These are some of the Questions that I Want Answered about Coronavirus!

This blog normally focuses on education issues, but I am addressing the coronavirus pandemic here (and it is very likely a pandemic) because it is very probable that schools will be a primary mechanism of transmission if current quarantine efforts fail.  Kids just do not stay home from  school when ill, due in part to their desire not to fall behind, but also due to frantically busy parents shuffling them off so that the parents can go to work.

Sadly very often the media does not seem to have the expertise to ask the right questions.  I read a lot of news reports but have not seen answers to the following concerns.  Answers may exist, but, if so, they are not being distributed broadly.  CNN will have a special “town hall” the evening of March 5th on this topic, but my bet is that it will merely recycled the current oft-repeated news stories.  [Update – it turned out to be an EXCELLENT show.  Please see the Comments section following this article for details.  Regarding school closures, one participant noted that in poor areas closing the schools may also mean that some kids will miss their only good meal of the day.]

1. We hear that 80% of the cases are “mild” and yet young healthy people, like the ophthalmologist who was one of the first who reported the disease in China, became extremely ill and died.  This can be due to many factors.  Initially it was thought that the doctor was exposed to a patient from the Wuhan marketplace with a very high “viral load”.  However, there may be multiple strains of the virus circulating of varying mortality (I have been wondering about this for some time and CNBC just reported this news finally this AM).  The CNBC report stated that the initial virus may have caused more severe illness than the more recent mutation, but data is still preliminary. Evolutionary pressure favors viruses that do NOT kill their hosts because a virus needs its host to replicate.  There are also possible genetic variations in cell surface proteins that viruses may target, possibly making it cause more serious disease in some people than others.  We need people in the government and media with the appropriate scientific background to look into these questions and get better information out to the public.  No discussion that I have heard to date has addressed any of the above, but instead focuses merely on obvious items like hand washing and the pros and cons of wearing masks.
2. Reports abound of the virus mysteriously circulating in communities “undetected” and then cases suddenly appearing due to “community transmission.”  Clearly one wonders about the availability AND reliability of coronavirus test kits.  I read earlier that the initial kits distributed by the CDC were flawed and had to be replaced.  We have to resign ourselves to the fact that, in the middle of regular flu season, many cases of illness are NOT going to be tested.  Secondly, even if they are tested, what is the rate of false positives and false negatives for these tests?  The media immediately seems to report positives tests as gospel truth.  Without knowing the validity of the tests we do not know how much to trust this data. (False negative rate reported on 3/4/2020 to be <4% – see Comment section below). (3/5/20 – SF Chronicle article link in Comments below shows some patients getting variable results during repeated tests.)
3. We heard the other day that there are over 8000 people in California alone under self-quarantine and I have seen reports that the number is over 9000.  Initial quarantines occurred at Travis Air Force base and other bases in southern California.  I have seen almost no follow-up reporting about the outcomes of any of these quarantines.  I would imagine by now that many of the people have been released, but the media seems less excited about reporting such news.  I would hope that our state public health agency is monitoring this list and is providing updates somewhere as to whether the quarantine case load is increasing or decreasing.  The media needs to focus on reporting this information as well as the more sensational stories of people testing positive for the virus.

I will update this article with other concerns as more information becomes available; so please check back again and look at the Comments section below.

Author: David Kristofferson

Retired Ph.D. scientist, teacher (after retiring from industry, taught in private and public high schools and then worked a decade in my own private tutoring business), bioinformatician (managed both the NIH-funded GenBank National Nucleic Acid Sequence Databank and the BIONET National Computer Resource for Molecular Biology), IT director at Eos and Raven Biotechnologies, software product manager, AAAS Fellow, avid cyclist, and backpacker! View all posts by David Kristofferson