SPIEGEL: Ms. Ciesek, how would you describe the coronavirus to someone who has been missing for the past few months?
Ciesek: A new virus has triggered a pandemic since December 2019. This virus is highly contagious and can be transmitted from people who have not yet experienced symptoms. Although many people and especially children fortunately do not get seriously ill in most cases, hundreds of thousands of people around the world have already died from the disease Covid-19. Affects the lungs, but also other organs. Subsequent damage can also occur after an infection.
SPIEGEL: Is it unusual for Sars-CoV-2 to affect organs other than the lungs?
Ciesek: There are other viruses that can damage various organs. For example, the hepatitis E virus, which mainly causes inflammation of the liver, can also cause shoulder paralysis (neuralgic amyotrophy of the shoulders) or Guillain-Barre syndrome, a nerve disease. What is new is that the coronavirus affects such a large number of people at the same time.
SPIEGEL: Patients with Covid-19 can damage the lungs, kidneys, heart, blood vessels and brain. This is a wide range.
Ciesek: However, it is not yet clear what damage the virus itself causes and what the result of an overactive immune response is. Maybe both play a role. It is not yet known exactly how common the different types of injuries are, how long they last, in which people they occur and how they can be prevented.
SPIEGEL: Is it actually a specialty of Coronavirusthat some people hardly notice the infection, while others become seriously ill or even die?
Ciesek: No, it is not uncommon for a virus to develop little or no symptoms in some infected people while others become seriously ill. Other common pathogens that cause respiratory infections, such as the influenza virus or the RS virus, have asymptomatic infections and life-threatening courses. Another example would be yellow fever: In this virus disease, which is rightly feared, many infections are mild or asymptomatic – but they can also be very severe and fatal.
SPIEGEL: Why is she
Ciesek: Many different factors determine how severe an infection is. Of course, the immune system is important as it undergoes major changes over the course of life. Newborns, young children, adults, and the elderly respond differently to infections, which can affect the severity of an illness. Another factor is previous illnesses, for example existing lung damage or diseases of the immune system. Environmental impacts such as particulate matter also play a role and a general lifestyle, for example when smoking. After all, our genes influence the course of the disease in a complex interaction. It can happen that two very similar, completely healthy outsiders have very different disease courses.
SPIEGEL: How can you reduce the risk of serious illness in the event of coronavirus infection?
Ciesek: Many seriously ill people are at risk from previous illnesses. What can you do yourself What is recommended anyway: eat healthy, do sports. At the moment, the most important thing is to adhere to the hygiene rules. Therefore, keep your distance and wear a mask if the minimum distance cannot be maintained. And hand washing – this is certainly not the biggest factor, but it also helps against other pathogens.
SPIEGEL: Yes for example Vitamintabletten?
Ciesek: It makes sense to make up for a deficiency. But if you have no shortcomings, then you should not swallow pills. With vitamin D, for example, it is important not to overdo it in an uncontrolled manner. Otherwise, it can also be harmful.
SPIEGEL: Some studies conclude that around 40 percent of those infected had no symptoms. Is that amazing?
Ciesek: It is by no means easy to determine whether an infection was completely symptomatic; H. asymptomatic or when symptoms were mild. Maybe you remember him Publication in the magazine “NEJM” up to the first cases in Germany. Initially, the team wrote that the patient from China was asymptomatic. Only later did conversations with the woman show that she was some mild symptoms and took a pain pill to adjust the next day.
Shortly afterwards, we examined the returnees from WuhanTwo of them were positive but had no symptoms. After the excitement about the next issue, we asked both patients very carefully if they had any symptoms. And whoever said first that he had nothing, then reported earache and a slight reddening.
SPIEGEL: Can’t it skew even a really provocative question? As the respondents think for a moment, there may have been a warning of a headache, a slight upset stomach, in the past few days – but wasn’t that seen as a complaint at the time?
Ciesek: Yes it is difficult. For this reason, I prefer to talk about minor wellbeing concerns, not symptoms or ailments. Virus research does not usually focus on researching asymptomatic courses, so the percentage of people who are asymptomatically infected with other viral infections is often not precisely known. For research on Sars-CoV-2, it is now interesting, for example, whether or how the immunity after an asymptomatic or very mild infection differs from that after a severe course.
SPIEGEL: There was a lot of talk about herd immunity, especially at the beginning of the pandemic – if 60 to 70 percent of people had passed the infection, it would have been achieved. But would it be possible to achieve herd immunity without a vaccine in the sense that nobody should worry about the coronavirus anymore?
Ciesek: Firstly, this route is not worth trying at all as the virus does a lot of damage and a lot of people would die. The idea of herd immunity is that a certain number of people have antibodies, so these chains of infection are broken – not through isolation, of course, as is happening now. If a sufficient number of people were immune and the virus could no longer find a host, it could theoretically go away. To do this, the protective immune response must last for a long time. So far we don’t know how long this will take after a coronavirus infection.
SPIEGEL: Do you think we’ll find a vaccine against Sars-CoV-2?
Ciesek: We currently have promising candidates and look forward to having one or more vaccines available in the next year. Of course, there may be random mutations relevant to a particular vaccine, or a vaccine not being suitable for all people – this needs further monitoring. So it’s not a bad thing that several vaccines with different properties are being developed in parallel.
SPIEGEL: Has Sars-CoV-2 mutated faster or slower or is it in between?
Ciesek: Anyone researching hepatitis C viruses laughs at the level of the coronavirus mutation. The hepatitis C virus lacks so-called repair mechanisms, which is also one of the reasons why it is not yet possible to develop a hepatitis C vaccine. However, Sars-CoV-2 is not as stable as other pathogens. Sars-CoV-2 is an RNA virus and it is perfectly normal for errors to keep recurring during reproduction. However, it does not have a fragmented genome like influenza viruses. We have the flu vaccine. So I’m optimistic at the moment.
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