Monday, July 13, 2020

The Coronavirus Disease

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Hardi Talwani

Article Title

The Coronavirus Disease

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Global Views 360

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July 13, 2020

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Computer generated representation of COVID-19 virions (SARS-CoV-2) under electron microscope

Computer generated representation of COVID-19 virions (SARS-CoV-2) under electron microscope | Source Felipe Esquivel Reed via Wikimedia

Severe acute respiratory syndrome-Coronavirus 2 (SARS-CoV-2) is a novel virus from the family of coronaviruses which causes COVID-19 i.e. Coronavirus Disease-2019. It is the successor of the SARS-CoV-1 which caused the SARS outbreak in the year 2003-2004. This is a positive-sense single-stranded RNA virus which has rapid mutation properties.

The etymology of the name suggests that 'Corona' comes from the Latin word corōna meaning crown, garland, or a wreath. When seen under an Electron Microscope, the virion which has a diameter of 50-200 nanometres looks like the solar corona hence named Coronavirus.

When the virus enters the body; it attaches itself to the binding site or the ACE 2 receptors of healthy lung cells through its spike protein. Then it enters the cell via this attachment and causes apoptosis or cell death. The virus also affects organs other than lungs such as the brain, heart and kidneys. The multiple impact points make it problematic for the researchers to create a vaccine in addition to its rapid mutation properties.

The disease might have a zoonotic origin i.e. the transmission occurs from animals to humans. On comparing the genomic sequences the Human Coronavirus strain is found to be 96% identical to Bat Coronavirus samples and 92% similar to the Pangolins samples. Human transmission of the disease takes place via air droplets when the infected person is coughing, sneezing or talking.

The first cases of this respiratory illness were reported to the World Health Organization (WHO) from Wuhan City, Hubei Province, China, on 31 December 2019. It is the first severe outbreak since the 2009 H1N1 Influenza Pandemic. Initially, it was supposed that the site of origination is Huanan Seafood Wholesale Market but, in May 2020 the negative samples tested, by  Chinese Center for Disease Control and Prevention, from the livestock market suggested that it was the site of the super spreading of the virus.

SARS-CoV-2 is known to have an average reproduction number of 2.2-2.6 which means that, on an average, one infected person can spread the infection to 2-3 people. Although if measures like social distancing are put into use, to reduce the exposure of the infected population, it leads to a significant reduction in transmission rates. The infection fatality rate (IFR) of COVID-19 in various studies till 16th June 2020 was projected to range 0.60% to 1% of infected people . However few studies suggested the IFR as high as 3.6%.

The testing of an individual takes place through a method known as real-time Reverse transcription Polymerization Chain reaction (rRT-PCR). The process of obtaining strains and testing the patients usually involves nasal swabs or sputum swabs; the results come in within a span of a few hours to a couple of days.

Currently, there are no known vaccines available for the virus or any specific antiviral treatments, but there are numerous vaccines in works all over the world to tackle COVID-19. Experts believe that the minimum time required to test a vaccine is 12 to 18 months.

Trials are also going on for the repurposed drugs or the drugs which are useful for treating other diseases and might be capable against COVID-19: Some of these drugs are Hydroxychloroquine, chloroquine, Remdesivir, Dexamethasone, Lopinavir-ritonavir, and Convalescent plasma.

The only current solutions for tackling the pandemic are social distancing, hand wash, hygiene and face masks.

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February 4, 2021 5:14 PM

Asian countries & the race for COVID-19 Vaccine

Our relationship with the new strain of coronavirus is almost 8 months strong now. Countries like the US, Russia, UK, China, India, and many more have already set their brainy scientists in the task of developing a vaccine, turning it into a race which desperately needs a winner, since no one wants this deadly relationship to endure. Several attempts have proved to be successful, especially in countries like Russia, USA, India, and China.

China was the first to start scouring for a vaccine the day WHO declared that the new strain of SARS-CoV, originating in Wuhan-China, has resulted in a pandemic. It is a fierce competitor, especially to the US, as almost 8 of the 24 promising vaccines approved for clinical trials are from China. It used the technology of ‘inactivated vaccine’ which basically means killing the actual virus and using that to create a vaccine. This method is quite useful in treating measles and influenza, thus, increasing the chances of success in the case of COVID-19 as well.

“It’s a tried and true strategy”, Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said  about the inactivated vaccine. One potential vaccine from China-based Sinopharm is already in the phase 3 of trials whereas Sinovac will enter the third phase this month. Moreover, China has permitted Sinovac and Sinopharm to dilute phase 1 and 2 of vaccine trials on humans to hasten the process.

The head of the Chinese Center for Disease Control and Prevention, Gao Fu, had also been injected with a potential vaccine on July 28, 2020. “I’m going to reveal something undercover: I am injected with one of the vaccines'' Gao Fu said in a webinar hosted by Alibaba Health, an arm of the Chinese e-commerce giant, and Cell Press, an American publisher of scientific journals. However, he did not reveal any more details about how and when exactly he administered himself with the vaccine and ‘hopes’ that the vaccine works.

Vladimir Putin, President of Russia | Source: Wikimedia

Elsewhere in Russia, on August 11, 2020, President Vladimir Putin proudly announced that Russia was the first country to grant regulatory approval to their vaccine after carrying out human trials for less than 2 months by the Gamalei Institute in Moscow. Regulatory approval permits vaccination of the masses. Although it has not undergone phase 3 of trials, Russia expects to initiate mass production of the vaccine by the end of this year. Kirill Dmitriev, head of Russia's sovereign wealth fund states that the vaccine will be called ‘Sputnik V’, named after Sputnik 1, the first satellite launched by Soveit Union which was a euphoric moment for Russia. More recently, China and Russia have joined hands in proceeding with the clinical trials of their vaccines.

These two instances seem to bring a new hope for the future, yet raise alarms and invite scepticism from the experts in the field of public health. One major concern is that without prolonged trials, vaccines should not be authorized for public use. Anthony Fauci, an infectious disease expert based in the US said “I do hope the Chinese and the Russians are actually testing the vaccines before they are administering the vaccine to anyone. Because claims of having a vaccine ready to distribute before you do testing is problematic at the very least”. Hence, some people are still in doubt regarding the safety of the product. Putin, however, rubbished such concerns and said "I know that it works quite effectively, forms strong immunity, and I repeat, it has passed all the needed checks".

An Indian biotechnological company, Bharat Biotech developed ‘Covaxin’ in collaboration with Indian Council for Medical Research (ICMR), using the mechanism of inactivated vaccine. It was successful in getting approval for human trials which were scheduled to begin in July, 2020. Initial reports stated that it would be ready for mass use by August 15, 2020, which also marked the 73rd Independence Day of India. However, Bharat biotech was clear in letting the public know that phase 1 of the trials are still on-going. ICMR cleared the confusion by stating that it would prepare the results of the phase 1 trials by August 15, 2020, not the actual vaccine for use. Phase 2 of the trials are awaited in September, 2020.

So far, the results of phase 1 trials have been positive as no serious side-effects are observed in the vaccine candidates. “The vaccine has been safe. No adverse effect has been reported. Even the point of injection pain, which is normal in vaccines, has been very mild” said Dr Kushwaha of Prakhar Hospital.

Meanwhile, the South Korean government stated on August 21, 2020, that it will secure adequate vaccine supply to its citizens by cooperating with international bodies and promoting local drug development. Three South Korean companies have started the process of making a vaccine and all are in the clinical trial phase. Bill Gates asserts that the South Korean pharmaceutical company, SK Bioscience, will have around 200 million vaccine doses ready by June 2021.

Japan is jointly collaborating with the UK, France and other European countries to establish a $20 billion fund to buy coronavirus vaccines, with Japan pledging a contribution of $800 million. It’s vaccine program aims to focus on giving primary attention to its medical workers and the elderly people of the country when the first doses of the vaccine are made. The state-funded vaccination program is believed to be officially adopted by Japan in September this year with negotiations with the UK and US based drug makers already in place.

With the race to bring COVID-19 vaccine seemingly coming to a close and it will hopefully be ready by the end of 2020 or early 2021. Till then, the entire world is watching this race with bated breath.

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