Ostrich Syndrome and The Pandemics
Elias Hakalehto, PhD, Adj. Prof.
CEO, Finnoflag Oy
Vice President, International Society of Environmental Indicators
First published in 22.1.2021
Current COVID-19 pandemics is possibly just a start of widening epidemiological issues globally. I hope to be wrong but do think that still more novel variants and even new rampaging virus strains may emerge by mutation and recombination as the SARS-CoV-2 has pooled into population. Also the risk of epidemic antibiotic resistant bacteria is increasing in the aftermath of the pandemics. We need international sharing of views during these times. - The undersigned was on the 20th of January in the Finnish broadcasting company YLE´s netpage main news discussing the issues above. Also was interviewed by Radio Suomi. One main point in the future preparations against contagious epidemics should be the passive immunization using chicken egg antibodies for the first-line protection.
In early December 2020, nearly everyone was relieved because of novel vaccines' hopeful news getting ready soon against the nightmare-like SARS-CoV-2 coronavirus causing the COVID-19 disease. Some remarks were there, reminding the delays in getting the products into the market to safeguard citizens. Some doubts have also been cast about the durability of the vaccine protection for all patients. For example, some studies have hinted that for 5% of the injected people may have lost the resistance against the virus in less than 6 months. So, what would be the consequence of the initially promising piece of information (of getting the vaccines soon) getting more distorted? What happened if putting the vaccinations would still get more delayed? The confusing situation with increasing numbers of infected individuals in most countries would warrant other tools to be mobilized, besides the vaccination, which is one of the most important innovations of Mankind ever.
Now, in less than two months after the superficially relieving news, we live through this adversary type of reality. It brings up memories of last Spring, very unpleasant and saddening ones to most of us. Then there were hopes about vaccines protecting the population already in the Autumn of 2020. - It is not wrong to be an optimist. But if the optimism is preventing us from the wise action, it may become a problem. Most citizens would have liked to see the fulfilment of their aspirations regarding the safe and effective vaccines blocking the virus, saving lives, and lifting the economy. But what does the reality look like, where we are living in now? Or the future we might need to cope with? Who knows? Could it be possible that fighting against the nightmare-like epidemics and situation in the healthcare, or the individual lives of ours, may "prevent us from seeing the forest from the trees"? Hopefully, this is not the case, but some steps need to be taken up most urgently.
The species of flightless huge birds were included into the genus Struthio already in 1758 by Swedish father of the biological taxonomy, Carl von Linnaeus. Later such relatives as emus of Australia, rheas of South America, and cassowaries of New Guinea were moved out of that genus. All these birds are at least of humans' height, but common ostrich can reach 280 cm. From that height, it could bend its head down and cover it with sand if danger is threatening it, instead of running away with its powerful legs. This rather obscure behaviour has been named as "ostrich syndrome". This habit of the vast birds has been associated with human individuals or communities' behaviour, as we often refuse to recognize unpleasant facts or fears of ours. And do not start the obviously necessary or seemingly self-evident counter-measures to protect ourselves. Environmental catastrophes have often been such issues, namely "ostrich syndromes" on both the individual and society levels. Unfortunately, this has been the case with pandemics, too, every so often. And they are interlinked with the ecocatastrophes most of the time.
As humans, we easily focus on the more comprehensible problems and easier to solve, regardless of their proportional relevance or risk involved. Our healthcare system is overly strained (and for a good reason), as it struggles against the COVID-19. However, history's lessons warn us about the modified virus strains and bacterial pneumonia or other complications following the viral infection. According to the NIH, the occurrence of pneumococcal lung disease was the biggest cause of immortality in 1918-19 during the "Spanish flu" which was initiated by the influenza virus. It weakened the patients, whose lungs the bacteria then intruded or overtook. The narrow bronchial ducts and alveoli were damaged and swallowed by the virus and the deadly destruction then completed by the pathogenic bacteria inhabiting the nose and throat areas.
You may say that there were no antibiotics available to treat the bacterial secondary infection in the time of Spanish flu. But correspondingly, in today´s world, many bacteria have developed antibiotic-resistant strains. They have not emerged as epidemics as yet, and this could explain (together with the improved level of medicine) that "only" two million lives have been lost globally during the COVID-19 nightmare so far? However, the Spanish flu killed somewhat 50-100 million people, or more, a century ago. - Let us not bury our thinking into sand now. In the aftermath of the second wave of influenza virus spreading worldwide, the death toll started to skyrocket because of the bacterial complications, and no effective antibiotic treatment was available. The viral contagions started to spread in high numbers amongst CA (Community Acquired) cases among the otherwise healthy population. The numbers of the virus-infected individual increased rapidly, forming a reservoir of the pathogen. Now it is possible that no vaccination could catch up with the altering SARS-CoV-2 or its descendants, while the bacterial epidemics caused by antibiotic strains will simultaneously emerge.
We have already experienced the high alarm caused by the British and South African and other virus variants. They spread quickly and unnoticed enough among the entire population, leaving the strains rampaging outside the healthcare system's radar. While battling with the virus, the overstrained and exhausted personnel may not have the strength to realize the upcoming and possibly even bigger dangers. Now it is the time to make urgent plans against this, not only for distributing the vaccines, since the novel threats may start disseminating with a quicker pace than the vaccines are getting introduced. They also possess different and only partially foreseeable hazards.
Although different viruses are basically universal by appearance, they are also specific to their hosts, plants, animals, man, bacteria, fungi, etc. They also are dependent on their hosts´ characteristics, ecology and distribution. Occasionally, the virus strains modify by, e.g. mutations or recombine with foreign DNA of other viruses or host organisms. These variations may sometimes change the rules of the game from the healthcare point-of-view. Moreover, success in that combination against the inevitable developments requires some foreshadowing. - Although the presence of viruses belongs to life in general, and there are several types of them around, they originate from their hosts. In 1953 physicist Seymour Benzer picked up Watson and Crick's ideas regarding the genetic code and produced the map of the genomic sequence of a bacteriophage. In cellular organisms, we now know to exist lots of extrachromosomal DNA, and transposable genes. The messenger RNA is on the move every time transferring the information to be converted into protein structures. Hence, there are opportunities for various viruses to make up novel genetic combinations for themselves - and for their hosts, too. This recombination event is mostly intraspecific, but it may also happen between different hosts.
Professor Arthur Kronberg elucidated the function of the DNA polymerase in St.Louis. He received the Nobel Prize in Physiology and Medicine three years before James D. Warson, Francis Crick and Maurice Wilkins. They received the recognition for describing the double-helical structure of the DNA. But many viruses, including the coronaviruses, are RNA viruses. In other words, their genome is consisting of RNA, which is copied by RNA polymerase. Maybe this could explain the lesser specificity of the SARS virus, for instance? If the intruding viruses genomic code is of RNA, it needs not to get into the host nucleus' DNA copying machinery. This could give more degrees of freedom in the choice of host organism for the virus. And it adds options for the virus for surviving and modifying itself.
The SARS-CoV-1 originated in 2002 from Guangdong province in China. MERS-CoV was disseminating mainly in the Middle East. These two epidemics changed the previously prevailing concept about coronaviruses by causing severe pneumonia-like respiratory illnesses instead of the relatively mild ones in humans or animals. Before the current SARS-CoV-2 distribution, none of the coronaviruses had led to global pandemics. It can be suspected that these viruses and, e.g. such paramyxoviruses as the measles virus (MV), could cause suppression of both innate and adaptive immune responses to secondary bacterial infections. This observation regarding the measles was published by researchers of the Scripps Research Institute in La Jolla, California, Oregon Helth and Science University, Beaverton, the USA in the Journal of Clinical Investigation (2003).
In case of the utmost risks being realized, the spreading of such bacteria as lungs incapacitating antibiotic-resistant pneumococci, staphylococci (MRSA) or mycobacteria in the aftermath of widely distributed viral pandemics, could cause a truly apocalyptic situation. It is noteworthy that the pathogens may also transform into more infective or more damaging ones. The chapter "Bacteriological Indications of Human Activities in the Ecosystems" by the undersigned in the book "Environmental Indicators" (Eds. Armon and Hänninen, Springer Verlag, 2015) is describing the metamorphosis of Vibrio cholerae some 60 years ago: "This environmentally originally important capability can influence even human pathobiology. Since the seventh pandemic of cholera caused by Vibrio cholerae El Tor variant in 1961, cholera's pathogenic strains have been using the 2,3-butanediol (butylene glycol) route of fermentation instead of the mixed acid fermentation associated with earlier pathogenic strains of this bacterium (Yoon and Mekalanos, 2006). The explanation of the main metabolic route could be related to the better survival of the strains inside the human body by improved ability to utilize sugars without acid production." Although most mutational changes in the genome sum up with regenerative alterations for the microbial agent, some recombination may lead to novel patterns of survival and infection. There are antibiotic-resistant forms of the antibiotic-resistant agents of cholera and the multitudes of pathogenic coliform ESBL strains, which most evidently increase the risks of dangerous epidemics initiating in the population with the decreased potential of the immune system to give protection.
In many areas, there are such pathogens as MDR, TDR and XDR spreading in the population. These designate the different kinds of antibiotic-resistant tuberculosis-causing Mycobacterium tuberculosis. It has been supposed that tuberculosis has deprived more human lives than all other contagious diseases together during human history. It is without doubts constituting a major risk for the societies. In India, the antibiotics tolerating multiresistant forms of this bacterium are involved in 20 % of the patient cases. During 2013-14 the undersigned published in Pathophysiology (Elsevier) articles introducing the PMEU (Portable Microbe Enrichment Unit) helped detect slow-growing mycobacteria in a couple of days instead of weeks.
When Finnoflag Oy and Led Future Oy studied a few years ago the occurrence of antibiotic-resistant bacterial strains in the operational theatres and other premises of two private hospitals, we found out that no MRSA or ESBL strains could be observed. However, in the seams between different building materials and on some surfaces, environmental bacterial strains carried the resistance markers. Therefore, a real risk of these capabilities being transferred to harmful organisms does exist. Moreover, if various viral vectors are available, this may increase the potential for transfection by bacteriophages between various bacteria. In any case, we should be alerted with the possibility of modifications.
Similar patterns may facilitate the spread of genetic elements by human viruses. When their numbers are high enough in the society, not only in the hospitals, clinics, cohorts or other healthcare units, this may lead to the "critical mass" or "active pool of genetic material" among the microbial community. Then recombination may occur more readily between various viruses, or between the virus and its hosts.
An escalation of pathogenic microbial functions may escape from the normal microflora or the immune system's control. This might lead to the generation of novel diseases or combinations of symptoms and syndromes. Such a development may lead to chaotic infectious conditions within the societies, which cannot be controlled by single vaccination only. To increase the readiness for rapid responses, we need the early-warning system, physicochemical methods like UVC or hydrogen peroxide vapours, surveillance for the emerging agents, and methods for passive immunization with foreign antibodies. One possibility is the use of prophylactic antibodies produced in the eggs of chicken or other birds, as suggested by Hakalehto and Kuronen some 25 years ago in their patent applications of that time. These birds could be even ostriches.