1. Version 1.0
March 22, 2020
Protect Yourself by
Knowing your Enemy
Pat
Vic
A Napkin Story by Dan Roam,
Karl Malamud-Roam, & Lloyd Dangle

2. 2
Know your enemy
and know yourself;
in a hundred
battles you will
never be in peril.
- Sun Tzu, The Art of War

3. We put this story together to help
ourselves better understand COVID-19 in
a super-accessible way. Maybe our story
can help you better understand it too.
3
Like many of you, we’re pretty freaked out
about the rapid spread of Corona Virus
COVID-19. And for us, we find one of the
best ways to stay sane is to get to work.
So as healthcare heroes are saving patients,
virologists are working on vaccines, and
public health teams are tackling everything
else, we decided to do what we do best:
Let’s try to tell a well-informed visual story.
A quick note from Dan, Karl, & Lloyd:
The story we chose to tell is from the virus’s
own point of view. It’s not a story we’ve
seen told yet, and we thought that knowing
what our enemy is up to is the best way to
defend against it.
Getting to know the virus has given us a
renewed sense of perspective, helped us see
what makes sense to do now and why, and
even given us a bit of needed calm.
We hope this story does the
same for you.
A note on the science: We based
everything here on published
sources and provide a list of
sources at the end. If we got
anything wrong, please let us
know – and send your sources so
we can make valid corrections!
We plan to update this as new information
comes in; updates will be posted on
slideshare.net
Also, we know a virion doesn’t
have eyes and a mouth ☺. We’ve
chosen to represent COVID-19
this way so that we can more
easily understand how it works
and what it is trying to do.

4. The characters you will meet:
4
Vic the Virus
Vic’s Family
Crazy Cousin
Pat
Pat’s Cell
Pat’s Family
• A single virion of Covid-19
• Protein COAT
• RNA CODE
• Billions and billions of nearly-
identical Covid-19 virions
• Simplified for clarity
• A single wildly mutated virion
of Corona Virus
• Clearly messed-up and even
more dangerous
• A human host
• Generally healthy
• A single human cell
• Membrane “cell wall”
• DNA in the nucleus
• Many RNA strands
• Ribosome “protein printer”
• Many human hosts
• Simplified for clarity
Interferon
T-Cell
Antibody
• The alarm system inside
Pat’s cell
• On the lookout for
intruders
• Natural defenders in
Pat’s body
• The “cops” waiting for
the call
• Specially-trained SEALs
created in Pat’s body
• Deadly and targeted on
one enemy: Vic

5. The Story
Unfolding
Today
- Part 1 - ❑ Meet VIC the Virus
❑ What Vic does
❑ How Vic kills
❑ How dangerous Vic is
❑ Why the Pros are so
scared of Vic
❑ Some good things to
do now to be safe

6. I’m Vic the Virus. You people call me Covid-19.
I’m a new member of the
“corona virus”
family, and a pretty simple
one, at that.
I’ve got some code (RNA)
inside a protective coat
(made of protein), and a
key (a chemical sensor also
made of protein). That’s
about it.
My job, like all organisms, is
to pass my genetic
code to my kids and send
them out into the world.
Sounds simple, right? Well, it
isn’t.
6
Call me Vic.
Years ago, they named my family of
viruses “Corona” because in
early microscope images our
sensors sort of looked like a crown.
This is my PROTEIN COAT.
This key is one of my
ACE-2 receptor sensors.
I’m lucky in that I’m one of
the first to have this
special key. (You’ll see why
in a moment!)
This is my RNA CODE.

7. I’m just trying to make my way through the world and do my job:
ensure my code keeps living and gets passed on to my kids.
But it isn’t easy.
Three things make my life
tough:
First off, traveling is
tricky; I can’t walk, I can’t
swim, and I can’t climb. What
I can do is “fly” and cling to
things.
Second, I need a home
(my ‘host’) to live in. Out here
in the world I’m fragile and
can die from almost anything:
heat, soap, dryness…
Third, I can’t make my
kids by myself. I need
my host to do that for me.
It’s rough!
7

8. Lucky for me, you’re the perfect home!
When we meet, I hope you
let me in.
If you do, three things might
start to happen:
1) Infection
2) Illness
3) Immunity
But I’m getting ahead of
myself; let’s take those one
at a time…
8
PAT

9. Because your nose, throat, and lungs are the perfect
host home for me, I would love to infect you!
The cells in your nose and
throat are a great place
for me to live. I’m happy
there… and I can be so quiet
you might not even know I’m
there.
But what I really want is to
get into your lung cells.
They’re like heaven for me.
Give me enough time in your
nose, and I’ll try to make my
way down to your lungs.
9
1) Infection

10. The reason you’re so perfect is because my key opens your cells!
Just what I needed!
With your help, here’s what I do:
✓ I attach myself to the outside of
your cell.
✓ Guess what: Your cell wall* has an
ACE-2 lock (a specific
receptor)!
✓ Luckily for me, I have my ACE-2
key!** I open a little vestibule
into your cell wall.
✓ Because I have the right key, your
cell is happy to let me in.
10
* Scientists prefer to say “membrane.”
** My cousin SARS also had an ACE-2 key,
and he killed a lot of people too!
My key fits your cell’s lock.

11. I’m going to use your cell to make my kids.
when my genetic material enters your cell you don’t even notice!
Leaving my coat at the door,
I shoot my RNA code into
your cell. Then I trick your
cell to make my RNA.
Inside your cell, there’s a
bunch of your RNA.
Normally, your RNA tells your
ribosomes which
proteins to make.
But lucky for me, your
ribosomes can't tell your
RNA from mine!
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My code…
hijacks your ribosomes!

12. And before long you’ve made my kids for me!
So my RNA tells your ribosomes
to make more of ME!
First, my RNA tells your cells to
copy my RNA.
Next, your cell makes copies of my
protein coat.
Finally, your cell puts my RNA in
my new coats.
And now you’ve made more of me!
Cool! I get your cells to make my
children, complete with their own
coats to protect our code.
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Which then make
more of ME!

13. Then we all like to settle in and really make ourselves at home.
Most of my kids settle in the
neighborhood, entering cells in
your nose, throat, or lungs.
Eventually we take over big
chunks of the territory and
then start thinking about
moving on.
13
We’re tired of
quarantine! Can
we go out now?

14. And then you send my kids out into the world for me!
Coughing sends my little babies
flying!
Even just exhaling could be
enough to send some out into
the world.
Now they can infect your whole
human family and keep my story
going!
14
PAT’s Family, Friends,
colleagues, and even
random folks!

15. There’s just one problem with our deal. You might get ill.
Now here’s the thing about us
viruses: although we love you,
your body doesn’t love us.
15
2) Illness

16. Because I trigger your own defenses to react so strongly,
your own body might hurt you. Sorry.
Once I’m inside you doing my work,
your cells might detect me.
If they do recognize that I don’t
belong there, your body sends all
kinds of defenses to try and take
me out:
First, you cough to try to get
me out of your body.
Next, in order to lock me down and
keep me from spreading, your cells
tighten up and surround me with
fluid.
That’s called inflammation…
and with me, that’s likely to
backfire.
16
Your body inflames to try
to lock me down.
You cough to try to get me out.

17. In extreme cases, I might kill you. But it’s not just
me that does you in; it’s your own inflammation!
Remember, I love to live in your
lung cells.
But here’s the problem for you:
when your lung cells become
inflamed, they can’t do your
breathing anymore.
Your lungs fill with fluid, you get
pneumonia, and if it
spreads to both your lungs…
well, you suffocate, your organs
fail, and you die.
WHICH MEANS I’m mostly
dangerous to people with old or
weak lungs.
Sorry. It sucks for me and a lot
of my kids too.
17
When your lung fills with fluid,
you can’t breathe.

18. But here’s the thing, I don’t kill everyone.
In fact, I’m not as deadly as some other viruses.
18
Because many people will
get me, a lot of people are
likely to die.
If I infect you, you will
probably get really sick, but
you probably won’t die.
MERS
2012-2015
2,519 cases
SARS
2002-2003
8,098 cases
Covid-19
2019-2020
300,000+ cases so far
FLU
2019-2020
40,000,000 cases
Legend:
How many
people died
among all
infected
How many
people
infected
(so far)
Source: Mar 22, 2020 https://www.worldometers.info/coronavirus/coronavirus-death-rate/#comparison
34% died 10% died 2% died so far .02% died
Infected and
did not go to
hospital.
Infected, went to
hospital, and lived.
Infected, went to
hospital, and died.
But I will kill a
lot more than
they did.

19. 5 reasons the Pros are so scared of me…
Look, I might
not be the
deadliest virus
out there, but I
do have some
special traits
that freak
experts out:
19
1) Having the ACE-2 key means
I have a super easy time
infecting your lungs – which is
really dangerous to you.
3) I’m so good at hiding inside you so
that you might not even know I'm there.
Which means nobody really knows how
contagious I am – and how many of you
are already infected.
4) My family is good at
mutating and adapting.
(More on that in Part 2)
5) Scariest of all is I’m new,
unknown, and unpredictable…
and you’re not testing fast
enough to know who’s infected.
2) I spread much
more easily than my
deadlier cousins.

20. The super good news for you is that you have a lot of ways to avoid me.
20
Wash your hands a lot.
Plain old soap and water
literally melts my
protective coat!
Practice good social distance:
- Cough danger distance = 6 feet.
- Avoid groups.
- Stay home.
- Don’t travel unless you really have to.
This is why governments are
quarantining; they are trying to
keep people from getting
infected!
Wearing a mask might help keep
me out of your mouth and nose
– which is my only way in.

21. If you spread me
to as many other
people as you can,
I’ll be happy.
But you won’t. It’s easy to spread me around:
I fly well, cling to hard surfaces
like spiderman, and love it when
people put me directly into
their own mouths and noses.
That’s how I’m growing my
family! I can’t do it without
your help.
Remember, my job is to keep my
code going. If you spread me
around, you're helping me, but
not your friends and family!
21
You might be
tempted to hang out
with a lot of others;
just remember –
that’s good for me.
(And you can’t tell who has
me just by looking!)

22. - Part 2 -
The Story as
it might
progress in
the future
❑ How we might
develop immunity
❑ How Vic might
mutate
❑ Potential Vaccines
and drugs
❑ What you might
want to think
about…

23. Normally, your body can figure out how to defeat me
with tools you already have. (Innate immunity)
23
3) Immunity Aside from inflammation, your body has
other built-in defenses:
• Interferons in your cell notice
my RNA, try to block it, and hang
signs outside the cell that it's
infected.
• Your killer T-cells then rush
through your body and destroy the
cells I’ve infected.
Together these try to stop my infection
before I cause serious damage, and for
most germs they work well.
But they’re slow and they kill a lot of
your cells – and they’re just not good
enough to stop me.

24. But if that doesn’t work, you call in the Seal Team! (Acquired immunity)
24
Your better defense is acquired
immunity: your body develops it
when you recognize that I’m a new
kind of bad guy.
You create specific antibodies
that are like Navy SEALS trained to
kill only me. They’re deadly to me but
they take time to create and train.
It’s a race to get your SEALs
deployed before pneumonia kills you.
If you stay alive long enough to
develop antibodies, they recognize
me and stop me before I can get
into any more cells.
Now you’re immune and I can’t
make you sick anymore.
Game over for me, man!

25. Here’s the thing… just like in your family,
my children aren’t all identical.
Knowing that your body wants
to recognize and kill me, I want
to make sure my children
aren’t exactly like me.
I want them to be close
enough to live like I do, but I
also need my kids to mutate
just enough to stay ahead of
your defenses.
25

26. Hey, I can’t control all the mutating. Sometimes I might mutate into a
Crazy Cousin who’s really hard on you.
Sometimes the mutations in
my code get more extreme.
If one of my descendants
becomes a Crazy Cousin, you
never know what might
happen.
My crazy cousin MERS
popped up a few years ago
and killed over one-third of
the people that he infected.
But he was so deadly he killed
his hosts before they could
send out his children. He died
out, but so did about 800
people.
26

27. Vaccines are cool for you because they supercharge your antibodies.
Vaccines are great for you and
terrible for me!
They trick your body into making
antibodies without having to
get infected or sick!
That's not fair to me!
But it's hard to get them to kill
me and my cousins without
hurting you – and getting that
right takes time.
In any case, vaccines only work if
you people get them before you
get sick!
27

28. Drugs might slow or stop your illness if you are infected.
Drugs don’t stop me from
infecting you, but they might
stop me from killing you… and
will probably make you recover
faster.
Bad news for you, there are no
proven drugs against me or my
Corona family.
But bad news for me, your
researchers are looking at
several that seem promising.
Very possibly, you’ll have a safe
treatment available to you
before you have a vaccine.
28

29. Look guys, if you REALLY want to kill me and
protect yourselves, you can…
29
Stay rational and believe
in science; you will build
a safe vaccine and find
effective treatments.
Stay kind and believe in
each other.
Stay away from
crowds and keep
your hands clean.
Remember: You’re the
resilient ones! (I’m
just a damn germ!!)

30. The most important thing is to be realistically positive!
30
The impact of the economic downturn
might be worse than the public health
effects… so let’s be thoughtful about
how we buckle down.
And once things have stabilized, and
they will, let’s be prepared to kick the
economy back into gear FAST.
Remember: This too shall pass.
Let’s be as realistic as we can (based on what
we know and think we know) about what that
means, and for how long it might take.
A closing thought from Dan, Karl, & Lloyd:

31. Dan Roam is a
bestselling
author of visual
business books
31
Dan is the author of five international
bestselling books on visual clarity
including THE BACK OF THE NAPKIN.
Dan’s “napkin” explanation of
American healthcare reform has been
viewed more than 5 million times and
won the BusinessWeek award for “The
World’s Greatest Presentation” of
2009. Dan’s napkinacademyschool.com
has taught thousands of people around
the world how to make visual stories
like this one.
Who we are
dan@danroam.com
Karl Malamud-
Roam is a PhD
scientist who
studies diseases
Karl Malamud-Roam is a public health
scientist that studies the distribution of
infectious diseases and the effectiveness
of protective measures. Karl is a PhD
research scientist who studied at
Princeton and Berkeley and worked as
Senior Research Scientist at Rutgers
University. For the past three years, Karl
has served as a Special Advisor on Data
Quality for the World Health
Organization. Karl is the Founder and
President of Vector Control Consultants.
Vector.control.consultants@gmail.com
Lloyd Dangle is an
award-winning
cartoonist &
visual strategist
Lloyd Dangle drew the comic strip
TROUBLETOWN for over twenty years and
has illustrated for many products (Airborne
Health Formula, SC Johnson, Fedex),
hundreds of publications (NY Times,
Entertainment Weekly, Wired..) and has
helped a wide variety of clients tell
complex stories with simple pictures. He
currently works for Amazon Web Services
where he incorporates live drawing in
executive strategy sessions focused on the
possibilities of cloud computing.
lloyd@lloyddangle.com

32. 32
Citations:
General: https://www.cdc.gov/coronavirus/2019-nCoV/index.html
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
https://coronavirus.jhu.edu/
Name: "Virus Taxonomy: 2018b Release". International Committee on Taxonomy of Viruses (ICTV). March 2019
Pathology (Illness): https://www.nationalgeographic.com/science/2020/02/here-is-what-coronavirus-does-to-the-body/#close
Herd Immunity: https://www.technologyreview.com/s/615375/what-is-herd-immunity-and-can-it-stop-the-coronavirus/
Coronavirus Variation: http://www.centerforhealthsecurity.org/resources/COVID-19/200128-nCoV-whitepaper.pdf
Maps / Numbers / Distribution: https://coronavirus.jhu.edu/map.html
Mortality / number of cases: https://www.worldometers.info/coronavirus/coronavirus-death-rate/#comparison
Morphology / drug potential: https://www.economist.com/briefing/2020/03/12/understanding-sars-cov-2-and-the-drugs-that-might-lessen-its-power
Sources (Partial List)