Interview With The Doctor: A Scientific Point Of View On The Coronavirus

Doctor Marta Maschio, Director of the Center for Epilepsy tumor-related of the IFO Regina Elena National Cancer Institute and Director of the Neuro-Oncology Section of the International School of Neurological Sciences in San Servolo, answers to some covid-related questions and gives us her scientific point to view on this pandemic.

 

How does the swab work and what does it tell us?

The procedure for the swab, first of all, is painless. It can be done only by a medical professional and it’s done to search traces of the viral RNA in the oral and nasal mucosa. It tells us if that person has had contacts with the virus COVID-19, and so if they have it now, but it does not specify if that person has ever been in contact with the virus, then becoming immune. To clarify, the results for the test tell you if RIGHT NOW you are infected, also if asymptomatic, not if you took it and are now immune because that can be seen only through particular blood analysis. This is because immunity is reached only with the creation of antibodies specific for this virus, which cannot be seen through the swab. It’s fundamental to recognize the people who do not know if they are ill and are an important source of the transmission of the infection since they do not show the symptoms. This is why the State should do the test to everyone who has been in contact with covid-positive people, to avoid further contamination and the spread of the pandemic.

 

Different types of swabs and the percent of success

There are no different types of swab, the nasopharyngeal is the only one currently used. There’s a very high percentual rate of success, indeed the swab is 95% effective in recognizing if you’re now infected with the coronavirus.

 

How much is the incubation time for the virus?

For now, we’re sure that the incubation time lasts for 14 days, it might be three weeks but that has not been proven yet.

 

Which are the main symptoms?

Fever, cough, and dyspnea (troubles breathing). These are the most well known and recognized, but others can be muscle fatigue or weakness, gastrointestinal disorders, ageusia (inability to taste) and anosmia (inability to smell). This is why it belongs to the class of coronavirus, which all bring troubles in both the respiratory system and the gastrointestinal tract. The main differences are related to the easiness in the transmission, the higher mortality rate and the possibility to bring complications to the lungs or to the circulatory system, in particular into people who might be already predisposed (elderly people, people with immunodepression or with heart or lung diseases, cancer patients, smokers, obese people) and it can cause death.

 

How does it affect the brain?

36.4% of hospitalized patients have neurological symptoms, and these are more common in patients with more severe infection, with 45%. The presence of neurological symptoms should never be underestimated by the clinical professional because it can be a sign of a severe-acute-respiratory syndrome, also known as SARS-COVID. 

There are two kinds of mechanisms. The first one regards the inflammatory answer that the human body has to destroy the virus. This inflammation might destroy not only the virus but damage otherwise healthy organs, like the brain, creating meningitis or encephalitis. Another mechanism, which is dictated by a consequence of the inflammation created by the COVID-19, is that blood can start to coagulate in an anomalous way, especially in the brain, creating ictus or hemorrhages. Neurologic manifestations are grouped into three main categories: central nervous system manifestations, peripheral nervous system manifestations, and skeletal muscular injury manifestations. The first one is related to dizziness, headache, impaired consciousness, ictus, ataxia (no balance), and seizure, while the second one is linked with taste, smell and vision impairment, and nerve pain. In extreme cases, a person can also have a coma or die. 

 

How does it work with asymptomatic people and why are people asymptomatic?

People can be asymptomatic because the virus can remain in the nasal or oropharynx mucosas since the immune system of that person will block it. So that individual might have a simple cold or throat problems, which might go unnoticed and, for this reason, the covid-related illness will go undiagnosed. This still means that the person is infected, so it only takes a breath or a word to spread the infection around. 

 

Are you immune after you get it and heal from it?

Yes, but we still don’t know for how long.

 

What is the vaccine situation right now and how long will it take?

All around the world people are working to find a vaccine and an enormous quantity of money is being invested. The most optimistic calculations suggest that it might take six more months, but we have to remember that a vaccine, after the first experimental phase, needs to be tested on individuals, especially for security and possible collateral effects. So it takes time not only for finding the right molecule but also for testing it on people and avoid negative effects.

 

Precautionary measures: how should we protect ourselves?

First of all social distancing. Then the mask is fundamental in closed spaces and when proximity with another person is inevitable. Cleanness and hygiene of hands, clothes, and objects, which should be the norm regardless of a pandemic, is another important aspect. For all the rest follow the ministerial instructions.

 

How do you understand when you’re healed? 

You cannot understand it by yourself, you need the swab. You actually need to do two swabs, with 24 hours of difference, and both of them need to be negative. In the beginning, we did not know how to treat an illness that, in this particular form, we had not encountered before. Luckily, we are now capable to face it with more clarity and safety, because we have discovered many drugs that can prevent the complications and that can cure the symptoms of the illness.

 

Can someone be immune a priori (without even taking it)?

No. Being immune means that our body came in contact with an enemy and created antibodies to protect itself specifically to fight against that enemy. If you don’t find the antibodies, you never came in contact with it, and vice versa you can’t have antibodies without contracting it.

 

Do you have anything to say to our young readers?

With everything that I’ve said I do not want to scare or frighten you, my only intention is for you to be careful, understand this virus and how does it affect your bodies and trust medical experts in taking care of you and knowing what’s best.

 

By Annalinda Giudiceandrea

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