Question

In the winter of 2019, in Wuhan, China, a “silent killer” emerged that ravaged many of the smaller villages and towns just outside of Wuhan. This wasn’t unlike many “silent killers” that have attacked China; after all, not even 20 years ago, the country (and the world) was forced to deal with a nemesis known as SARS (severe acute respiratory syndrome)which arose in the Yunnan Province of China. This enemy, however, was different.

Unlike SARS, which did not discriminate among who it affected, this new virus appeared to most highly affect the elderly and immunocompromised. Inoculation time varied among the different residents of the Wuhan province, but there appeared to be one common thread among all of the sufferers of this virus: the end result would be a need for mechanical ventilation and acute care and, often, drastic life-saving interventions. The death toll in China rose to the thousands within an extremely short span of time. Epidemiologists in Wuhan were both astounded and stricken with fear at how rapidly the virus replicated and spread among hosts as well.

As with most rapidly spreading viruses, unfortunately, what began as a virus which ravaged one village in China eventually became one of the most prevalent pandemics the world has ever seen. This virus, initially termed the “Wuhan virus,” was eventually identified as a coronavirus with similar viral features to two pandemic viruses: The MERS (Middle Eastern Respiratory Syndrome) virus and SARS, the very same virus which was rampant in China less than 20 years ago. The virus has since been termed the “SARS-CoV-2” virus (“Coronavirus”).

You are currently an epidemiologist working for the WHO. You, along with a group of 20 colleagues, are formulating a plan to contain this pandemic and potentially devise a vaccine/cure for it. Using at least three medically/scientifically accredited sources (see “South College Library” website for possible sources), answer the following:

1. When treating any infection, it is important to “know your enemy.” What are some intrinsic/specific features of the SARS-CoV-2 virus which renders it unique when compared to other pandemic viruses?
2. From an epidemiologic perspective, how would you explain the reasons as to why the virus has been able to disseminate among the nations?
3. What are the standards of care/management options for SARS-CoV-2 virus?
4. How do we determine who requires testing for this virus? What are some exclusion criteria for testing for SARS-CoV-2? What would be the potential harms in testing a large enclave of the population for SARS-CoV-2 (would this change your management of the virus)?
5. There have been 2 potential interventions which have been suggested for the treatment of SARS-CoV-2 based on “in vitro” testing: Azithromycin and Hydroxychloroquine (an anti-malarial medication). What is the evidence that either one of these is sufficient for the treatment of SARS-CoV-2? KEEP IN MIND THE FOLLOWING: In order to introduce a treatment for a particular disease/infection, the BENEFITS MUST OUTWEIGH THE RISKS. Is this the case with these two treatments?
6. What population(s) of patients are most highly affected by SARS-CoV-2? In the United States in particular, what are some risk factors which could predict worse outcomes?
7. How long will this viral pandemic ravage the world? What are some of the statistical projections which predict how long it will be before the virus is managed?
8. What are some of the ways in which the population can mitigate/decrease the transmission of the virus among the population? Is there evidence which supports “social distancing?”

Please use at least 3 medically/scientifically accredited sources for this assignment! Please cite these sources at the end of your submission please

Answer 1

1.SPECIFIC FEATURES OF SARS-CoV-2

SARS-CoV-2 can also cause pneumonia which exhibits strong infectivity, compared with other members of the coronavirus family such as SARS and MERS . SARS-COV-2 has shown lower rates of morbidity and mortality. This may be result of a more indolent cause of infection. Which allows for patients to be paucisymptomatic and obtain medical care before critical level is reached.

SARS-COV-2 spreads mainly through the respiratory tract binding with high affinity to the angiotensin converting enzyme 2, the same receptor used by SARS-COV-2 . The ACE 2 receptor is highly expressed in blood vessels, kidney as well as the majority of Gastrointenstinal tract. So there symptoms include with this is diarrhoea and vomiting. These are the intrinsic features of SARS-COV-2.

The dissemination of virus among nations is travelling . From china people travels to all over the world that the time of coronavirus outbreak . So this will lead to the key factor of spreading disease across the nation. The number of people each infected person has contact with is estimated. So let's say each infected person comes into contact with 3 people susceptible to the virus. Then the number of contacts is then multiplied by the percentage chance that one of those contact has been infected. That number is then multiplied by the length of time individuals are able to contract the disease from the infected person.

2.STANDARDS OF CARE AND MANAGEMENT OF SARS-COV-2

▪Screen and isolate all patients with suspected SARS-COV-2 the first point of contact with health care system.

▪ Screen should be done at first of contact at emergency department or outpatient departments or clinics . Suspected patient should provide mask and directed to separate the area. Keep atleast 1 m distance from the others.

▪Standard precaution is applied for community and also health care facilities

▪Patients with mild symptoms do not require hospital intervention, but isolation is necessary to contains virus transmission.

▪Provide antipyretic for fever with mild symptoms

▪Counsel patients with mild symptoms about sign and symptoms of complicated disease. If they develop any of these should seek for emergency care.

▪In severe conditions give supplemental oxygen therapy immediate to patients with SARS-COV-2 and respiratory distress.

▪Closely monitor patients with Coronavirus for signs and clinical deterioration such as rapidly progressive respiratory failure.

▪ Instruct peoples to wear mask when contact with public.

▪Ask to do handwashing or sanitize hands when were ever go to a public place.

▪Keep minimum 1 m distance from every situation.

▪Use conservative management in patients with SARS when there is no evidence of shock.

▪ give empiric antimicrobial to treat all likely pathogen causing disease.

▪ Provide mechanical ventilation for needed patients . Avoid disconnecting patient from ventilator.

3..Testing of corona virus mainly,

• Elderly peoples

• Children's

• Health care professional

• pregnant women's

• suspected persons

4.Criteria For TEST

Authorized assays for viral testing include those that detect SARS-COV-2 nucleic acid or antigen .

* If the person have symptoms like fever ,cough the health care provider may advise for test

* if the person test positive they don't need to repeat a test for atleast 3 months

* If the patient have been close contact with SARS-COV-2 infected and do not have symptoms they go for an test

*If patient do not have covid symptoms and have not been in close contact with someone known to have SARS-COV-2 infection. So they don't go for test.

* If the patient is high in transmission area and attend a public or private gathering of more than 10 people they must test .

*Health care professional must go for an test.

5.TESTING FOR LARGE ENCLAVE POPULATIONS

Need more surveillance and effort to do that and also there is chance of spreading from the other side in the incubation periods . Lack of collecting suspected persons . And large sample size may give error in test .

Jekel's epidemiology, biostatistics, preventive medicine and public health 5th edition by Joann.G