Although human clinical trials will soon be conducted, the prospect of globally applying the SARS-CoV-2 vaccine still faces many challenges.
Recent times have helped the world realize that even the most aggressive preventive measures only slow the rate of spread and cannot completely eliminate the threat from COVID-19.
Since the World Health Organization (WHO) declared COVID-19 to be a global pandemic, the preparation of vaccines against coronavirus has immediately become the focus of public attention.
About 35 research organizations and businesses are racing against time to produce a vaccine that is expected worldwide. Notably, Moderna Biotechnology Company ( USA ), in cooperation with the US National Institutes of Health, produced the first batch of vaccines in February and began conducting human trials with financial support fromCoalition for Epidemic Preparedness Innovations (CEPI).
Efforts by China in January contributed significantly to this progress. Prior to that, China successfully decoded the corona virus genome and allowed research groups around the world to apply the work to disease prevention.
Besides, scientists have also prepared in advance. Specifically, after the coronavirus strain causes severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), the study of the prototype virus is focused on promoting and investing.
The Guardian quoted CEPI CEO Richard Hatchett: “The speed at which the vaccine is made quickly is due to the investment and knowledge of previous coronavirus vaccines.”
owever, dealing with a new strain of virus has never been easy. Manufacturers “struggle” to approach the problem in a “do it and try” method based on the existing knowledge combined with more advanced research.
Usually, vaccines are made based on the same pharmacokinetic principle: using antigens to stimulate the immune mechanism against pathogens. However, this method has the disadvantage that the antigens are not fully compatible with the body of all individuals. Meanwhile, instead of limiting the disease, the vaccine makes the body more susceptible to infection in more serious ways.
Therefore, a series of more modern methods are brought in instead. For example, the Novavax unit is adopting a “recombinant” vaccine strategy based on the principle of incompletely recombining linked genes to create new gametes. CureVac and Moderna, meanwhile, make vaccines from the genetic code of the viral genome.
According to CEPI, investments in vaccine manufacturing projects conducted by Novaxax and Oxford University amounted to US $ 4.4 million . The head of the organization, Mr. Hatchett, said that diversity is the key to success, especially when the vaccine production process is in an extremely difficult period – the stage of clinical trials in humans.
Fast is not necessarily good
uccessful clinical trials are essential for the vaccine to be approved and widely used. But before that, manufacturers had to overcome three milestones: Test the vaccine on dozens of healthy volunteers and track side effects; Test the efficacy of the vaccine on several hundred people in areas affected by the disease and eventually carry out a similar trial on several thousand patient samples.
“Not every horse that can leave the starting line can finish the race,” The Guardian quoted the fact of the head of the Sabin Vaccine Institute, Mr. Bruce Gellin.
This statement is not entirely a reflection of the negative because clinical trials will help eliminate unsafe and ineffective vaccines. According to Gellin, the best way to limit the risk from new vaccines is to be willing to conduct thorough clinical trials, detect weaknesses and make reasonable adjustments.
A prime example of the correctness of this thesis is the fact that the National Institute of Allergy and Infectious Diseases (NIAID) urgently prepared a vaccine for respiratory syncytial virus in children in 1960. At that time, As a precaution, the vaccine causes serious infections, even leading to 2 deaths.
Therefore, the process of making a vaccine successfully and fully approved can take more than 10 years. This explains President Trump’s statement on March 2 that the Covid-19 vaccine completed by the end of this year is impossible.
Annelies Wilder-Smith, a professor at London’s School of Tropical Medicine and Hygiene, frankly said that the vaccine being tested would not be ready by a year and a half.
There is still a long way to go
After approval, producing a vaccine in large quantities is also a problem because manufacturers currently do not have enough resources to implement this. The vaccine development process is inherently high in financial risk, so few units produce large quantities without certainty about the effectiveness of the new preparation.
Currently CEPI and similar organizations are actively working to support vaccine preparation units in this regard. Specifically, CEPI plans to both develop the COVID-19 vaccine and boost its production capacity through a $ 2 billion donation .
However, the post-approval phase is still rife with challenges. Jonathan Quick of Duke University, North Carolina – author of “The End of a Pandemic” (2018) said: “Manufacturing a vaccine that is safe and effective is only 1/3 of the way. road of global immunization project only. The challenges of biological research and production technology are only initial difficulties. New political institutions and economic systems are bigger barriers. ”
Access to vaccines by everyone in the world is a big challenge for countries, especially when many countries are “struggling” to develop a treatment process. For example, the UK will prioritize vaccinations for health workers, social care workers and vulnerable groups in the event of an outbreak. However, if a pandemic occurs and countries compete for a scarce supply, how will you fulfill those desires?
Develop a fair distribution strategy
andemics often target vulnerable countries with weak health systems. Therefore, an imbalance between demand and purchasing power is entirely possible when the vaccine is widely produced.
WHO has called on governments, charities and vaccine manufacturers to work together to develop a fair distribution strategy. Many organizations such as GAVI and the Vaccine Alliance also offer initiatives to donate and support developing countries.
However, each pandemic is a variable and WHO cannot bind all countries committed to future unknowns.
Professor Wilder-Smith gave an optimistic view: “This pandemic may peak and decline before we produce the vaccine.” The prospect of how to resolve this public health crisis is still quite vague. Until it’s over, all we should do is take responsibility for ourselves and the community to minimize the spread of the virus.
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- Wrong calculations led to the US ‘fall’ before the pandemic Coronavirus
March 26 marked an unhappy milestone for Americans when it officially became the country with the most cases of coronavirus infection in the world.
The number one position previously belonged to China , where the disease began. As of March 27, the country has recorded 81,782 cases, according to Johns Hopkins University. Italy holds the second position with 80,589 cases.
United States jumped to China’s position with 82,404 cases. The situation is forecast to continue to deteriorate further.
In late February, the disease in China reached 80,000 cases and just started outbreaks in Japan , Korea , Iran and Italy. At that time, America on the surface still seemed quiet. As of February 20, the US recorded only 15 positive cases and all were related to travel abroad.
Then American officials began to take the test seriously, with the number of cases rising every day. On March 1, the US recorded 75 infections. About 6 days later, this number increased to 435. On March 14, there were 2,770 cases. On March 21, 24,192 patients were confirmed. The United States now steps past more than 82,000 cases and the number will continue to rise over the next few weeks.
Why is the ‘leading the world infection’ moment so fast?
Many opinions explain that: By the time the US recorded few cases, the disease actually began to develop seriously but was not detected.
The mismanagement in February led to disaster. Government officials, a large part of the media and even some experts reassured the American people they had nothing to fear. This allows the virus to spread, until the scale is too large to continue to ignore. At that time, the disease would have spread so much that it could not be stopped if the United States did not take measures to limit social exposure, leading to severe economic trade-offs.
Many criticisms are directed towards President Donald Trump , as he has cut the resources, personnel, and authority of many health agencies making them difficult to operate. He makes crisis statements in his usual style, cites controversial information about accuracy and uses great words. This tactic has been effective in many scandals recently, but not with coronavirus
Still, failure to respond is not just about the leader. Zeynep Tufekci, an information science expert at the University of North Carolina, in recent months has called on the United States to take more drastic action to prepare for the prospect of a coronavirus outbreak.
“The message of lullaby spread not only from Donald Trump and his audience, but also in the US media, exhorting us to worry more about seasonal flu and warning people not to react excessively, ”Tufekci said.
While the government was ignoring, there were signs from some other countries that the disease was “docking” in the US. However, those who know the situation hardly ever speak out. Those who openly warn against comments are overreacting. People believed in the reassurances from public health experts and thought that the low number of cases was true.
The United States remained normal while the virus spread. Now, the most powerful country in the world is facing the most serious epidemic in the world. The question is: Is it too late to turn things around?
Most cases but still in control
The fact that the United States has identified more coronavirus cases than any other country is a sign that the situation is extremely serious. However, this does not automatically mean that this is the most serious outbreak in the world.
Testing is the first factor to consider. The United States initially had low levels of karma, with many cases showing moderate symptoms that were still required at home to follow up and not immediately tested. However, there are also other countries that are testing at even lower levels than the US.
Some estimates suggest that the number of infections in Iran could reach millions, but the government did not record it. There are concerns that some other pandemic hotspots such as India and Indonesia are inaccurately reporting cases due to limited health systems and poverty. One study found that Indonesia is only accounting for about 10% of symptomatic infections. This figure in India is estimated to be between 10-30%.
The remaining factor to consider is the population. America is the 3rd most populous country in the world. In Italy, on average, one in 750 people will detect a positive case. The number in the US is 1 in 4,000, and in New York City alone it is 1/400. The number of infections per capita will show more clearly the level of overload of the health system and the scale of the impact of the virus.
While the per capita infection rate in the US is still lower than in many European countries, the final statistics still seem more serious. Although only a small part of the population of a populous country, the fact that thousands of people suffer from illness and high mortality is obviously a tragedy.
The high number of infections in the United States is a result of a large population, widespread virus outbreaks and improved testing capacity. The fact that the number of HIV-infected cases in the United States has jumped through testing may be a good sign that the country is still able to turn things around.
How did the epidemic land?
By the end of January, China tightened restrictive travel measures across the country. Wuhan City is placed in a blockade. Hospitals and aggressive treatment units overload patients with corornavirus.
Under this situation, the US prohibits entry of all foreign citizens who have been to China. The move helps significantly delay the number of people infected in the US and gives the country more time to prepare better, according to Tom Frieden, former director of the Centers for Disease Control and Prevention (CDC).
“Every other response of the government is horribly embarrassing,” Frieden said. The United States wasted its preparation time.
The government’s budget cuts and mismanagement reduced the capacity of many crisis response agencies. The CDC then started research and testing to identify the new strain of coronavirus, but they sent it to laboratories with the wrong reagents. New test kit instructions are also sent.
The US Food and Drug Administration (FDA) has delayed approval of self-developed test applications from laboratories across the US. Independent researchers at the Flu Study project, Seattle, Washington, where the first serious outbreak occurred, asked to conduct the tests themselves, but were also denied by the government.
“We feel like we are waiting for a pandemic to explode. We can help, but nothing can be done, ”said Helen Chu, who led the research.
The government has regulations restricting testing for people who have been to China or who have contacted people who have confirmed positive for coronavirus. The shortcoming is that people who have been to Korea, Iran, Italy or countries where the epidemic has been detected will not be tested. If they spread the disease to others, they cannot be tested either . Attempts to identify virus that are spreading in the US have become an impossible task.
By comparing a patient’s genetic sample, virologist Trevor Bradford estimated that the disease had started spreading in Washington state since mid-January. By the end of February, the virus had passed to a nursing home and died. US health officials have repeated the message that there is no infection of the community. The director of the National Institutes of Health Anthony Fauci then identified the risk of coronavirus in the US as low. On February 17, he focused on warning people of the risk of dying of children from seasonal flu at its highest level in a decade.
The American people are aware that the situation is still not worrying. Many media outlets posted content emphasizing that the risk from the flu is higher than coronavirus. This is a serious communication mistake but also reflects exactly what they have received from leading national health officials.
According to Bedford’s estimates, more than 7,000 actually occurred in the United States by the end of February, far ahead of the 68 confirmed positive patients. It was then that a laboratory in California announced they had detected the first community-acquired coronavirus in the United States.
By March, everything had become so clear that it couldn’t be ignored. Community transmission is reported in many cities. However, the reaction of the US government is still slow.
FDA does not urgently permit laboratories to conduct independent testing. Even the testing regulations were tightened, which caused some establishments to cancel the collected samples. The US test level improved, but at that time the virus was speeding up the spread.
One by one, the county and state governments decided to close schools, declare a state of emergency, call people to limit social contact or conduct blockades. Everything happened in a hurry when the local leadership did not have enough research data on hand because the test was too few.
Italy closed all schools on March 4 and sealed off the nation with fewer than 10,000 infections. Meanwhile, the US in turn passed the milestones of 10,000 cases (March 19), 20,000 cases (March 21) and 50,000 cases (March 24) without any travel restrictions was issued on a national scale.
Some local and state officials, such as the Mayor of London Breed of San Francisco and Governor Mike DeWine of Ohio, have chosen their own path, taking drastic measures early on to stop the spread of infection. Some local leaders, such as Texas Deputy Governor Dan Patrick, do not want to cause economic damage. Mr. Patrick argued: If a person were asked “do you want to trade your chance of survival to keep the America that Americans love for your children and grandchildren”, every grandpa and grandmother across the country will accept take risks and let viruses spread.
Statements such as that of the Texas vice governor were criticized for being incomplete. Blockade measures can have an economic impact, but the deaths of thousands of Americans and the overcrowded health system and declining worker health have caused equally great economic losses.
When testing and detecting cases of New York were out of control, Governor Andrew Cuomo and Mayor of Bill de Blasio openly debated the measure to ban people from going out, similar to the policy. Early on in the California Bay Area.
While epidemiologists urge people to limit social contact, the lack of organization and the transmission of ambiguous messages from politicians, coupled with the lack of testing, have reduced awareness.
Recently, the US has taken stronger action to prevent the disease. Schools are closed in many places. The measure is applicable to both restaurants and bars. California, with more than 40 million people and accounting for a fifth of the nation’s GDP, soon asked residents to stay indoors. There are 19 other states in the US that follow the model in the West Bank.
The reality is that the United States has responded slowly and current measures risk not being able to work as intended. It is still not possible to ensure that current measures are sufficient to address the situation in New York, New Orleans and Atlanta, which is seriously lacking in intensive care beds. Coping efforts will therefore continue to “escalate” in the battle with the coronavirus, creating a greater economic burden.
A false start over 1 month ago put the United States at a disadvantage in the next phase of the battle with the coronavirus. March is almost over and the US is still in a defensive position, the virus continues to “attack” and spread with the number of infections increasing hour by hour.
- Woman survives thanks to silicone breast implant
A woman survived thanks to a silicon breast implant that prevented the bullet from penetrating her left breast.
Research in the medical journal SAGE describes a case of breast implants that saved a woman’s life when shot at close range. CNN reported on April 21 that the incident occurred in Toronto, Canada in 2018.
According to surgeon Giancarlo McEvenue, this is a rare case when breast implants deflect bullets and save suffering.
“First, the bullet damaged the left skin, skimmed through the sternum to the right and broke the right rib,” McEvenue explained that the breast implant changed the direction of the bullet.
According to experts, if the bullet goes in the right direction to the left chest, the heart and lungs can be seriously injured, causing death to the victim.
Dr. McEvenue also said the woman walked to a hospital on her own after being shot. Here, the doctor must remove the breast implant bag, treat the wound and prescribe antibiotics for the patient.
The authorities have not found the weapon and identified the culprit, CNN cited information from the research.
In the US , breast implants often implant silicone breast implants containing saline or silicon. These bags come in many sizes, shapes and are often used to replace fat tissue in plastic surgery.