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What we’ve learned about COVID-19

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Since 2019 that the CoronaVirus (COVID-19) broke out from China, the world has learned many things about the pandemic. The disease has not changed, but scientific understanding is evolving dramatically. The first scientifically documented case of COVID-19 was from the United States in February 2020. It was after, that early warnings from U.S. Centres for Disease Control and Prevention (CDC) that a very serious public health threat loomed. Then, health officials had only a rough idea of how the novel virus spread, who the disease affect most; and how best to combat transmission and provide treatment. Public messaging on the disease was at times conflicting and confusing, including the early advice declaring masks unnecessary. Now, scientists have a firm handle on how the virus spreads and what should be done to get the pandemic under control. Here are the nine things we know about COVID-19 now. The virus is also airborne. Early advice emphasized hand-washing, disinfecting surfaces, and sneezing into your elbow. It was then assumed the coronavirus spread mostly through handshakes, contact with infected surfaces and through close contact with infected people within six feet.

Now, after months of scientific discussion and study, the experts agree: The virus can become airborne-within tiny, suspended droplets called aerosols. They can infect people beyond six feet, in poorly ventilated indoor spaces where the aerosols are trapped and build up. After six months of mounting evidence, the World Health Organization has agreed with scientists on this point. The risk outdoors is lower but not zero. What this means is that COVID-19 is still spreading, we can only avoid large crowds, observe physical distancing, wear masks inside and outside and continue vigilant hand-washing. Then, health officials held firm to the notion that the only recognizable symptoms of COVID-19 were fever, cough and shortness of breath.

Now, the science of how to stop or slow the pandemic has been settled for months; it settled that every health expert now recommends face masks. Face masks are crucial to the control of the pandemic. Beyond masks, experts advise, prevent large indoor gatherings at non essential gatherings like bars; provide widespread testing with quicker results, paired with contact tracing, mandate physical distancing in public places; direct all these in coordinated fashion from the federal level. “We truly have great knowledge of how to control the virus,” says Yonatan Grad, assistant professor of immunology and infectious diseases at Chan School of Public Health, Harvard University.

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What this means is that science has been largely ignored or applied half-heartedly in many states, and unless something changes, experts don’t expect the pandemic to let up. Obviously, there are many political and economic pressures winning out over concerns about the health of the people. Moreover, we now know Covid19 affects the whole body, not just the lungs. Now, studies showed the virus caused body aches, nausea, and diarrhea in some people. Later came the news of anosmia, the loss of smell. We learned of COVID toe; brain infections causing dizziness and confusion, and severe reactions by immune system leading to blood clots, heart attacks and other organ failures. More recently, scientists avow, blood vessels are being infected. Few if any diseases cause such a wide variety of symptoms.
   
What it means is that physicians need to think of COVID-19 as a multisystem disease. There is a lot of news about clotting, but it is also important to understand that a substantial proportion of these patients suffer kidney, heart, and brain damage, says a resident doctor at Irving Medical Centre, Columbia University, Aakriti Gupta, MD. By recognizing all these, doctors can improve treatment and develop follow-up plans to see how people are doing, well after they’ve been discharged. We’ve also discovered that younger adults and children are attacked by the virus too. In the beginning, Covid19 was avowedly declared more dangerous for older people. It ravaged nursing homes, and long term care facilities, which have accounted for more than 40 percent of deaths as of June 2020. Then, that developed an impression that younger adults and children were not at risk.
   
But now, the risk of death in children and teens is low, but it isn’t zero. The risk rises consistently with age. Increasingly, doctors are noting more severe outcomes for children, teens and younger adults. What is all the more remarkable is that doctors are learning of the catastrophic consequences of this viral infection from strokes in young persons, multisystem inflammatory syndrome in children, cardiac and renal complications, and long lasting consequences of symptoms related to a post-COVID-19 syndrome. What this means is: No age group gets out of this unscathed. And now with the perspective of time, it is becoming clear infections can leave people in any age group with chronic effects.
   
Further, experts say, when the disease builds in younger populations, as it has been doing since May, it then inevitably infects more older people leading to rising toll of daily deaths as we now see. Moreover, we’ve now learned that the virus ignores seasons. Because heat and humidity reduce the virulence of influenza  and some other viruses, slowing their spread in the summer, it had been speculated coronavirus might similarly subside. But outbreaks in March when it was warm, largely dashed those hopes. Rising case numbers across the sun belt in June and July provided abundant evidence that heat will not help the virus go away. It means a huge reservoir of infected people would build up, causing new infections to surge even more rapidly as cold weather forces people into more crowded indoor situations.
   
Since science has been largely ignored at the government level in many states, experts don’t the pandemic to let up. Also, we now know, COVID-19 is far more deadly than the flu. It is 10 times more lethal than the flu we know. COVID-19 death rate remains elusive as actual case count worldwide is 10 times higher than the official tally. We would expect one in every 200 infections to lead to death. Infection fatality rate for flu is about one in 1,000. However, the risk of death starts to tick up around the age of 50 and gets extremely high over the age of 70. Since there isn’t any immunity in the population, the rate of death will continue to rise.
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We now know, the virus won’t disappear on its own. Like the flu pandemic of 1918-19, the USA leads the world in COVID-19 deaths, with 24 percent of the global total despite having just 4.2 percent of the world population. Lockdowns which were aimed to buy time to develop a coherent mitigation strategy, tools, and supplies were wasted at great economic cost. The number of infections has now spiraled beyond the point where voluntary mask-wearing and social distancing alone will get the pandemic under control. Meanwhile, nations have to develop testing capacity, and vaccines for turnaround times are too slow to sufficiently enable useful contact tracing and effective isolation of newly infected people.
   
People spread corona virus unwittingly. Younger children are about half as likely to become infected in a contact as adults, only a little bit less likely to transmit. In recent weeks the spread has been led by younger adults crowding bars, and other places where the wearing of masks have been anathema. Experts think, about 80 percent of COVID-19 infections are caused by about 20 percent of infected individuals. As children return to school this month, the extent to which they exacerbate the viral spread remains to be seen. Certainly, a vaccine is the solution. Several teams around the globe have been working towards providing its vaccine for months.

Dozens of vaccines are in various stages of testing by different companies, research groups in many nations. Optimism was recently boosted when three separate groups- in China, at Oxford University UK and in the United States announced successful early trials, each generating an immune response to this novel virus and appearing to be safe. With each company able to ramp up production of its own vaccine separately, that would mean more total doses would be available sooner. For effectiveness, a vaccine needs to be just 50 percent effective to make it to the market. The other big question is when? Expecting a vaccine being delivered to the public by March 2021 isn’t out of the question.

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