In 2020, before the vaccine, I wrote a book predicting Covid would become a common cold. Amazon blocked the sales as instructed by the government, so I wanted to publish it here, on the internet as a testimony to what I was thinking about Covid even before the vaccine.
Chapter One: From Killer to Common Cold
1 How a virus views the world
A virus, yet again, changed the world. A bag of protein and genetic material intent on making copies of itself has been unleashed on humans.
SARS-CoV-2—the virus responsible for causing COVID-19—isn’t even a living thing. A virus is just a tiny collection of proteins and genetic material wrapped in your own cellular membrane with one goal: to make more copies of itself.
This killer virus jumped from bats into humans, rapidly traversing the globe in the respiratory secretions of an interconnected planet. Yet, since the introduction of animal domestication, human pandemics from viruses have been relatively commonplace. These human pandemics have shaped our shared histories.
Consider a virus like smallpox. Once a common cause of childhood death and disfigurement, evidence of this virus has been found on mummified remains from ancient pharaohs. Waves of this viral pandemic wiped out vast numbers of humans, from European royalty to entire Aztec and Inca civilizations. Smallpox influenced politics in Europe and decimated the native populations of the New World, allowing settler colonialism to flourish. There are multiple examples of pandemics every century, and now, after a one-hundred-year hiatus, another pandemic virus is upon us.
Although viruses are not living organisms, it might be helpful to think of viruses like SARS-CoV-2 as if they could live, breathe, and walk, just like us. What if we could walk a mile in SARS-CoV-2’s shoes? How does a virus perceive its human host? What inherent limitations do viruses have, and how do human cultures influence those limitations? Can we gain insights into COVID-19 by imagining how a virus experiences the world?
The interaction between humans and viruses is complex. Anthropomorphizing viruses helps us think beyond the one-week or one-month pandemic planning horizons that governments typically use. On one side, a virus evolves and changes the rules of the game as it progresses. On the other side, we humans try to understand the rules, anticipating the changes—both for us and the virus—that are likely to come. One thing is clear—this virus, SARS-CoV-2, will affect people around the world.
Human culture is based on identifying problems and organizing people to create solutions. Where we live in the world significantly influences our experience of COVID-19. We all have different social norms, political strategies, and constantly changing attitudes toward the virus. Culture shapes how we perceive COVID-19.
Moreover, many have struggled to learn the science of virology and epidemiology through the lenses of political, social, and economic concerns. We are seeing the messy give-and-take of the scientific process in action, occurring simultaneously with haphazard policy proposals. Too often during this pandemic, policymakers endorse a solution now, only to scorn the same solution later. The political response to the pandemic feels like constructing your parachute after jumping off the plane.
Individuals, on the other hand, handle viruses differently, both physically and through their personal choices. We all have slight differences in our immune systems and overall health, which greatly influence our experience with Covid-19, both for ourselves and our loved ones. Our personal encounters with the virus shape how we view what people can do now and what to expect in the future.
Instead of concentrating on the rapidly changing political and scientific landscape for fragments of information, what if we analyzed COVID-19 as if we were profiling a criminal? Let’s identify all the usual suspects! Who (or what) has done something similar before? What can we learn from previous pandemics and, more specifically, from the family of coronaviruses that already infect humans? We may not be able to sentence our culprit (or cure it, for that matter), but hopefully we can gather enough knowledge about Covid-19 to predict some of its behavior and anticipate what might happen in the coming years and beyond.
Profiling relies on homology and behavioral consistency. Homology, the idea that similar crimes are committed by similar offenders, helps us examine other pandemics and consider how Covid-19 differs. Can we learn anything from the crimes of smallpox and influenza that might help us understand the future of COVID-19? Behavioral consistency refers to the idea that an offender’s crimes tend to be similar in nature. We know there are seven other human coronaviruses currently in existence. Can we study the crimes of these other coronaviruses to predict what to expect with COVID-19?
Instead of relying on the typical back-and-forth of scientific progress to predict Covid-19’s future, what if we used what we already know about evolution and virus/host interactions to make future predictions? As we develop the scientific evidence to understand COVID-19 better, is there a way to know now, ahead of time, how it all will turn out? Yes.
I believe the destiny of SARS-CoV-2 is already written. With or without a vaccine, with or without an effective treatment, with or without expected technological advances, we are destined to interact with this virus forever. Only a major paradigm-shifting development of the future—something truly out of left field—will rid this world of Covid-19.
This book is not so much about current science as it is about evolution. Since science changes too quickly to write a comprehensive book on it, this story focuses on evolutionary biology and the natural limits placed on viruses, humans, and the cultures they develop together. Within those boundaries, we understand that SARS-CoV-2 cannot be eliminated and will likely become endemic.
There are already four coronaviruses that are endemic and cause the common cold. Endemic means that they circulate widely, at all times, and in low levels within human populations worldwide. SARS-CoV-2 is expected to become the fifth endemic human coronavirus. Believe it or not, the process of a coronavirus becoming endemic has already occurred at least once before in our recorded history.
Although we cannot eliminate COVID-19 completely, it is likely to become less deadly in the future. This can be expected either through the virus’s own evolution or through changes in its host. Humans, our immune systems, or our cultures will alter this deadly disease so that it becomes similar to the common cold.
Pandemics and infectious diseases have caused more deaths and shaped human history more than any other natural force. We have been in an ongoing arms race with infections since the beginning. Until the twentieth century, infections killed more soldiers in war than enemies did. We have, and continue to have, a long-standing struggle against infections, though we tend to forget this when looking only at our own lifetimes. Hygiene, clean water, antibiotics, vaccines, and good public health have transformed the way infectious diseases impact society.
Although there are still many places on earth where infectious diseases are the number one killer of young children, diseases of civilization, such as heart disease and cancer, have overtaken infectious causes of death in wealthy countries. The impact of infection on our daily lives has faded. It has been over one hundred years since the last truly devastating pandemic plagued us. We forgot. We did not plan, and deaths and disabilities from Covid-19 are the inevitable and unfortunate consequences of not preparing for the usual suspects to return to their old, criminal ways.
This will be a short book. Using basic virology and evolutionary biology, I aim to convince you that COVID-19 will become endemic no matter what humans do. We will need to learn to live with this virus, and I hope to show you how to do so.
We’ll start by reviewing some basic science about viruses and how they interact with hosts. Next, we will look at influenza and discuss some prior pandemics, contrasting influenza to the family of coronaviruses. Once we have a basic understanding of viruses (the usual suspects), we will learn a little about epidemiology, viral replication dynamics, and herd immunity. From this, I will demonstrate how eradication of SARS-CoV-2 is unlikely and discuss how the next few years may play out. COVID-19 infections will continue during what I call the “Transitional Phase,” as we progress from epidemic to endemic. Finally, we will review how a current common cold coronavirus, OC43, transitioned from epidemic to endemic during our written history.
COVID-19 is here to stay, but rather than drinking from the fire hose of ongoing scientific discovery, what can we learn from a review of science theory? We have evidence and probable cause. It is time to prosecute SARS-CoV-2 and understand the fallout from the crime. Instead of looking at statistics, modeling, and the ongoing messiness in medical journals, let’s look at history to see potential futures.