Eric Lammertsma has a unique background in both Biomedical Science and Marketing Technology.
He researched Toroviruses and the Hepatitis C Virus at Yale and Utrecht Universities. In 2008 Eric founded CrimsonBase where his team built the first user-friendly genetics software. In 2011 Eric founded Pixplicity, a creative technology agency with clients such as Nestlé and BMW. At the helm of Pixplicity Eric guides adoption of a wide range of emerging technologies from machine learning and IoT to robotics and augmented reality.
Below is an excerpt of our conversation on March 11th, 2020. This is Part I in a two-part series. Part II, our exploration of the economic impacts of this global pandemic, can be read here.
Dave Donars (DD): Please tell us a little about yourself.
Eric Lammertsma (EL): Today and for the past 10 years I've been a creative technology director and entrepreneur. But before that, I was actually formally trained in medical biology and more specifically, microbial pathology and even more specifically virology. At Utrecht University I researched the Toroviruses (ToV), which are part of the Nidovirus family, which also includes Coronaviruses (CoV). After that I worked on Hepatitis C and HIV at the Department of Microbial Pathogenesis at Yale. Like everyone else I’ve been following the news--and the Coronavirus coverage is both really interesting and really frustrating..
DD: Let's dive into that. So the audience understands your perspective, can you kind of give a definition of what virology is and what a virologist does?
EL: Very broadly, virology is the study of viruses. But with a laser focus on the virus itself: trying to understand the structure of the virus, how it works, really trying to understand a specific virus through and through. Most of all, virologists study genetics because a virus is not much more than a little packet of genetic information. Every virus has a fatty acid lipid membrane on the outside with some proteins. The outside structure is kind of like the keys to the castle to get into host cells. Inside the membrane there is just a little packet of genetic information--usually a single strand of DNA or RNA. And so a virologist is doing a lot of the time trying to understand the genetics of those genes and how closely related they are to other viruses. For example Virologists can make a virus fluorescent to see where it goes when it enters a cell and what the pathway of replication is.
Jon Lorenzini (JL): Help me out here. I know nothing about biology. What's the difference between a bacterial infection and a viral infection?
EL: They're very different beasts. Bacteria are actual organisms--they can replicate on their own and live in a variety of different environments. Bacteria are interesting in their own right. They do cause infections too, purely by being in the wrong place. However there are also really advantageous bacteria like the E. coli in our gut. E. Coli help digest food, so humans simply couldn't live without them. Viruses, on the other hand, are totally different. They don't have many of the criteria for life. Viruses are not organisms and don't have any goals. Something that has always attracted me to the viruses is that they are kind of stupid. Really stupid. They're basically a wrench thrown into the works of Life. Because, as I said before, viruses are just tiny packets of genetic information and this is just such a kind of fluke of evolution.
EL: This one specific strand. If you have this specific amount of these few genes that tend to be like around 3,000 base pairs which are the letters of genetics.
JL: We've all seen before the little steps on the...ladder
EL: Right, the steps on the ladder of DNA. Viruses have 3000 of those versus human’s 3 billion. There can be as few as five genes in a virus versus a human’s 46,000. Such a minute amount. But you put that virus in a human cell, and suddenly it takes the whole thing over. The replication mechanism of that cell just gets completely hijacked and does nothing other than replicating the virus until it dies.
JL: So, in a way, being a technologist, and a biologist, the concept of viruses are very similar in a sense that a small piece of code could hijack a huge piece of machinery.
EL: Yeah the term for computer viruses was very aptly chosen because that's kind of the same thing. A very complex machine is functioning but if you add one tiny little program the virus messes the whole thing up. So sure they are very similar.
DD: Just to focus on the newscycle a bit, I know you've been very frustrated with some of the coverage out there. Could you speak to where you see Coronavirus going? Should we all be panicking or is this nothing?
EL: First of all no one should be panicking. This is not the zombie apocalypse. Terrible stuff is not going to start happening all of a sudden. I understand the desire from governments to try to contain Coronavirus, but all those efforts will do is slow down the spread a little bit. Government efforts are not going to prevent anything. That is a big part of the problem. In some ways it is like trying to contain the flu with two notable exceptions. First of all, I'm not going to gloss over the fact that Coronavirus is much more deadly than the seasonal flu. Second--one of the most important points about Coronavirus is that infected people show no symptoms for a number of days. That’s the reason it is going to be impossible to contain.
DD: Aren't people most contagious during that period?
EL: Yes before you show symptoms is the time you are most contagious because the virus is replicating in your airways. The biggest problem with Coronavirus is the fact that people are asymptomatic and infectious for the first couple of days. Most notably coughing can spead Coronavirus but even regular breathing can as well.
There's all of these articles popping up asking if people should wear facemasks. I mean, it's ridiculous for everybody to be walking around with facemasks all the time. Most people don't do that for the flu. Coronavirus can still infect you through minute little water droplets floating in the air, not just coughs. Only a professional grade mask can stop the smaller particles. Other than mandating everyone to stay home, it's something that can't be overcome with regulations.
DD: People buying in bulk can create shortages in medical facilities...
EL: Yes. People in the medical fields and people caring for those already infected really need supplies.
Mike Lichter (ML): I have a two part question. I assume we're in the mitigation phase now--beyond containment. What as part of your training in virology. Based on your training in virology can you talk a little bit about what that strategy looks like?
And then please explain in general terms what virologists are doing over the next few months as they work towards a vaccine.
EL: It's good question. Let me first clarify about the work of virologists. The focus of virologists themselves is very narrow--laser focused on, “What is the virus?” “How does it work?”. Virologists are not the people planning what the population should do. Virologists are studying how Coronavirus works to identify weaknesses and how it can be attacked.
One of the important points of it is creating a vaccine. It's often stated a vaccine is a dead virus. You're just injected with a dead virus. Sometimes that's the case, sometimes it's actually even simpler. A vaccine triggers the immune system to try to recognize the virus, without your body actually being infected with the virus. Virologists do by producing empty husks without any genetic information from the virus. Labs can produce a bunch of those, and the husks simply can't replicate because there's no machinery in the virus particles to do so. On their own, those husks can't do any harm at all.
Once vaccinated, your body will encounter the husks in the bloodstream and grab them, make a kind of immune system antibodies log. Then, if it encounters the real virus, your body already has kind of the blueprint in place to say, “Hey, I've seen this before.”. Let's produce antibodies to attack it. The antibodies help your immune system to recognize the virus as something that needs to be taken out.
JL: Just throwing an analogy out there. Boxers spar before big matches. So creating a vaccine is almost like sparring with someone who's not actually throwing their strength behind it. The boxer can get used to a certain type of attack and prepare for a fight without causing any damage.
EL: A vaccine is more like a wanted poster. A vaccine just throws these wanted posters into the bloodstream and then your immune system recognizes the virus.Then once the actual bad guy enters your body is like, “I've seen you before!” and starts attacking the virus.
DD: Is it possible to create a vaccine for Coronavirus? Because we don't have a vaccine for the common cold.
EL: Very good question. The common cold is actually caused by a number of different viruses. And the reason colds and flus come up every year is because of changes to those outside structures. So your body hasn't encountered this variation before; so the antibodies it would have created for last year’s cold won't work against this year’s cold because the outside structure of the virus has changed. So, it can easily fight the one from last year with the antibodies it has. But you don't catch that one again. It's a different cold--changing so much the wanted poster is no longer relevant.
When they name a virus like H1N1, those are actually names of proteins. The H and the N are two different proteins, and the numbers are the variants of those proteins. We could also have H4N13 or something, for example. And everytime those change, they change the outside structure.
JL: In other words, the face on the wanted poster changes?
EL: Yes, the outside keys change. And when they change, your body can't recognize them so you get infected again by the new string. Something like that can theoretically happen with the Coronavirus as well. Scientists already discovered two different strains of the Coronavirus. One strain has infected approximately 70%, the other about 30%. The 30% variant has been recognized as the ancestral variant, meaning it's the original. Circumstantially this points to the fact that the 70% variant has gained a mutation that makes it more infectious to humans. Just more prevalent, we can't be sure right off the bat the 70% strain is more infectious. Maybe it has fewer symptoms or the symptoms show up later. Something causes an advantage in infection rates.
JL: So as these infections increase does the likelihood of future mutations increase because there are more hosts?
EL: Yes. The short answer is yes but that is not necessarily a big deal. Mutations are absolutely random but Coronavirus is not going to suddenly change and attack immune systems overnight. It's still a respiratory virus and attacks cells in the respiratory pathway.
ML: Do people develop an immunization against Coronavirus?
EL: Yes. Same as your question about those cold viruses except that the Coronavirus isn't known to develop new variants of its outer shell. Infected people will develop an immunity to Coronavirus and will not get infected by the same string again. Now there are two different strings of Coronavirus but it's very unlikely they are different enough for somebody to be infected by each one. A mutation would have to change the outside of it, to an extent it's no longer recognized by antibodies (remember the wanted posters). On the other hand HIV changes its outer shell constantly, which is why there is no vaccine for HIV. That is why HIV is such a famous virus and why research is still going on.
DD: Today, in early March, there are about 100,000 infections globally. And it has maintained, at least for those symptomatic and being tested, a mortality rate of about 3.5%.
EL: Well there are many articles saying the mortality is much lower--around 1% based on calculations from reported cases. We are looking at a mortality rate between 1% to 3.5%.
I would definitely lean towards the 1% mortality rate.
DD: Are we outside of the containment phase?
EL: There's absolutely no chance of containment. If New York City has 100 people with verified cases of Coronavirus; at that point, the number of people that they've been in contact with is huge. Authorities have already lost track of how people got the virus. There is just no way you can quarantine everybody that's been infected and hope this goes away. That's simply
DD: So the whole country of Italy is on full scale quarantine. Will that be effective?
EL: Quarantines definitely slow things down. I mean, it's not like it doesn't do anything at all. Yet certain people are still going to be allowed to travel. People have mitigating circumstances which allow them to sidestep the rules. Even the people in charge are getting infected, like these health officials are getting infected and these are people that know what they're doing.
ML: If we're in mitigation, various governments are trying to buy time to study the virus, develop a vaccine, and hopefully keep the infection rate and death count as low as possible.
EL: Well, purely looking at how people are getting affected right now, by the time we have a vaccine I think the bulk of this is going to be over. My take on this, it's simply taking far too long for people to focus on sensible voices. All the alarmism can be really attractive. So we just need to be sensible. So please:
Wash your hands regularly.
Don't visit your grandparents, give them a phone call.
Make sure that you have a couple of cans of chicken soup.
If you're caring for an infected person, wear a mask and limit going outside as much as possible .
Don’t rob Walgreens blind of all of their sanitary stuff. Consider the people who are actually infected with Coronavirus
For the conclusion of our series please read Part II where we explore the response Coronavirus and the economic implications of a global pandemic.
Freehand Circle thanks: Eric Lammertsma and Jon Lorenzini.