Virus? ...sim­ply a piece of bad news wrapped up in pro­tein.

—Jean and Pe­ter Medawar

by Christoph

In the mid­dle of the first ma­jor pan­demic of my life­time I feel the need, as a mi­cro­bi­ol­o­gist, to make oc­ca­sional con­tri­bu­tions that may help in­di­vid­u­als and so­ci­ety ap­proach the pan­demic in a rea­son­ably in­formed way. To­day, I'd like to con­tribute with a small dose of 'mi­cro­bial lit­er­acy,' as called for by Ken Tim­mis and col­leagues well be­fore "the coro­n­avirus" hit. Here is the ques­tion: are viruses alive? Short an­swer: No. Long an­swer: it's com­pli­cated be­cause of bi­ol­ogy (see part 2, next Mon­day).

Short an­swer: No, viruses are not alive

Fig­ure 1. See be­low for leg­end Source. Fron­tispiece: SARS-CoV‑2 by @dsgoodsell

In a pa­per pub­lished on March 17th in The New Eng­land Jour­nal of Med­i­cine (NEJM), a team of 13 NIAID research­ers an­a­lyzed the "Aerosol and Sur­face Sta­bil­ity of SARS-CoV‑2 as Com­pared with SARS-CoV‑1." They state that "SARS-CoV‑2 re­mained vi­able in aerosols through­out the du­ra­tion of our ex­per­i­ment (3 hours), with a re­duc­tion in in­fec­tious titer from 103.5 to 102.7 TCID50 per liter of air." And they con­clude "that aerosol and fomite trans­mis­sion of SARS-CoV‑2 is plau­si­ble, since the virus can re­main vi­able and in­fec­tious in aerosols for hours and on sur­faces up to days..." (My em­phases in both cases.) What they ac­tu­ally did was ex­pose dif­fer­ent sur­faces un­der care­fully con­trolled con­di­tions to aerosolized virus par­ticles, and mea­sure their time-de­pen­dent de­cay rate by tis­sue-cul­ture in­fec­tion of Vero E6 cells (a stan­dard cell line used in vi­rol­ogy). This last ex­per­i­men­tal step, the in­fec­tion of tis­sue cul­ture, was the only one dur­ing which the virus mul­ti­plied (Fig­ure 1).

Un­for­tu­nately, vi­rol­o­gists ha­bit­u­ally speak of the "vi­a­bil­ity" of viruses when they ac­tu­ally mean (and mea­sure) their "in­fec­tiv­ity." This talk of vi­ral vi­a­bil­ity ex­tends to the World Health Organiza­tion (WHO) in their Q&A on coro­n­aviruses (COVID-19): "...the virus that causes COVID-19 sur­vives on sur­faces," and "...sim­ple dis­in­fec­tant to kill the virus..." (My em­phases.) One can thus hardly blame the press to con­tinue along those lines, like in this head­line in The Econ­o­mist: "How long can the novel coro­n­avirus sur­vive on sur­faces and in the air?"

Why is a dis­tinc­tion be­tween "vi­a­bil­ity" and "in­fec­tiv­ity" rel­e­vant and not just merely se­man­tic? Be­cause the ther­a­peu­tic and hy­gienic mea­sures re­quired to treat and con­tain vi­ral dis­eases are dif­fer­ent from those re­quired for bac­te­r­ial dis­eases. It is dif­fi­cult enough to con­vey to the pub­lic − and to gov­ern­ments, by the way − that an­tibi­otics are not ef­fec­tive against viruses (spoiler: an­ti­virals are). But there's some­thing more ba­sic here. Viruses only mul­ti­ply within cells af­ter they have in­fected them, and, once re­leased from the cells, stay in­fec­tious only for a while. That is, un­less they're brought again into con­tact with other host cells, they de­cay. Bac­te­r­ial hu­man patho­gens, on the other hand, not only sim­ply sur­vive out­side hu­man hosts but can usu­ally grow and mul­ti­ply in var­i­ous non-hu­man en­vi­ron­ments ('nat­ural reser­voirs' is the tech­ni­cal term). Vib­rio cholerae, for ex­am­ple, thrive hap­pily on chiti­nous sur­faces of ma­rine in­ver­te­brates (form­ing bio­films) and in coastal wa­ters (plank­tonic). Or take Staphy­lo­coc­cus au­reus (MRSA), which are per­manent guests in an­i­mal breed­ing fa­cil­i­ties and waste wa­ter.

Peo­ple from all cul­tural back­grounds iden­tify liv­ing be­ings by their abil­ity to grow, re­pro­duce and even­tu­ally die. (I am of course fully aware that this is the low­est com­mon de­nom­i­na­tor, and peo­ple from dif­fer­ent cul­tures add other in­gre­di­ents to this 'ba­sic recipe,' usu­ally meta­phys­i­cal or re­ligious). So, for the sake of your 'mi­cro­bial lit­er­acy' you can rely on the fact that viruses have the abil­ity to re­pro­duce (within host cells), but do not grow (host cells do), and can­not die (host cells even­tu­ally can). No, viruses are not liv­ing be­ings be­cause they only ful­fill one of the three ba­sic con­di­tions.

There's noth­ing wrong with this naïve, in­tu­itive way to un­der­stand what "life" is when it comes to deal­ing with the coro­n­avirus, SARS-CoV‑2. But don't take the quote of the Medawars in the ti­tle of this post as a quip, take it lit­er­ally − "bad news" refers to you! Con­tinue with the prac­tices of phy­si­cal dis­tanc­ing and fre­quent thor­ough hand wash­ing − 20 sec min­i­mum, with soap − as rec­om­mend­ed by the WHO. Soap does not "kill" the virus, but breaks it down neatly into its then harm­less in­di­vid­ual com­po­nents (Lizah van der Aart made a fancy poster about this). And do not touch your face − avoid pick­ing your nose or bit­ing your fin­ger nails, and re­mem­ber Stan­ley Falkow's car­toons. It can also be help­ful to wear a self-sewn face mask − you don't pre­vent the in­hala­tion of aerosolized virus par­ti­cles but you re­duce it; more im­por­tantly, you re­duce the ex­ha­la­tion of virus par­ti­cles by wear­ing a face mask if you are in­fected but asymp­to­matic, that is, you do not show any of the symp­toms typ­i­cal of COVID-19.

 

Leg­end to Fig­ure 1. Vi­a­bil­ity of SARS-CoV‑1 and SARS-CoV‑2 in Aerosols and on Var­i­ous Sur­faces. As shown in Panel A, the titer of aerosolized vi­able virus is ex­pressed in 50% tis­sue-cul­ture in­fec­tious dose (TCID50) per li­ter of air. Viruses were ap­plied to cop­per, card­board, stain­less steel, and plas­tic main­tained at 21 to 23°C and 40% rel­a­tive hu­mid­ity over 7 days. The titer of vi­able virus is ex­pressed as TCID50 per mil­li­liter of col­lec­tion medium. All sam­ples were quan­ti­fied by end-point titra­tion on Vero E6 cells. Plots show the means and stan­dard er­rors (bars) across three repli­cates. As shown in Panel B, re­gres­sion plots in­di­cate the pre­dicted de­cay of virus titer over time; the titer is plot­ted on a log­a­rith­mic scale. Points show mea­sured titers and are slightly jit­tered (i.e., their hor­i­zon­tal po­si­tions are mod­i­fied by a small ran­dom amount to re­duce over­lap) along the time axis to avoid over­plot­ting. Lines are ran­dom draws from the joint pos­te­rior dis­tri­b­u­tion of the exponen­tial de­cay rate (neg­a­tive of the slope) and in­ter­cept (ini­tial virus titer) to show the range of pos­si­ble de­cay pat­terns for each ex­per­i­men­tal con­di­tion. There were 150 lines per panel, in­clud­ing 50 lines from each plot­ted repli­cate. As shown in Panel C, vi­o­lin plots in­di­cate pos­te­rior dis­tri­b­u­tion for the half-life of vi­able virus based on the es­ti­mated expo­nen­­tial de­cay rates of the virus titer. The dots in­di­cate the pos­te­rior me­dian es­ti­mates, and the black lines in­di­cate a 95% cred­i­ble in­ter­val. Ex­per­i­men­tal con­di­tions are or­dered ac­cord­ing to the pos­­terior me­dian half-life of SARS-CoV‑2. The dashed lines in­di­cate the limit of de­tec­tion, which was 3.33× 100.5 TCID50 per liter of air for aerosols, 100.5 TCID50 per mil­li­liter of medium for plas­tic, steel, and card­board, and 101.5 TCID50 per mil­li­liter of medium for cop­per.

  

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