Demystifying “It’s Just a Virus”

“I know that you are going to tell me that it’s just a virus, but…” 

We’ve heard this utterance countless times from parents.  It is usually said (and understandably so) in anticipated frustration that we would not have a prescription that would quickly relieve their child’s symptoms.  Most likely the parent first heard the phrase during a sick visit for a cough or sore throat.  From a healthcare provider standpoint, the primary intention of “it’s just a virus” is to convey that viruses are different from bacteria, and that antibiotics – often perceived as the golden ticket to getting better the fastest – will not help the patient fight the viral infection.  Over time, however, “it’s just a virus” has inadvertently led people to believe that viruses are not as harmful as bacteria.  A pandemic like COVID-19 has been eye-opening for many to learn how serious viral infections can be.  

How do bacteria and viruses differ?  Why can’t you treat a virus with an antibiotic?  What makes viruses so hard to treat?  Hopefully, the rest of this post will help you to understand these families of germs better.

Bacteria and viruses do share some qualities.  They are both microorganisms – too small to be seen without a microscope.  They both can cause illnesses in humans that range from mild to moderate to severe.  They both vary in their rate of contagiousness and can be passed by sneezing, coughing, body fluids or in contaminated water or food.  This is where their similarities end.

Bacteria and viruses are different in size, survival skills, and impact on humans.  Viruses are much smaller than bacteria.  The largest virus is only a fraction of the size of the smallest bacteria.  Bacteria are complex, single-celled organisms.  They live and reproduce on their own.  Viruses, on the other hand, consist of only a protein coat and a center of genetic material – DNA or RNA.  They must attach to a living cell to reproduce.  Without a host, they cannot survive.  Many bacteria are either harmless or, better yet, helpful to humans.  “Good” bacteria help by fighting cancer cells, destroying disease causing microorganisms, providing essential nutrients, or digesting food.  In contrast, most viruses cause disease. 

In 1928, Alexander Fleming’s discovery of penicillin led to one of the most transformational medical developments in the last 100 years – antibiotics.  Antibiotics provide treatments for such infections as rheumatic fever and tuberculosis, as well as ear, skin, lung, bloodstream and urinary tract infections.  Antibiotics attack bacteria by either killing them or stopping their reproduction.  With repeated exposure, however, bacteria may develop resistance to the antibiotics.  Overuse or misuse of antibiotics (i.e. taking them for viral infections) is a large contributor to bacterial resistance and is considered to be one of the world’s most pressing health threats. 

Viruses are much harder to treat since they are within the human host cells.  Most antiviral medications slow down the virus but do not kill it.  Antivirals keep the infection under control, or stop the virus from multiplying, while your immune system does the heavy lifting.  The cell walls specific to bacteria that antibiotics destroy do not exist on viruses, making antibiotics ineffective against them. Another big difference between our treatment of bacteria and viruses is the number of medicines available. Whereas at least one antibiotic is available to treat a given bacterial infection, most virus infections do not have a corresponding antiviral treatment.  The best way to treat viral infections is actually to prevent them with vaccines.  We’ve seen the successes with polio, measles, mumps, rubella, and chicken pox.  There’s hope that protection against COVID-19 will be similarly attainable.

So where does this information leave us?  Especially when we continue to face an unrelenting viral pandemic.  Hopefully it:

  •  gives us an appreciation for the similarities (few & simple) and differences (many & complex) between bacteria and viruses.
  • allows us to be on the same page about our limitations for treating viral infections and reinforces that antibiotics are not the answer.
  • puts us on the same page regarding the origin and intention behind that dreaded phrase.

Ideally, we can now all agree it’s never “just” a virus.