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What is Covid-19?

The coronavirus disease-19 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China, in December 2019. Since then, it has spread globally, already infecting millions of people worldwide. As of 30 June 2020, 213 countries have reported COVID-19 cases, with a total number that reached above 10.3 million, the most being in the USA (2.6 million), Brazil (1.4 million), Russia (640 thousand), India (548 thousand) and UK (314 thousand). USA has the highest number of deaths (126 thousand) followed by Brazil (58 thousand), UK (44 thousand) and Italy (35 thousand). The worldwide case fatality rate across all communities is 4.9%.

Microscopic image of the Coronavirus

Coronaviruses (CoVs) are enveloped viruses entrapping non-segmented, positive-sense and single-stranded ribonucleic acid (ssRNA). Their genome size ranges from 26 to 32 kb, being the largest known RNA virus. SARS-CoV-2 3’ terminus encodes structural proteins, including spike (S) glycoproteins1,2, membrane (M) glycoproteins3, as well as envelope (E)4 and nucleocapsid (N) proteins2,5 (Fig. 1). In addition to the genes encoding structural proteins, there are specific genomic regions encoding for viral proteins required for replication6, in addition to other non-structural proteins, such as the papain-like protease (PLpro)7 and coronavirus main protease (3CLpro)8.

According to the Centers for Disease Control and Prevention (CDC), the incubation period following infection is 2–14 days, with an estimated median of 5.1 days9,10. However, cases with longer incubation of 24 days have been reported11. The long incubation period is the primary reason for the massive infection, as it is mostly asymptomatic yet contagious10. Although the estimated patients’ age average is ~70, all age groups are susceptible to this virus. However, the elder population (>60) and people with comorbidities are more likely to develop severe symptoms upon infection12. Much like previous CoVs, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), SARS-CoV-2 is predominantly infecting the lower airways, ranging from mild respiratory illness to severe acute respiratory syndrome and septic shock in advanced stages6. The most commonly reported symptoms are fever, dry cough, dyspnea, fatigue and myalgia, which are early characteristics of the most frequent manifestation of SARS-CoV-2 infection, pneumonia13–15. Physicians and pathologists are also reporting devastating damage to the cardiovascular system, gut, kidneys, and brain16,17. Of importance is the recently observed the tendency of COVID-19 patients´ blood to clot, which leads to vessel constriction and ultimately can result in pulmonary embolism or large-vessel ischemic stroke, in addition to ischemia in fingers and toes16,18.

At the start of the pandemic in early January 2020, there are no specific treatments or vaccines available for COVID-19. The key breakthrough happened on on January 11, 2020 as the genetic sequence of COVID-19 was published. As a result, an international response to place to start the development of a COVID-19 vaccine.

On 7 May, remdesivir was approved for COVID-19 in Japan19. In the rest of the world,. To the best of our knowledge, the only available options are the condition marketing authorization to remdesivir recommended by the European Medicines Agency (EMA) on 25 June, as well as the emergency use authorizations (EUA) provided by the US Food and Drug Administration (FDA) on 1 May for remdesivir20, on 30 March for the decades-old malaria drugs hydroxychloroquine sulfate and chloroquine phosphate21, and on 24 March for the infusion of plasma of COVID-19 convalescent patients22. The latter was supported by data obtained on only 5 critically ill COVID-19 patients23, which had high levels of neutralizing antibodies, raising the realistic hope of producing virus-specific enriched immunoglobulins, similarly to the ones used for tetanus, hepatitis A/B, cytomegalovirus, varicella and measles. On 2 June, a clinical trial designed to evaluate the safety and tolerability of the antibody LY-CoV555 was posted. This IgG1 antibody is the first potential preventive and therapeutic medicine developed to specifically target the spike protein on the SARS-CoV-224.

The rapid spread of SARS-CoV-2 requires accelerated development timelines for COVID-19 vaccines and therapeutic candidates to enter expeditiously into phase 1 clinical trials. Hence, the type and extent of preclinical and preliminary clinical data needed to inform these clinical development programs must be weighed against the overall risk-benefit assessment of this unmet medical need. In fact, so far, most published clinical trials on prophylactic and therapeutic strategies against COVID-19 have countless weaknesses, such as not being randomized nor controlled, studying small populations, and/or lacking a placebo group, making it difficult to draw conclusive outcomes.

As of December 2020, the first COVID-19 vaccine were proved and accepted after early positive results from their Phase 3 trails. Three major companies have been approved by several counties to ship the first orders of the COVID-19 vaccine: - Pifzer Inc / BioNTech - Moderna - University of Oxford / AstraZeneca

Most Common Symptoms:

COVID-19 affects each person in different ways. Most infected people will develop mild to moderate illness and recover without hospitalization.

Most common symptoms:

Fever

Dry cough

Tiredness

Less common symptoms:

Aches and pains

Sore throat

Diarrhea

Conjunctivitis

Headache

Loss of taste or smell

Rash on the skin, or discoloration of fingers or toes

Serious symptoms:

Difficulty breathing or shortness of breath

Chest pain or pressure

Loss of speech or movement


One should seek immediate medical attention if they experience any serious symptoms. Remember to always call before visiting your doctor or health facility. People with mild symptoms, who are otherwise healthy should manage their symptoms at home. On average it takes 5–6 days from when someone is infected with the virus for symptoms to show, however it can take up to 14 days.

To help prevent the spread of COVID-19:

The best way to prevent illness is to avoid being exposed to this virus. In order to do that, one should:

Clean your hands often, either with soap and water for 20 seconds or a hand sanitizer that contains at least 60% alcohol

Avoid close contact with people who have contracted Covid-19

Keep a distance between yourself and other people (at least 6 feet)

Cover the mouth and nose with a mask when around others

Cover a cough or sneeze with a tissue, then throw the tissue into the trash

Clean and disinfect frequently touched objects and surfaces daily

Wear masks, as the CDC recommends, in public settings and when around people outside of their household, especially when other social distancing measures are difficult to maintain. Masks may help prevent people who have COVID-19 from spreading the virus to others.

Testing Sites

As the weather gets colder, people start getting flu like symptoms that can be similar to COVID-19. For many that are worried but don't know where to look for help. Check out the nearest testing sites available through the government's website. Nearest Testing Site Locations

Treatments of Covid-19

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.

Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.

The best way to prevent and slow down transmission is to be well informed about the COVID-19 virus, the disease it causes and how it spreads. Protect yourself and others from infection by washing your hands or using an alcohol based rub frequently and not touching your face.

The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes, so it’s important that you also practice respiratory etiquette (for example, by coughing into a flexed elbow).

Coping with Diabetes during Covid 19

Covid-19 and Diabetes.png

Life during the Covid 19 pandemic can be extremely depressing and boring. There are many things you can accomplish during your time at home. Try to reconnect with things that make you move, working out or even late-night walks help release endorphins. If you have a small child who has a lot of energy check out, Go Noodle. https://www.gonoodle.com/ It has a lot of activities for kids. Diabetes has forced a lot people to quarantine more than others. The disease make compromises the immune system and has made people have to take extra precaution during the virus. Diabetes effects more than 30 million people in the United States alone. Being stuck inside is no fun, here are a few things you can do if you are living with diabetes

1- Take Your Medication 2- Stay active – Work out, do some manual labor around the house, Ditch modern technology and break a sweat cleaning with a broom 3- Stay hydrated – We are made of 70 percent water, that does not change just because you have diabetes 4- Talk to friends and loved ones, strangers too. Depression is real, it is better to talk about what is going on with you. Meditation and reading can really relieve stress on the mind. https://utswmed.org/medblog/diabetes-covid-19-risks/ [1]

COVID-19 Vaccine

COVID-19 Vaccine Vs. Traditional Vaccine Timeline

Since the publication of the COVID-19 genetic sequence, it has become an international race to develop the COVID-19 vaccine, as COVID-19 cases continue to rise at a rapid rate. The World Health Organization reported the the vaccine would not be ready before the end of 2020, however to establish vaccine against the SARS and MERS, gave many organizations an established foundation on the different functions of coronaviruses, as well with large funding from international governments and private organizations. The World Health Organization reported that a total cost for the COVID-19 vaccine at a cost of $8 billion U.S. Dollars. [2]

Traditional Vaccine development take roughly 10-15 years, from exploratory and in-lab experiments, to preclinical, then then must be submitted as a new Investigation New Drug (IND). Once that is approved, then there are three phases of human trials, and once there are positive results a biologics license application is submitted. Towards the end, the Food and Drug Administration (FDA) reviews it and then approves it. IN the end the vaccine can be mass produced, manufactured and release. In the case of COIVD-19, the whole timeline had to be accelerated as well overlap several phases as well, especially Phase 3 of the Clinical trials, the FDA and other organizations reviews and approval and rapid manufacturing, in less then a year.

As of December 2020, three companies has reported positived Phase 3 results and were approved by several countries for manufacturing:

- Pifzer Inc / BioNTech

- Moderna

- University of Oxford / AstraZeneca

Margaret Keenan.jpg

The UK is the first country in the world to start using the Pfizer vaccine after regulators approved its use last week. On Tuesday December 8, 2020 Margaret Keenan, 91 years old British grandma, became the first person in the entire world to receive a clinically approved vaccine. [3] [4]

COVID-19 Home Testing Kit

Testing kit image.jpg

COVID-19 cases are increasing every day, people are scared to go to the hospital to take the test. Also, some people do not know if they do have the virus. However, as of October 1, people can take the Corona Virus test at home. Nine companies are authorized to sell COVID-19 test kits. The companies will be sent to people's house collection kit to collect people’s nasal swab. Then, people will ship it back to the company’s lab for the results. The test result is usually delivered to the people within twenty-four hours through people’s email or online website. Also, people need to be 18 or up to take the COVID-19 test at home. The price of the kits starts from $109 to $155. People may wonder how accurate are the COVID-19 home tests? The FDA says that they worked with LabCorp to ensure that at-home test kits are safe and accurate as of the hospital, doctor’s office, or any other testing site. One of the websites to buy the kit is: https://www.pixel.labcorp.com/at-home-test-kits/covid-19-test-home-collection-kit.

How to prevent Covid-19 misinformation

Please see links below:

http://images.shoutwiki.com/newmedia/3/39/WHAT_IS_COVID-19.pdf

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

https://www.who.int/health-topics/coronavirus#tab=tab_1

Reference

[5] [6]