Vic the Virus tells the story of how it infects and spreads within the human body. It uses its ACE-2 key to unlock and enter human cells, hijacking their machinery to replicate itself. This can trigger an immune response and inflammation that may lead to pneumonia and death in some cases. While not the deadliest virus, COVID-19 is concerning due to its high transmission rate and unpredictability. The story emphasizes the importance of social distancing, hand washing, and the hope that vaccines and treatments will be developed.
VIC THE VIRUS; Protect Yourself by Knowing Your Enemy. A "back of the napkin"...Dan Roam
A clear and simple visual story on how COVID-19 spreads and kills -- and how we will beat it. In the spirit of Sun-Tzu's "Know your enemy," we chose to tell the story from the point of view of the virus.
Written by a bestselling author, a disease scientist PhD, and an award-winning cartoonist, this story gives a renewed sense of perspective. Writing this helped us see what to do next, and even gave us a bit of needed calm.
We hope this story does the same for you.
VIC THE VIRUS; Protect Yourself by Knowing Your Enemy. A "back of the napkin"...Dan Roam
A clear and simple visual story on how COVID-19 spreads and kills -- and how we will beat it. In the spirit of Sun-Tzu's "Know your enemy," we chose to tell the story from the point of view of the virus.
Written by a bestselling author, a disease scientist PhD, and an award-winning cartoonist, this story gives a renewed sense of perspective. Writing this helped us see what to do next, and even gave us a bit of needed calm.
We hope this story does the same for you.
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É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
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Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
VIC THE VIRUS; Protect Yourself by Knowing Your Enemy. [Phone optimized!]
1. Version 1.0 phone
March 23, 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 this can help you
better understand it too.
3
A note from Dan, Karl, & Lloyd:
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!
4. The characters you will meet:
4
Vic the
Virus
Vic’s
Family
Crazy
Cousin
Pat
Pat’s
Cell
Pat’s
Family
Interferon
T-Cell
Antibody
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.
6
Call me Vic.
This is my
PROTEIN
COAT.
This key is one
of my ACE-2
receptor sensors
This is my
RNA
CODE.
7. I’m just trying to make my way through the world
and ensure my code 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
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!
11
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.
12
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
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
Legend:
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.
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.
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