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Not a scientist, I can only attempt to retell what virologist Prof. Christian Drosten from Charité Berlin told in in his podcast[1]:

It's not really clear at the moment but it could be due amount of dose (more virus particles, faster replication) and where the virus makes contact with the body (if you are unlucky you are breathing a high dose directly into your lungs i.e. coughing patients in a hospital) - your immune system does not know the virus and it takes a while until it's able to fight it off and if the virus is directly in the lungs or you've got a high dose it has less time to do so. If you have it only in the throat it takes a lot of time, like multiple days until it goes into the lungs (if at all, this is also not clear when and when not this happens) and he suspected that in this time period you already have a better immune response.

Besides that (not from the podcast) I've read that the virus can induce inflammation that can can cause blood clots and other nasty things - so you may die from stroke or heart problems and not pneunomia.

There was also a paper that hypothesized that the virus can either replicate in the throat and go the lungs but it's probably also possible for the virus to use the nervous system to reach the brain via the olfactory bulb.

China did isolate ill patients from their families and it was hypothesized that sharing a bed/room with a sick person is a bad idea because the virus is in high doses in the air. So you can read that you should keep fresh air flowing in and possible avoid too much direct contact.

1: https://www.ndr.de/nachrichten/info/podcast4684.html (only in german)




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