The SARS-Cov2 virus discovered in December 2019 has been a powerful hindrance in the year 2020.

It caused the coronavirus disease (covid 19) which has caused 33.1 million deaths from 50.7 million
infections worldwide and 251 deaths from 8498 infections in Zimbabwe according to the World
Health Organisation (WHO) as of 9 November 2020.It was found in the Chinese city of Wuhan in the
seafood marketplace.

The virus is similar in genetic structure with the SARS (Severe Acute Respiratory Syndrome)
discovered in 2002 which was believed to have a zoonotic infectious property. It is also similar to the
MERS (Middle Eastern Respiratory Syndrome) virus which also has zoonotic infectious properties.
Rather all three viruses are closely related in terms of their RNA, Spike proteins etc. They are
believed to have originated from the Bat (animal reservoir where the virus mutated) then was
passed through an intermediate mammal in which it mutated to be able to infect humans. A process
called homologous recombination.

(Arinjay Banerjee, Sonu Subudhi, Noreen Rapin, Jocelyne Lew, Richa Jain, Darryl Falzarano, Vikram
Misra. (2020) Selection of viral variants during persistent infection of insectivorous bat cells with
Middle East respiratory syndrome coronavirus. Scientific Reports 10:1.)

According to BBC news the R naught value which is the average number of people a person is
estimated to infect ranges from 1.4 to 3 this is an indicator for an exponential rate of infection by the
virus. This is shown graphically below

There is also the series interval si which is the time taken by an infected individual to infect another
individual. According to the World Health Organisation the series interval for Covid 19 is 3 days. This
shows that the overall rate of spread of the virus is seriously high. This therefore shows that there is
need for social distancing that is avoiding large crowds, wearing masks etc. This then helps in
‘flattening the curve’ as shown above.

The virus can be spread through touching of faecal and oral routes that is the mouth, faeces, salivary
droplets, eyes etc. as well as other surfaces that have been contaminated by the virus. The other
way is through coughing and sneezing of an infected person towards other uninfected individuals. A
single cough can produce up to 3000 salivary droplets. These particles can land on different surfaces
including wood, peoples clothes, walls but the vast majority will remain in the air for about 3 hrs. A
certain investigation showed that a viral DNA that affected plants was placed on a hospital bed and
within ten hours it was found to have replicated on 18 different surfaces including door handles,
waiting chairs, books in waiting area etc. this shows how much viruses can be spread rigorously. This
shows the need for continuous disinfection of contaminated surfaces, washing of hands and use of
hand sanitizers. The SARS-Cov2 virus can also last on cardboard for about 24 hours, aluminium
surfaces for about 8 hours, countertops, glass, wood, plastic and stainless steel last for at least 1 to 7
days. These are termed fomite surfaces.

(BBC News, Richard Gray, March 2020)

Inside the human body the virus attaches tissues/cells with ACE 2 receptor (angiotensin converting
enzyme). These cells are found primarily on the alveoli and other different organs inside the body
such as the intestines, liver, kidney, and heart. The SARS-Cov2 virus first affects the lungs by
attacking cells known as the type 2 pneumocytes through binding with their ACE 2 receptors using its
spike proteins and hemagglutinin esterase protein. The virus therefore enters the cell through the
process of endocytosis henceforth it releases its single stranded RNA which then binds with the
cytosolic ribosomes or ribosome on the rough endoplasmic reticulum. A process of transcription
then occurs thereby coding the endoplasmic reticulum to produce spike proteins, hemagglutinin
esterase proteins, m proteins, envelope proteins, nucleocapsid proteins and the enzyme RNA-
dependant RNA polymerase. The enzyme produces more RNA from the virus. The viral proteins are
then assembled in the Golgi body thereby producing viruses inside the cell. The viruses fuse with the
cell membrane and the viruses are released through the process of exocytosis. A continuous process
of this will result in cell death as the viral load increases.

(New York Times, Jonathan Corum and Carl Zimmer, March 2020)

As more cells are destroyed by the virus they release different types of molecules such as alpha and
beta interferons which signal uninfected type 2 pneumocytes in the alveoli to produce antiviral
peptides. They also release damage associated molecular patterns as well as inflammatory cytokines
which activate alveolar macrophages. These macrophages produce interleukin 1, interleukin 6,
interleukin 8, Timor necrosis factor alpha and gamma interferons. These molecules diffuse into the
blood capillaries hence they signal capillaries to undergo dilation. However, the endothelial cells in
the tissues would have contracted thereby increasing permeability of the blood capillaries. In
summary there is vasodilation and increased capillary permeability. Fluid inside the blood capillaries
will the begin to move into the interstitial tissues. There is going to be an outward pressure on the
alveoli by thereby compressing the alveoli. The surface tension on the alveoli begins to increase and
according to Laplace’s Law pressure is directly proportional to surface tension hence the alveoli
collapses. There is alveolar collapse. This means that there is more work of breathing required for
oxygen to diffuse into the capillaries. This leads to hypoxemia thereby leading to ARDS (acute
respiratory distress syndrome).

The inflammatory mediators also trigger release of neutrophils which releases reactive oxygen
species and proteases meant to digest the virus. However, type 1 pneumocytes also get destroyed in
the process thereby worsening the situation. This leads to consolidation of the alveoli as residual
fluids, dead cells, macrophages accumulate in the dead alveoli. The interleukin 1 and interleukin 6
are in high concentration in the blood. When it reaches the hypothalamus inside the brain it then
signals it to release specific prostaglandins to reset the thermostat by increase in temperature
resulting in a fever. There is also low partial pressure of oxygen in the alveoli which is sensed the
chemoreceptors and there is a reflex action triggering increased heart rate.
If this condition is left untreated it can lead to the concentration of inflammatory mediators
increasing. This leads to vasodilation and increased permeability if blood vessels inside the body.
Henceforth, the blood plasma gushes out into the interstitial tissues inside the blood and this results
in reduced blood pressure and total peripheral resistance. The patient becomes hypotensive and this
reduces blood flow to different organs thereby leading to multiple organ failure (a fatal condition).