A Comprehensive Update on SARS-CoV-2 and COVID-19

Throughout the pandemic, I have tried to inform and educate my readers of what we were learning in real time about the SARS-CoV-2 virus and the disease that it causes – COVID-19. We have covered a broad range of topics from virology to immunology to epidemiology. I have also tried to dispel some of the misinformation and disinformation.

At times, I was not able to blog as frequently as I wanted. In 2020 and 2021, I was heavily involved in advising schools and businesses as to how to safely navigate this pandemic during a period of time that we had more questions than answers. I also served on the Governor’s Coronavirus Work Group, began appearing on a weekly NPR broadcast (Boise State Public Radio on Wednesdays at noon with host Gemma Gaudette), and was interviewed, at times a number of times each day, by local and national press and media to explain various aspects of the pandemic and what we were seeing.

Later, my co-author – Dr. Ted Epperly – and I began our work on a book that was released in print (as well as an e-book and audiobook) last April, entitled: Preparing for the Next Global Outbreak: A Guide to Planning from the Schoolhouse to the White House https://www.press.jhu.edu/books/browse-all?keyword=Pate%20and%20COVID-19%20.

More recently, there were just times I needed a break from it all.

Over the years now, we know much more about both the virus and the disease as researchers from across the globe have shifted the research they were conducting prior to the pandemic to focus on this area of study. Science doesn’t often provide answers quickly. Early studies often provide insights, while later studies provide a more in-depth understanding. This is all the more the case when the virus itself is changing and we are seeing many more and different presentations of the disease.

So, what my plans are is to bring you up to date. Perhaps you are someone who just kind of zoned out during all the initial part of the pandemic given the heated debates and uncertainty as to who to believe. Perhaps you are someone who followed things closely at first, but then tuned out once COVID was no longer in the news on a regular basis. Or perhaps you are someone dealing with long-term health consequences from your infection(s) or someone you care about is dealing with these health challenges and you want to understand the disease better. No matter your reasons, this latest blog series will assume that you have been asleep for the past 4 years and just woke up and want to know what is going on. It will also presume that you know little about virology, immunology, vaccinology, disease pathogenesis, cell biology, genetics, and infectious diseases. Therefore, I will try to explain the material in a clear manner, while explaining significantly complex topics surrounding the virus and the disease it causes.

Anytime one explains complex matters in simple terms, highly trained experts will find much to critique as not technically correct or not true in every case. This update is not intended for experts, as they obviously will know more than me. The intent is to give you clear, but yet not merely superficial, information that will give you a far deeper understanding of the science behind this virus and disease. I hope this will further your interest in medical science, and perhaps even your appreciation for the amazing amount of information we have learned in what is a relatively short period of time for the acquisition of scientific information about a novel organism and disease.

I will also provide you with references for those that want to dig in even deeper or for those who want to question my opinions and assessments, which I always encourage.

Finally, a major reason that I want to write this blog series is that I fear far too many are being much too complacent about becoming infected. Some people are under the false impression that getting COVID will somehow “boost” their immune system, which is a dangerous misunderstanding.

Some are under the mistaken impression that the virus has naturally evolved to become milder such that future infections will always be milder than prior ones and that COVID is nothing more than a cold or “the flu.”

Of greatest concern to me is that there is a public perception that COVID in children is almost always mild and of little consequence or concern.

There are others who have just given up believing that getting COVID is inevitable, so why even try to avoid it. First of all, my wife and I do most of the things that we want to do, yet neither of us, as well as a number of the folks who have sought and followed my guidance, have been infected in the four years of this pandemic to our knowledge. At the same time, I realize that our luck may run out, but as we will discuss, the longer you can delay getting COVID and the fewer times you get infected, the lower your risks for many of the long-term health consequences we are going to discuss.

I don’t strive to create panic or overreaction. I think that the important thing is for people to understand the known and suspected risks, and then make decisions that are right for them and their families as to what degree people wish to mitigate those risks. It is also important to realize that we may not know all the risks of COVID-19 for decades, as has been the case for other viruses, for example the evidence that human papilloma virus infection is the primary cause of invasive cervical cancer and the evidence that Epstein Barr Virus can cause a number of malignancies and that it can predispose some to develop multiple sclerosis was not clearly established for decades.

My prayer is that there will be no surprise illnesses down the road for our kids and grandkids. However, I feel compelled to explain my reasons for expressing concern as to the “signals” I see today that give me concern that we may very well see problems in the future for some who have been infected, even in those who experienced only mild illness, and that multiple repeated infections seem likely to only increase those risks.

We will cover all of this in much detail over the course of this blog series.