User:Aepryer/sandbox/COVID-19: An In-Depth Look

Abstract The following document provides an in-depth analysis of the COVID-19 pandemic in regards to the changes it has caused to society, as well as the adaptations that are being made to fight this virus. Although this is a fairly new obstacle society has had to face, a vast amount of research has been done in order to provide an answer to how one can fight off, or rather protect themselves from the problems that are caused by this. From this research, one could better understand what this virus is as well as ways to cope or rather understand how to live in a society that revolves around the constant protection from a global pandemic.

Introduction Over the past year, our world has been faced with the vigorous challenge of a virus that occurred with little to no warning, and of which there was little understanding about how detrimental it would be to the population. The virus that this paper will be referring to is the COVID-19 virus. The reason this particular virus has been so significant is that it is a new strain that scientists had little knowledge or understanding of prior to its emergence. Due to the lack of knowledge about the virus, efforts to limit its spread were slow to be implemented. Furthermore, understanding how best to treat people infected with this Novel Coronavirus required a lot of experimentation early on to establish which treatment methods were most appropriate. As this information was being explored, people were spreading the virus across the globe, and tragically, many lives were lost. Over the last year, as understanding of the virus has improved, and preventative measures have been honed, the virus’s impact has slowed somewhat; however, it continues to impact society in ways far more significant than anything in recent memory. By exploring the emergence of the virus, its causes and impacts on society, and the efforts to treat and prevent further cases one can better understand the impact that COVID-19 is having on society.

Literature Review What is COVID 19 (Why is it different than the flu) COVID-19 is a new respiratory virus that has emerged over the last 18 months. While not exactly like the flu, there are some commonalities between the two viruses. This virus is more alarming than the common flu though because it is new, and there were initially no new treatments or vaccinations available to protect people from the potentially deadly virus. To help understand the differences between COVID-19 and flu, one can look to experts on both diseases, including Andy Pekosz, professor of molecular microbiology and immunology at Johns Hopkins University’s Bloomberg School of Public Health, who has long warned people about the dangers of influenza. Amid the pandemic, he says that hearing people compare the flu to COVID-19 "borders on making me incredibly angry" (Law, 2020). The proclaiming of this by the professor of molecular microbiology and immunology showcases the importance of understanding the difference between the flu and COVID-19. With the status of this professor, meaning the amount of knowledge one must have in the profession Andy Pekosz is, the insight he has on the new virus would allow others to see that the anger caused by this misinterpretation is fueled by knowledge of knowing the difference between the two. Additionally, Pekosz adds onto this by saying, "Our hospital staff is working like crazy to keep up with the demand of patients that are coming in. It's all around us, the effects of this disease...there are thousands of sick people every day that are coming into our hospitals” (Law, 2020). This showcasing the importance behind the need for separation in the aspects of healthy patients and COVID-19 patients. Due to the lack of spacing between the groups, an outbreak or rather the unnecessary spread of the virus.While different strains of the influenza virus typically spread each year, immunity from past exposure to other strains, as well as vaccination, can still offer protection. But compared to our typical seasonal flu, what makes SARS-CoV-2 dangerous is that it's a brand new virus. Even months into the pandemic, relatively few people have COVID-19 antibodies. Fewer than 10% of people in areas across the U.S. possess the necessary antibodies to help their bodies defend against this virus (Law, 2020). So far, the novel coronavirus has killed 1.6 million people worldwide, including more than 300,000 Americans (Park, 2020). Looking at these numbers, one can see that this virus is causing problems in the health status of people across the world. These problems can be seen as a separate contribution to the health of society when compared to the flu. Due to this separation, a vast majority of people contracting the COVID-19 virus are left hospitalized as opposed to those who suffer the flu and are treated at home with over the counter medications. As the pandemic worsens, many more people are winding up in the hospital with the coronavirus than typically do with the flu. When hospitals become crowded with COVID-19 patients, as well as those sick with other illnesses that can put major strain on vulnerable and exhausted health care workers and the hospital system more broadly, potentially worsening patient outcomes. "At a certain point, it becomes very difficult to provide the level and quality of care that you want to provide for your patients," says Dr. Paul Thottingal, national lead for infectious disease for Kaiser Permanente.This can affect even people who were just mildly sick with the disease, and those who are young and otherwise healthy. Those who are affected by this with otherwise healthy bodies, can experience the pain and burdening that goes behind giving this disease to others. To further branch off of this, if one were to contract this virus and pass it on to a relative in of poor health, the outcome could be substantially detrimental to this relative as well as the mental health of the healthy individual. Since COVID-19 is still so new, scientists still aren't sure just how long these symptoms could last or whether they could become permanent. The best approach, for now, remains following public-health guidance like mask wearing and social distancing which, thankfully, should help curb the seasonal flu, too. The Impact of COVID 19. A case of unknown pneumonia in late 2019 December was reported in Wuhan, China. This case was the initial appearance of the virus that would become known and the Novel Coronavirus (COVID-19). COVID-19 is a respiratory disease, which affects many people in different ways, and infected people will get mild-to-moderate symptoms, usually seen after 2–14 days. According to the WHO and Johns Hopkins University, COVID-19 has affected more than 28,46,536 people, and total deaths were 1,97,859 across worldwide (Nadig, A., & Krishna, K., 2020). This large mass of people that were affected by the COVID-19 were placed into situations that resulted in these numbers being lower than that of what they could have been. An emergence protocol prevents the spread of infection between individuals staying in a given area. The lockdown protocol usually allows essential supplies such as pharmacies, hospitals, banks, and grocery shops and mandates the shutdown of all nonessential activities throughout the period. Implementation of such lockdown resulted in reduced spread of the virus both in Hubei and in other parts of China by a 2 weeks period. However, even these precautions were not enough in some places. Aafter implementation of complete nationwide lockdown and containment measures, India witnessed only 7,447 COVID19 positive cases by April 15, 2020 (Nadig, A., & Krishna, K., 2020). With this number being a substantial amount, with proper social distancing as well as lockdown being implemented, one could only imagine how detrimental this virus would be without proper precautions being made. An additional sidefall to this virus can be seen through a study shown on numerous models of mass emergency behavior suggests a social psychological basis for resilience. Fear and anxiety symptoms led individuals into compliance with necessary public health behaviors such as personal hygiene and social distance. These prosocial behaviors include washing hands more frequently and for longer, avoiding public gatherings, canceling travel plans, and keeping distance from others. If measures like these are adopted on a temporary basis, experts suggest that the deaths caused by coronavirus would drop dramatically. The coronavirus epidemic has exponential growth characteristics and caused a global mayhem. Due to high degree of contagiousness and absence of specific vaccines, non-pharmaceutical intervention like lockdown can be effective asis the only prescription to battle the virus. Additionally, those who are in isolation due to the COVID-19 virus have then developed anxiety, frustration, extreme fear of death, and insomnia after their isolation from society due to quarantine. These effects can even lead to chronic posttraumatic stress disorder and even increase a person's tendency to drug abuse. Therefore, it is necessary to consider the social psychological interventions for these people, especially those who are in-home quarantine, via providing the necessary facts and information. What is Being Done to Aid COVID Cases From this, a rare glimmer of hope can be seen. In November, both Moderna and Pfizer/BioNTech reported that their much anticipated COVID-19 vaccines are around 95% effective in protecting people against getting sick with the disease. The Food and Drug Administration planned to begin distributing their vaccines, and the agency was expected to review those requests in mid-December. But those same public-health experts also warn that vaccines aren't the panacea that many desperately hope they will be. That's because, for now, the studies show that rather than preventing a person from getting infected, these shots appear to keep people from getting dangerously sick. It's a distinction that's easily lost in the discussion of "efficacy." Yes, Moderna and Pfizer/BioNTech reported that their shots are 94.1% and 95% effective, respectively, but that doesn’t mean COVID-19 is simply going to disappear. Because the study homed in on just those volunteers who had tested positive, there's no way to tell for sure whether the vaccinations confer total immunity for anyone else. However, because the vaccines do not necessarily protect against infection, we won't be abandoning public-health measures, such as wearing masks, social distancing and avoiding indoor gatherings anytime soon. Even if the shots are authorized, initial supplies will be limited until manufacturing can match demand that health care workers and older residents in long-term care facilities, both of whom are at higher risk of getting COVID-19, should be vaccinated first. While both companies have begun producing doses, it's likely that the majority of Americans won't be vaccinated until next spring at the earliest, so the ultimate goal in controlling the pandemic through herd immunity probably won't happen until well into next year. And even then, he points out, researchers will have to remain vigilant about tracking any changes in the virus. "The big message is that we have an additional tool, in the form of vaccines for fighting COVID-19, but we don't have a tool to replace everything we do just yet," says Dr. "Hopefully as the country and world gets massively vaccinated, this virus will be essentially backed in, with no place to go because everybody is protected.". Vaccinations The U.S. now has two COVID-19 vaccines that are safe and effective enough for the public. On December 18th, the Food and Drug Administration issued an emergency use authorization (EUA) for a COVID-19 vaccine made by Moderna, a biotech company based in Massachusetts (Park, 2021). The decision followed an overwhelming 20 to zero vote, with one abstention, in favor or authorizing the vaccine by an FDA vaccine advisory committee. This is another crucial step in the fight against a global pandemic that is causing vast numbers of hospitalizations and deaths in the United States every day. The transparency around the review of the Moderna COVID-19 vaccine should reassure the public that this vaccine met the FDA's rigorous standards for quality, safety and efficacy. Following this, the agency issued the first EUA for a COVID-19 vaccine to Pfizer-BioNTech. The two vaccines use the same technology, based on the genetic material mRNA, and in trials showed similar efficacy in protecting against COVID-19 disease. Dr. Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, said it will be possible to get a better idea of which component of the vaccine might be generating the allergic reactions as more people are vaccinated with the two different shots; for example, if people also develop similar allergic reactions to the Moderna vaccine, the culprit may be common pharmacological ingredients used in both shots (Park, 2020). With two vaccines, the government's Operation Warp Speed program will come closer to meeting its promised goal of shipping about 20 million doses around the country by the end of the year. During a day-long meeting on December 17th, in which Moderna scientists made their case for an EUA, and FDA scientists presented their analysis of the company's safety and effectiveness data, an independent panel of vaccine, infectious disease, and ethics experts parsed the data and asked detailed questions about the existing data and Moderna's plans for continued testing of its vaccine. Moderna executives presented data from the company's Phase 3 study of the vaccine, which involved more than 30,000 people and included participants from a number of groups at higher risk of COVID-19, like those over age 65; people from certain racial and ethnic groups; and those with underlying health conditions (Park, 2020). This correlates from results found elsewhere, stating that the vaccine was 94.1% effective in protecting against COVID-19 disease, and was 100% effective in protecting people from severe COVID-19, which is defined as requiring hospitalization or supplemental oxygen support (Lawton, 2020). Even though Moderna's vaccine is now authorized, it's still not approved, which means that the company will need to continue monitoring for effectiveness and side effects among participants in its ongoing study. One question that the FDA authorization of the Moderna and Pfizer-BioNTech vaccines raises is whether study participants who were given a placebo should now get the actual shot. For now, the studies show that the vaccines protect people against getting especially sick with the disease. If people in the placebo group are allowed to learn their status and get vaccinated, that could weaken the strength of the study since the placebo group serves as a control to compare the vaccine's safety and efficacy. So Moderna has proposed a different plan: anyone in the company's trial who wants to learn of their status can request to become "unblinded." On Dec. Last week, during the committee meeting on the Pfizer-BioNTech vaccine, Dr. Steven Goodman, associate dean for clinical and translational research at Stanford University, proposed that the companies allow people to switch from their current group to the other—vaccinated people would receive the placebo, and people who had been given the placebo would receive the real vaccine. Pfizer decided instead to allow its study participants to learn their placebo or vaccine status when they became eligible for vaccination and receive the vaccine if they were in the placebo group and remain in the trial, or leave the study. "We need to consider volunteers; viewpoints on fairness, equity, trust, and larger societal interest," he said, noting that already, since last week's EUA of the Pfizer vaccine, "We have seen a substantial dropout...that undermines the data integrity and what can be learned. We must be proactive and provide the best choice to participants to remain in the study and ensure that the task of them is reasonable and respectful and ensure that they are treated fairly. (Roache, 2020)". Ultimately, the majority of the panel supported the proposal made by Moderna. While such a design would dilute the placebo group and potentially weaken the power of the study on important questions about safety and efficacy, that loss doesn't outweigh the benefits of giving more people protection against COVID-19. The committee also analyzed the data on potential allergic and anaphylactic reactions to the Moderna vaccine. The FDA noted that "no anaphylactic or severe hypersensitivity reactions with close temporal relation to the vaccine" were reported in the Moderna studies, but that the agency and the company are continuing to monitor for any potential cases as more people get vaccinated (Lawton, 2020). Vaccination (Pftizer). The results are from a phase III clinical trial, the final stage of testing whether a vaccine or drug is both safe and effective. An independent committee then "unblinded" the study and found that about 90 per cent of the cases were in the placebo group. It is an interim verdict, not a final one. And the "end point" of this trial - the criterion against which success or failure is judged - is almost the bare minimum. Of course, people who don't catch the virus cannot get very ill or die from it. "The studies do not have adequate numbers of patients in them to be able to reliably tell us if they prevent severe disease," says Susanne Hodgson at the University of Oxford's Jenner Institute, which researches vaccines, who spoke to New Scientist about covid-19 vaccine trials in general, not about Pfizer's specifically (Waxman, 2020). "We will need to give these vaccines to much larger populations in order to collect that kind of data." (Sotoudeh, 2020). Another thing to bear in mind, says Hodgson, is that vaccine effectiveness in the real world can be lower than that seen in clinical trials (Hodgson, 2020). According to the World Economic Forum, vaccine approval usually takes one or two years (Kambhampaty, 2020). Even if a regulator says yes, there are hurdles to overcome, not least a limited supply. Vaccines also require careful post-licensure evaluation, often called phase IV trials, because adverse reactions may be too rare to be picked up in clinical trials but serious enough to make the vaccine unsuitable for widespread use, says Hodgson (Hodgson, 2020). Some adverse reactions may take months or even years to be detected, she says. No serious safety concerns have been seen in the present trial, the companies said. The companies said that trial participants will be monitored for two years after receiving their second dose. The FDA has a procedure called emergency use authorisation (EUA), which can grant temporary approval to unproven medicines in an emergency situation. Pfizer and BioNTech said they intend to apply for one for their vaccine but don't yet have enough safety data. Yes. This vaccine requires two doses, which the WHO regards as less than ideal. Another downside is that the results exclude people who have been infected with the virus before. Then there is the fact that the results were released by press release, not in a scientific paper, so the fine details are hard for scientists to evaluate. Pfizer and BioNTech said they will submit the data to a peer-reviewed journal. Again, scientists don't know for sure, but it looks reasonably promising that if enough people get vaccinated herd immunity will be a realistic expectation. Given that the herd immunity threshold for SARS-CoV-2 is estimated to be about 70 per cent, a vaccination rate of about 78 percent of the population could then produce herd immunity. But with vaccine hesitancy hovering at around 25 per cent in many countries, that might be a stretch. Yes. "Even a partially efficacious vaccine could have a really significant impact on the course of the pandemic," says Hodgson. In other words, the best way to establish herd immunity in order for everyone to return to normal life is to get vaccinated. Without widespread acceptance for the vaccine, it is possible that the virus will continue to spread and have a significant impact on the planet for years to come. Conclusion Over the last year, as understanding of the virus has improved, and preventative measures have been honed, the virus’s impact has slowed somewhat; however, it continues to impact society in ways far more significant than anything in recent memory.The overall understanding of which one takes from the analysis of the summarization of sources alongside the correlation to the virus and the vaccinations thus causings a complete thought that the reader can be left with. Exploration of said virus, COVID-19 causes the world as a whole to be able to look in depth as to what actions need to take place as well as the lengths one must go in order to fight for a word without a global pandemic. Once one can see the impact that is occurring on society, one can then see the ways in which one needs to adjust accordingly.

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