THE CASE OF CORONA VIRUS [COVID19]

EXECUTIVE SUMMARY

Given the diversity of NGOs, a feeling of “collective responsibility” has been articulated for several years that led to supporting quality and performance standards initiatives. A new strain of coronavirus (COVID-19) was discovered in 2019 and was not previously identified in humans. Currently, the strain is spreading rapidly. Considering that this new virus is being introduced worldwide, the resources in public health that we must monitor are blunt. This may have significant side effects, both economic and social. Health authorities rely on strategies such as quarantines and social barriers, while doctors (who fear lack of equipment) use oxygen and fever reducers, such as ibuprofen, to treat patients. The efforts by Singapore and Hong Kong to contain the virus and eliminate its spread have been commended worldwide. Currently, both Singapore and Hong Kong have a record of below 200 cases of infected patients. While the number of cases in the first hit countries is reducing, they keep increasing in states that had their first cases later. Countries such as Italy and the US are examples with Italy recording a total of 328 deaths in 24 hours. The rate at which the disease is spreading has left no choice but for governments to implement stringent measures to contain the virus with some governments like Morocco shutting its borders.

1.      INTRODUCTION

Many scientists from previous encounters with global health emergencies (from SARS, bird flu to Ebola) point out that China, South Korea, and Japan are closely monitoring the extraordinary outbreaks of the virus. The experts are calling on policymakers around the world to prepare for the latest coronavirus before it gets into their countries or when it gets into their countries, the same way Hong Kong and Singapore did. Within a few weeks, after the outbreak was discovered, the virus genome was sequenced and shared by Chinese scientists (Burke et al., 2020). They then mobilized and developed new approaches to prevent and manage Covid-19, with collaborations from both pharmaceutical companies and research centers. The key to creating the right thing now is placing focus on the development of vaccines and pharmaceutical treatments.

Most attempts to improve vaccines and drugs have been based on previous efforts to tackle other viral outbreaks, including coronaviruses such as MERS and SARS. The bad news is that such projects are likely to face the relentless obstacles of medical innovation. This includes extended deadlines (especially for vaccines used in healthy people), crazy funding, and shifting policy priorities. The “urgent request” for the $2 billion production vaccine against Covid-19 was made on Friday by foreign researchers (Wang et al. 2020). All of this is a reminder that we need a better way of keeping constant pressure on intermittent yet dangerous attacks.

With the outbreak turning into a global crisis, the observers say Beijing has also agreed to share their expertise with backers of the Belt and Road Initiative, such as China, Italy, and Iran, to enable them to contain the spread of COVID-19 in their countries. To encourage the effectiveness of their disease control steps, Beijing has increased its efforts to change the international discourse on its involvement in the coronavirus outbreak, thus setting an example for other countries. Collaboration with global health bodies is a crucial step towards resolving the emerging pandemic that is rapidly spreading across the globe and claiming the lives of many.

ANALYSIS OF THE CASE

Dozens of Covid-19 safety vaccines are under development. One of the hard-learned lessons in the 2014-16 Ebola outbreak, which killed 11,000 people, was the prospect of creating lifesaving vaccines for mild illnesses. With Ebola, experimental vaccines had been carried out, but corporations had no business incentive to complete the study and manufacture it. An Ebola vaccine approved in 2019 was eventually established by a major donor and the World Health Organization (WHO), and it is now used to combat outbreaks. The Coalition for Epidemic Preparedness Innovations (CEPI), a public-private initiative founded in 2017, has pointed out that more Ebola-like outbreaks will occur, thus the need for an effective vaccine and containment procedure (Morens, Daszak, &Taubenberger, 2020). They are to award funds for the accelerated production of vaccines to tackle emerging threats that would otherwise be neglected by the pharmaceutical industry.

Just two months after the outbreak, CEPI has undergone legal animal and human trials, to ascertain the best way to combat Covid-19. Funds have been channeled from the US government mainly through the Biomedical Advanced Research and Development Authority (BARDA). Some manufacturers are also rationalizing the process (Rasmussen et al., 2020). To prevent the disease from spreading, public health officials, virologists, and epidemiologists need to offer mitigating factors that can help contain the situation. They should also find the right vaccine to help curb the spread of the virus. Tara Smith, an epidemiologist at Kent State University, adds that if an effective vaccine can be synthesized, the population’s infection rate may reduce to a manageable condition.

A grant for the development of a Covid-19 vaccine INO-4800 was awarded to Inovio Pharmaceuticals and Beijing’s partner Advaccine Biotechnology, a biotech firm. Inovio is noteworthy as it has already been validated with a promising MERS (and CEPI-sponsored) vaccine, a coronavirus closely associated with Covid-19. NO-4800 is in the preclinical phase of testing, meaning it has not yet been tried in humans. The company is aiming to test on people later this year. It uses a “DNA vaccine” approach, meaning INO-4800 delivers synthetic genes into a person’s cells (Guan et al. 2020). Those gene codes for proteins that should, in theory, ramp up the recipient’s immune response to Covid-19.

When MERS and SARS emerged, Barney Graham, deputy director of the National Institute for Allergy and Infectious Diseases (NIAID), said: “It has been clear that coronaviruses will be a threat. Throughout the past few years, NIAID has studied the molecular structure of this family of viruses and has produced plans for the rapid development of vaccines. The competition is paying off with the development of a vaccine, mRNA-1273 from the NIAID, and the creation of Moderna biotech which has emerged as another CEPI-funded competitor (Burke et al., 2020). Theirs is a vaccine of mRNA, which is short of the molecules that teach cells to generate different proteins, “messenger ribonucleic acid.” This mRNA technology, like the DNA vaccine of Inovio, incorporates genetic code fragments into the muscle of an individual so that the muscles begin processing the viral protein themselves. mRNA only gives guidance on how the [virus] protein should be made by your cell, and after it has been made, the immune system can take over and do its job.

The vaccine will be ready for approval in the next few months for the first clinical trial (to prove safety). When approved, mRNA-1273 will be the first human-approved mRNA vaccine. If it works, a new, rapidly evolving vaccine technology will be introduced. (The hope for mRNA vaccines is that they will be more effective than the older methods and result in faster and cheaper production, and they are also theoretically healthier because they do not use live viruses). The pharmaceutical firm CureVac also is working on an mRNA vaccine sponsored by CEPI, which would work in the way that Moderna and NIAID operate (Zhao et al., 2020). That is because the corporation has previously attempted a synthetic mRNA vaccine against rabies.

Johnson & Johnson’s Janssen is studying a less invasive approach to the Covid-19 with the use of BARDA, a vector-based vaccine that is being developed. The vaccine has previously led to the successful synthesis of the vaccine against Ebola. Primarily, the vaccine is produced by creating a non-replicating virus (or virus vector), which includes some genetics from coronavirus. The vaccine is injected into the muscles of a person where the virus injected creates an antigen (Wang et al. 2020). This protein will induce an immune response if it folds correctly (and achieves the right form).

Vaccine production is an incredibly hard science. Introducing a small piece of coronaviral protein to the body, to make the immune system know what a coronavirus looks like. All the different methods aim to do the same: If the immune system can be vaccinated to locate this protein and kill it, the body is immunized from the virus. But it may take years to identify the right immune stimulus and then show that it is safe enough to use in healthy people.

As the disease became a global problem, China was able to remedy the harm to its image by placing focus on containing the spread of the virus and avoiding the many international medical cases presented. China has gained global praise for its robust effort in suppressing viruses and contributing to global public health (Morens, Daszak, &Taubenberger, 2020). Beijing previously cited the recommendations of WHO condemning the US for banning travel on its residents, claiming the coronavirus came from China. The WHO has described Beijing’s response efforts as perhaps the most aggressive, agility, and an aggressive containment campaign in history. A meeting of China and WHO experts to discuss the containment measures and the effect of coronavirus on the ground too place. This also lauded China’s “profound commitment” to concerted action on the virus and the “positive approach,” which has contributed to a decline in newly reported cases daily (Guan et al. 2020).  It concluded that China’s experience in responding to Covid 19 and the material goods it offers to the global response are desperately needed in the rest of the world.

Recently, Beijing agreed to invite a team of Chilean health experts to learn about its control measures. In a few weeks, only one coronavirus case was confirmed in the South American region. Chinese Minister of Foreign Affairs Wang Yi also provided Italy’s first Western nation to sign up for the belt and road plans, as well as his experience in disease prevention and containment, to provide medical assistance (Guan et al. 2020). Once the leadership learned the severity of the problem, China made necessary steps to contain the outbreak, action such as the lock-out of Wuhan in other countries became unrepeatable and civil rights were violated.

DISCUSSION OF LESSONS

The UK can learn several lessons and other countries on the critical steps Singapore, Taiwan, and Hong Kong have taken towards containment of coronavirus. The 2003 pandemic of the severe acute respiratory syndrome (SARS) infected approximately 8000 people globally. It killed 774 others, with 299 deaths recorded in Hong Kong (Barron, 2020), the three countries were prepared for the next crisis considering they were at a significant loss in the period of the SARS pandemic. Better systems for handling such epidemics were set in place to guarantee they have a fighting chance if another life-threatening epidemic emerged. Quick response, rigorous detection and strict quarantine, social distancing and banning mass gatherings, and effective communication are the mitigating factors that helped Singapore, Taiwan, and Hong Kong contain the spread of coronavirus (Barron, 2020). If the UK, Italy, and other affected countries adopt this for mitigating factors, containment can be effectively achieved.

1. Quick Response

The story could easily have been a disaster for Singapore, Taiwan, and Hong Kong. On the occasion of Lunar New Year, when millions of individuals travel the region in the world’s most significant annual human migration, the novel coronavirus emerged. All three areas are closely linked to China with direct flights towards Wuhan, the epicenter of the outbreak (Wells, 2020). Even as the virus continues its seemingly inexorable growth, bringing reported cases to 132,500 and growing, cases of recoveries in Singapore, Taiwan, and Hong Kong have started to measure up with the current global active cases (Barron, 2020). The decision to react aggressively from the beginning was the key to their success so far. Arrivals from the Wuhan area in Taiwan, an island of 23 million, were tested. Human to human transmission the virus was confirmed on January 20.

By February 1, Taiwan, Hong Kong, and Singapore had all quickly and effectively applied travel restrictions on continental passengers, violating the WHO’s presumption that no travel bans were required. These international hubs, all of which rely on mainland China as their leading trading partner and tourist source, were hit with high economic costs. The three destinations were well prepared to respond quickly. In contrast to South Korea and Japan, which are also close to China in advanced healthcare systems, Taiwan’s rapid mobilization contrasts sharply (Wells, 2020). They were criticized for their initially slow reactions and subsequent explosions.

Taiwan set up a central center for epidemics following SARS in 2003. By January 20, the government planned and executed the coronavirus response. According to an article in the American Medical Association Journal, it quickly compiled a list of 124 “action items,” including border controls, school and work policies, public communication plans, and hospital resource evaluations (Barron, 2020).

2. Rigorous Detection and Strict Quarantine

Singapore appeared fateful for a large-scale outbreak when the virus began to cross Chinese borders in January. The small city-state was the third country to report COVID-19 cases, with more than 80 infections reported in mid-February, the highest in and around China. However, the tally indicated that the island of 5.7 million was thoroughly tested. Singapore is estimated to detect nearly three times as many cases as compared to the world average due to Singapore’s active disease monitoring and tedious tracking of contact (Wells, 2020).

Singapore’s health authorities decided to try all influenza-like and pneumonic cases early to uncover COVID-19 infections, which might have evaded detection otherwise (Barron, 2020). In hunting for every possible contact of infected persons, they have also spared no effort. This process, which runs 24 hours a day, begins with patient interviews and involves the police, flight manifests, and a local antibody test that is clear even after infection.

The government advertising on the front page of the largest daily newspaper in Singapore urges people to see a doctor and refrain from going to school or work with even mild symptoms. And nobody in Singapore must be afraid of treatment. Testing is free of charge, and the government gives updates regularly concerning hospital reports on suspected or confirmed cases for Singaporean residents (Wells, 2020).  Some suggest that the active response of Singapore to coronavirus is less related to its authoritarian tract than to transparency, extensive testing, and quick quantization and isolation of suspected cases.

3. Social Distancing and Banning Mass Gatherings

Social distance and banning mass gatherings have been successful measures towards reducing the spread of coronavirus. Hong Kong implemented social distancing and the placement of hand sanitizer stations at different points of the city, as mitigation measures to contain the range of COVID-19. Many companies have shut down and requested their employees to work from home. movie theatres, churches, and courts of basketball are currently unoccupied since the banning of social gatherings. The actions seem to work. The province of the neighboring Guangdong registered 1,356 cases, the largest outbreak in China outside Hubei. The number of infections remains 131 in Hong Kong (Barron, 2020).  The familiar reflexes such as good hygiene of hands have come back into practice within a city deeply scarred by the SARS outbreak–and still populated by hand sanitizer stations.

4. Effective Communication

Experts say that government communication with the public is crucial if people are to remain cautious, with no panic. Currently, Prime minister Lee Hsien Loong in Singapore is doing a commendable job. The Singaporeans emptied the supermarket shelves after the government increased the outbreak alert on February 7 to orange, one level below the maximum limit. To alleviate anxiety, Lee sent the nation an address in three of the four official languages of the city-state (Barron, 2020). The discourse seemed immediate as supermarket lines were quick to ease. For people to trust you, one has to be open, honest, straight forward, and confident. The demonstration of your skillset is evidence of who you are.

REFLECTIONS

Benefit organizations are responsible for the manufacture of vaccines and antivirals in much of the world. If there is not enough demand, you cannot produce a vaccine or an antiviral. It is a mistaken pattern. Work is required to ensure that the vaccine can quickly be created and used if an epidemic occurs. At present, global efforts are concentrated on reducing the spread and effects of the virus. To counter this public health danger, the federal government works in close partnership with national, local, tribal, and territorial partners and public-health agencies. The CDC’s pandemic prevention and response plans are being implemented and operate on many fronts, including detailed guidelines on measures for preparing communities to respond to COVID-19 spread locally. In anticipation of an influenza pandemic adapted for a possible COVID-19 pandemic, a wealth of pandemic guidelines is created.

Individuals and communities should familiarize themselves with advice to avoid the onset and spread of respiratory diseases such as COVID-19, to help us respond to this growing public health danger. Special measures should also be taken in older individuals and those with extreme medical conditions, as they are at higher risk for COVID-19 severe diseases. Self-analysis of compatible signs and symptoms for COVID-19 is crucial towards taking precautionary measures such as taking the test to determine your status. Self-isolation is critical towards reducing the spread of the virus.  Please be vigilant and follow prescribed infection management protocols if you are a healthcare provider or a public health care respondent looking after a COVID-19 patient.

Contact the healthcare professional to tell them about your symptoms to treatment if you are closely related to someone with COVID-19 and experience symptoms of COVID-19. You determine whether to check it, but note that COVID-19 is not treated, and people who are slightly ill may isolate themselves in their homes. You should contact your health care provider to inform them about your symptoms if you are a resident to continue to have COVID-19 symptoms. Please follow CDC guidelines on how to minimize the risk of spreading the disease to others for those who are ill with COVID-19 but not sick enough to be hospitalized. People with COVID-19 are slightly ill and maybe isolated during their illnesses at home. You will encounter any restrictions on movements and behaviors if you were in China or other affected areas or have exposed someone with COVID-19 in the past 14 days. During this time, please follow the directions. The continuing public health response to slow the spread of this virus is an integral part of your cooperation.

References

Active monitoring of persons exposed to patients with confirmed COVID-19—United States, January–February 2020.

Barron, L. (2020). Coronavirus Lessons From Singapore, Taiwan, and Hong Kong. Time. Retrieved March 16, 2020, from https://time.com/5802293/coronavirus-covid19-singapore-hong-kong-taiwan/.

Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X., … & Du, B. (2020). Clinical characteristics of coronavirus disease in 2019 in China. New England Journal of Medicine.

Morens DM, Daszak P, Taubenberger J (2020) Escaping Pandora’s Box – Another Novel Coronavirusexternal icon. N Engl J Med. February 26, 2020. DOI: 10.1056/NEJMp2002106.

Rasmussen SA, Smulian JC, Lednicky JA, et al. (2020). Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. Amer J Ob Gyn. Available online February 24, 2020. DOI: https://doi.org/10.1016/j.ajog.2020.02.017external icon.

Wang S, Guo L, Chen L, et al. (2020). A case report of neonatal COVID-19 infection in China. Clinical Infectious Diseases, ciaa225, March 12, 2020. DOI: https://doi.org/10.1093/cid/ciaa225external icon.

Wells, S. (2020). Singapore is the model for how to handle the coronavirus. MIT Technology Review. Retrieved March 16 2020, from https://www.technologyreview.com/s/615353/singapore-is-the-model-for-how-to-handle-the-coronavirus/.

Zhao D, Yao F, Wang L, et al (2020). A comparative study on the clinical features of COVID-19 pneumonia to other cases of pneumonia. Clinical Infectious Diseases, ciaa247, March 12, 2020. DOI: https://doi.org/10.1093/cid/ciaa247external icon.