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How a large viral load can make the coronavirus infection worse

In addition to reducing the risk of coronavirus spreading, social distance can also make people’s symptoms milder when they get the disease, scientists say.

It can do this by reducing a patient’s viral load – the number of particles of the virus that they first become infected with.

Having a high viral load ‘jumpstarts’ an infection and increases the risk of a patient’s immune system becoming overloaded in his fight against COVID-19.

People can reduce their chances of a massive initial infection by staying away from others who may be sick and by strictly following the rules against close personal contact that millions of people around the world are now facing.

Someone indirectly infected by touching a door handle may eventually develop milder symptoms than someone who inhales an infected person’s cough, experts say.

And this is because it gives the immune system more time to get the infection under control before it becomes overwhelmed and starts showing symptoms.

Viruses make people sick by rapidly multiplying in the body and over-driving the immune system to get rid of them - causing symptoms such as fever and fatigue

Viruses make people sick by rapidly multiplying in the body and over-driving the immune system to get rid of them – causing symptoms such as fever and fatigue

According to a study conducted in China, patients with a higher virus concentration in their body were more likely to have a serious illness (photo: an intensive care patient in the Czech Republic)

According to a study conducted in China, patients with a higher virus concentration in their body were more likely to have a serious illness (photo: an intensive care patient in the Czech Republic)

According to a study conducted in China, patients with a higher virus concentration in their body were more likely to have a serious illness (photo: an intensive care patient in the Czech Republic)

“In general, in respiratory viruses, the outcome of an infection – whether you get seriously ill or just get a mild cold – can sometimes be determined by how much virus actually got into your body and the infection started,” says professor. Wendy Barclay, an infectious disease expert at Imperial College London.

“It’s all about the size of the armies on each side of the battle, a very large virus army is difficult to fight by the army of our immune system.”

The way viruses make people sick is by quickly multiplying once in the body and building up in such numbers that the body takes weeks to destroy them all.

WHY CAN LOWER INFECTION DOSE REDUCE SYMPTOMS?

Anyone contracting COVID-19 will develop massive amounts of the virus in their body, but people will first be infected with different amounts of it.

For example, someone who inhales a seriously ill patient’s cough while they have a fever will be exposed to more viruses than someone who touches a door handle that was coughed up two days ago.

Most of the symptoms of the coronavirus are caused by the immune response caused when the virus is discovered in the body.

In an effort to destroy the viruses, the body raises its internal temperature to kill them, causes a fever, and uses huge amounts of calories to send immune cells into the blood to attack the viruses, causing fatigue and pain.

If the body is initially exposed to a smaller number of viruses, it may mean that the body can start with a smaller immune response.

However, more viruses would mean that a larger response would be needed, which could cause worse symptoms and then increase the risk of it turning into sepsis later in the disease.

This process is inevitable once someone has contracted an infection, but it is possible that people first get sick with just a small dose of a virus.

This could theoretically make it easier for their body’s immune system to cope with and ward off the early infection.

In fact, for coronavirus, it seems likely that a large majority of patients will get sick under this condition and take an unusually long time to notice they are sick.

Because of this, people seem to spread COVID-19 more widely than if they had a more serious illness.

Dr. Michael Skinner, also from Imperial College, said that if someone starts with a huge amount of the virus, it could overload their immune system.

The virus would jump-start in such circumstances, he suggested, as it could build up faster before the body had time to respond.

Dr Skinner said, “We need to be more concerned about situations where someone receives a huge dose of the virus (we don’t have data on how big that could be, but body fluids from those infected with other viruses can contain a million, and up to a hundred million viruses per ml), mainly by inhalation. ‘

He said this would be a “rare occurrence” and that people outside hospital staff were unlikely to be exposed to massive amounts of the virus.

Scientists don’t think people’s viral load will increase if they are exposed to more infected people after they first become ill themselves.

They also don’t think it is likely that the virus will be built from multiple sources before it reaches a threshold that will make them sick.

Scientists say the chances of people becoming seriously ill are greater if the first doses of the virus are given en masse, but people outside hospitals are unlikely to encounter them (Pictured: staff at King's College Hospital, London)

Scientists say the chances of people becoming seriously ill are greater if the first doses of the virus are given en masse, but people outside hospitals are unlikely to encounter them (Pictured: staff at King's College Hospital, London)

Scientists say people are more likely to become seriously ill if the first doses of the virus are given en masse, but people outside hospitals are unlikely to encounter them (Pictured: staff at King’s College Hospital, London)

Professor Wendy Barclay and Dr. Michael Skinner, both virus experts at Imperial College London, said that contamination with a larger first dose of the coronavirus could lead to worse symptoms because the immune system would struggle to contain the infection

Dr Skinner added that if someone is infected with a large viral load: “The virus is taking a huge leap forward, leading to a massive immune response, which will have a hard time controlling the virus so that time has been gained immunity to act while at the same time leading to significant inflammation and a cytokine storm. ‘

Uncontrollable inflammation (swelling) caused by the body’s immune system can be devastating and cause fatal conditions, such as kidney failure or sepsis.

It is known to be a contributing factor in severe illness and death in COVID-19 patients.

And a “cytokine storm” occurs when white blood cells become confused and can cause kidney or lung failure and death.

Professor Jonathan Ball, a virology expert at the University of Nottingham said, “It is possible that people with pneumonia with a higher viral load will develop a more serious disease, but the development of the disease is complex and no doubt many factors will have an impact.”

A scientific paper published this month in the British medical journal The Lancet suggested that high viral load was associated with worse symptoms.

WHAT IS SOCIAL DISTANCE?

The best way to reduce the amount of coronavirus someone is infected with is, according to experts, to be strict about social distance, to ensure that viruses are well diluted in the air or spread thin before they reach the airways.

Social distance measures are used to slow down the spread of diseases by keeping an appropriate distance between people.

This is two meters (6’5 “) in the UK and the US, but is 1.5 meters in Australia.

This is because coronavirus can be transmitted by coughing, sneezing, or being in the same room as someone who has had the coronavirus for a long time.

The goal of social distance is also to minimize physical contact with each other, by encouraging working from home, avoiding busy areas and public transport as much as possible.

Social distance is a method of behavior that takes scientists time to develop a vaccine.

However, World Health Organization Director-General Tedros Adhanom Ghebreyesus has said “on their own, these measures will not quell the epidemics.” He insisted that tests be conducted on a large scale to limit cases.

Social distance measures are:

  • Avoid contact with someone who shows symptoms of coronavirus (COVID-19) – these symptoms include high temperature and / or new and continuous cough.
  • Avoid non-essential use of public transport – change your travel times if possible to avoid rush hour.
  • Work from home whenever possible – your employer should support you in this.
  • Avoid large gatherings and small gatherings in public areas – pubs, restaurants, leisure centers and similar locations are currently closed because infections spread easily in closed spaces where people gather.
  • Avoid gatherings with friends and family – stay in touch using external technology such as phone, internet and social media.
  • Use telephone or online services to contact your doctor or other essential services

Sources: NHS Inform

The study looked at 76 coronavirus patients in Nanchang, China who were hospitalized and tested positive for COVID-19.

The researchers, led by Dr. Wei Zhang, wrote, “The average [average] the viral burden of severe cases was approximately 60 times higher than that of mild cases, indicating that higher viral loads may be associated with severe clinical outcomes. ‘

At least 80 percent of coronavirus patients are believed to have only a mild illness similar to a cold, while some may experience more severe breathing problems.

The most severely ill end up in the hospital with pneumonia and in intensive care units they have a survival rate of about 50 percent.

Dr Wei and colleagues added that high viral load also seemed to increase the risk of serious illness in patients with SARS, a similar virus that caused an outbreak in 2002.

They wrote, “This finding suggests that the viral load of SARS-CoV-2 may be a useful marker for assessing the severity and prognosis of the disease.”

Researchers at Oxford University agreed that studies seem to show that a higher viral load worsens coronavirus symptoms, but there was no solid evidence.

An analysis by the Nuffield Department of Primary Care Health Sciences states, “The evidence suggests an association between the viral dose and the severity of the disease.

However, the evidence of the relationship is limited by the poor quality of many of the studies.

To avoid becoming infected with a greater viral load, the best thing people can do is to stay away from others who are or may be sick, said Dr. Wendy Barclay.

The viral load would be higher if someone coughed directly in your face than if they were two meters away and the viruses were spread in the air.

So when people always have to keep their distance from others in public, Dr. Wendy Barclay The Telegraphespecially if they cough or sneeze.

Wearing gloves, washing hands and avoiding touching their face can also protect people from picking up viruses in public places.

And if someone lives with someone infected with the coronavirus, they should try to avoid close contact with them – stay two meters (six feet) away if possible.

This includes stopping cuddling and kissing, sleeping in separate beds if necessary, and making sure they clean frequently-touched surfaces like door handles regularly.

Social distance measures, such as those currently in force in the UK (pictured: people standing in a remote line outside a Sainsbury's supermarket in London) are the best way to reduce a person's risk of exposure to the virus

Social distance measures, such as those currently in force in the UK (pictured: people standing in a remote line outside a Sainsbury's supermarket in London) are the best way to reduce a person's risk of exposure to the virus

Social distance measures, such as those currently in force in the UK (pictured: people standing in a remote line outside a Sainsbury’s supermarket in London) are the best way to reduce a person’s risk of exposure to the virus

Dr Barclay added that it would be wise not to share towels or cutlery and crockery.

Anyone who shows symptoms of coronavirus (coughing, fever, or shortness of breath) should try to isolate themselves from healthy housemates as much as possible.

“The point of social distancing is that by moving further away from someone when they breathe in or cough up the virus, it probably means that fewer virus particles are reaching you,” Dr. Barclay on the Telegraph.

‘Then you become infected with a lower dose and you become less sick. Your own viral load, which starts the battle, will decrease and you are more likely to win it. ‘

A higher viral load is not only more dangerous for the patient himself, but also for those around him, because it makes them more contagious.

The more of the virus is in a person’s body, the more they exhale and expel coughing and sneezing – a process called viral secretion.

This increases the risk of them infecting someone else.

Professor Ball, from the University of Nottingham, added, “We know that the risk of virus transmission increases with the duration and frequency of exposure of an uninfected individual to someone infected with the virus.

“We also suspect that the amount of virus that an infected person produces – also known as the viral load – and possibly the shedding, will also affect transmission; the higher the viral load, the more contagious someone will be. ‘

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