, alteration of our DNA is an infrequent event.]

Woad root works by first building a firewall at the cellular level, preventing virus attachment. The second layer of defense is to disrupt a virus’ ability to replicate. The cells that are infected would experience a natural cell death (senescence) and be cleared by our immune system.

References

Bajema, Kristina L, et al. “Persons Evaluated for 2019 Novel Coronavirus – United States 2020.” Centers for Disease Control and Prevention, 14 Feb. 2020, www.cdc.gov/mmwr/volumes/69/wr/mm6906e1.htm?s_cid=mm6906e1_w.

Battegay, Manuel, et al. “2019-Novel Coronavirus (2019-NCoV): Estimating the Case Fatality Rate – a Word of Caution.” Swiss Medical Weekly, 2020, doi:10.4414/smw.2020.20203.

Chen, Jieliang. “Pathogenicity and Transmissibililty of 2019-NCoV–A Quick Overview and Comparison with Other Emerging Viruses.” Microbes and Infection, 4 Feb. 2020, doi:10.1016/j.micinf.2020.01.004.

“Coronavirus Disease 2019 (COVID-19), Situation Report – 27.” World Health Organization, 16 Feb. 2020, www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/.

“Coronavirus Disease 2019 (COVID-19), Situation Report – 28.” World Health Organization, 17 Feb. 2020, www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/.

Fehr, Anthony R., and Stanley Perlman. “Coronaviruses: An Overview of Their Replication and Pathogenesis.” Coronaviruses Methods in Molecular Biology, 2015, pp. 1–23., doi:10.1007/978-1-4939-2438-7_1.

NIH, National Institute of General Medical Sciences (NIGMS). “Our Complicated Relationship with Viruses.” ScienceDaily, 28 Nov. 2016, www.sciencedaily.com/releases/2016/11/161128151050.htm.

Su, Jia-Hang, et al. “Modes of Antiviral Action of Chemical Portions and Constituents from Woad Root Extract against Influenza Virus A FM1.” Evidence-Based Complementary and Alternative Medicine, vol. 2016, 2016, pp. 1–8., doi:10.1155/2016/2537294.

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