Coronavirus Disease Pandemic: A Public Health Perspective

Abstract

The new novel coronavirus was discovered by a Scottish virologist in London in 1964. As is usual with new discoveries, it seems the article she wrote about this discovery, was rejected by a peer reviewed journal. Dr Almeida wrote to the prestigious journal Nature (Nature 220, 1968), outlining her findings and proposed the name “coronavirus” for the new family of viruses. The name referred to the “crown like” appearance, she first observed on these viruses by electron microscopy. While SARS CoV-2 infection seems to be in control in China (less than 100,000 for a population of over billion), where it originated, the epidemic has moved briskly to the rest of the world. What seemed to be impossible to achieve, - imposing and enforcing strict quarantine of people, -is now a reality in majority of the countries. Success of preventive efforts is related, to how best the key principles of prevention strategies are followed; testing for infection, contact tracing, social distancing, wearing masks, and containment of the infected individuals. In December of 2019, several people in Wuhan, China, developed pneumonia and respiratory failure, like what happened during SARS epidemic of 2003. This virus is easily transmissible by symptomatic as well as asymptomatic individuals. As early as January 2020, SARS CoV-2 virus was found to spread during workshops, company meetings. Hospitals seem to provide a favorable environment for the propagation of coronavirus disease(Covid-19). Long-term care facilities are high-risk settings for infections of respiratory diseases. In the long-term care facilities, majority of the senior citizens, seem to have pre-existing conditions, such as hypertension, obesity, type-2 diabetes or cardiovascular diseases, which puts them at high-risk associated with Covid-19 severity. Several mass gatherings have been associated with explosive outbreaks of Covid-19, including political rallies, protests, sports and entertainment events. The possible role of children in transmission of the coronavirus is still not clear. Several individuals who had recovered from the COVID-19 have tested positive again at a later date, suggesting that the infection has been reactivated. These observations raise question about immunity in covid-19 patients for future infections, as well as the ‘herd immunity’ that we all are hoping for. In the absence of an evidence-based cure, the only choice we have of preventing infection is social distancing, wearing masks where needed, hand washing, contact tracing, and containment. SARS CoV-2 virus spreads through a receptor called angiotensin(ACE 2), which is expressed on many cells including the nasopharyngeal epithelial cells, by attaching to these receptors via its spike like external projections.In view of this observation, there is considerable interest in interventions, that may prevent these interactions including vaccines. The mRNA-1273 Group members have published their preliminary report in NEJM (July 14, 2020) about the successful completion of a phase-1 study of 45 healthy adults, who received two vaccines containing stabilized perfusion of SARS CoV-2 spike protein. The vaccines seem to have induced the SARS CoV-2 immune response in all participants. These preliminary findings, support and encourage the development of such novel vaccines, as well as drugs that interfere with the host receptor and virus interaction