Covid-19 is not just an extremely infectious respiratory illness; it's a new disease, the first to occur during the era of modern medicine.
The covid virus encodes its genome into segments of messenger RNA that attack the host by altering the infected cell's epigenetics (the expression of the cell's DNA). A majority of documented effects interfere with the host's immune response. Some cells infected with COVID-19 die, others create more viral copies, and some induce micro-aneurysms in infected tissue. This is a new type of pathology that has never been seen before.
In up to 10 percent of patients, symptoms of COVID-19 develop slowly and persist long-term. Some are calling this form of COVID-10 a 'slow virus.' AIDS, Multiple Sclerosis (MS), Creutzfeldt-Jakob disease, and a variety of brain encephalitis infections are considered to be slow viruses. Prior to the COVID-19 pandemic, there was little evidence that viral messenger RNA might alter a host's DNA. Yet some COVID-19 patients have continued to test positive on PCR assays long after the acute infection. This finding and lab work using reverse transcriptase suggest that fragments of viral RNA are being incorporated into host DNA. Currently most specialists doubt that these viral induced changes in DNA have significance. The human genome is huge, including more than 20,000 genes. But inherited diseases and evolutionary changes can occur after the mutation of just one nucleotide. Many common diseases, including Rheumatoid Arthritis, cancers, diabetes, and hypertension, are associated with multiple sets of mutated genetic markers. It is possible that such multi-gene changes were inherited through DNA altered by viral infections. If this scenario is true, we will have the new disease of COVID-19 to thank for demonstrating the limits in some of what we had presumed to understand of genetics and evolution.
Before COVID, a new medical diagnosis reflected a new understanding of a disease pattern that already existed, much like what happened when I came up with the "new" diagnosis of "nightmare disorder." Before un-traumatized individuals with frequent nightmares were often given the diagnosis of PTSD, the only other diagnosis with nightmares as a symptom. Sometimes therapists led them into a search for false memories of the un-remembered, non-existent trauma that must have been there to cause their nightmares. The new disease of nightmare disorder provides a diagnostic safe harbor for those individuals with frequent nightmares lucky enough to have never experienced severe and irreconcilable trauma.
COVID-19 is different. Already, specialists, clinics and hospitals are dedicated to addressing this untreatable, freely mutating virus. The new Delta variant is the among the most infectious ever known. New mutations are likely to become vaccine resistant. COVID forms with high mortality, such as SARS and MERS, may cross pollinate with the delta carrier.
But for the near future, there is still the possibility of safe harbor. Widespread vaccinations offer hope. COVID vaccines are not "live." These vaccines protect from infection and viral induced changes in epigenetics and DNA. They induce and empower immune reactions to the virus by introducing small amounts of viral based spike proteins (the basis for the virus's high infectivity). There is no evidence that these vaccines have any capacity to alter host DNA. But this virus has proven us, our specialists, and our politicians wrong time and again, and many remain unvaccinated, more afraid of the treatment than the disease. There seems little question that the pandemic will continue to worsen. This nightmare is what we are living.
Jim Pagel is an Associate Clinical Professor at the University of Colorado School of Medicine who lives in Arroyo Seco.
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