COVID-19 virus does not want to kill me
Note to COVID-19 virus: It does you no good to kill your host – me. I die: you die.
So encountering the same virus, why do some people experience minimal symptoms while others end up on ventilators? The toll of an infection depends not only on the type of virus but also our immune response to it.
Let’s watch a movie: "Alien 5: Invasion of SARS-CoV-2."
An innocent breath: Viruses land on airway cells via moist microscopic droplets. They enter the cells. Hypnotized by viral gene coding, the host cells mass-produce more viruses. Straight out of "Alien."
Noting fishy business on the surface of infected cells, frontline defense cells are alerted. They recruit specialized cells. Some kill infected airway cells directly while others produce target-specific weapons – antibodies – which can neutralize the viruses directly or label them to be swallowed by other giant defense cells.
A movie of our immune system fighting alien life forms is slicker and smarter than "Alien." But in real life, all this fighting, killing and neutralizing creates a milieu of inflammation. Before our own tissues are unnecessarily and irreparably damaged in the crossfire, our body produces anti-inflammatory chemicals to rein in the hotshot defense cells. The balance is exquisite and well-done, most times.
When the balance is off, in certain advanced stages of the infection, steroids, potent anti-inflammatory drugs, might tip the scale.
These steroids are different from the muscle-building sex steroids. You most likely have taken them this summer, for a poison ivy rash or eczema. They’re used in many autoimmune diseases and cancer treatments. Most asthmatics have been on a steroid inhaler or pill.
But the side effects of steroids are as numerous as their benefits. Given for the wrong infection or at the wrong time, they can worsen the original infection or predispose us to new ones.
For example, studies showed steroids might modestly improve COVID-19 infection, but they can make flu worse.
The first time I went on high-dose steroids for asthma, I took the first dose on Friday. On Saturday, I woke up with, according to my husband, a “crazed” look in my eyes. I declared I wanted to clean the house and laid out an impossible plan.
He mumbled something about a birthday party and disappeared with the children.
And clean I did: I swept and mopped the floors, vacuumed and SteamVac’ed the whole house, scrubbed the toilets, stripped the beds, did dishes between laundry.
Late afternoon, I called him to get the “grass machine” started. He popped his head in: Inside, the house smelled like spilled detergent; the poor dog was curled in a corner, trying to stay out of my way. Puff, he disappeared again, and didn’t come home until I don’t know when.
Later, I figured I had steroid-induced mania – such energy and impulsiveness. When I heard President Trump tweeted 120 times in three days while on steroids for COVID-19, I had to laugh.
Even now, I remember vividly the day when the army of me, myself and I mowed, scrubbed, rinsed – and puzzled: Well, this is not normal. And just couldn’t figure out why.
Now I do. My house never looked that clean again.