Social Distancing, Masks, Influenza, COVID-19 & R0: A Tutorial for Parents

Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Coronavirus (COVID-19), go here. These expert reports are free of charge and can be saved and shared.

The conspiracy meshugenah has posted again on COVID-19 health issues. I’m talking about the same individual whose confusion and mythology I have summed up and debunked previously on the topics of masks and vaccines, so I thought I’d utilize his misconstruing to drive home a few points regarding influenza, COVID-19, epidemiology, and preventive measures. As a parent, or expectant parent, you are a particular target for health conspiracy myths, so in preparation for the possibility that you may encounter this latest twisted thinking in some form let’s take a look at what he posted and see what’s wrong with it. Doing so, we shall meet up again with our old friend from when we first started discussing the pandemic, R0 (pronounced “R naught”).

R0 represents that average number of people that an already-infected individual infects. If R0 equals 1, then each infected person infects just one other person, which means that that the number of cases does not increase over time. If R0 equals 2, then each infected person infects two other people, so the number of infected people doubles over the average amount of time that the infection takes to spread from person to person, and the number of cases doubles over an amount of time that depends both on how long it takes for the infection to spread from person to person and how long it takes for people to become symptomatic. An example of a viral infection with an extremely high R0 is measles, which has an R0 in the range of 12-18. That is ridiculously high and is the reason why many people used to die from measles prior to the advent of measles vaccination, even though the chances of any given person with a measles infection of dying is very low. In contrast, R0 for the SARS-CoV2 (the virus that causes COVID-19) is in the range of 2 to 5. That is lower than for measles, but still fairly high. And —relevant to our story today— it is higher than the R0 of influenza, which is typically in the range of 1 to 2. Oh, and by the way, the R0 for the UK variant of SARS-CoV2 is higher than the 2 to 5 that we are talking about with respect to the virus over all. Stay tuned as we learn more.

With the R0 perspective in mind, now we can take a look at conspiracy meshugenah’s latest belief. To begin, he reports on the incidence of flu versus COVID-19. Never mind that his numbers are not correct. The point here is for you to see the concept that he is promoting and what is wrong with it. He is actually correct that the incidence of influenza —the flu— is dramatically lower this year than it has been in previous years. What is blatantly wrong in his first sentence, however, is the implication that the drop in incidence should be a surprise. As expected, fewer people are becoming infected with influenza viruses, because of the measures that we are taking to reduce the spread of SARS-CoV2. I must point out that, based not just on this and the two other posts of his that we have debunked but on other posts of his, it’s important to note that this individual does not understand the basic biology of viruses, and that influenza viruses and coronaviruses are different groups of viruses. But if you have been reading my posts, then you already know generally what influenza viruses and coronaviruses have in common and what makes them different. What they have in common is that both groups use RNA as their genetic material. This makes them different from herpes viruses and hepatitis B virus, for instance, which use DNA. Another thing that influenza and coronaviruses have in common is that they are transmitted through respiratory droplets. But they have very different proteins on their surfaces and they produce disease in very different ways. These are important things to know when you confront claims from people who misconstrue and misunderstand, people like the individual who posted, who reject basic information from people with credentials.

And rejecting the most basic information he surely does; his post goes on to accuse physicians and public health specialists of inventing clinical cases, laboratory findings, imaging, and epidemiological data at such a ridiculous level, and with such a degree of international coordination, that his belief could easily be the basis for a comedy film or novel —if only the claim were not part of an effort to deny one of the greatest health tragedies in modern times.

So let’s review a few more things about COVID-19 to drive home the point. The various COVID-19 vaccines that we have been discussing are designed to trigger an immune response against the spike protein. As you know from our earlier discussions, that’s the protein that not only sticks out from the protein coat of SARS-CoV2, giving it a corona-like (crown-shaped) appearance under electron microscopy, but also gives the virus a way to attach to the ACE-2 receptor on body cells. Attaching to ACE-2, not only enables SARS-CoV2 to enter and infect pneumocytes —cells of the air sacs of your lungs— but also causes a cascade of events, leading to out-of-control clotting —thrombosis— with numerous detrimental effects in multiple organ systems. Additionally, because of how SARS-CoV2 hijacks the ACE-2, COVID-19 can present with various non-respiratory manifestations, including problems in the nervous system and in other organ systems.

Influenza generally doesn’t do that. It does other things that are very bad and sometimes horrible influenza viruses emerge, like the influenza virus of 1918 that killed a large chunk of humanity. Then there is the fact that the entire basis of everything we are doing in terms of testing and vaccines, and studying new variants of SARS-CoV2, rests on sequencing of the viral RNA genomes, sequencing that gets reported, shared, and discussed, between thousands of scientists, and tens of thousands of physicians, throughout the planet. The molecular differences between different viruses, furthermore is the basis, not only for testing people who may be sick for COVID-19 as well as influenza, but also for testing them for different influenza strands when they present, not to mention emerging routing testing for different SARS-CoV2 variants.

All of this just barely scratches the surface. Findings on computed tomography (CT) of the lungs, gross anatomic samples, histological (microscopic) samples, and hematologic and immunologic effects are different in patients with COVID-19 versus influenza. We could go on with these topics for pages, but all of this should reassure you of the reason why the incidence of influenza is low. Namely, having a lower R0 than that of SARS-CoV2, influenza viruses simply are more susceptible to the measures that we have been using to slow the spread of COVID-19. Even so, you should still be vaccinated against influenza, because the outcome for people with both the flu and COVID-19 together is horrible, and the risk is all the worse if you are pregnant with both infections. So, once again, discussing just a little bit from the beautiful world of biology, we have unpacked a great deal.

David Warmflash
Dr. David Warmflash is a science communicator and physician with a research background in astrobiology and space medicine. He has completed research fellowships at NASA Johnson Space Center, the University of Pennsylvania, and Brandeis University. Since 2002, he has been collaborating with The Planetary Society on experiments helping us to understand the effects of deep space radiation on life forms, and since 2011 has worked nearly full time in medical writing and science journalism. His focus area includes the emergence of new biotechnologies and their impact on biomedicine, public health, and society.

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