Three months ago, no one knew about the existence of SARS ‑ CoV ‑ 2. Now the virus has spread to almost all countries, having infected more than 723 thousand people – and these are only those cases that are known.
Covid-19 brought down the economies of different countries and broke down the healthcare system, crowded hospitals and devastated public places. Separated people from relatives and forced to leave jobs. Covid violated the familiar life of modern society on a scale that almost no one living today has ever seen.
Soon, everyone will know someone who is sick with a coronavirus.
A global pandemic of this magnitude was inevitable. In recent decades, hundreds of health professionals have written books, reports, and articles warning of this possibility. In 2015, Bill Gates spoke about this at the TED conference. And so it happened. The question “What if?” turned into “So what next?”
1. The coming months
To some extent, the near future is already predetermined, because COVID ‑ 19 is a slow-moving disease. People who become infected a few days ago will only now begin to show symptoms. Some of them will go to intensive care units in early April. Now the number of cases is growing rapidly reasing at times.
The situation in Italy and Spain is a serious warning to us. There are not enough places, equipment and staff in hospitals, and the number of deaths from coronavirus per day is 700-800 man. To prevent this from happening in other countries and to prevent the worst case scenario (millions of deaths due to lack of medical equipment and human resources), four measures are needed – and quickly.
1. Establishment of the production of medical masks, gloves and other personal protective equipment. If medical workers are not healthy (and it is easiest for them to become infected), the remaining efforts will be undermined. The lack of masks is due to the fact that medical products are made to order, and their production depends on the most complicated international supply chains, which are currently being pulled.
It is imperative that industrial enterprises switch to the production of medical equipment, as during wars they switch to the production of military equipment.
2. Mass release of tests . The process is slow due to five separate factors:
- There are not enough masks to protect the people who take the analysis.
- There aren’t enough swabs to take a swab from the nasopharynx.
- There are not enough kits to isolate viral genetic material from samples taken.
- Not enough chemicals are included in these kits.
- Not enough trained staff.
This shortage is also largely due to supply stress. Something has already been managed, because private laboratories are connected. But even now, tests still have to be used to a limited extent. According to Harvard epidemiologist Marc Lipsitch, first of all, it is necessary to check the medical staff and hospitalized patients so that hospitals can “put out” the current fires. And only after that, when the immediate crisis wanes, can they be disseminated more widely.
All this will take time, during which the spread of the virus will either accelerate and exceed the capacity of health systems, or slow down to a controlled level. And the development of events depends on the third necessary measure.
3. Social distance. Look at the situation from this point of view. Now the entire population is divided into two groups: group A includes all those involved in medical measures to combat the epidemic (those who work with patients, conduct tests, produce masks and other materials), and group B includes all the rest.
The task of group B is to win more time for group A.
This can be done by physically isolating yourself from other people, that is, breaking the chains of transmission of infection. Given the slow progress of COVID ‑ 19 in order to prevent the collapse of the healthcare system, these seemingly radical steps must be taken immediately before they seem commensurate with what is happening. And they should last for several weeks.
However, convincing entire countries to voluntarily stay out of the house is not easy. In such a situation, when the general well-being rests on the victims of many people, the fourth urgent measure is very important.
4. Clear coordination. It is necessary to convey to people the importance of social distance (but not to intimidate them). However, instead, many business leaders are prepared to abandon isolation measures in an attempt to protect the economy. They emphasize that it is possible to protect representatives of high-risk groups (for example, the elderly), and the rest to be allowed to go to work.
This position is very attractive, but erroneous. People underestimate how much the virus can hit low-risk groups and how crowded the hospitals are, even if only the young are sick .
If people follow social distance measures, if enough tests and personal protective equipment are done, there is a chance to avoid the worst predictions about COVID ‑ 19 and at least temporarily take the epidemic under control. No one knows how long it will take, but the process will not be fast.
Even an ideal response will not end the epidemic. As long as the virus exists somewhere in the world, there is a chance that one infected traveler will bring sparks of the disease to countries that have put out the fire. Under such conditions, there are three possible scenarios of events: one extremely unlikely, the other extremely dangerous, and the third extremely long.
1. An unlikely scenario. All countries will simultaneously pacify the virus, as was the case with SARS (caused by SARS coronavirus) in 2003. But given how widespread the infection is now and how poorly many countries are coping, the chances of synchronous virus control are steadily diminishing.
2. Extremely dangerous scenario. The new virus does the same as the previous flu pandemics did – it travels around the world, leaving enough survivors who have immunity, so that it can no longer find organisms suitable for life. The group immunity scenario is faster and therefore more seductive. But he would have to pay a terrible price. The SARS ‑ CoV ‑ 2 strain has a higher transmittance than conventional flu.
Attempting to build group immunity is likely to lead to millions of deaths and the destruction of health systems in many countries.
3. Extremely long scenario. According to him, all countries will continue to fight the virus for a long time, suppressing outbreaks of infection here and there until they create a vaccine . This is the best option, but at the same time the longest and most difficult.
First, it depends on the creation of the vaccine. It would be easier if it were a flu pandemic. The world already has experience in creating flu vaccines – they are made every year. There is no vaccine for coronavirus yet. Until now, such viruses have led to mild diseases, so researchers had to start from scratch. According to preliminary data, its creation will take from 12 to 18 months, and then some more time to produce it in sufficient quantities, deliver it around the world and introduce it to people.
Therefore, it is likely that coronavirus will remain part of our lives for at least another year, if not more. If the current round of social distance measures works, the epidemic could wane enough to get everything back to a semblance of norm. People will again be able to visit offices, bars and universities.
But when the usual routine of life returns, the virus returns. This does not mean that all people must remain in strict isolation until 2022. But, as Harvard immunologist Stephen Kissler says, we must prepare for multiple periods of social distance.
Much of the coming years, including the frequency, duration, and time of periods of social isolation, depend on two characteristics of the virus that are still unknown.
Firstly, seasonality. As a rule, coronaviruses turn out to be winter infections, which weaken or disappear in the summer. Perhaps the same will happen with the SARS ‑ CoV ‑ 2 strain. However, it is likely that changing the weather will not slow down the virus enough, because most do not yet have immunity against it. Now the whole world is looking forward to the onset of summer and the answer to this question.
The second unknown characteristic is the duration of immunity . When people become infected with milder types of human coronaviruses, which cause symptoms like colds, immunity lasts less than a year. But in those infected with the first SARS virus (the causative agent of SARS), which was much more serious, immunity lasted much longer.
Provided that the SARS ‑ CoV ‑ 2 is somewhere in between, people who have recovered from it can be protected for a couple of years. For confirmation, scientists need to create accurate tests that check for antibodies that provide immunity. And also make sure that these antibodies really do not allow people to get the virus and transmit it. If this is confirmed, people with immunity will be able to return to work, take care of vulnerable members of society and support the economy during periods of social distance.
Between these periods, scientists will be able to create antiviral drugs and look for possible side effects. Hospitals will be able to replenish the necessary supplies. Healthcare providers – perform massive tests to detect the return of the virus as quickly as possible. Then, such harsh and broad measures of social distance, as now, will no longer be needed.
In any case, either due to the appearance of the vaccine or due to the formation of group immunity, the virus will become more and more difficult to spread quickly. But it is unlikely that it will disappear completely. Perhaps the vaccine will have to be modified to adapt to changes in the virus, and people should be given regular vaccinations .
Perhaps epidemics will recur every couple of years, but with less rigidity and less disruption of the usual life. COVID ‑ 19 may become what influenza is now — an annual winter companion. Perhaps someday it will become such a common thing that even despite the availability of a vaccine, children born today will not be vaccinated, forgetting how much this virus has affected their world.
The price that will have to be paid to achieve this with a minimum of deaths will be enormous. As he writes my colleague Annie Lowrey, the economy is now “experiencing a shock more sudden and brutal than anything previously seen by thoe who live today.” Only in the USA approximately every fifth will lose working hours. Hotels are empty, airlines cancel flights, restaurants and small points close. And economic inequality will only grow, because social distance measures will hit low-income people hardest.
Diseases undermined the balance of cities and communities many times, but in developed countries this has not happened for a long time, and not on the scale that we are seeing now.
Once the spread of infection has subsided, a second pandemic will follow – mental health problems . Now, at the moment of fear and uncertainty, people are cut off from comfort – human contact. Hugs, handshakes, and other social rituals are now associated with danger. People with depression and anxiety disorders find it harder to get support.
The elderly, who already participate so little in public life, are asked to isolate themselves even more, only enhancing their loneliness. Asians are more often exposed racist attacks. Most likely, cases of domestic violence will become more frequent because people are forced to stay at home, even if it is unsafe there.
Health workers will need time to recover. According to researchers, two years after the outbreak of SARS in Toronto, medical staff were still less productive and more likely to suffer from burnout and post-traumatic stress. People who survive a long quarantine will also experience lasting psychological consequences. “Colleagues from Wuhan say some residents refuse to leave home and someone has developed agoraphobia ,” says psychologist Steven Taylor, author of The Psychology of Pandemics.
But there is a chance that after this injury, something in the world will change for the better.
For example, the attitude to health. The spread of HIV and AIDS “has completely changed sexual behavior among young people growing up during the peak of the epidemic,” says Elena Conis, a medical historian at the University of California at Berkeley. “Condom use has become the norm, and testing for sexually transmitted infections has become commonplace.” Perhaps, in the same way, washing your hands for 20 seconds, which until now was difficult to enter even in hospitals, during this infection will become a familiar action that will remain with us forever.
In addition, a pandemic can be a catalyst for social change. Now, people and organizations have surprisingly quickly adopted innovations that they were not in a hurry to switch to, including remote work , video calls, normal hospital and flexible conditions for caring for children. “This is the first time in my life that I hear anyone say,“ Oh, if you’re sick, stay home, ”said Adia Benton, an anthropologist at Northwestern University.
Perhaps society will understand that preparedness for an epidemic is not only masks, vaccines and tests, but also a fair work schedule and a stable health system.
Usually, society quickly forgot about the problem after the initial wave of panic. After each infectious crisis – HIV, anthrax, SARS, Zika virus, Ebola – diseases are paid attention to, and invested in treatment methods. But soon the memories are erased, and budgets are reduced. This was partly because these epidemics affected only limited groups of people or occurred somewhere far away. The COVID ‑ 19 pandemic affects everyone and directly affects everyday life.
After the terrorist attack of September 11, 2001, the world concentrated on anti-terrorism measures. Perhaps after COVID ‑ 19, focus will shift to public health.
One can already expect a jump in investments in virology and vaccinology, an influx of students into medical universities and an increase in the domestic production of medical equipment. Such changes alone can protect the world from the next inevitable epidemic.
The lessons we will learn from this pandemic are hard to predict. We can go by distance from each other, build metaphorical and physical walls. Or learn unity, ironically born in social isolation, and cooperation.
Imagine such a future: we are moving from a policy of isolationism to international cooperation. Thanks to constant investments and the influx of new minds, the number of employees in the healthcare sector is growing. Children who are now born at school write essays on how they dream of becoming epidemiologists. Public health is becoming a central element of international politics. In 2030, the SARS ‑ CoV ‑ 3 virus appears out of nowhere and pacifies for a month.
- American raises a record nearly 50,000 Covid-19 cases in a day
The number of new Covid-19 infections in the US on July 1 increased to nearly 50,000. This is the number of Covid-19 infections in a record high day of the world’s top pandemic hot spot.
Leading infectious disease expert of the US government , Dr. Anthony Fauci, has warned that the number of cases of Covid-19 a day can reach 100,000 if the Americans do not agree to take necessary preventive measures. For example, such as wearing mask if unable to adhere to social distancing
“We cannot focus only on areas where the number of cases is increasing. This will put the whole country at risk, ”said Fauci, director of the National Institute of Allergy and Infectious Diseases.
During the first week of June, the US recorded an average of 22,000 cases of Covid-19 each day. A month later, in the Solar Belt, an area across the West and Southwestern of the United States, the Covid-19 hot spots emerged. In the last week of June, the number of infections per day nearly doubled, with 42,000.
Brazil is the only country to report more than 50,000 cases of Covid-19 in a single day. On June 30, the US announced at least 49,286 cases.
More than half the daily new infections of the US come from Arizona, California, Florida and Texas, home to 30% of the nation’s population. These 4 states and 10 other US states had double the number of new infections in June.
This increase is in part related to Memorial Day party parties in late May. US health professionals are concerned about the National Day of July 4 this week, when Americans often flock to beaches and Camping area to see fireworks.
- WHO updates mask recommendations
Now they are advised to wear not only sick.
WHO Director-General Tedros Hebreyusus, at a new briefing on COVID-19, announced new recommendations for the prevention of coronavirus. Here are the main points:
- Doctors and other medical staff should always wear masks, regardless of whether they work with infected coronavirus infections or not.
- People over 60 years of age, as well as those who have chronic diseases, are advised to wear masks wherever it is impossible to maintain physical distance.
- The governments of the countries should encourage the wearing of masks in any places where it is impossible to maintain physical distance, especially for public transport and shops.
- Those with symptoms similar to coronavirus infection should stay at home. All who contacted him should be quarantined.
- If a sick person or someone who has contacted him needs to leave the house, he must wear a mask.
- WHO considers masks to be of high quality, which consist of three layers of different materials or more.
Previously, the WHO spoke only about the need to wear masks for patients who were ill, because there was insufficient data (apart from clinical studies, which many experts consider to be of little relevance to real life).
- WHO recorded 106,000 new infections globally in 24 hours
The WHO recorded 106,000 infections in 24 hours, a record day since the outbreak, with two-thirds of these cases recorded in only 4 countries.
Tedros Adhanom-Ghebreyesus, Director General of the World Health Organization (WHO), said on May 20 that the number of coronavirus infections reported to the agency in the past 24 hours has been higher than at any time since outbreaks, according to CNN.
“We still have a long way to go in this pandemic,” Tedros said at a news conference in Geneva, Switzerland. “In the past 24 hours, 106,000 cases have been reported to WHO – the highest daily level since the outbreak.”
“About two-thirds of these cases have been reported in only four countries,” he added.
According to WHO epidemiologist Maria Van Kerkhove, confirming with CNN via email, these four countries are the US , Russia, Brazil and India.
It should be noted that there may be a delay in reporting the number of cases at various points in the process, so the above date record does not mean that these 106,000 people were infected, tested or statistically counted in the last 24 hours.
According to the constantly updated data of John Hopkins University, the world has recorded nearly 5 million cases of coronavirus, of which more than 326,000 people have died. The United States remains the leading country in both cases – more than 1.5 million, and deaths – more than 93,000.
Notably, Russia has recently become the second country in the number of cases – more than 308,000, although only a few weeks earlier did not even make the top 20 of the list. Brazil also climbed rapidly in the ranking, ranking third in the number of cases – more than 271,000.
Russia is ranked second in terms of deaths – more than 35,000, followed by Italy – more than 32,000, France – more than 28,000, Spain – more than 27,000.
- Brazil has most deadly day of epidemic, patients do not have enough breathing machines
Brazil recorded the highest number of Covid-19 deaths since the outbreak, as coronavirus continues to exert a heavy influence across South America.
According to the Guardian , the number of deaths due to the coronavirus recorded on May 19 in Brazil is 1,179, the highest number of deaths per day since the outbreak in the country. Earlier, the highest number of deaths in 24 hours due to the disease was recorded on 12/5 with 881 cases.
Brazil has also officially overtaken the UK in the number of cases to become the 3rd largest outbreak in the world. The South American country has recorded 271,628 cases positive for coronavirus, an increase of 17,408 cases compared to the previous 24 hours.
Other South American countries also noted the heavy impact of Covid-19. As in Brazil, many cities in South America report deaths due to don’t have enought breathing machine.
Chile is facing the risk of collapse of public health system due to overload. More than 90% of the intensive care beds in Chile’s capital Santiago have been mobilized to treat Covid-19 patients. The city cemetery had to dig 1,000 emergency graves urgently to prepare for the “wave of death” approaching.
In the Peruvian capital Lima, cases of Covid-19 infections account for 80% of the intensive care beds. “We are in a bad situation, this is a war,” said Pilar Mazzetti, who heads the Peruvian government’s anti-Covid-19 task force.
Public health organization Pan American Health said there was growing concern about the risk of virus spreading in the border areas between Brazil and Colombia and Peru. The organization calls on regional authorities to step up measures to protect vulnerable groups such as aboriginal people, the poor and ethnic minorities.
In Africa, the number of Covid-19 infections across the continent has exceeded 90,000 cases, with a total of 2,907 deaths. South Africa is the country most affected by the disease with more than 17,200 cases, of which 312 cases have died. The number of Covid-19 infections in Africa has been described as “stabilizing” in recent days.
- Covid-19 caused infections of the intestines, kidneys and many other organs
Pneumonia virus can spread throughout the body, to the lungs, throat, heart, liver, brain, kidneys and intestines.
Published on May 13 in the journal Nature Medicine , a research team at the University of Hong Kong said the pneumonia virus can attack many different parts of the body.
This finding helps explain why the symptoms of people infected with Covid-19 appear in many parts of the respiratory system. This includes blood clots that cause strokes in young people, blockage of the dialysis system, headaches and even kidney failure.
Covid-19 is classified as a respiratory virus, spread through respiratory droplets, but it can still cause diarrhea and many other digestive symptoms. The researchers also found virus traces in the faeces of patients with Covid-19. This evidence shows that it can be transmitted through waste.
Researcher Jie Zhou and colleagues at Hong Kong University tried to find out how the SARS-CoV-2 virus can thrive in the gut. In laboratory samples in both bats and humans, the virus invaded many internal organs. Viruses not only live but also grow exponentially.
“The human intestinal tract may be the infectious route of SARS-CoV-2,” the research team said.
“A 68 year old female patient had a fever, sore throat, high cough and diarrhea after being admitted to the hospital at Princess Margaret Hospital. We isolated the infectious virus from her stool sample. Here we have demonstrated that the virus replicates in organic matter in the intestinal tract, ”Zhou said.
In addition, another team at the University Medical Center Hamburg-Eppendorf (Germany) also performed autopsies of 27 patients who died of Covid-19. They found traces of the virus in many parts of the patient’s body.
The pneumonia virus is mainly active in the kidney, which explains the rate of kidney damage is usually higher than other parts in Covid-19 patients.
Infection with SARS-CoV-2 virus can make underlying diseases worse. Conversely, people with heart disease, diabetes and especially kidney disease will also be more vulnerable to the virus because of the lower ability of self-healing than healthy people.