Coronavirus Turns over Immunity into Weapon that Backfires

Kompas/Heru Sri Kumoro

A motorist drives past street art on Thursday (2/4/2020) beneath the Jl. Latuharhari overpass in Central Jakarta. Graffiti artists and talented locals have responded to the public health emergency by painting murals and graffiti to raise awareness and urge togetherness, as well as to cheer on medical workers on the front lines of the outbreak in Indonesia.

Why is this new type of coronavirus so deadly?

How does this virus attack the human body, and why can it cause victims to die very quickly – in 4 to 7 days? In patients with HIV/AIDS it generally takes years to become fatal.

If HIV/AIDS is like a guerrilla war, Covid-19 destroys victims in a blitzkrieg. The damage caused is described in a video circulating in social media. Doctor Keith Mortman, head of thoracic surgery at George Washington University Hospital, used 3D modeling to show how quickly Covid-19 attacks the lungs, from the stage of flooding the alveoli to the stage where the lungs stop functioning. The whole process from the beginning of the infection up to lung failure only takes a week if the patient has no immunity. "I want people to see this and understand what can be done. People need to take this seriously," he says in the video.

It can even be asymptomatic in fit, young people, whose health prevents the virus from attacking them.

Covid-19, the name of a disease caused by this virus, was initially underestimated because when the body is infected, the initial symptoms are just like the flu accompanied by coughing and breathing difficulty. It can even be asymptomatic in fit, young people, whose health prevents the virus from attacking them. However, these people can still be carriers and as such transmit the virus to others, including more vulnerable people, such as the elderly or people with a history of chronic illness, where symptoms can be immediately apparent.

Friendly fire

In this condition, ache, pain and fever appear in the body. Cells that are attacked by this virus will be irritated to cause coughing. Initially a dry cough. However, it can turn into a cough with thick mucus, which contains lung cells killed by the virus. This stage takes about a week. When the immune system eradicates the virus, the body recovers. However, if it loses a battle, it will fall to a more serious stage of illness.

Ironically, the body does not lose this war because the immune system is not excited to fight against Covid-19, but precisely because the immune system overreacts in the face of viruses, like uncontrolled tantrums. Cytokines are deployed throughout the body, causing massive inflammation or a "cytokine storm". In this condition it can still be overcome if supported immediately with intensive care. If the spread of cytokines is uncontrollable, the process continues into severe inflammation, which will cause damage to all parts of the body, especially six important organs: the heart, lungs, brain, kidneys, liver and digestive tract. This happens when the virus is pushed into the deepest breathing passage (lungs), all small air bags called alveoli will become infected. In fact, in these alveoli bubbles oxygen moves to flow into the blood and carbon dioxide (CO2) moves out into the wild.

This is the condition of pneumonia, where the bags of alveoli begin to be flooded with concentrated fluid and cause breathing difficulty. This concentrated liquid is rich in protein so it is very attractive for the germs to prey on. The lungs are damaged too. Coupled with the "cytokine storm", patients cannot breathe (like drowning in the air). Inevitably, the patient needs a ventilator to breathe. In the case of HIV/AIDS, it can take up to 10 years before pneumonia becomes fatal, but with Covid-19, it can take as little as four days.

KOMPAS/AGUS SUSANTO

Clowns resemble coronavirus disease (Covid-19) tauke a walk around in the socialization of Operation Safety 2020 by the Jakarta Metropolitan Police in the Gelora Bung Karno area, Jakarta, Monday (6/4/2020).

As the body\'s organs begin to fail, the chances of recovery get dimmer. All parts of the body are sick because six vital organs have failed as they are filled with destructive germs. The blood pressure drops dramatically to very dangerous levels and these important organs either stop working or fail miserably. In this situation, the body does not get enough oxygen to survive. Possible effects are that the kidneys fail to work to cleanse the blood and damage to the intestinal layers in the digestive tract leads to bleeding.

Also read: Analyzing the Global Spread of Covid-19

As a result, the spread of cytokines that were intended to deal with the virus eventually trigger an imbalance of the immune system\'s response, thereby resulting in severe inflammation. Like a weapon that backfires, the virus attack even triggers an attack from cytokines that are supposed to defend the body. The body\'s defense system becomes hyperactive, even inefficient. The "cytokine storm" even attacks its own friends, namely lymphocytes or T-cells. In fact, this group of white blood cells is the main army in the immune system. Finally, the lymphocyte number drops instantly. This is the end of the patient\'s body defense period.

The way to do it is by living a healthy and clean lifestyle, frequently washing hands to prevent this virus from entering the breathing passages or channels that are connected to breathing.

To avoid fatality, besides relying on vaccines that are still in the process of accelerated research, it is very important to maintain and strengthen the body’s immune system. The way to do it is by living a healthy and clean lifestyle, frequently washing hands to prevent this virus from entering the breathing passages or channels that are connected to breathing. It is also necessary to be disciplined to live a healthy life and to engage in self-isolation so as not to participate in spreading the disease, and to fulfil nutritional and vitamin needs and get sound and enough sleep. Do not ignore, let alone underestimate it. And, do not forget to pray to God, the Healer. May the global wave of deaths by these microorganisms pass swiftly.

Djoko Santoso, Professor, Medical Faculty of Airlangga University