Coronavirus and viral load explains symptom severity

by Mars

We received this interesting and insightful email from a doctor in the Midlands that focuses on Coronavirus and viral load, which explains why people are experiencing varying degrees of symptoms when contracting the virus.

I would like reiterate that I have not written this. This information has been written by an experienced healthcare professional.

Coronavirus and viral load

Why do we need to shut places where people group?

The answer is viral load.

With this virus, the amount of virus in your blood at first infection directly relates to the severity of the illness you will suffer. This isn’t unusual – HIV management is all about reducing viral load to keep people alive longer. But it’s very important in COVID-19.

So if you are in a pub, religious building or entertainment venue with 200 people and a large number don’t have symptoms but are shedding, you are breathing in lots of droplets per minute and absorbing a high load of the virus.

They become ill over the next 48 hours. Three days later people wonder why they can’t breathe and end up in hospital. They’d decided because they were young and healthy that it wasn’t going to be a problem. Wrong.

Coronavirus and viral load

Fortunately, but unfortunately at the same time, because the elderly are isolating quite well, the initial UK data suggests that all age groups above 20 are almost equally represented in ITUs in England. Most of the cases are in London, but the wave is moving outwards.

This means that being under 60, fit and well doesn’t seem to be as protective as we thought. Why? Viral load.

This may be skewed simply by the fact that too many Londoners didn’t do as asked and congregated in large groups in confined spaces and got a large initial viral load. They then went home and infected their wider families. Which is why, as London is overwhelmed, we need to shut everything down to save the rest of the UK.

If I sit with one person and catch this virus, I get a small viral load. My immune system will start to fight it and by the time the virus starts replicating, I’m ready to kill it.

No medicine will help this process meaningfully hence there is no “cure” for this virus. All we can do is support people with a ventilator and hope their immune system can catch up fast enough.

If I sit in the same room with six people, all shedding I get six times the initial dose. The rise in viral load is faster than my immune system can cope with and it is overrun. I then become critically ill.


If you are a large family group, remember that by being ill and in the same room, you will make each other ill or “more ill”. If you get sick, isolate just yourself to one room and stay there. Don’t all sit in one room coughing. You will increase the viral load for all of you, reducing your survival rate.

A family of six people may produce double the droplets of a family of three in the same space. Maths is important.

If one of you is symptomatic, assume you are all shedding and make sure you keep some space.

Parents are getting it from their kids because no one is going to stop comforting their child (nor should they) so the parent gets a big hit as well as the child. I don’t think that can be helped.


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