Table Of ContentCOVID-ology
The COVID-19 outbreak and response have been characterized by
institutional missteps, media misinformation, and economic and social
upheavals. This book is intended to de-mystify and inform in a succinct
and straightforward text. The lessons shared are applicable to other
infectious diseases and future inevitable pandemics. Readers will learn
about the origins of SARS-CoV-2, the disease it causes, clinical tests and
how they work, therapeutics, and prophylactic measures such as vaccines.
This information will prepare readers to be better able to respond to future
emerging infectious diseases and pandemics.
Key Features
• Positively influences career choices within public health
• Applies basic science to problems raised by the COVID-19 pandemic
such as vaccine development and herd immunity
• Prepares readers with context and tactics for understanding future
infectious disease outbreaks
• Successfully used in college senior health sciences seminars
• Engaging and balanced treatment of the politicization of public
health issues, especially COVID-19
COVID-ology
A Field Guide
Dr. Michael T. Myers, Jr., MD, MBA
Cover Image Credit: Shutterstock.com
First edition published 2023
by CRC Press
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© 2023 Taylor & Francis Group, LLC
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ISBN: 9781032316055 (hbk)
ISBN: 9781032316031 (pbk)
ISBN: 9781003310525 (ebk)
DOI: 10.1201/9781003310525
Typeset in Minion
by Deanta Global Publishing Services, Chennai, India
To all future public health leaders
Contents
Acknowledgments ................................................................................xv
Author .................................................................................................xvii
Acronyms .............................................................................................xix
COVID-19 Timeline .........................................................................xxiii
Introduction: Foray into the Field ....................................1
COVID-19 Update: May 9, 2022 .................................................1
A Bewildering Landscape .......................................................2
An Emerging Infectious Diseases Field Guide ....................2
Using This Field Guide ............................................................3
The Many Paths of Exploration .............................................4
Venturing into COVID-19—and EIDs ......................................4
Notes ...............................................................................................5
Chapter 1 The SARS-CoV-2 Virus .....................................................7
Field Expedition: NASA’s Ten-Word Definition of Life ..........7
Lesson Learned: NASA’s Ten-Word Definition of Life ............9
Concepts Covered in This Chapter ..........................................10
Nucleic Acids Are the Self-Sustaining Chemical
System of Life ..........................................................................10
The Virus as Industrial Insurrectionist ..............................13
Virus Classification Systems ................................................15
The SARS-CoV-2 Genome ....................................................16
SARS-CoV-2 Is a Single-Stranded Positive Sense
RNA Virus .........................................................................17
Protein Translation Starts with ORF1a Making
NSP1–NSP11 ......................................................................17
Protein Translation Continues with ORF1b
Making NSP12–NSP16 .....................................................19
Immune System Evasion and Accessory Proteins .......20
SARS-CoV-2 Life Cycle ........................................................20
vii
viii • Contents
SARS-CoV-2 Cell Entry, Cytoplasmic Replication,
and Exit...............................................................................21
Interrupting the Virus Life Cycle ...................................21
Virus Mutability .....................................................................23
How Mutations Occur ......................................................23
Mutation Terminology .....................................................24
SARS-CoV-2 Variants .......................................................25
More Variants: Not If, but When ....................................26
Looking Back, Looking Ahead ............................................26
Future Outings ............................................................................27
Student Research Questions .................................................27
Notes ............................................................................................28
Chapter 2 The Origins of SARS-CoV-2 ............................................29
Field Expedition: The Bat Woman ...........................................29
Lesson Learned: The Bat Woman ............................................30
Concepts Covered in This Chapter ..........................................31
SARS-CoV-2: An Emerging Infectious Disease ................31
Zoonotic Spillover Theory ....................................................33
Bats as Animal Reservoirs for Lethal Zoonotic
Pathogens ...........................................................................33
Laboratory Leak Theory........................................................35
Official Reviews of Laboratory Leak and Zoonotic
Spillover Theories ...................................................................37
Looking Back, Looking Ahead ............................................38
Future Outings ............................................................................39
Student Research Questions .................................................39
Notes .............................................................................................41
Chapter 3 COVID-19 Disease Manifestations .................................43
Field Expedition: The Three Phases of Syphilis .....................43
Lessons Learned: The Three Phases of Syphilis......................45
Concepts Covered in This Chapter ..........................................45
COVID-19 Is a New Disease Entity ...................................46
Symptoms ...............................................................................46
COVID-19 Symptoms .....................................................46
Clinical Stages .......................................................................48
Contents • ix
COVID-19 Clinical Stages ..............................................48
Host Factors ............................................................................49
COVID-19 Host Factors ...................................................49
Comorbid Conditions ...........................................................49
COVID-19 Comorbid Conditions ..................................50
Pathophysiology .....................................................................50
COVID-19 Pathophysiology ............................................50
ACE2 Receptors, Fluid Balance, and Inflammation ....50
Alveolar Epithelial Cells ...................................................51
Acute Respiratory Distress Syndrome ...........................51
PASC and MIS-C ..............................................................52
Looking Back, Looking Ahead ............................................52
Future Outings ............................................................................53
Student Research Questions .................................................53
Chapter 4 Testing ...............................................................................55
Field Expedition: Michael Mina’s Mission .............................56
Lesson Learned: Michael Mina’s Mission ...............................57
Concepts Covered in This Chapter ..........................................57
Types of Clinical Tests ...........................................................57
Performance Characteristics of Clinical Tests ...................58
“Gold Standard” or Reference Standard Test ................59
Positive and Negative Predictive Values ............................60
Clinical Test Results and Disease Probability ..............60
Bayes’s Theorem of Pre-Test Probability .............................61
Making the Correct Diagnosis of a Disease .......................61
Using Clinical Tests in Making Diagnoses ...................62
Making the Correct Diagnosis of COVID-19 ....................63
SARS-CoV-2 Clinical Tests..................................................64
Serologic Antibody Tests .................................................64
PCR Tests ...........................................................................65
RDTs ..................................................................................68
Using Clinical Tests in Making COVID-19 Diagnoses ....70
Looking Back, Looking Ahead ............................................71
Future Outings ............................................................................72
Student Research Questions .................................................72
Notes .............................................................................................72
