10 things a conspiracy theorist taught me about the novel coronavirus
Perhaps everyone likes to think they are more of a free thinker than they really are. But at least in the spirit of free-thought, I belong to a couple of Facebook groups where ideas less traveled are freely shared and my posts rub shoulders with those of different political leanings. But lately, even in my core groups, among the people I’ve come to think of as my tribe, I’ve been noticing a marked increase in posts that seem driven less by healthy skepticism and more by paranoid ideologies — what some would refer to as ‘conspiracy theories’. In following some of the more out there threads, I’ve become increasingly intrigued by the similarities between the most ardent devotees of these conspiracies and religious zealots or cult followers.
- A need to feel special and endowed with privileged knowledge.
- An intolerance of and disdain for the ‘unbelievers’ who question their narratives.
- An identification with meta-narratives of mythic proportions.
- Theories indistinguishable from dogma.
- A rigidly binary (good vs. evil/black vs. white/this vs. that) view of the world.
I’m not talking about those of us who pop down the rabbit hole once in a while. I am talking about the ones who have bunkered down in the warren. For them, ideas are no longer updatable expressions of current knowables in an ever-changing landscape, but hardened ideologically-forged bricks of ego-identity. They inhabit a world where no other power except the dark arts of the human mind is at work. Unable to face the terrifying awe of nature, with her impersonal power and unfathomable chaos, they see all events as the result of malicious calculations of the human mind, and brought about as the result of some dastardly mechanism of hyper-control. Never because of an honest mistake, or incompetence, or sheer chance or because of the particular coordination of certain conditions or, heaven forbid, natural laws.
Conspiracy theorists come in many stripes and their ‘theories’ are multiple, weaving in and out of one another like fractals. But they all carry a similar thumbprint. Here are some common markers that I’ve found.
- The assertion of some version of a dark state — a group of powerful and wealthy individuals who control politicians — -with nefarious plans that threaten individual freedom, and access to practically unlimited resources and influence to enact them.
- A distrust of most traditional institutions, particularly those with international credentials.
- A distrust of widely accepted narratives.
- A distrust of experts.
- A preference for data that fits pre-assumed narratives and the dismissal of facts that don’t support these narratives.
- A discomfort with doubt, mystery and the unknown.
- Difficulty with understanding events as having multiple causes.
- The labeling of those who disagree with them as brainwashed, deluded or close-minded.
- A distrust of the “mainstream media”.
- A loosely defined core value of heroically asserted individual freedom that serves as a kind of divine salvation.
- Alienation from family, friends and co-workers and a sense of belonging within an online sub-group of like-minded believers.
- A heavy reliance on social media.
If you recognize a little bit of yourself in some of these descriptions, don’t worry. It just means that you’re human like the rest of us. I mean, who hasn’t had some post-modern moments questioning the narratives we’ve been conditioned to accept? And wouldn’t it be cool to be part of a secret maverick army of the good against the thieves of liberty, capable of inflicting losses on the enemy without even leaving the living room? And like you, I find grains of truth in their discourse, except with so much background noise that separating those grains from the chaff is a task fit for Sisyphus.
And perhaps, like me, you also sharesome of their concerns. For the record, I am uneasy about the rollout of 5G and its potential effects on health and the environment. I remain unconvinced about the wisdom of forced vaccinations. I am informed enough to harbor a healthy distrust of pharmaceutical companies, and I do not believe everything I read in a newspaper — far from it. I pretty much take it as read that there are puppet-masters pulling the strings of politicians. Conspiracists who tend question everything can encourage us to question more things; to be less passive in our consumption of information and more alert to the potential erosion of our rights and freedom. On the other hand, challenging some of the whackier conspiracies can help us to muscle up our rational evidence-based debate skills.
Under more normal circumstances then conspiracy theorists are pretty benign, possibly even beneficial, particularly since their innate distrust of the organs of civic life keeps them mostly deprived of the broader influence that could cause actual harm. But these are not normal circumstances. There is nothing like a pandemic to whip up the imagination, speculation, conjecture, and circumstantial evidence into a head-thumping ground-whirling cocktail. And today, with real lives at stake, some of it seems a bit less harmless. As the saying goes, ‘a little knowledge is a dangerous thing’, but a little knowledge about a dangerous thing is even more dangerous yet.
There are more variations of conspiracies around the origin and nature of the Covid-19 pandemic than there are plot lines in the Game of Thrones; from the virus having been engineered by Bill Gates (a common protagonist), to being the brainchild of a Jewish cabal of bankers supported by satanic pedophile rings involving everyone from Prince Charles to Oprah Winfrey, all the way to the (comparatively prosaic) leak (accidental or intentional) from a Chinese bio-weapons lab. Many of us at some point in our lives, have questioned the prevailing narratives from our governments and the media. And many of us have paused to contemplate the more nefarious opportunistic potential of the lockdowns that governments around the world have enforced on their populations. It would be naive to believe that some political leaders are not already taking advantage of the situation for their own power games (just look at what’s happening in Hungary). As one friend colorfully put it, “The corona virus pandemic is a wet dream for authoritarians.”
Most conspiracists I’ve come across accept the real and present danger of the coronavirus while claiming that it’s man-made and/or designed to re-boot society in some way post lockdown to strip us of individual rights. These people do not suggest that the coronavirus is not real or not a health risk, although some may think it’s dangers are being over-sold. Others, however, go further. It is in this more sinister camp that we find the likes of Dr. Andrew Kaufman who was introduced to me by a Facebook friend. The link directed me to a Youtube video under the ominous heading: Doctor explains the Covid deception.
I should say here that I have nothing personally against Dr. Kaufman. He is rather a symptom of the kind of thinking that is pandemic in the conspiracy world. I could easily have turned my attention to any one of dozens of others that congregate on the speakers’ corner of Youtube. This article is simply the product of coming across his video at the same time as becoming fascinated with conspiracies and wanting to learn more about the virus.
Even on first viewing, without the hours of reading that this video subsequently inspired me to embark upon, I found it hard to understand why anyone would take the content seriously. Kaufman is singularly unimpressive and unconvincing. He blatantly cherry-picks data and seems up to his eyeballs in conformation bias. His profession is psychiatry not medicine and he has no obvious background in virology except perhaps whatever he learned in medical school.
In a nutshell, Dr. Kaufman believes that the coronavirus is a hoax and does not pose any health threat. What we are being told is a dangerous virus, he says, is something that is actually beneficial to our health. Dr. Kaufman doesn’t even attempt an explanation of how such a hoax could possibly succeed, or why it would inspire such loyal support from so many governments, international bodies, health authorities, research institutions, scientists, doctors, health workers, and journalists. Conspiracists often avoid discussing the strategies of their proposed deceptions because to so would be to expose how far-fetched their ideas really are. The pandemic, being such a deeply viscerally frightening event, is such fertile ground for paranoid story lines that all that the likes of Dr. Kaufman have to do to rack up the ‘likes’ is to poke holes in the accepted narratives.
Since conspiracy theorists distrust experts, and because the feeling is mutual, few of those with any meaningful background in the subject at hand would bother to critique their ideas. And so they remain safely tucked away from the laser beam of true scientific scrutiny. Dr. Kaufman only needs to drop a few breadcrumbs of suspicion that this is all a deception, and the viewers he’s targeting, already predisposed to the ideology he’s promoting, will seize onto it like the last loo roll in lockdown, with little or no critical analysis.
Dr. Kaufman’s presentation has racked up an astonishing 48K views and 2.2K likes last time I checked. There are 75 dislikes (for the record one of them is mine. Yes, I too am a keyboard warrior!) That’s a lot of people watching a guy professing that the coronavirus is fake news and all the health precautions are unnecessary. He proudly declares in the first few minutes that his children are “the only children in my area who are not afraid of getting sick and they’re out playing and having a good time.”
I am not trying to convince anybody of anything, least of all the people who have drunk the conspiracy Kool Aid, since they cannot be convinced through rational analysis. No, it was something else, something that I only discovered after I set out my sails for this unlikely (and long!) inquiry. I wanted to be reminded that although it may sometimes seem that all truths are created equal in this tangled world of mis and dis information, it is not and never has been true. And reminded I was. I also wanted to be re-introduced to the intellectual rigour that must be required to present a theory that can qualify for life and death consequences. And re-introduced I was.
In addressing Dr. Kaufman’s talk point-by-point, I was forced to delve into the facts around this pandemic in a far deeper way that I would ever have done out of casual curiosity, and for this reason alone I remain grateful to him. I am also well aware that I am less qualified than he is to discuss this topic and I don’t claim to have any scientific background. But that is exactly my point. If I can pull his presentation apart so easily, so can anyone.
What I do have is a pretty good sense of when someone is trying to shoehorn their bias into an argument and a healthy distrust of those who declare certainty about any situation that is so in flux and keeping some of the best minds on the planet up at night. This sense began to twitch right off the bat, when Dr. Kaufman began his presentation with the words, “I learned some things lately that have helped me develop a theory and I think I know what is really going on here, so I want to give that information to everyone.”
So here they are: the 10 things I learned courtesy of Dr. Kaufman.
- I learned that when it comes to viruses, expect the unexpected
Dr. Kaufman begins by talking about the unhygienic conditions at the seafood/wet animal market in Wuhan. He poses a multiple-choice styled question and asks which of the following is the “most likely” cause of 198 people suddenly falling acutely ill.
- A new genetic disease
- A new virus
- An auto-immune disease
- Bad seafood (poisoned from contaminated meats)
He chooses d) and supposes that the viewer has done the same. I guess if you had asked me last year to choose one of these options, I would have picked d) also. But the most likely thing isn’t always the thing that happens. Putting aside the fact that some of those 198 patients in Wuhan had no had connections to the outbreak market whatsoever (crashing the bad seafood theory), the chances of a virus emerging to pandemic levels is not quite as unlikely as one might think.
It was only a century ago that the Spanish influenza killed 50 to 100 million people and took the lives of up to 10% of the world’s young adults, wouldn’t have been a multiple-choice winner either. RNA viruses have a much higher mutation rate than DNA viruses, a quality referred to as hypermutability. While mutations provide variations essential for natural selection to work, they can also wreak havoc. Around 99% of newly created influenza viruses are unable to infect another cell. But since the mutation rate is so high, this leaves thousands of viruses from each infected cell capable of not only infecting other cells, but of having the potential to become more virulent than before and better able to hide from the immune system. Research into the SARS coronavirus, for example, has revealed that only one or two mutations in viral receptor sites can lead to serious epidemic outcomes.
- I learned about the courage of the Wuhan doctors
The doctors in Wuhan were initially baffled by the symptoms they saw in these early patients that rapidly developed into unusually severe pneumonia. They originally referred to the mysterious condition as ‘SARS-like pneumonia’ basing their observations on the 2003 outbreak. Contrary to Dr. Kaufman’s claim that China was “primed” to blame the illness on a virus “right away”, Chinese health authorities tried hard to downplay the situation, directly contradicting the reports and warnings from the scientists and doctors on the ground. Doctors were reprimanded by the Wuhan police for spreading “rumours” of an outbreak, including Dr. Li Wenliang who lay dying of the virus in his own hospital even as the Wuhan Health Commission continued to deny human-to-human transmission. Labs were instructed to destroy pathogen samples, publishers of the virus’ genome sequence were shut down, doctors found themselves unable to submit their reports to disease tracking networks. Only on January 20, several weeks after the initial warnings, did the government official admit to the reality of human-to-human transmission.
Kaufman finds it suspicious that after finding viral RNA in their samples and determining the genetic sequencing, the Chinese scientists “rushed to develop a test when in fact they were simply following World Health Organization protocol. Sadly, in Dr. Kaufman’s malice-driven world, the correct multiple-choice answer for why scientists might be in a hurry to test for a contagious disease would not be that they wanted to save lives.
Dr. Kaufman’s concerns with the hurry everyone seemed to be in to develop a test is rather like questioning why ambulances would go faster to the site of an accident. The Chinese weren’t the only ones to decide that with the rapid rates of infection, testing for the virus should be made a topmost priority. Under ordinary circumstances the US Food & Drug Administration would conduct a study to determine the accuracy of the tests for any virus. But since such tests can take up to a year to set up, the FDA relaxed its standard requirements to enable labs to begin testing people for the Covid-19 virus without formal approval and to submit their internal research findings later on. For better or for worse, the same relaxations are presently in place with home blood serum tests.
The rapid identification of the coronavirus by the Chinese scientists is probably due to their recent advances in the detection of respiratory virus infections and the development of tests for viral RNA. Why had Chinese scientists made such advances in viral testing protocols? a) because they were involved in a conspiracy to roll out a fake virus to fool the entire world? Or b) because of what they had learned through their experience with another coronavirus — SARS?
- I learned that there are different bodily fluids used to test for Covid-19 (and none of them are pleasant).
I looked into this because Kaufman likes to emphasize that the testing of the Chinese patients in Wuhan involved lung material, which he seems to find suspect for reasons never explained. He later reluctantly admits that the doctors did also take blood, saliva, and nasal swab samples from these patients. For the record, they also underwent tests for bacterial and fungal pathogens, had various biochemical tests, and were given CT scans and x-rays. The paper that describes the protocol, which Dr. Kaufman surely has read, states that samples were analysed for 22 pathogens including 18 viruses and 4 bacteria. The preferred material for Covid-19 testing in the first 21 days of infection according to international guidelines is mucus, saliva and cells swabbed from the nasal cavity where the nose meets the throat. The Center for Disease Control recommends taking a lower respiratory tract specimen when the patient is not producing sputum, when severely ill, or undergoing mechanical ventilation, for the simple reason that you don’t want to shove a swab up someone’s nose or down their throat when they are already struggling to breathe.
- I learned about the RT-PCR test, CT scans, and immunoassays
RT-PCR stands for Reverse Transcription Polymerase Chain Reaction. The PCR is a diagnostic tool for infectious diseases that’s been in use since the mid-80s. The test is performed by a machine that looks a bit like an automatic bread maker or a really fancy calculator depending on the model. For coronaviruses, these tests measure the amount of viral RNA. This is how it’s done :
- The virus RNA is extracted from the swab sample.
- It is then purified and isolated from the human cells and from enzymes which may otherwise interfere with the test.
- The purified RNA is then mixed with an enzyme called reverse transcriptase which converts the RNA to DNA. This allows the polymerase chain reaction to expand the genetic material.
- The virus DNA is then added to a test-tube along with short strands of DNA (called ‘primes’) designed to bind to characteristic parts of the virus DNA. Nucleotides — the building blocks of DNA — are also added as is a DNA-building enzyme that makes copies of the DNA.
- The PCR machine heats up this mixture so that the DNA unravels and the ‘primes’ bond to it as it cools. This provides a starting point for the DNA-building enzyme to help copy it. This process continues through repeated heating and cooling until millions of copies of the DNA have been created, amplifying the virus’ genetic code.
- Fluorescent dyes are added while the genetic code is being copied. These dyes bind to the copied DNA and as more of the copied DNA is made, the fluorescence increases. This extra light is what confirms the presence of the virus.
Kaufman has concerns about a particular marker for the RT-PCR test called the Ct (cycle threshold). The Ct is defined as the number of cycles required for the fluorescent signal to cross the threshold (i.e. when it exceeds the background level). Ct levels are inversely proportionate to the amount of target RNA in the sample, so the lower the Ct level the greater the amount of target nucleic acid in the sample.
Kaufman mentions that when the Ct values are higher than 35, the signal from background fluorescence is also heightened and so Ct values over 45 are considered inconclusive. He then claims that the Ct value recommended for the Covid-19 virus RT-PCR test is 40, thus putting it at the top end of what is considered a reliable test. He fails to mention who is recommending this value.
I checked the FDA guidelines on the Ct values for the SARS-CoV-2 test. Nowhere could I find anything that suggested a recommended Ct value of 40. FDA guidelines clearly state that the amplification curve should have a Ct value no higher than 35 for a positive result to be reliable. The European Centre for Disease prevention and Control suggest that if Ct values are higher than 35, repeated testing should be considered. All the labs that I checked appeared to be following this lead of 35 as an upper Ct value limit, well within Dr. Kaufman’s margin of reliability.
At the beginning of the pandemic, the RT-PCR was universally used to test for Covid19 because it had already proved its worth as a reliable test for SARS. Another test for Covid-19 is the immunoassay that uses blood serum as the sample. Our immune system produces its own unique proteins — antibodies — that attach to protein structures on the virus which are unique to that virus. The immunoassay test uses antibodies as bait to capture their respective partners from the virus. Immunoassays aren’t as sensitive as RNA tests but they’re easier to use, portable and fast and don’t require a laboratory. Finger-prick immunoassay tests have now been developed that test for immunity to Covid-19, although their accuracy is being called into question.
Kaufman’s curious beef with the testing of lung samples appears to be so that he can refer to a study published in the summer of 2019 that sets out the protocol for lung cancer diagnostics using the same RT-PCR tests used to identify the presence of coronaviruses. He finds this “interesting and coincidental” but doesn’t elaborate. (A classic technique of conspiracists is to leave comments such as “interesting and coincidental” hanging in the air to infect the listener with suspicion without offering further explanation.) I looked into this and found that RT-PCR tests are indeed used as a protocol for determining gene mutations in patients with small cell lung cancer. There have been numerous papers published on this subject going all the way back to 2008. I found one from 2013, 2014, 2017 and 2018 and yes, one from 2019. Why does he call this coincidental? He doesn’t say.
CT scans can also be helpful in Covid-19 diagnostics. Researchers have found that while the imaging appearance of Covid-19 is not specific to the virus, the presence of what’s eerily referred to as “ground glass” — a hazy opacity in the lungs — can serve as an important indicator. A moving photograph taken shortly before the death of the 34-year-old Wuhan ophthalmologist, Dr. Li Wenliang, who had tried to warn his colleagues that they were dealing with a SARS like virus, shows him in a hospital bed holding up an image of his CT scan with the tell-tale “ground glass” effect.
5. I learned that the main problem with the RT-PCR test is false negatives
Dr. Kaufman then adds the astonishing claim that there is an estimated 80% of false positives for Covid-19 with the RT-PCR tests which, if it were the case, would lead to a vast over-estimation of the extent of the disease. He fails to mention the source of this figure. His complaint that there is no specific gold standard for the RT-PCR test for SARS-CoV-2, is addressed in the current literature — it the reason it is called a novel coronavirus. We have never seen it before. I find it hard to believe that Dr. Kaufman is unaware of this. No test is infallible, but I found the RT-PCR repeatedly referred to as the ‘gold standard’ for diagnosing coronaviruses, including SARS-CoV-2, easily fulfilling the standard definition of the ‘gold standard’ in medicine, which is ‘the diagnostic test or benchmark that is the best available under reasonable conditions’. In short, it is the best test we have so far.
Kaufman goes on to claim that the supposed false positive inaccuracies are the result of questionable guidelines for the RT-PCR test such as the cycle threshold that favour positive readings. And yet in every paper and article I read on the subject, the prevailing concern of scientists and health care workers when it comes to the accuracy of the RT-PCR test is not false positives but false negatives.
It turns out that although the RT-PCR tests have a 90% accuracy for detecting positives, an estimated one third of patients who actually have Covid-19 are wrongly testing negative, and there have been a worrying number of cases of patients who tested negative testing positive later on. If one were to conspiratorialise (I know it isn’t a word, but it should be) this story, it would make more sense to run a narrative where the ubiquitous they are strategizing to under-estimate the numbers of coronavirus patients not exaggerate them.
All tests suffer from some margin of error. Contamination and degradation of the test can also cause false positives and negatives and there is extensive discussion in the literature about ways to avoid this and the importance of confirming test results in other ways. Many doctors and researchers are also openly discussing the over-estimation of the mortality rate since there are clearly many people who get the virus and never develop symptoms serious enough to warrant going to the hospital and getting tested. Therefore, the people getting tested tend to be the ones who are sicker and this pushes up the mortality rate. All of this discussion is freely available to the interested reader. It is early days, and there is a lot of confusion, lively debate, and some conflicting findings, as one would expect in the task of trying to understand something of this scope and nature.
6. I learned about viral cultures and why they are not generally used in testing.
Kaufman continues to call into question the accuracy of the internationally accepted test for Covid-19 — the RT-PCR test — because, he says, it a) tests for the RNA sequence not the virus and b) because Covid-19 has never been purified and visualized. Here, I had to assume that Kaufman is talking about the process of creating a viral culture. This is created by taking a sample of body fluid or tissue and adding it to certain cells to grow a virus outside the body and it is one way to test for a virus.
Contrary to Kaufman’s claims to the contrary, there have been a number of viral cultures of SARS-CoV-2. The virus was first purified and isolated in culture in South Korea in mid-February 2020, and it has since been cultured in labs around the world including Hong Kong University and the Peter Doherty Institute for Infection and Immunity in Melbourne, Australia. Some labs not only culture the virus but conduct a complete sequencing of every virus sample to look for possible new strains, as well as imaging it with electron microscopy. This is the protocol at Westmead Hospital in Sydney, for example.
Since conspiracy theorists are less interested in the truth than in confirming their own theories, they rarely follow up on the latest developments in a story once they have the puzzle-piece they’re looking for. This ‘snapshot’ approach to information is why they will repeatedly share the status of a certain situation which may have been true at one point (such as the Covid-19 virus not having been cultured) oblivious to the fact that the situation has since changed. This often makes their information less wrong than outdated, and especially so when conclusions are frozen in a such a rapidly changing scenario as a global pandemic.
The WHO actually advise against using viral cultures to test for Covid-19. Let’s use Kaufman’s own logical reasoning to assess their possible motivations. Is it more likely that the WHO advise against using viral cultures to test for the coronavirus because:
- They don’t want independent scientists discovering that the virus doesn’t exist
- Viral cultures have a tendency to produce giant mutant reptiles
- Testing using viral cultures has been linked to prostate cancer
- Viral cultures require very expensive and elaborate equipment, labs with extra safety and security features and highly skilled technicians. They also require weeks for the results to be determined.
- 7. I learned about very cool tiny things called exosomes.
Dr. Kaufman, who seems very pleased with himself by this point, tells us in jolly Mr. Rogers fashion that he is “going to talk about something most of you have never heard of whatsoever”. (Are you sitting comfortably, kids?) Well, I for one, had not heard of exosomes and I will always remember that it was from Dr. Kaufman that I heard about them first. What I discovered is absolutely fascinating but (with apologies in advance to Dr. Kaufman) not for the reasons he asserts.
Dr Kaufman tells us that exosomes are cellular entities that mostly involve communication between cells. Inside the cell, exosomes are called endosomes and are found in MVE’s (multi-vesicular endosomes) sometimes called MVB’s (multi-vesicular bodies). These MVEs merge with the cell membrane at the surface and release exosomes out into the extra-cellular fluid outside the cell. These exosomes then travel to other cells to deliver surface protein and cytoplasm by fusing with the cell membrane.
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Dr. Kaufman puts up an electron micrograph slide of exosomes outside the cell. Though he doesn’t identify it as such, this slide shows an Epstein-Barr virus-transformed B cell displaying newly expelled exosomes at the cell surface. Since the point is to show us exosomes, however, the slide serves his purpose. The slide on the right shows “the supposed” SARS-CoV-2. What Kaufman fails to mention is that this slide is of a novel coronavirus that was isolated and grown in cell culture at Hong Kong University in February (you can even make out the letters HKU Med on the photo). It is the very cell culture that he earlier claimed did not exist.
He then points out the visual similarities between the two entities — the “supposed” coronavirus and the exosomes — which are undeniably striking to the untrained eye. But then pretty much everything inside a cell at electron micrograph magnification looks much of a muchness to me. Next he shows two slides of an MVE inside a cell next to SARS-CoV-2 also inside the cell. “Can you tell the difference?” he asks? To be honest, I could not. But then, I have not been trained in virology. Come to think of it, neither has Dr. Kaufman.
He then lists some supposed physical similarities between exosomes and SARS-CoV-2. The point of this exercise seems to be to convince us that the novel coronavirus IS an exosome, that they are, in fact, one and the same thing.
Here is his list:
- The diameter of MVEs (which he calls ‘exosomes inside the cell’) and the virus are the same — 500 nanometers (nm).
- Outside the cell, both exosomes and the virus measure a diameter of 100 nm.
- Both the Covid-19 virus and exosomes use ACE2 [an enzyme attached to the outer surface of cells] as their receptor.
- Both contain only RNA
- Both exosomes and Covid-19 virus are found in bronchial fluid.
Let’s go through this list one by one.
- The diameter of MVEs and the virus are the same — 500 nanometers (nm). Reading the papers that describe the utterly evil genius way that viruses enter the human cell by encasing themselves in cell membrane and passing themselves off as MVE’s has been a real eye-opener. Dr. Kaufman’s argument about exosome/viral equivalence is actually far more interesting than he himself realizes, and way more exciting than the idea that some nefarious band of Lex Luthers are trying to pass exosomes off as viruses. We’ll get back to this in a bit.
- Outside the cell, both exosomes and the virus measure a diameter of 100 nm. No, they don’t. Exosomes range in diameter from 30 to 150 nm. And, depending where you get your numbers from, the coronavirus has a diameter of 60 to 140 nm; 60 to 220; 80 to 120 or 50 to 200 with an average diameter of 125 nm. Remember, this is a new virus and data is still being collected, but as much as I tried, nowhere in the literature could I find a measurement of 100 nm.
- Both SARS-CoV-2 and exosomes use ACE2 [an enzyme attached to the outer cell surface] as their receptor to enter target cells. This is true. In fact, so does the virus that causes SARS — SARS-CoV. There is a whole basket of literature on the fact that some coronaviruses use the ACE2 receptor for cell entry. But to use shared cell membrane receptors as an argument for exosome and Covid-19 virus equivalence is like saying that Mary and John are the same person because they put their keys in the same lock to enter the house. The Covid-19 virus actually has a number of keys on its keyring and this diversity of receptor usage is a distinct feature of the coronaviruses. So far, four distinct pathways have been discovered for how the virus enters the cell: ACE-2 receptors, furin targets, GRP78 receptors, and CD147 receptors. The CD147 receptor pathway has only recently been discovered. It is also known as Basigin or EMMPRIN and is a type of protein that, apart from viral infections such as measles, is involved in tumour development and parasitic invasion such as that which occurs through mosquitos.
- Both exosomes and the Covid-19 virus contain only RNA. As Dr. Kaufman himself points out, RNA is freely available in the human body. RNA is present in cerebrospinal fluid, blood urine. Even in tears. It’s also everywhere in the cell including the nucleus. Many viruses contain only RNA, including the Ebola virus, SARS, rabies, common cold, influenza, hepatitis C & E, West Nile fever, polio, measles and, yes, you got it, SARS-CoV-2.
- Both exosomes and the virus are found in bronchial fluid. In fact, exosomes are found in all body fluids so why is this anything to write home about? That’s like saying that John and Mary were both found in the cellar so they must be the same person. (I’m starting to develop a tangential romance between these two for a bit of light relief — hang in there intrepid reader. Things are about to get a lot more interesting!)8. I learned that the Covid-19 virus could kick 007’s ass
Is SARS-CoV-2 an exosome? No. But it would like you to think it is. It certainly has Dr. Kaufman fooled. And it also fools our immune systems. This is how it does it.
Viruses need cells in order to replicate. They can’t do it alone. The virus invades the cell through stealth, and shanghais the cell’s own machinery to produce millions of copies of itself that then go on to infect other cells. When it arrives at its target cell, the coronavirus spikes latch onto receptors on the cell surface, unlocking them with its perfectly fitting mechanism, a kind of molecular ‘skeleton key’. In the case of SARS-CoV-2 this is usually the ACE-2 receptor. The virus then grabs a disguise to avoid alerting the immune system. It hijacks plasma-coated endosomes at the cell boundary and cloaks itself in this bubble of cell membrane (called a vesicle).
The invagination (my new favourite word, meaning the act of folding back upon itself) of these endosomal membranes creates larger entities that are packed with endosomes called MVE’s. (When they’re not being commandeered by spy viruses, these MVEs can release exosomes at the cell surface.) The virus, now disguised as an MVE, heads towards the cell’s replication sites niftily avoiding detection by the patrolling agents of the immune system. (This explains why the coronavirus looks identical to the MVEs on the slides that Dr. Kaufman showed us.)
Once at the site of replication, the virus sheds its membrane envelope disguise and releases its RNA genes which contain coded instructions for making proteins. It then takes over the cell factory to make thousands of copies of itself. The virus then re-cloaks itself in cell membrane and exits the cell the same way. This process is aptly described as a ‘Trojan horse-like pathway’.
As we read in a paper in the Journal of Cell Science: ‘Viral Escape from Endosomes and Host Detection at a Glance’, ‘Viruses have developed complex mechanisms to penetrate the endosomal membrane and have developed and co-opted several host factors to facilitate endosomal escape.’
Dr. Kaufman doesn’t mention any of this in his talk, but he does quote Dr. James Hildreth (President & CEO Meharry Medical College and former Professor at John Hopkins and HIV researcher) as saying that ‘the virus is an exosome in every sense of the word.’ This sentence, says Kaufman, “really helped me validate my opinion.” A very revealing choice of words.
Dr. Hildreth is not actually talking about the novel coronavirus here. He is talking about HIV. Retroviruses such as HIV (which produce DNA from RNA) use the same Trojan-horse type pathway as the coronavirus for cell entry, replication, and exit. These and other observations have led to the descriptor of retroviruses as ‘viral exosomes’. The same comparison with exosomes, however, could likely be made with the coronavirus. In the paper that contains the Hildreth quote, we read, ‘…an exosome makes a perfect vector for HIV because an exosome is not just proteins in a vesicle, it’s something that’s meant to traffic.’ The name of the paper? When a Virus is an Exosome by William. A. Wells.
Dr. Kaufman concludes that the “supposed” Covid-19 disease is caused by conditions that produce exosomes, which emerge as the body’s natural response to threat. These include poisoning, stress, infections (flu, pneumonia), and electromagnetic radiation (even though he acknowledges that there is no evidence for this). According to him, the coronavirus is actually exosomes rather than the cause of the illness. And exosomes are a good thing. The hundred thousand plus people who have died so far from the novel coronavirus all actually died from stress, or some other disease. Or perhaps from 5G. No one would argue that a weak immune system doesn’t factor in how a person responds to infection. This does not mean infection doesn’t exist. In choosing one over the other, Kaufman reveals the stark limitations of the kind of either/or thinking that cannot tolerate a both/and scenario.
It walks, talks and acts like a duck, so….
Exosomes and SARS-CoV-2 are, he claims, “essentially the same in every important way.” All except for one very important way, Dr. Kaufman. An exosome is an enzyme that holds great promise for our understanding of cell communication and chemical pathways. SARS-CoV-2 is a virus that walks, talks and acts like an exosome and has infected, crippled and killed millions of human beings.
9. I learned that we really need scientists.
By the end of this exercise, I was far less interested in challenging Dr. Kaufman and more interested in the process of learning itself. I urge anyone who’s interested to do a bit of reading about viruses and how they work. It has actually helped me manage the emotions around these epic developments. Perhaps, like me, you’ll find yourself newly humbled by the natural world. You might find yourself, as did I, feeling a whole new appreciation towards the scientists and researchers sincerely seeking answers. You might find yourself, as did I, with a burning gratitude in your chest as you read the message boards of front line health workers discussing and sharing data and troubleshooting problems, and realizing that you understand less than 2% of what they’re talking about. And you might, as I did, marvel at the uncanny ingenuity of this microscopic scourge, and even more over how a handful of hairless monkeys have managed to find out anything at all how the little bastard works.
10. I learned that conspiracists have their place.
After five days of reading, of falling into alternating bouts of wonder, horror and awe, Dr. Kaufman seems less of a threat than he first appeared to be. For when all is said and done there remains a little of the conspiracy theorist in us all. We can allow this part of ourselves its place without letting it stifle our critical faculties or crush our sense of humour. Our collective immune system can adjust to make room for the ‘them’ who occasionally become ‘we’ as one or other of us (and I include myself here) tumbles down the rabbit hole and gets temporarily lost in the dark echo-chambers of the conspiracy warren.
Because Camus was right. It is human decency, as he wrote in his prophetic novel, The Plague, not fear that will be what makes the difference in the end in how we come out of all this. And in that spirit, while we do our best to tune out the background noise that fuzzies up our already frazzled brains, let’s stick our head down the rabbit hole, and give a call to our stranger and more fearful selves. “Ahoy! You okay down there?”
Lin, Q. Mao, W., Shu, Y. et al. A cluster of specified microRNAs in peripheral blood as biomarkers for metastatic non-small-cell lung cancer by stem-loop RT-PCR. J Cancer Res Clin Oncol 138, 85–93 (2012). https://doi.org/10.1007/s00432-011-1068-z
Huanqin. H, Qingfeng, L et al. SARS-COv-2 RNA more readily detected in induced sputum than in throat swabs of convalescent COVID-19 patients. The Lancet (March 2020). https://www.sciencedirect.com/science/article/pii/S1473309920301742
Lanese. N. Even if you test negative for COVID-19, assume you have it, experts say. April 2020. https://www.livescience.com/covid19-coronavirus-tests-false-negatives.html
Park WB, Kwon NJ, Choi SJ, et al. Virus Isolation from the First Patient with SARS-CoV-2 in Korea. J Korean Med Sci. 2020;35(7):e84. Published 2020 Feb 24. doi:10.3346/jkms.2020.35.e84. https://pubmed.ncbi.nlm.nih.gov/32080990/
Chen. N, Zhou. Min et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. February 2020. The Lancet, Vol 395, Issue 10223. https://www.sciencedirect.com/science/article/pii/S0140673620302117
Cascella M, Rajnik M, Cuomo A, et al. Features, Evaluation and Treatment Coronavirus (COVID-19) [Updated 2020 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554776/
Real-Time Fluorescent RT-PCR Kit for Detecting SARS-2019-nCoV. https://www.fda.gov/media/136472/download
Stahl. P.D, Barbieri. A.M. Multivesicular bodies and multivesicular endosomes: The “Ins and Outs” of endosomal traffic. Science’s Stke. Vol. 2002, Issue 141, pp. pe32
Real time PCR Ct values. https://www.wvdl.wisc.edu/wp-content/uploads/2013/01/WVDL.Info_.PCR_Ct_Values1.pdf
ACE2, The Hottest Target of SARS-CoV-2 Invasion. Cusabio. https://www.cusabio.com/c-20982.html
Suchorska, Wiktoria & Lach, Michał. (2015). The role of exosomes in tumor progression and metastasis (Review). Oncology Reports. 35. 1237–1244. 10.3892/or.2015.4507.
Edgar JR. Q&A: What are exosomes, exactly?. BMC Biol. 2016;14:46. Published 2016 Jun 13. doi:10.1186/s12915–016–0268-z
Pelchen-Matthews, Annegret & Raposo, Graça & Marsh, Mark. (2004). Endosomes, exosomes and Trojan viruses. Trends in microbiology. 12. 310–6. 10.1016/j.tim.2004.05.004.
Wells WA. When is a virus an exosome?. J Cell Biol. 2003;162(6):960. doi:10.1083/jcb1626rr1
Cusabio. CD147, a New Target of SARS-CoV-2 Invasion. https://www.cusabio.com/c-20985.html
Staring. J, Raaben. M, and Brummelkamp. T.R. Viral escape from endosomes and host detection at a glance. Journal of Cell Science 2018 131: jcs216259 doi: 10.1242/jcs.216259 Published 3 August 2018. https://jcs.biologists.org/content/131/15/jcs216259
White JM, Whittaker GR. Fusion of Enveloped Viruses in Endosomes. Traffic. 2016;17(6):593–614. doi:10.1111/tra.12389
SARS-CoV-2 RNA, Qualitative Real-Time RT-PCR (Test Code 39433). Quest Diagnostics. https://www.fda.gov/media/136231/download
SARS-CoV-2 Coronavirus Real-Time RT-PCR (RT-qPCR) Detection Kit (CVPD). ScienCell Research Laboratories. https://www.sciencellonline.com/PS/7038.pdf
Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–1069. doi:10.1001/jama.2020.1585
Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA. Published online March 11, 2020. doi:10.1001/jama.2020.3786
Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan China: the mystery and the miracle [published January 16, 2020]. J Med Virol. 2020. doi:10.1002/jmv.25678
Questions and answers regarding laboratory topics on SARS-CoV-2. European Centre for Disease Control and Prevention. https://www.ecdc.europa.eu/en/all-topics-z/coronavirus/threats-and-outbreaks/covid-19/laboratory-support/questions
Dahse R, Berndt A, Kosmehl H. PCR-based testing for therapy-related EGFR mutations in patients with non-small cell lung cancer. Anticancer Res. 2008;28(4B):2265–2270.
Matthew J Binnicker, Emergence of a Novel Coronavirus Disease (COVID-19) and the Importance of Diagnostic Testing: Why Partnership between Clinical Laboratories, Public Health Agencies, and Industry Is Essential to Control the Outbreak, Clinical Chemistry, , hvaa071, https://doi.org/10.1093/clinchem/hvaa071
Cooper, Sam. Global News. Coronavirus conspiracies pushed by Russia, amplified by Chinese officials: experts. April 8, 2020.
Weaver. C. Questions about Coronavirus tests sow worry. Wall Street Journal. April 2, 2020.
Science Direct. Virus Isolation : An Overview. https://www.sciencedirect.com/topics/immunology-and-microbiology/virus-isolation
World Health Organization. (2020). Laboratory testing for coronavirus disease 2019 (COVID-19) in suspected human cases: interim guidance, 2 March 2020. World Health Organization. https://apps.who.int/iris/handle/10665/331329
One-third of patients who have coronavirus could wrongly test negative, according to health experts. Advisory Board. Daily Briefing. April 6, 2020. https://www.advisory.com/daily-briefing/2020/04/06/false-negative
How do the tests for coronavirus work? March 19, 2020. https://www.compoundchem.com/2020/03/19/covid-19-testing/
Viral Tests — Overviews. University of Michigan. https://www.uofmhealth.org/health-library/hw235580
Nichols.J. Watch how the novel coronavirus grows in culture. Honk Kong University. 4 February 2020. https://fightcovid19.hku.hk/the-new-novel-coronavirus-growing-in-culture/
Wuhan nCoV outbreak quadruples, spreads within China. University of Minnesota. Jan 19 2020. https://www.cidrap.umn.edu/news-perspective/2020/01/wuhan-ncov-outbreak-quadruples-spreads-within-china
hibo Jiang, Lanying Du, Zhengli Shi. (2020) An emerging coronavirus causing pneumonia outbreak in Wuhan, China: calling for developing therapeutic and prophylactic strategies. Emerging Microbes & Infections 9:1, pages 275–277.
Zhou. Y. The changing coronavirus outbreak narrative pushed by China. 14 February 2020. https://qz.com/1801985/the-changing-coronavirus-outbreak-narrative-pushed-by-china/
Zhu N, Zhang D, Wang W, et al; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019 [published January 24, 2020]. N Engl J Med. doi:10.1056/NEJMoa2001017
Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. Updated April 8, 2020. https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html
Li. F. Structure, Function, and Evolution of Coronavirus Spike Proteins. Annual Review of Virology 2016 3:1, 237–261
Chest CT findings in Coronaviris Disease-19 (COVID-19): Relationshihp to duration of infection. Adam Bernheim, Xueyan Mei, et al. February 20, 2020. RSNA. Radiology online journal. https://pubs.rsna.org/doi/10.1148/radiol.2020200463
Abbott, B and Roland. D. Health Authorities Roll Out New Coronavirus Tests to Gauge Infection’s Spread. Wall Street Journal. Updated April 10, 2020. https://www.wsj.com/articles/health-authorities-roll-out-new-coronavirus-tests-to-gauge-infections-spread-11586511004
SARS-CoV-2 invades host cells via a novel route: CD147-spike protein. Cold Spring Harbor Laboratory. Wang. K, Chen. W, et al. March 14, 2020. https://www.biorxiv.org/content/10.1101/2020.03.14.988345v1
Coronavirus cover-ups, disinformation, netizen pushback. China Media Bulletin (№143).
Freedom House. https://freedomhouse.org/report/china-media-bulletin/2020/coronavirus-cover-ups-disinformation-netizen-pushback-no-143
A transmission electron micrograph of an Epstein–Barr virus-transformed B cell displaying newly expelled exosomes at the plasma membrane. Multivesicular bodies (MVB) can be seen which can deliver content to lysosomes for degradation or can fuse with the cell surface to release intraluminal vesicles as exosomes, indicated by the arrows at the top of the picture https://www.stemcelltraining.net/qa-what-are-exosomes-exactly/
Part of a coronavirus infected cell grown in culture with multiple virus particles being released from the cell surface. Image credit: John Nicholls, Leo Poon and Malik Peiris, The University of Hong Kong. https://aal.hku.hk/admissions/international/latest-research-and-development-hku-lks-faculty-medicine
Electron micrograph of a multivesicular body present in a neuron of the CA1 region of the adult rat hippocampus. Note the budding of a vesicle from the limiting membrane of the MVB (upper right; Fiona Hemming, unpublished). (B) Electron micrograph of a multivesicular body in a dendrite (colored; CA1 region of an adult rat hippocampus).
Zhou et al. Coronavirus inside cell. The new coronavirus shown in electron micrograph. Nature. 2020. Reprinted in Science News. https://www.sciencenews.org/article/sars-new-coronavirus-target-same-cellular-lock-infect-cells