dr looi on fb malaysia, page-1937

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How deadly a virus infection is and how fast it spread is dependent on factors like virulence, the ambient heat, humidity,sunlight (UV), age of patient, innate and acquired immunity and concomitant diseases in the patient.

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But there are 2 important factors which have rarely been mentioned i.e. (1) the inoculation dose and (2) the mode of entry of the virus into the body of the patient.

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(2) It is well known in the medical fraternity that if the inoculation dose (the number of viruses that the patient is inoculated with) is large, the incubation period will tend to be shorter and because the body’s defences have less time to mobilise, the infection tend be more severe.

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Health workers tend to receive a much higher inoculation dose and as a result their illness tends to be much more severe.

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Wearing a mask will obviously reduce the

inoculation dose and although this will not stop the infection, it will obviously reduce the inoculation dose and as such reduce the severity of the infection.

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So masks, in addition to being useful in reducing the spread of the disease from symptomatic patients as well as healthy carriers,is also useful in reducing the severity of the illness of the patient.

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(2) The mode of entry of the virus into the body is another factor which may determine how serious the subsequent illness will be.

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Sneezing, coughing and even talking can produce particles of between 1 to 20 microns.

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How long these particles remain in still air

depends mainly on the size.

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In one study, it was shown that a 100 micron size droplet takes about 10 seconds to fall from a room of about 6 meters high.

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40 micron particle takes 1 minutes.

20 micron particle takes 4 minutes.

10 micron particle takes 17 minutes.

Less than 10 micron will stay in the air for a longtime!

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Particles of between 2 to 5 microns will go deep into the bronchioles and alveoli of the lungs.

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When the humidity is low, airborne micron size particles tend to rapidly lose their moisture fast.

This means that even the larger particles from the infected patient can become small enough to enter the lower respiratory tract.

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The COVID-19 virus is best adapted to the cells of the lower respiratory tract and this is where it causes the most serious damage.

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Unlike polio and other enteroviruses, coronaviruses are inactivated by the acid, bile and enzymes in the stomach and gut.Theoretically it may be able to penetrate and enter the body via the lining of the mouth and the oesophagus but since the inoculation dose would be rather small, the illness it will cause via this mode of entry may be expected to be relatively mild.

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Infection via other modes like contact with contaminated surfaces would not introduce the virus into the lower respiratory tracts and as such would most likely to result in a milder form of the illness.

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SO PLEASE WEAR YOUR FACE MASK IF YOU ARE IN A PLACE WHERE AN EPIDEMIC IS PRESENT.

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Dr H W Looi, Malaysia

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