(gasps) Daddy!
We love you. You're going to beat this.
We need you.
Over 21 million people infected.
We lost three people within an hour.
You don't get time to like pause.
700,000 have lost their lives.
As the pandemic, tightens its grip on the world,
there are important unanswered questions
about the novel coronavirus.
Why does this infection spread so rapidly
from people with no symptoms?
Why do some people become critical while others don't?
Will a definitive treatment be found?
The underlying key to these questions
lie in our immune system.
Immune cells are microscopic warriors,
combating viruses, which invade our bodies.
And we have two trillion of them.
Immune cells rapidly detect and devour the enemy,
inject toxins to destroy them
and even release a sticky web to ensnare them.
The latest scientific discoveries are starting to shed light
on the enigmatic mechanism behind immunity.
As for the novel coronavirus,
it's become clear that it can break down our immune defenses
with its formidable powers.
It slips through, suppresses and unleashes chaos.
In this program, state-of-the-art microscopy
and extensive CGI will reveal a battleground,
never seen before: the war between the novel coronavirus
and our immune system.
Research taking place around the world about our immunity
is helping to find potential new treatments
to combat the coronavirus.
Vaccines are being rapidly developed,
and it's been found that even blood from recovered patients
can be used to save the lives
of patients suffering from severe symptoms.
Aided by cutting edge science,
we'll unveil the astonishing powers
of this novel coronavirus,
as well as the ways in which we may be able to overcome
this formidable enemy.
(dramatic dreamy music)
Cases of COVID-19 continue to surge around the world.
The virus spreads from tiny droplets
that are released from an infected person's mouth.
A special camera system has been used to film droplets
that are exhaled from our mouths as we talk.
They are tiny,
smaller than a thousandth of a millimeter in diameter.
A droplet around one millimeter across can in fact contain
as much as seven million virus particles
So if you get infected, what happens to your body?
Advanced microscopic technologies are powerful tools
that help us visualize this world within.
For instance, this next generation microscope
enables us to observe living cells at work.
It captures our immune cells in attack mode in 3D.
Other tools such as ultra high resolution 8K microscopy,
3D reconstructions of electron microscope images,
as well as the latest CGI techniques
will allow us to see the battles between viruses
and our body's cells.
Now let's dive in to take a look
at this microscopic universe within our body.
Carried by these droplets, the novel coronavirus
gets into our body through the mouth.
But it can't just keep going.
The first barrier it meets is our respiratory tract,
the airway that leads to the lungs.
This image of the respiratory tract
magnified by more than 10,000 times
by an electron microscope shows many hairlike structures
growing on the surface called cilia.
They are about a hundredth of a strand of human hair
and make tiny rapid movements
over a thousand times per minute.
These movements allow foreign matters such as viruses
to be pushed away.
However, the novel coronavirus
can also infect these celia cells.
By stopping their sweeping movements,
it definitely slips through.
It then passes through the airways
and finally works its way deep into the lungs.
The infection is about to begin.
The virus particle approaches a lung cell
It's target is a strange looking protrusion
on the cell surface
measuring only 100,000th of a millimeter.
The novel coronavirus attaches its spike
onto this protrusion on the cell surface.
Then the virus slowly burrows into the cell.
The infection is now complete.
This is a cunning trick, unique to viruses.
The protrusions on the cell surface
normally act like a keyhole
only letting in essential substances, such as cholesterol.
Only those who have the right key can enter the cell.
(tense music)
But the novel coronavirus has a fake key
that fits perfectly with the cell's keyhole.
It basically tricks the cell
into letting an intruder inside.
Image taken by an electron microscope
shows the inside of a cell
that's been infected by the novel coronavirus.
The red dots are all virus particles
Once inside a cell, the virus can replicate itself
as much as a thousand times before breaking out.
This is a microscopic image
taken by the U.S. National Institute
of Allergy and Infectious Diseases.
It captures the moment where coronavirus particles in red
have burst out of an infected cell.
Vast amounts of viral particles scatter all around,
looking for new cells to infect.
let's see what happens next.
This is an X-ray image of a COVID-19 patient,
and the lungs are shown in black.
These wWhite spots indicate areas of inflammation
caused by the viral infection.
As these spread, symptoms of pneumonia worsen.
Our immune cells, the defense corps that protect our bodies
are mobilized to prevent such a crisis.
A cell infected with a novel coronavirus
starts to release large amounts of blue particles.
This substance called interferon is an alarm
that warns immune cells of danger.
It is a message alerting them to the presence of an enemy.
The alert is carried all across the body
through the bloodstream.
Messages are received by round cells like these
roaming in our blood vessels.
These immune cells are called phagocytes.
This is a video of an inside of a blood vessel.
Normally phagocytes are on patrol inside these blood vessels
all around our bodies.
And when they receive a message,
alerting them of an enemy incursion,
they head out from the blood vessel
to the site of infection.
When phagocytes locate their target,
foreign matter, such as viruses,
they move in and devour it whole
even if their targets are larger than themselves.
People who are infected with the novel coronavirus,
but remain asymptomatic,
are thought to have very active phagocytes in their bodies.
These powerful defense units, which engulf their enemy
are known as our innate immunity.
A part of our immune system that's been with us since birth.
But why do symptoms keep getting worse in some people,
even though they are protected by innate immunity?
The latest research has uncovered an intriguing possibility.
The novel coronavirus may be evading such attacks
from our innate immune system.
This was discovered by dr. Kei Sato
at the Tokyo university Medical Research Institute.
Dr. Sato looked at the genetic information
stored inside the novel coronavirus.
When he compared these with other types of viruses,
he discovered that the novel coronavirus had a unique gene.
He conducted experiments to find out the function
of this particular gene.
And it became clear that it gave the virus
the ability to deceive our innate immunity.
Remember, a cell infected with the virus
releases masses of alert messages
to warn others of the presence of an enemy.
But when this special gene in the novel coronavirus
is activated, these alerts are suppressed.
So only about a 10th of these warnings get out.
If this happens, alerts of an enemy invasion
failed to get through to the phagocytes,
so they can't be mobilized.
The virus is left at large, free to replicate at will.
Another study has found
that in the absence of these warning substances,
the novel coronavirus can replicate
by as many as 10,000 times in just two days.
Research has shown
that people with severe symptoms
produce lower levels of interferons.
It's very likely that this is allowing viruses
to spread throughout the body, resulting in severe symptoms.
Suppressing the human body's red alerts
is one weapon in the viruses arsenal.
This may also be the reason why COVID-19
has become such a global emergency.
Countries around the world
have been taking desperate measures,
such as lockdowns at the cost of their economy
in a bid to halt the spread of infection.
But the difficulty is that in many cases,
there is a delay before any symptoms appear.
So if people are unaware that they'd been infected,
they can go on to infect others.
Usually when we are infected by a virus,
an alert substance is released in our bodies.
This causes our body temperature to rise
in order to activate the immune response.
However, since the novel coronavirus
is suppressing these warning signals,
there are still no fever,
even though the viral load keeps increasing.
So due to this superficially asymptomatic state,
people may not realize that they're infected
and this could be how the virus is going unchecked.
New studies have shown something even more disturbing.
The virus's ability to suppress these warning signals
may be getting stronger.
This diagram shows the different genetic types
of the novel coronavirus
that have been spreading throughout the world.
You can see how new types appear as each branch splits away.
Let's look at this strain found in Ecuador.
There is a slight alteration in the gene
that suppresses the alarm substance.
In Ecuador the virus has been spreading rapidly since April.
Dr. Paul Cardenas has been studying COVID-19 patients
at a hospital in the capital of Quito.
The two patients are brothers.
They are young, all of them and develop the symptoms
almost at the same time.
And the whole family went to the intensive care unit.
In terms of infectious diseases
in our respiratory infection, it's very rare.
I mean, usually you have young people
developing those symptoms that week.
After collecting virus samples
from the brothers and analyzing their genes,
a mutation was found in that special gene.
Experiments confirmed that because of this change,
the quantity of alarm substances made
was being reduced even further - to one 20th.
If this powerful strain spreads,
our immune systems defense corps will be forced
to fight even tougher battles against the coronavirus.
There are many other variants of the novel coronavirus,
a new types keep emerging due to genetic changes.
Such changes may create further variants
that could even be resistant to vaccines or drugs
that are currently being developed.
If the novel coronavirus manages to successfully evade
our innate immune system and continues to multiply,
let's see what happens next in our bodies.
In most cases, patients remain asymptomatic
for around five after infection,
but when the viral load in the body exceeds a certain limit,
they begin to develop symptoms
such as fever, cough, and fatigue.
(man coughing)
Having overrun our innate immunity, the novel coronavirus
is now replicating itself (indistinct).
However, our immune system hasn't given up yet.
This is when our secondary defense force,
our adaptive immune system, is deployed.
One of the phagocytes that had been fighting the virus
is moving off to a different location.
It's now acting as a messenger, seeking reinforcements.
The messenger attaches itself to a blue immune cell.
Let's look closer.
The messenger cell is holding out a fragment
of the novel coronavirus it had devoured earlier
on something that looks like clasp.
The blue immune cell accepts it. This is enemy intel.
The immune cell is now activated.
This is a killer T cell ready to attack.
These killer T cells specifically target cells,
which are infected with the novel coronavirus.
Fragments of the virus can be seen protruding
from the surfaces of infected cells.
Killer T cells compare these fragments
with the intel they'd received earlier.
If they match and their target is confirmed,
they commence their attack.
The virus, as well as the cell are completely obliterated.
A cutting edge microscope has caught this moment of attack
by a killer T cell.
In green is the killer T cell.
Once it attaches itself to its target cell in blue,
it injects a toxic substance shown in red.
It destroys the infected cell along with the viruses inside.
However, it now appears that the novel coronavirus
may even be able to dodge a killer T cell attack.
Recent findings from China
suggest that the novel coronavirus
has a unique quality setting it apart from other viruses.
It seems to target those clasps on an infected cell,
which hold out viral fragments.
Their research has suggested that the virus
is breaking down these clasps
even before they can reach out of the cell surface,
reducing their numbers by 60%.
This makes it much harder for the killer T cells
to locate infected cells.
The infection remains unchecked,
and the virus continues to multiply.
In retaliation, our immune system sends out another unit:
the B cells.
B cells also get their enemy intel
through the contact with viral fragments
and they produce powerful projectile weapons.
See how the B cell starts to release
those small yellow particles?
These projectiles are called antibodies.
When magnified under a microscope,
it looks like the letter Y.
How do they work?
Antibodies released from B cells
close in on the novel coronavirus.
They bind to those spikes, the fake keys that viruses use
to invade human cells.
Once the cell is covered with antibodies,
the virus can no longer infect or replicate.
With nowhere to go,
they are devoured one by one by phagocytes.
Once you've reached this stage, you're out of the woods.
Your body will start recovering slowly.
But the work of T cells and B cells doesn't end here:
they retain their memories about the virus
and continue to stay alert in our bodies.
So if there is another coronavirus invasion,
they will be ready to fight back.
These special units study the enemy,
launch an intensive attack, and even after repelling them,
they remain vigilant to protect our bodies from harm.
It's our adaptive immune system in action.
Vaccines being developed against COVID-19
are attempting to enhance the power
of this adaptive immune system.
Fragments from an attenuated virus
are injected into the body.
So that information on the novel coronavirus
can be passed on safely to T cells and B cells.
In this way, the adaptive immune system
can learn about the enemy before any infection occurs
and be prepared to attack.
Researchers are working as quickly as they can
to ensure the safety of these vaccines
and maximize their effectiveness.
While vaccine trials continue, the virus spreads worldwide.
It has infected more than 21 million people
and taken the lives of over 760,000.
So what may have happened in the bodies of patients
who became critical and ultimately lost their lives?
The University Medical Center Hamburg-Eppendorf in Germany
has conducted more than 150 autopsies.
(somber music)
Scientists here discovered something unusual
in the lungs of COVID-19 patients.
From our past studies, where we learned
that with every new disease, there are new findings.
When you do autopsy on a regular basis,
we thought it might be very interesting
from a scientific point of view,
to get it more into detail in COVID-19.
We were really, really surprised
about the very, very high incidents
of venous thromboembolisms and pulmonary embolisms.
We discovered that within the first 12 patients,
we had about one third of patients
who died from pulmonary embolism.
Pulmonary embolism is a disease
where blood clots form in the lungs.
This is a blood clot that was found in the lung
of a COVID-19 patient.
It caused their blood circulation to fail.
And the resulting lack of oxygen led to their death.
What could have caused these blood clots?
A closer look shows many of these blue dots
amongst the red clots of blood.
They are the dead remains of a type of phagocyte
called neutrophils, that had caused the clots.
Clotting is triggered when our immune system
goes into overdrive, a phenomenon called a cytokine storm.
When viruses replicate in huge numbers,
our immune cells can become overly activated.
Researchers had long suspected that hyperactive immune cells
were inadvertently damaging our blood vessels.
And in order to close the wound,
platelets in the blood would come together
to form blood clots, becoming bigger
and ultimately blocking circulation.
But here's the important point:
Recent research has shed light
on an even more disturbing mechanism
where a cytokine storm can trigger blood clot formation.
When neutrophils start to detect
that there are these pathogens
circulating in the bloodstream,
they will start to take their DNA inside of the cell
and they expel it outside the cell.
They spit it out to form something
called a neutrophil extracellular trap.
We know that certain cytokines that are released
in the setting of COVID-19 can prime the neutrophil
and make the neutrophil more likely to form NETs.
Neutrophil extracellular traps called NETs
is essentially a suicide attack.
And it was first discovered in 2004.
This image captured by the Max Planck Institute in Germany
shows the moment of attack.
The yellow phagocyte is a 100th of a millimeter wide,
it's self detonates hurling its contents
toward the enemy in red.
This weblike structure is the phagocyte's DNA.
The cells sacrifices itself in a desperate effort,
taking advantage of its DNAs, sticky texture
to trap the enemy.
This video shows a phagocyte releasing its DNA.
You can see it in orange, just bursting out from that cell.
Normally such attacks will not cause any clotting,
but if there is a cytokine storm,
overly active phagocytes in our bloodstream
self detonate in huge numbers.
(pensive music)
If too many DNA NETs have been cast,
they can even scatter blood components in the vicinity.
Lumps from these blood components form clots
and bind to each other to become larger and larger
to the point where they can completely block blood vessels.
Despite trying to save us,
these extreme suicidal attacks backfire.
By forming blood clots they can cause death.
COVID-19, as you know,
is caused by the SARS-2 coronavirus.
And this is a novel virus
that our bodies have not encountered before.
As a result of that,
the bodies don't know how to respond to it.
And so they are pulling out every tool
that we have in the toolbox to try and fight this infection.
What this means is the infection results
in unregulated amounts of inflammation.
And so inflammation can be very helpful in the beginning
to try and fight off infection and help to repair organs.
But if the inflammation is unregulated
and continues at high levels for long periods of time,
that inflammation can actually be damaging to the body.
Autopsy results have shown
that blood clots were the direct cause of death
for a third of those who lost their lives.
In order to prevent such excessive self detonations,
cytokine storms must be suppressed.
This is why drugs to dampen the immune response
are being trialed as a potential treatment for COVID-19.
Armed with a new strategy, hope is now on the horizon
to help patients with the severest symptoms.
Our immune system is our ultimate weapon
in the fight against pathogens.
And its presence can be traced way back
in the evolutionary history of life.
Approximately 550 million years ago,
the Cambrian explosion created a diverse range
of living organisms.
Viruses were already in existence back then
and are believed to have had spikes on their surfaces:
the fake keys used to infect their hosts.
Our evolutionary kin back then looked like this.
It's believed that cells from our adaptive immune system,
such as T cells and B cells came about
as they endured these viral attacks
with the ability to remember the enemies they encountered.
Although the coronavirus continues to cause havoc worldwide,
studies have shown that viruses and hosts
weren't always antagonistic during the course of evolution.
There have been times when they co-existed,
mutually taking advantage of one another.
Some viruses are known to have embedded their genes
into the DNA of cells they've infected.
Viruses had, in fact, infected our ancestors
and permanently left their mark in our DNA.
As much as 8% of the human genome comes from viruses.
And our bodies may have taken advantage of those viral genes
to gain various important functions.
Here's an example.
The process of fertilization where sperm binds to an egg.
The sperm carrying the father's DNA
is about to enter the mother's egg.
Because sperm is a foreign substance to the egg,
it uses a special key to gain entry.
It looks remarkably similar to how a virus enters a cell.
Researchers believe that the fertilization process
may have taken advantage of viral genes
that had infected our ancestors long ago.
Other functions are also thought to have evolved
from viral genes picked up along the way,
like the placenta, which enables babies inside the womb
to get nutrition and oxygen from their mother,
and some brain functions, which relate to longterm memory.
(dreamy music)
Through the long process of evolution,
our immune system became stronger and more sophisticated.
Today, more than 40 different kinds of immune cells
are working together in our bodies,
forming an elaborate defense network.
On the other hand, viruses have also been evolving,
gaining even more powerful traits
to break through our defenses.
This current war between our immune network
and the novel coronavirus is at its most intense
in our shared evolutionary history.
And new insights into the workings
of our immune system and viruses
are helping to uncover effective measures against COVID-19.
Daddy!
Baby, yes!
We love you. You're gonna beat this, okay?
We need you.
We can't wait for you to come home, Dad.
We love you. Kisses!
Love you, daddy!
Michael Kevin was infected
by the novel coronavirus and was in a coma for eight days.
The first signs were similar to the flu,
but within five days he had trouble breathing
and was admitted to hospital.
He was then transferred to the ICU and put on a ventilator.
He was given three different drugs
as part of a clinical trial,
but his condition did not improve.
He was running out of options.
At that point, he was given a special treatment.
Baby, how are you?
You're looking good.
He regained consciousness in four days
and started recovering very quickly.
(people cheering and applauding)
I'm so glad to be out of the coma.
So glad to be out of the hospital room.
I was ecstatic.
It really (indistinct), where we were, it was our miracle.
Michael was saved by blood
from an individual who possessed special powers.
This is the man
who donated his blood to Michael - James Crocker.
He himself is a COVID-19 survivor.
Antibodies contained in James's blood
were collected and injected into Michael's body.
This special treatment
is called convalescent plasma therapy.
Antibodies are projectile weapons
tailor-made by immune cells
based on information from the virus.
It is a powerful weapon that can specifically target
the novel coronavirus to disable it.
James's body was able to produce vast amounts of antibodies.
When his antibodies were injected into Michael,
they successfully eliminated the virus.
This treatment is expected to save the lives
of critically ill patients
until a vaccine becomes available.
And in August the U.S. Food and Drug Administration
issued an emergency authorization
for its use on hospitalized COVID patients.
After being discharged from the hospital,
Michael met up with James
to express his gratitude personally.
I'm very grateful.
It's really nice (indistinct) you came all the way here
in South Florida.
You have an opportunity to give,
to help save the life of another person.
Why wouldn't you want to do that?
It feels so wonderful to give back.
The latest research has shown that some people
are able to produce vast amounts of antibodies,
enough to save the lives of patients
with very severe Simmons.
Blood was collected from 149 COVID-19 survivors.
This graph shows the levels of antibodies
found in their blood samples.
They vary from patient to patient.
Some are able to produce 10 times more antibodies
than the average.
I strongly believe it would help us
to understand exactly what happens in a person's body.
Why some people get really sick,
why others don't get really sick.
Some people did have higher levels
of neutralizing antibodies.
They're making really good antibodies.
They really are. They work very well.
What is the difference between people
who are able to produce large amounts of antibodies
when infected by the novel coronavirus and those who don't?
We don't know the exact answer yet,
but scientists have a theory.
Remember the moment when antibody production is triggered?
Immune cells, holding viral fragments, handover enemy intel
two units from our adaptive immune system.
B cells then produce antibodies based on this information.
The key here is the shape of the clasp
jutting out from the messenger immune cell.
We now know that there are
more than 10,000 types of these clasps
and we all have differently shaped ones.
For example, some clasps are able to hold
onto the fragment of the novel coronavirus perfectly,
so they can keep sending out intel
to allow large amounts of antibodies to be made.
But in people who have differently shaped clasps,
these can't grip the viral fragments as well.
Unable to precisely pass on their message,
only small amounts of antibodies can be made.
Interestingly, we are beginning to understand
that these differences may be associated
with geography and ethnicity.
For example, in Africa, you can find many people with clasps
that are well suited for holding
onto fragments of the malaria parasite.
Meanwhile, in Southeast Asia,
there are lots of people who have the best kinds of clasps
to grip fragments of bacteria, responsible for leprosy.
Scientists believe that these differences
come from variations in a gene called HLA,
responsible for forming the shape of these clasps
in our immune cells.
The middle door pathogens
have emerged throughout our history.
In different regions, in different ages.
That is why mankind has acquired different HLA types,
to fight off different pathogens.
(somber music)
About 200,000 years ago,
mankind born in Africa began to migrate
to different parts of the world.
Wherever they went, our ancestors were attacked
by different viruses and pathogens.
And after each attack,
it's thought that the HLA gene adapted.
So, the clasps suitable for new enemies
can be created in us.
The diversity of HLAs
is our defense against the range of pathogens.
So only those who excelled in the fight against them
left their HLA types as a legacy to us.
We still don't know when or how
people like James managed to acquire
these kinds of special clasps
that can combat the novel coronavirus.
Maybe their ancestors experienced infections
from similar viruses in the past,
so had acquired clasps,
that just happened to be a perfect fit
to the novel coronavirus.
Each one of us has inherited a differently shaped clasp
within our immune cells to fight viruses.
It's a testament to our ancestors
who had fought and survived an incredible variety
of infectious diseases throughout evolution.
And now cutting-edge medicine is attempting
to harness this power from the few,
so that lives all over the world can be saved.
At this research institute,
scientists are culturing immune cells collected from people
who produce large amounts of novel coronavirus antibodies.
They are hoping to produce antibodies in vast quantities,
so they can be used to treat patients
suffering from severe symptoms worldwide.
Clinical studies are already underway,
and researchers are hopeful that these treatments
will be commercially available by the end of the year.
These may become available earlier than vaccines.
I think it would make things in the laboratory
that would work better than what people are making.
And maybe those would work at very low concentrations
and make a practical way of delivering to people
to protect them or help them if they're actually sick.
This is definitely a possibility.
And I think it's a very hopeful one, too.
If anyone was sick and they were willing
to donate their plasma to help other people
and to help science, then yes, they are definitely heroes.
The battle against COVID-19 continues
with no end in sight.
However our immune networks
have been supporting us since birth
and will do so until we take our last breath.
A woman is in labor in a hospital delivery room.
To prevent the spread of COVID-19,
her husband waits outside, watching the birth on screen.
(gentle music) (nurses chattering)
A new life joined the world today.
Right from birth babies are exposed
to many different pathogens like viruses and bacteria.
But the baby's immune cells are not yet ready to fight back.
What protects them is the mother's breast milk.
For the first few days after birth
breast milk contains large amounts of immune cells
and antibodies, belonging to the mother.
These all help the baby's own immune cells to develop
and protects it from various bacteria and viruses.
After several months, the baby's own immune network
begins to kick in.
In the years that follow, through exposure
to different types of viruses and bacteria,
our immune system continues to develop and grow stronger.
It had been thought that our immunity
reaches its peak in our 20s and then flattens out,
gradually declining in our 70s.
But during the current pandemic,
remarkable recoveries have been observed
in people across the world.
(group applauding)
In South Yorkshire in the UK,
Albert Chambers has recovered from COVID-19
and is being discharged from hospital.
He just turned 100 this year.
What would you love to say to the nurses?
There's nothing I can say but thank you very much,
And I appreciate every bit of what they have done for me.
Many places around the world
have been reporting centenarians
making astonishing recoveries.
(group applauding)
Recent studies suggest that in their bodies,
something special is keeping their immune cells young.
The human body is a remarkable and elaborate system
full of mystery.
Supported by specialist cells that protect our lives
with their unique skills honed
over four billion years of evolution.
The keys to overcoming this pandemic
may be locked away in our bodies,
and it could be hidden in you.
(uplifting music)