Question

Consider how COVID-19 and the Spanish flu pandemic impacted their respective population. Using your knowledge of emerging and reemerging infectious diseases, identify and critique four disease mitigation or treatment strategies implemented to control each disease (two strategies per disease for a total of four strategies all together). Explain why strategies were infective and how they could have been improved. Identify one strategy you believe would have been effective to control the spread of both diseases. (Be sure to include at least two peer-reviewed references. 30 points, Response should be between 500 to 800 words)

Answer 1

The 1918 influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. On the other hand, the ongoing COVID-19 pandemic caused by a novel coronavirus hailed by the world health organization as a “once in a century health crisis” which has led to devastating impacts to health and livelihood the world over. The prevailing situation is reminiscent of the Spanish flu where definitive cure is unavailable and the public health measures like quarantine, social distancing, hand hygiene and isolation are the only alternatives. Both these diseases are transmitted through respiratory droplets, highly contagious and target the respiratory organs. The parallels between these two events cannot be denied. The Spanish flu thrived at a time when the knowledge and availability of antivirals and vaccine development were inadequate

COVID 19

The outbreak of Coronavirus disease of 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), has posed a serious health threat. The increasing number of COVID-19 cases around the world is overwhelming hospitals and pushing the global death toll to over 746,000, which has pushed the sprint to find new treatment options.

Despite implementing worldwide combined efforts to prevent SARS-CoV-2 further transmission by quarantining the infected persons and their family members, social distancing, and schools closure, the spreading of infection could not be contained; therefore, on March 11, 2020, the WHO declared COVID-19 a pandemic. No specific antiviral therapeutic agents or vaccine for SARS-CoV-2 are currently available to save the infected patients, protect health care workers and others at high risk of infection. Therefore, to control the rapidly growing SARS-CoV-2 outbreak, the WHO, announced on March 18, 2020, the launch of SOLIDARITY, which is an unprecedented multinational coordinated effort to collect rapidly robust clinical and scientific data during the SARS-CoV-2 pandemic, giving hope and planning to eradicate the SARS-CoV-2 virus. Various antiviral therapies with much broader landscapes are being selected by WHO, including the experimental antiviral drug Remdesivir; the Malaria medication Chloroquine/Hydroxychloroquine; a combination of Human Immunodeficiency Viruses (HIV) drugs such as Lopinavir and Ritonavir; and finally, a combination of HIV drugs added to Interferon-beta.

Chloroquine and hydroxy-chloroquine have received intense attention worldwide because of the positive results generated from the preliminary studies of their use to treat SARS-CoV-2 patients. Chloroquine and hydroxychloroquine possibly decrease acidity in endosomes compartments of infected cells and can inactivate the virus. In addition, chloroquine and hydroxy-chloroquine can also impair the terminal glycosylation of the ACE2 receptor, thus inhibiting the viral penetration into the cells. However, ex-vivo studies performed in the cell culture model have suggested that chloroquine and hydroxy-chloroquine can cripple the SARS-CoV-2 virus, but the effective dose required is usually high, which can cause severe toxicity . After reviewing the safety concerns of antimalarial drugs , the WHO temporarily suspended the hydroxy-chloroquine arm of its Solidarity trial .

Another underway ‘SOLIDARITY’ trial for SARS-CoV-2 treatment combines two drugs, Lopinavir and Ritonavir. These drugs were originally developed to treat HIV patients by inhibiting the protease enzyme that is needed by the virus to cleave long polypeptides chains during the assembly of new viruses . Lopinavir and Ritonavir effectively inhibit the 3C-like proteinase, which plays a key role in the processing of viral polyproteins and posing a possible potent therapeutic option against SARS-CoV-2. Although the preliminary data from the Chinese study is unclear ,other clinical trials are underway. In addition to the known antiviral drug combinations, some trials are currently exploring these drugs in combination with the anti-interferon-beta, an anti-inflammatory molecule.

In addition to the antiviral treatment options, systemic transfusion of convalescent plasma collected from healthy donors who recovered from SARS CoV-2 is being tested in different clinical trials on severely infected SARS-Cov-2 patients to reduce the cytokines storm and to replenish the patient’s own antibodies during the acute phase of the disease. Interestingly, the administration of convalescent plasma containing neutralizing antibodies showed a significant decline in the viral load within few days post-transfusion and a substantial improvement in the clinical conditions of the patients.

Spanish Flu: This disease hit back in 1918.Back then, doctors and scientists were unsure what caused it or how to treat it. Unlike today, there were no effective vaccines or antivirals, drugs that treat the flu. (The first licensed flu vaccine appeared in America in the 1940s. By the following decade, vaccine manufacturers could routinely produce vaccines that would help control and prevent future pandemics.)

Like Corona virus many control of disease strategies like mask,quarantine and closing of public places were imposed.People were advised to avoid shaking hands and to stay indoors, libraries put a halt on lending books and regulations were passed banning spitting. Public gatherings were banned and those without mask were charged for disturbing peace.

By 1919 last, many infected died and others developed resistance.

Vaccines for Spanish flu was licensed only by 1940s many years after it first hit. COVID 19 vaccines are still on clinical trials. Since virus genetically mutate to more resistant forms, no one can predict how effective vaccines can be. No particular medicines are discovered for COVID 19, still only symptomatic treatments are going on.

Public need to be made more aware about the spread of the disease. Lockdown leading to complete stoppage intraction should not be imposed, but there should be some restrictions so disease not essentially spread.

Wearing mask, quarantine, social distancing and

Washing hands are some strategies to control the spread of COVID 19 and Spanish flu.