How and why this tiny microbe makes you sick: A coronavirus story of one married couple

How and why this tiny microbe makes you sick: A coronavirus story of one married couple

CINCINNATI – Doug Hicks used to say he didn’t get sick. Cold bugs. Flu season. None of it fazed him. His kids might get sick. His wife might get sick. Not him.

Until last month, the 33-year-old autoworker from St. Bernard, Ohio, had a hard time remembering the last time he’d caught anything but a pass in the football league he plays in.

Then he met the novel coronavirus.

“I wasn’t prepared for this,” Hicks says.

Few people are. The virus is a terrifyingly efficient marvel of evolution, built to spread easily from person to person, then settle in for a long stay.

Sometimes, the host barely knows it’s there, allowing the virus to more easily travel and meet new hosts. Sometimes, the host can’t get out of bed for days or weeks. On rare occasions, the host dies from all the damage the virus has done.

Why does the novel coronavirus do these things? It’s a question that occurred to Hicks and his wife, Sheena, more than once as they endured three weeks of misery from the middle of March to early April.

To find an answer, the Cincinnati Enquirer asked Doug and Sheena to describe their symptoms and then asked an infectious disease specialist to explain what was happening to them and why.

A warning: Like Doug, you might not be prepared for this. It’s not a tale for the squeamish.

An illustration showing how the novel coronavirus is contracted.

Contracting coronavirus

Sheena appears to have been the first to encounter the virus. It could’ve happened at her job at a call center or while visiting bars during a pre-St. Patrick’s Day pub crawl. The location might matter to scientists tracking the pandemic, but it doesn’t matter to the virus. Some public health experts say contact tracing is a key strategy in stopping the spread of the virus.

Dr. Carl Fichtenbaum is a professor and infectious disease specialist at the University of Cincinnati. He says the virus is spread when an infected person expels tiny droplets from the mouth, throat or lungs, usually during a cough or sneeze.

The virus can live for hours or for more than a day, depending on the surface and temperature, just waiting for someone new, like Sheena, to come along. Once she touched a droplet and then touched her face, the virus would have been well on its way to finding a home in her nose or throat.

At this point, Sheena wouldn’t have felt any symptoms. But the virus was getting to work.

It can take two to 14 days for a person to develop symptoms after initial exposure to the virus, according to Dr. Martin S. Hirsch, senior physician in the Infectious Diseases Services at Massachusetts General Hospital. The average is about five days.

An illustration showing how the novel coronavirus enters a person's body and what symptoms appear.

A dry cough, lost sense of smell

The coronavirus wastes no time. Within hours, it begins burrowing into the cells that line the nose and throat, which have receptors that allow the virus to attach and begin replicating. Soon, it’s making billions of copies.

“Viruses need something else’s machinery to help generate them,” Fichtenbaum says. “They’re what we call a parasite.”

Sheena might not have noticed this for days, or even weeks. Eventually, though, she got a scratch in her throat and a dry cough, the first sign of the body’s immune response to the virus. Then she lost her sense of smell, a tell-tale sign the novel coronavirus had arrived.

The American Academy of Otolaryngology – Head and Neck Surgery said anosmia and dysgeusia are symptoms associated with COVID-19. Anosmia is the loss of smell while dysgeusia is an altered sense of taste.

Fichtenbaum says scientists haven’t figured out yet why it happens, but the virus somehow interferes with the olfactory nerve, which transmits sensory data to the brain and is responsible for the sense of smell.

This is when Sheena started to worry she had COVID-19, the disease caused by the coronavirus. She told Doug to stay away from her and started spraying bleach all over the bathroom.

“It smells like a swimming pool in here,” Doug told her. Sheena couldn’t smell a thing.

By then, it already was too late for Doug. The virus was going to work on him, too. He just didn’t know it yet.

An illustration of novel coronavirus symptoms.

The spread

Within a week or two, the virus would have been churning out copies of itself at an incredible clip. And Sheena and Doug’s immune systems would have shifted into overdrive.

Sheena’s cough and runny nose? That was the immune system attacking the virus, causing tissue to swell and ache, and causing infected cells to slough off.

Doug’s headache and blazing fever? That’s the body heating up to kill the invaders.

The full-body aches and fatigue they both felt for days? That’s the collateral damage of the invisible war between the immune system and the virus. Turns out, battling billions of tiny microbes is exhausting.

“I felt like I got hit by a train,” Doug says.

Fichtenbaum says the immune system was doing what it was built to do: protect the body. The problem, he says, is that sometimes the immune response can be so strong it does harm to the body it's supposed to be saving. This happens most often with a new invader, one the immune system doesn’t recognize and attacks aggressively.

It’s like carpet-bombing a big city in wartime. It might kill the enemy, but it wipes out a high percentage of the civilian population, too.

An illustration showing how the novel coronavirus affects the patient's body.

Breathing trouble

This is when things get particularly frightening with the coronavirus. The virus is happy in the mouth, nose and throat, but it really seems to thrive in lung tissue. And if it gets a foothold there, look out.

“It seems the kind of receptors this virus likes are in the lower lung,” Fichtenbaum says. “When it finds those things, it really does go crazy.”

Doug says he didn’t have severe breathing trouble, but Sheena struggled so much she thought she might end up in the hospital.

“It was kind of hard to breathe,” she says. “That was scary.”

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Thousands of COVID-19 patients do go to the hospital and some deteriorate so quickly they must be placed on ventilators to keep them breathing. The problem, again, is twofold: The virus is destroying cells and the immune system is attacking the virus.

The result can be bronchitis or, worse, pneumonia that fills the lungs with fluid and interferes with the body’s ability to get oxygen to the blood.

This is the tipping point for the most seriously ill COVID-19 patients. Most endure the assault and begin to recover, but a minority don’t. Their lungs essentially stop working.

The recovery

Sheena and Doug never got to that point. By the first week of April, Doug’s fever had broken and Sheena’s breathing had improved.

But nothing about the coronavirus is easy, so the recovery has been a challenge. Doug bounced back faster and was cleared to go back to work a few days ago. Sheena is working again, albeit from home now like so many others, but she still doesn’t feel right.

“I still don’t feel all the way back to normal,” she says. “I can’t explain it.”

Fichtenbaum can. The doctor says Sheena, like anyone who’s had a full-blown case of COVID-19, has been through the ringer and needs time to recover.

Special cells in the body move into the former battleground areas and, essentially, start cleaning up the debris so new, healthy cells can generate. The recovery is underway, but the body still isn’t what it was before it met the coronavirus.

“Your body has done a good job,” Fichtenbaum says. “The repair process begins, and that takes time.”

Follow Dan Horn on Twitter: @danhornnews


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