Ataxic Hyperphagia is the fictional zombie pathogen featured in my young adult adventure trilogy, Survivor Max. I began writing the series in 2014, and finished in 2018, but by coincidence or providence I based the fictional outbreak on the real science of coronaviruses. Coronaviruses are a family of viruses common in bats, pangolins and humans.
In fact, although technically the pathogen in Survivor Max is not a coronavirus, the logo I created for the series still resembles their signature shape, because part of the point of the series, for me, is to teach scientific literacy. Under a microscope all coronaviruses resemble a solar corona, but CV19 gets called the Novel Coronavirus because this strain has never been seen before.
So, here are some things that the ghouls of Survivor Max can teach us about CV19.
1) A Respiratory Infection:
Have you noticed how on The Walking Dead everyone turns into a Walker when they die, even if they’ve never been bit? That’s because everyone is already infected, and the only way a pathogen can spread to that many people who’ve never been bitten is if it spreads by reparatory infection, not blood infection. In other words, you catch it, and spread it, with your breath.
Before I came up with the name Ataxic Hyperphagia, a fifth grader came up with the name Stink Pox. That kid rightly intuited that the infection was spread, in a sense, by the smell. In Survivor Max, most authorities assume that the undead outbreak is bloodborne, and transmitted by bites. This leads them to commit a number of serious strategical errors. Max possesses the scientific evidence to the contrary.
Like Cold and Flu, CV19 is spread via small bits of sputum and saliva expelled when we breathe. Sneezing and and coughing spreads it more. These respiratory droplets can be inhaled or infect us when we touch our face. The virus gets in and out of our body through our mouth and nose.
2) Asymptomatic Transmission:
Respiratory transmission isn’t enough for your especially virulent bug. It also helps if the patient doesn’t show any symptoms right away. If a virus makes people cough and sneeze right away, people figure out who’s sick and successfully isolate them. But if contagious people don’t cough and sneeze, they can spread the virus around for a while without knowing it.
In the case of Survivor Max, characters refer to the “hidden infection,” and the “active infection.” The hidden infection is when the person is alive, and asymptomatic until something triggers it to activate. The death of the host, in the case of zombies. The active infection is all the changes to the body after they begin to turn.
For CV19, the most common symptoms are fatigue, fever, cough, and shortness of breath. But symptoms may not appear until up to 14 days after exposure, and more than half of cases never have obvious symptoms. The problem is that asymptomatic and pre-symptomatic cases are still contagious, and can infect others. Some evidence suggests that viral load peaks before symptoms appear. That means, even if you feel healthy, you might still be a spreader.
3) High Morbidity and Low Mortality:
Morbidity describes the speed an infection spreads through a population. Mortality is the percentage of patients that die. The Death Toll is the product of those two numbers. A high morbidity means it spreads from person to person very quickly, while a low mortality means that only a small percentage of those who catch the bug actually die from it.
It turns out that this combination is actually more dangerous than the reverse. High morbidity combined with low mortality allows an infection to go unnoticed in a population for a long time. So it spreads out nice and easy, and seems like nothing to worry about. Conversely, a disease with a low morbidity and high mortality would be very dangerous to the individual infected, but also difficult to transmit to others. That means it’s easy to identify who’s infected, and put a stop to the outbreak. A good example of this is the Ebola outbreak in the US. Even though Ebola is much more deadly to the individual, only 11 people required treatment during the 2014 epidemic. This is because Ebola has a low morbidity. It’s transmitted by bodily fluids, which are much harder to share than air.
4) Loss of Smell:
Just kidding. I actually got this one exactly backwards. One of the most perplexing symptoms of CV19 is that patients may lose their sense of smell. Conversely, in Survivor Max, Ataxic Hyperphagia actually increases the sense of smell. In fact, smell is primary sense the ghouls use to hunt their prey. You can’t win all the time.
5) It Reaches The Alveoli:
No, “alveoli” is not type of pasta.
You’re probably seen pictures of all the little airways in the lungs. They look a bit like a tree. And at the end of each hair-thin branch is a tiny cluster of alveoli. The alveoli are super tiny inflatable air sacs that allow gas exchange between the lungs and the blood. Adult lungs normally contain between 300-500 million alveoli.
Most reparatory infections stay in the branches of the tree. We breath them in. They aggravate our throat, and our sinuses mostly. Even a bad bronchial infection, or pneumonia tends to stay in the lungs. But, to create a zombie with an infectious bite your pathogen has to go from the lungs into the bloodstream through the alveoli, and that’s exactly what happens in Survivor Max.
In the case of CV19, doctors were initially confused because some patients tested as having extremely low blood-oxygen levels, but they were not having any difficulty breathing. Their lung capacity was just fine. It wasn’t like having fluid in their lungs. They’re alveoli just weren’t giving the oxygen to the blood. Later, autopsies showed their alveoli had become clogged with with white blood cells, mucus, and the remnants of dead lung cells.
The risk is deoxygenated blood has no obvious outward symptoms, but it potentially damages every organ, especially the brain. Prolonged low level oxygen deprivation is particularly dangerous because it distorts our own perception of the problem we’re experiencing. Like a drunk who doesn’t realize how drunk they are, because they’re drunk.
6) Comorbidities Play A Major Role
A comorbidity is when a patient simultaneously has two or more diseases, and the two infections effect each other. A perfect example is HIV and AIDS. In both acronyms the “I” stands for “Immunodeficiency.” What that virus actually does is wear down our immune systems so we’re more vulnerable to another infection, and it’s actually those opportunistic infections that threaten the lives of HIV and and AIDS patients.
Similarly, in Survivor Max, it isn’t the bite, or the death of the host that activates the Ataxic Hyperphagia (although they will). It’s the host’s diminished immune system. The pathogen triggers the transformation just as soon as the host’s immune system is too weak to fight it off. Sometimes even while the host is still alive.
Cardiovascular disease, respiratory disease, cancer and many other underlying conditions can increase the danger of a CV19 comorbidity. This is why CV19 is much more lethal for patients with pre-existing, otherwise manageable, conditions. A greater risk exists for these patients because the virus doesn’t work alone, but leaves the body vulnerable to other opportunistic infections.
This is why it’s important to keep taking prudent precautions, even if you’re young and healthy, because if you’ve got loved ones with pre-existing conditions, you might transmit it to them by mistake.
In Survivor Max, Ataxic Hyperphagia attacks the brain. That’s how you make a zombie, after all. But CV19 is coming for our brains too… sort of.
In Survivor Max the pathogen hijacks the amygdala, which regulates the fight-or-flight mechanism, and our sense of hunger. In the living dead that means a thoughtless creature governed entirely by its basest instinct to hunt and eat. But in the living the effect is much more subtle. It might make an infected person more quick to anger, or less risk averse. As it takes hold, it makes the infected drawn to dangerous activities, and prone to poor judgement. In effect, the dormant infection is guiding the patient toward behaviors that might activate the infection.
CV19 attacks the brain in a different way. That oxygen deprived caused by the clogged alveoli can have a terrifying effect on the brain. It’s a bit like being drunk. But the person’s cognitive function drops before they consciously realize there’s a problem. And sometimes, such a person gets stubborn about it, and angrily insists there isn’t a problem. When you’ve got some time, go find videos of astronauts and scuba divers testing in low oxygen environments. Because that’s the kind of zombie created by oxygen deprivation.
Scientists now warn of a potential wave of CV19-related neurological complications, including inflammation, psychosis and delirium. There have been cases of CV 19 patients who suffered either temporary brain dysfunction, strokes, nerve damage or other serious brain effects. The big concern is that even after millions of people recover from CV19, some of those people may have permanent cognitive deficits moving forward.
Another recent study suggests that CV19 may hide in people’s brains after recovery and trigger a relapse later on. Although this was a study performed on lab mice, not observed in humans. The researchers found that the virus was located in the brains of mice at a level that was 1,000 times higher than in any other part of the body.
8) An Infodemic (Or Is It An Infopocalypse?):
In Survivor Max, as with many stories in the zombie genre, the response by the government and the media plays a major role in the devastation. Panic and misinformation pose as great a risk to public health as the outbreak itself. The mismanagement of authorities acting upon hasty or biased conclusions can actually facilitate the spread of an outbreak.
In the case of CV19, one study examined similar news shows and proved that misinformation correlated with increased infection and death among the shows viewers.
Claims that silver-infused toothpaste, or breathing hot air from a hair dryer can kill the virus, are completely unsubstantiated. Many have suspected that the Death Toll has been exaggerated. Some scientist claim that genetic markers prove that CV19 has a natural origin, but some have claimed the virus is some kind of bio-weapon of human design. Still others claim the disease is linked to 5G networks, even though CV19 has spread in many countries that do not have 5G networks. When medical science becomes politicized, misinformation makes it hard to know who to trust. So, media literacy can be just as important as scientific literacy in a crisis of this scale.
BONUS) Predicting Elliot Page’s Big Reveal
I know, this has nothing to do with CV19, but it did happen during the pandemic. That’s why it’s a bonus point, and not part of the numbered list.
In Survivor Max, I’ve had a character since the first book named Elisabeth Paige, or Ellie for short. But, in 2018 the video game “The Last of Us” won Game of the Year, and I discovered that their main character was also a young girl named Ellie surviving in the zombie apocalypse. Further, I learned that their Ellie was loosely modeled on “Ellen Page,” as they were known at the time. Quite a coincidence. So, in the third book I had Ellie begin presenting as male, and going by Elliot Paige.
Then, in 2020, the actor formally known as “Ellen Page” took the name Elliot Page. Am I crazy to think I’ve created the role of a lifetime for Elliot Page? Obviously he can’t go back in time and play “Ellie” as a young girl, but in the next trilogy of the series (yet unfinished) Elliot and Max are 10 years older, and no one left alive but Max even knows that Elliot was assigned female at birth. How amazing would it be for Elliot Page to play a character named Elliot Paige totally by coincidence?