A few months ago, the world was assured that there was “no clear evidence” of human-to-human transmission of Covid-19.
Shortly thereafter, when it became obvious that the virus was spreading among people, scientists believed that Covid-19 was primarily a respiratory infection that could result in viral pneumonia.
Today we know a lot more about this serial killer — and perhaps the most important fact we know is there’s a lot we simply do not know.
“One of the things that’s really frustrating is that because everyone is really hungry for answers, there’s this sort of a tendency to kind of pounce on the first information that becomes available,” Ellie Murray, professor of epidemiology at Boston University, recently remarked. “And not only can we really not be confident about things right now, the actual truth of the situation is just continuously evolving and it’s going to be changing for quite some time too.”
To put it plainly, we are going to, as poet Rainer Maria Rilke observed, have to “live in the question.” Not the most secure or comfortable place to be.
Drs. Clifford Marks and Trevor Pour recently made the point that Covid-19 “revealed itself to be more than straightforward pneumonia…Covid-19 can push kidneys into failure, send the body’s immune system into catastrophic overdrive and cause blood clots that impede circulation to the lungs, heart, or brain. It’s a disease of remarkable complexity, which even the most experienced doctors are struggling to understand.”
Evidence at this time indicates that 1 in 5 patients diagnosed with Covid-19 develop heart problems; this includes people who were previously healthy and had no underlying cardiac issues.
Covid’s widespread insidiousness — more toxic than other viruses — produces so much destabilizing inflammation that it eventually impairs the heart.
“It’s like one big stress test for the heart,” says Harvard Medical School’s Dr. Paul Ridker.
“Once inside the heart cell, damage to the cellular machinery directly from the virus and the human immune cell response leads to cell dysfunction and cellular death,” Dr. Jack Wolfson, Cardiologist, told Healthline.
To date, more than 7500 scientific papers have been written about Covid-19 — but there is still much more to be learned.
“In 12 to 18 months we’re going to have a great deal of information,” Harvard’s Dr. Peter Libby asserted. “But right now our job is to, number one, keep people from getting Covid-19 by strict adherence to now-familiar containment measures. Then, we need to get people who get the disease through this acute phase…we don’t have the comfort of our usual databases, so we have to rely on our clinical skills and judgement.”
The confusion about Covid-19 also applies to public health agencies. For instance, the Department of Health in the state of Illinois is weighing multiple factors in how to determine if the virus is the primary cause of a person’s death. Dr. Ngozi Ezike, head of the Department, said it can be difficult because of Covid-19’s complexity. “Covid can result in strokes, can result in heart attacks,” he noted. “It’s very hard to separate the respiratory illness from some of these other manifestations.”
Contradictory information has been the hallmark of Covid’s arrival. First, surgical masks weren’t a good idea, and then they became a good idea. Fever is considered one of the chief symptoms of Covid, yet studies are showing that 30 percent or higher of those with the virus experience no fever. Ventilators are essential, but 88 percent or more of those put on ventilators succumb.
Then there is the looming question about a second wave of Covid-19. Past flu epidemics have come in more than one season, so it’s logical to assume Covid will make another significant appearance. CDC Director Robert Redfield has suggested that next winter could even be worse than this past one.
“Living in the question” appears to be our shared fate for at least another year.