Background
The world today is undergoing an unprecedented health crisis that has affected different spheres of human society. The COVID-19 pandemic is continuing to ravage across the globe, leaving a trail of destruction. The loss associated with the pandemic is characterized by loss of life, destabilization of the global economy, loss of employment, and unsettling of social norms. The damage caused by the pandemic has been worsened by different factors such as lack of ready vaccines, insufficient information about the disease, and its mode of operation. For example, scientists around the world have had varying information concerning the etiology of the disease. As of 14 th May 2020, there were over 4.3 million cases of COVID-19 and 296, 680 deaths globally (“ COVID-19 situation update worldwide,” 2020 ). Researchers further predict that these statistics will rise as the virus spreads across the world. Currently, there is no vaccine for the virus; however, efforts are in top gear to have one before the virus causes further damage. Countries are being pushed to save as many lives as they can regardless of the inadequateness of resources.
Origin of Corona Virus and Similarity to Other Viruses
The Coronavirus has its origin in China, Asia. Reports indicated that the virus emerged in the Chinese city of Wuhan in December 2019 and spread to other regions of the world. Coronavirus is a member of the Coronaviridae family, which is found in the Nidovirale order (Li et al., 2020). It resembles other viruses such as SARS-CoV, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), and common cold viruses. Some of the common cold viruses that are similar to the novel coronavirus include NL63, OC43, and HKU1 (Li et al., 2020). Similar to other viruses mentioned, the novel Coronavirus (SARS-CoV-2) is minute in size and has one RNA strand, which forms its nucleic makeup. It has a diameter range of between 65 and 125 nanometers and a size range of 26-32 kbs in length (Shereen et al., 2020). All the viruses above are known to trigger acute respiratory problems such as injuries to the lungs. As such, they are associated with pulmonary failure, which is a factor for fatalities. SARS-CoV-2 has the characteristic coronavirus structure of a spiked protein. The spiked protein has a three-dimensional structure, which helps maintain the van der Wall forces (Shereen et al., 2020).
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Image 1 : The Structure of SARS-CoV-2.
Source : National Center for Biotechnology Information
Place of Origin: How and Where
As mentioned above, SARS-CoV-2 was first reported in China in December 2019. At the end of 2019, several cases of pneumonia with unfamiliar etiology were reported to the Chinese government (Shereen et al., 2020). These cases were noted at the famous Hunan seafood market in Wuhan. However, no specific animal was immediately associated with the virus ( Adhikari et al., 2020 ). As Chinese researchers attempted to uncover the mystery behind the virus, the outbreak was linked to several animals, including bats and pangolins. It is important to note that live animals are sold at the Hunan seafood market, including bats, snakes, marmots, and a variety of birds (Shereen et al., 2020). Within a short time, more than fifty people became infected. Initially, it was believed that the people who had the virus had visited the Hunan animal market.
The people may have contracted the virus by interacting with the animals or by consuming them as food. Later, it was established that some patients had contracted the pneumonic virus without visiting the market ( Adhikari et al., 2020 ). It was from this revelation that scientists revealed that the virus had the human-human spreading ability. The evidence on human-to-human transmission was verified when more than 7818 cases were reported by 30 th January 2020 (“ WHO Timeline - COVID-19,” 2020 ). Studies indicate that the virus is spread when an infected person gets in contact with one who is not infected. The earliest date of COVID-19 symptoms was 1 st December 2019, while on 8 th December, a person was found to have pneumonia-like signs. 29 th December 2020, local health facilities in Hubei announced the first four cases of the unfamiliar disease with pneumonia-like symptoms. 31 st December, WHO was notified about the string of pneumonia-like cases reported in Wuhan by the Chinese government. 1 st January, the Hunan seafood market is labeled as the suspected source of the virus (Kantis et al., 2020). Since then, the virus spread exponentially across the globe W.H.O., governments and other non-governmental agencies have been reporting about the pandemic.
Image 2: Global Distribution of COVID-19 as of 15 th May 15, 2020
Source: ECDC-Europe
Image 3: Global Distribution of COVID-19 Deaths as of 15 th May 15, 2020
Source: ECDC-Europe
Spread, Symptoms, Progression Timeline, and Human Body’s Response
Although the SARS-CoV could have originated from animals vended at Hunan seafood market such as bats, the transmission is now person-person. Fundamentally, the virus is spread from symptomatic individuals to others who are in close contact through droplets from the respiratory system. The virus can be contaminated when a negative person gets into direct contact with a COVID-19 positive individual. Another avenue for transmission is by coming into contact with contaminated services and items (“Coronavirus Disease 2019”, 2020). Also, asymptomatic people have a high rate of transmission because they appear healthy, and they interact with people as usual. Research shows that some people can test for COVID-19 between 1-3 days before symptoms emerge. Nevertheless, the incubation period for the virus is averagely between 5 and 6 days, but it can go up to 14 days after initial exposure. The incubation period is known as pre-symptomatic transmission, and it has been established that some people can be contagious.
COVID-19 has several symptoms that make it extremely dangerous. Shedding of the virus mostly occurs in the upper parts of the respiratory system. The disease’s signs include fever, headache, pneumonia, fatigue, dyspnea, diarrhea, cough, and shortness of breath (Adhikari et al., 2020; Shereen et al., 2020). The response of the human body to COVID-19 is varied as cases range from mild to severe. The virus enters the body either through the mouth or nose, and it then progresses downward into alveoli inside the lungs. Once in the lungs, it attaches to the walls using the protein spikes. After the virus's R.N.A. has entered a cell, it makes more copies of the virus infecting other cells (Shereen et al., 2020).
Image 5: Disease Progression and Immune Response
Source : World Economic Forum
The result of the hijacking process is inflammation of the lungs, which triggers a response from the immune system. The immune response is characterized by fluid filling the air sacs evidenced by a dry cough and shortness of breath. In mild cases that make up between 80 and 85 percent, these symptoms often run their cycle just like normal flu. In severe cases, the inflammation triggers a cytokine storm, which causes more damage to the body cell than the virus. Severe cases are occasioned by the collapse of the alveoli and acute respiratory distress syndrome (A.R.D.) (Shereen et al., 202). The latter requires one to be placed on a ventilator for breathing aid.
Mutation Variations and Status of the Disease as of 10 th May 2020
It is the nature of every virus to mutate and have several variations, and as such, SARS-CoV-2 has undergone similar processes. According to Yao et al. (2020), the virus has undergone more than 30 mutations, resulting in many variants. These variants are spread across the world. Just like other R.N.A. viruses such as those that cause flu and measles the different variants, the SARS-CoV-2 is prone to mote mutations compared to D.N.A. viruses (Laguipo, 2020). Scientists thus fear that the virus could mutate into something deadlier with an increased threat to humanity. As of 10 th May 2020, the global figures stood at 3, 917, 366 infections while the death were 274, 361. Europe had the highest figure of 1,707,946 cases and 155,552 deaths, while the Americas came second with 1,665,378 patients and 98,723 mortalities. Eastern Mediterranean came third with 255, 728 cases, and 8878 deaths. West Pacific countries were fourth with 159,662 cases and 6470 deaths. South-East Asia reported 95,3154 and 3356 cases and deaths, respectively. Last, Africa reported the lowest with 42, 626 cases, and 1369 death (“ Coronavirus Disease Situation Report– 111,” 2020 ).
Image 5 : Surveillance
Source : WHO
Image 5 : Number of Confirmed Cases
Source : WHO
Part Two: Covid-19 Outbreak: Strategic Plan Assessment
The mission of an epidemiologist is to break at least one of the sides of the Triangle, disrupting the connection between the environment, the host, and the agent, and stopping the continuation of disease.
Epidemiologic Triangle
______________
Agent
____________ _______
Host Environment
Key facts
Based on what you learned from your review of the critical information for the three elements in the Triangle above, in the space below organize key facts as 5-6 bullet points for-
AGENT :
COVID-19 is a viral and infectious disease caused by a novel coronavirus called SARS-CoV-2
SARS-CoV-2 is a (+) ssRNA in the sarbecovirus, ortho corona virinae family
It has several compound immune-avoidance components that inform its virulent nature ( Astuti & Ysrafil, 2020 )
Highly pathogenic since it uses the same receptor angiotensin-converting enzyme 2 (ACE 2 )
Its genome is highly identical to that of coronaviruses found in bats ( Guo et al., 2020 )
HOST :
Evidence point to bats as natural host and it is believed to have been transmitted to humans through interaction
Enters the host through its ACE 2 receptors found in organs such as the lungs ( Astuti & Ysrafil, 2020 )
Transmitted when an infected person comes into contact with the uninfected individual ( Astuti & Ysrafil, 2020 )
Spreads through the respiratory system
Evidence shows that there is a person to person transmission ( Guo et al., 2020 )
The virus's entry into the body activates the host's immune system response within 14 days ( Guo et al., 2020 )
ENVIRONMENT :
Poor hygiene in residential places, workplaces and other social places (“ WHO | Environmental factors influencing the spread of communicable diseases ” )
Lack of adequate water for washing hands
Poor living conditions such as unsafe food, congestion and inadequate excreta disposal facilities (“ WHO | Environmental factors influencing the spread of communicable diseases," 2020 )
Climatic conditions such as flooding which can result in water contamination
The virus just like other pathogens can spread from one area to another along air stream before finally landing on services (“ To What Extent Do Environmental Factors Impact Virus Transmission Routes, 2020 )
Covid-19 Outbreak Strategic Plan
Answer the questions in the space below in complete sentences. Make sure to use evidence from the critical information materials to support your plan.
Make a brief assessment of the situation by describing the Covid-19 crisis.
The COVID -19 pandemic is the defining moment for global public health. Since its emergence in Wuhan China, the virus has almost spread to each country and region in the world except Antarctica ( Shereen et al., 2020 ). Every day, cases are emerging in America, Europe, and Africa, with countries racing to slow down the spread of the virus through testing and treating infected people. Other measures being put in place include contact tracing, travel limitations, quarantining patients and their contacts, and cancellations of large gatherings. The virus is rapidly mutating, resulting in different variants that are worsening the situation.
As of 10 th May 2020, the global figures stood at 3.9million infections, while deaths were over 274,300. Europe and America were the worst hit regardless of their generally advanced healthcare (“ Coronavirus Disease Situation Report– 111 ,” 2020 ). As from the trends, the virus is ravaging continent after continent, and there is a need to find ways of stopping the cycle. Evidence shows that the virus is more potent in people with underlying medical conditions and whose immune system is compromised, including young children. However, it is also known to weaken the immune system of healthy people leading to fatalities.
Which side of the Epidemiologic Triangle do you recommend to be broken, and why? Explain your answer in detail and include your thought process that led you to your decision.
As for now, the host site of the Epidemiologic Triangle is the best bet to break the spread of the virus. The virus is currently causing untold havoc in human society, and there is no cure or vaccine. Health personnel and governments the world over are focusing on managing symptoms to help patients gradually develop immunity. Thus, focusing on the agent or the environment at this time will result in a spike in the number of infections and deaths, which is an unwanted scenario. It is important to note that the ultimate solution to COVID-19 lies in breakthrough studies on both the agent and the host. The host is undisputedly the weakest link for further transmissions, as evidenced by measures given by WHO and governments around the world ( Koopmans, 2020 ). As the research world is racing against time to find a vaccine and thus cure, the most appropriate solution is to educate the masses on the best course of action to prevent further spread of the virus.
The human body is the host to the virus, with the pathogen mostly being spread through respiratory droplets in the air and contaminated objects and surfaces. Undeniably, humans are the weakest link to the spread of COVID-19 disease. Global resources, besides being committed to research, should also be channeled to informing the public. Personal hygiene is critical at this moment because the lack of it will place more people at risk ( Cascella et al.,2020 ). Focusing on the host is currently the most viable option since the idea is to stop further spread as there is no vaccine or cure. Also, WHO has provided simple guidelines that are proving effective in checking the spread of the virus. For example, people are being sensitized to regularly wash and sanitize their hands using soap and water or alcohol-based sanitizer for the latter. Other measures include maintaining social distance, avoiding touching the face, ensuring good respiratory hygiene, self-isolating, and seeking medical attention if one has any symptoms. When human society is educated on the virus, fewer people will be infected, and more resources will be channeled to research on the vaccine and cure.
How would you carry out your strategic plan? What resources would you need? What do you believe will be the biggest challenges you would face carrying out your strategy, and how will you overcome them?
Public education is key to achieving this strategic plan. The idea is to have the masses understand each aspect of COVID-19, the threats, facts, and misconceptions in the simple terms. As indicated above, the public is the weakest link to the fight against the virus. The measures prepared by WHO and implemented by the governments and other not-for-profit organizations are aimed at ensuring that transmissions are checked. As such, this strategy will embrace similar strategies to help combat the pandemic. The best way to implement this plan is to use the available internet platforms such as social media platforms to create targeted campaigns. Social media platforms have a broad reach, and they do not require one to physically contact the rest of society ( Merchant & Lurie, 2020 ). Hence, one will be exercising social distancing while at it. It will be possible to recruit people from different regions to join the campaign against COVID-19.
In implementing this strategy, several resources will be critical if success is to be achieved. First, the people factor will be central since they will be carriers of the information. Public health campaigns are not only conducted by experts, but other people can be involved. That notwithstanding, the pandemic is labor-intensive since most health workers have been recalled to help address the problem. People will need internet-enabled devices since the plan will majorly be executed through the internet to minimize physical contact. Last, finances will be crucial to facilitate different aspects, such as purchasing alcohol-based sanitizers for the most vulnerable groups. The biggest challenge will be to get funding for the campaign. The pandemic has occasioned a biting economic crisis, which means that most finances are already budgeted for. However, this will be addressed through crowdsourcing from well-wishers since it will not be money intensive.
What is the goal of your strategic plan? How will you know when you have reached it?
The goal of the strategic plan is to reduce daily infection rates through sensitization programs. The plan will be first piloted in the local community, where there is a ready network of friends and neighbors. The key is to actively engage each other on the WHO measures to combat the virus. The goal will be realized when the number of infection drastically reduce, thus helping flatten the curve.
References
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