COVID19…Amidst the conundrum and the chaos . Weekly musings of an ID Doc. July 24, 2020.

Going 6 months into this pandemic, we are still learning a lot of things about this thing. However, we know more now than we did back in March. There’s still a lot of unknowns about this thing but we could certainly say that this organism is predictable in its unpredictability. Or is it unpredictable in its predictability? Tomatoes, potatoes.

Anyway, its unpredictability of getting some people sicker compared to others still baffles us. How do you explain a patient in his early 90s going home after few days in the hospital and yet we have a 30 something year old on the ventilator right now? Why is it that some respond really well and faster with the antiviral Remdesivir and others don’t? Part of the answer might be genetics. And maybe blood type. I know, I was one of the skeptics of that blood type association early on. I still am but there might be some convincing data that can shed light soon. A study from Italy and Spain involving about 1600 patients published in NEJM tried to connect certain chromosomes that could encode for a person’s genetic vulnerability to COVID-19. That genetic testing might be next frontier in laboratory testing. We shall see.

On the other hand, this thing being a virus has certain patterns, characteristics that make it predictable. Even if you have an elementary knowledge of virology, you know that this thing is not going to infect you unless it meets you. Same knowledge also will make you convince that adequate barrier including distancing, mask wearing and adhering to meticulous hygiene could lower your risk of getting this thing. It is predictable that way.

What we can not predict is what it is going to do once inside your body.

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