Type of exposure and initial viral load?

Does how you are exposed to the virus make a difference in outcome?

I have a theory that I think helps explain the wide variance in outcomes among individuals and also from one geographic region and the next.

If you are exposed by your hands touching your face... I think you are likely to have the infection start in  your eye or nose.   If it starts there I think your immune system has time to react to it before  it settles into the lungs.

If you are exposed by aerosol I think the infection would start in the lungs, and by the time your immune system reacts.... there is already significant damage.  I also think that you then become a vector for aerosol infection for others.   In some instances I think toliet flushing also leads to aerosols, and this helps explain why nursing homes are so bad.

Also  think if you are only exposed to a few virus particles,  they may not be particularly hardy, or not well adapted to your body.   However if you are exposed to a large number, you are much more likely to get a stronger more well adapted virus strain.

I think in areas where you have a low levels of virus spread, when you are exposed it is more likely a very small contact exposure.   However when the virus starts spreading well, you get more severe infections, that leads to more and more other severe infections.   So maybe by just slowing the spread.... the people that do get sick will get less sick.

To the experts out there do my thoughts have any validity?

I had similar thoughts when we heard about young doctors in China dying from it.  It just didn't make sense that these young healthy doctors were dying, when we were told most of the dying were old and sick.  I wondered then if it was the amount of virus they were encountering, that their bodies just could not combat the deluge of insult.  One of the doctors that died made the comment he thought he was exposed through his eyes.  It is hard to say, and I think most experts are baffled by the behavior of this virus.

You are thinking like a clinical virologist, good job!  Higher dose nearly always results in more fulminant infection, although some viruses are so evil that only a few are enough to cause disease. 

Our HC workers really get it in the face when dealing with sick patients....ventilated patients exude vast quantities of lung fluids & other infectious debris which can contaminate the entire room.  

Please see this article:

https://jamanetwork.com/journals/jama/fullarticle/2763852?guestAccessKey=afd36314-652e-4195-87ef-793fcf167a76&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_term=mostread&utm_content=olf-widget_04032020

A key goal of such policies is to decrease the encounters between infected individuals and susceptible individuals and decelerate the rate of transmission. Although such social distancing strategies are critical in the current time of pandemic, it may seem surprising that the current understanding of the routes of host-to-host transmission in respiratory infectious diseases are predicated on a model of disease transmission developed in the 1930s that, by modern standards, seems overly simplified. Implementing public health recommendations based on these older models may limit the effectiveness of the proposed interventions.

DeepThinker wrote: Does how you are exposed to the virus make a difference in outcome? I have a theory that I think helps explain the wide variance in outcomes among individuals and also from one geographic region and the next. If you are exposed by your hands touching your face... I think you are likely to have the infection start in  your eye or nose.   If it starts there I think your immune system has time to react to it before  it settles into the lungs. If you are exposed by aerosol I think the infection would start in the lungs, and by the time your immune system reacts.... there is already significant damage.  I also think that you then become a vector for aerosol infection for others.   In some instances I think toliet flushing also leads to aerosols, and this helps explain why nursing homes are so bad. Also  think if you are only exposed to a few virus particles,  they may not be particularly hardy, or not well adapted to your body.   However if you are exposed to a large number, you are much more likely to get a stronger more well adapted virus strain. I think in areas where you have a low levels of virus spread, when you are exposed it is more likely a very small contact exposure.   However when the virus starts spreading well, you get more severe infections, that leads to more and more other severe infections.   So maybe by just slowing the spread.... the people that do get sick will get less sick. To the experts out there do my thoughts have any validity?

well said