Differences
This shows you the differences between two versions of the page.
| Both sides previous revision Previous revision Next revision | Previous revision | ||
|
group_5_presentation_2_-_coronavirus [2020/02/27 16:16] hanj35 |
group_5_presentation_2_-_coronavirus [2020/02/28 23:53] (current) gus10 |
||
|---|---|---|---|
| Line 1: | Line 1: | ||
| ===== What is Coronavirus? ===== | ===== What is Coronavirus? ===== | ||
| + | |||
| + | <box 30% round right | > | ||
| + | {{ :coronavirus_pic.jpg?300|}} | ||
| + | </box| Figure 1: Magnified image of coronavirus under electron microscope (BBC & Getty Images, 2020).> | ||
| The name “Coronavirus” was found in the mid-1960s and it was derived from the “corona” or the crown-like shape observed for these viruses. | The name “Coronavirus” was found in the mid-1960s and it was derived from the “corona” or the crown-like shape observed for these viruses. | ||
| - | Coronaviruses are a large family of viruses that cause illnesses. There are four main sub-grouping of the virus: Alpha, Beta, Gamma and Delta. Fun fact! Corona means crown in Latin. The name represents the crown-like spikes on the surface of this virus. | + | Coronaviruses are a large family of viruses that cause illnesses. There are four main sub-grouping of the virus: Alpha, Beta, Gamma and Delta. Fun fact! Corona means crown in Latin. The name represents the crown-like spikes on the surface of this virus (Centres for Disease Control and Prevention, 2020). |
| These illnesses range from the common cold to severe diseases such as the Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome, and the 2019 Novel Coronavirus (COVID-19). | These illnesses range from the common cold to severe diseases such as the Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome, and the 2019 Novel Coronavirus (COVID-19). | ||
| - | Coronaviruses are zoonotic. Zoonotic viruses mean that they are transmitted between animals and people. In the past, SARS was transmitted from cats to humans. MERS was transmitted from camels to humans. | + | Coronaviruses are zoonotic. Zoonotic viruses mean that they are transmitted between animals and people. In the past, SARS was transmitted from cats to humans. MERS was transmitted from camels to humans (Centres for Disease Control and Prevention, 2020). |
| - | COVID-19 is the novel coronavirus that emerged in Wuhan, China during late 2019. It is most likely from an unidentified animal in the live animal markets. A novel coronavirus means that this strain of coronavirus had not been previously identified in humans. | + | COVID-19 is the novel coronavirus that emerged in Wuhan, China during late 2019. It is most likely from an unidentified animal in the live animal markets. A novel coronavirus means that this strain of coronavirus had not been previously identified in humans(Centres for Disease Control and Prevention, 2020;World Health Organization, 2020). |
| ===== Severe Acute Respiratory Syndrome (SARS) ===== | ===== Severe Acute Respiratory Syndrome (SARS) ===== | ||
| Line 15: | Line 19: | ||
| ==== Overview of Epidemic ==== | ==== Overview of Epidemic ==== | ||
| - | The SARS epidemic started with an index case (patient zero) in the city of Foshan, close to Hong Kong, within the southern Chinese province of Guangdong in January 2003 (NCBI, 2004). With a population of 113 million, Guangdong is the most populous province of China, which allowed the virus to spread rapidly through human contact. Public health interventions and containment were further complicated by the huge number of people traveling during the Chinese New Year. | + | The SARS epidemic started with an index case (patient zero) in the city of Foshan, close to Hong Kong, within the southern Chinese province of Guangdong in January 2003 (NCBI, 2004). With a population of 113 million, Guangdong is the most populous province of China, which allowed the virus to spread rapidly through human contact. Public health interventions and containment were further complicated by the huge number of people traveling during the Chinese New Year (NCBI, 2004). |
| SARS is a type of coronavirus consisting of a single strand of RNA. As with other types of coronavirus, SARS is classified as zoonotic, meaning it was carried by wild animals before transmitting to humans. The wild animals at question were believed to be sold at a local grocery market in Foshan (NCBI, 2004). | SARS is a type of coronavirus consisting of a single strand of RNA. As with other types of coronavirus, SARS is classified as zoonotic, meaning it was carried by wild animals before transmitting to humans. The wild animals at question were believed to be sold at a local grocery market in Foshan (NCBI, 2004). | ||
| A total of 8098 cases were confirmed worldwide, 774 of which resulted in death. The case fatality rate was thus calculated at 9.6% (WHO, 2004). | A total of 8098 cases were confirmed worldwide, 774 of which resulted in death. The case fatality rate was thus calculated at 9.6% (WHO, 2004). | ||
| + | |||
| + | <box 40% round right | > | ||
| + | {{ :covid19_symptoms.png?400|}} | ||
| + | </box| Figure 2: Common pneumonia-related symptoms of patients infected with SARS or Covid-19 (BBC & WHO, 2020).> | ||
| + | |||
| ==== Symptoms ==== | ==== Symptoms ==== | ||
| - | Patients most commonly exhibit the following symptoms: | + | Patients most commonly exhibit the following symptoms (CDC, 2005): |
| * High fever reaching 38°C and beyond | * High fever reaching 38°C and beyond | ||
| * Headache, body aches, chills | * Headache, body aches, chills | ||
| - | * Dry, hacking or nonproductive cough appears in the next few days. Dry cough does not involve any mucus secretions or phlegm | + | * Dry, hacking or nonproductive cough appears in the next few days. Dry cough does not involve any mucus secretions or phlegm. |
| - | * Pneumonia or respiratory distress syndrome develops in most patients, with 20% of them being hooked up to mechanical ventilation (CDC, 2005) | + | * Pneumonia or respiratory distress syndrome develops in most patients, with 20% of them being hooked up to mechanical ventilation. |
| * Hypoxia - decrease in blood oxygen levels due to reduced lung capacity | * Hypoxia - decrease in blood oxygen levels due to reduced lung capacity | ||
| - | Less commonly, diarrhea was observed in roughly 20% of patients | + | Less commonly, diarrhea was observed in roughly 20% of patients (CDC, 2005). |
| ==== Diagnosis ==== | ==== Diagnosis ==== | ||
| - | There were three major laboratory techniques used for testing clinical samples: | + | There were three major laboratory techniques used for testing clinical samples (CDC, 2005): |
| * RT-PCR, which stands for reverse transcription-polymerase chain reaction, was used to detect and quantify viral RNA in blood or stool samples. | * RT-PCR, which stands for reverse transcription-polymerase chain reaction, was used to detect and quantify viral RNA in blood or stool samples. | ||
| * Serologic testing was used to detect antibodies produced in response to an infectious agent or virus. | * Serologic testing was used to detect antibodies produced in response to an infectious agent or virus. | ||
| - | * Viral culture was used to supplement the above two diagnostic techniques if needed. A sample of infected tissue or fluid is grown in cell cultures. If the virus is present and proliferates within the cells, morphological changes in the cells will be observed. | + | * Viral culture was used to supplement the above two diagnostic techniques if needed. A sample of infected tissue or fluid is grown in cell cultures. If the virus is present and proliferates within the cells, morphological changes in the cells will be observed (CDC, 2005). |
| ==== Transmission Route ==== | ==== Transmission Route ==== | ||
| <box 30% round right | > | <box 30% round right | > | ||
| - | {{ :hk_superspreader.jpg?300|}} | + | {{ :hk_superspreader_2.jpg?300|}} |
| - | </box| Figure 1: Chains of infection overseas initiated by the superspreader in Hong Kong. Image reflects number of confirmed cases as of March 28, 2003 (NCBI, 2004).> | + | </box| Figure 3: Chains of infection overseas initiated by the superspreader in Hong Kong. Image reflects number of confirmed cases as of March 28, 2003 (NCBI, 2004).> |
| The SARS coronavirus was primarily transmitted through respiratory droplets during short-distance human contact. The droplets are produced from coughing or sneezing, and can travel up to a radius of 3 feet/0.9m (CDC, 2005). | The SARS coronavirus was primarily transmitted through respiratory droplets during short-distance human contact. The droplets are produced from coughing or sneezing, and can travel up to a radius of 3 feet/0.9m (CDC, 2005). | ||
| - | Respiratory droplets deposit on the mucous membranes lining the mouth and nose, where the virus enters the respiratory tract and triggers inflammation. The virus-laden droplets were also known to infect the mucous membrane of the eyes, though not as frequently. | + | Respiratory droplets deposit on the mucous membranes lining the mouth and nose, where the virus enters the respiratory tract and triggers inflammation. The virus-laden droplets were also known to infect the mucous membrane of the eyes, though not as frequently (Lu et al., 2020). |
| The transmission rate, or R0, of SARS was estimated at around 3, meaning that a single patient can infect 3 other people on average. This puts SARS less infectious than influenza, but similar to smallpox (NCBI, 2004). | The transmission rate, or R0, of SARS was estimated at around 3, meaning that a single patient can infect 3 other people on average. This puts SARS less infectious than influenza, but similar to smallpox (NCBI, 2004). | ||
| Line 56: | Line 65: | ||
| At the beginning of the 2003 SARS outbreak, an infected Chinese doctor unwittingly passed on the virus to 12 other people while staying at a hotel in Hong Kong. The 12 people then traveled abroad and spread the infection to Southeast Asia, Western Europe, and North America. The resulting chain reaction accounts for most of the more than 8000 cases worldwide (NCBI, 2004). From Hong Kong, the infection spread to 5 countries within 24 hours, and to more than 30 countries on 6 continents within the following 6 months (WHO, 2003). The rapid spread was made possible by the ease of globalized travel from Hong Kong, a major airline hub, despite the virus having a lower transmission rate (R0) than many other infectious diseases. | At the beginning of the 2003 SARS outbreak, an infected Chinese doctor unwittingly passed on the virus to 12 other people while staying at a hotel in Hong Kong. The 12 people then traveled abroad and spread the infection to Southeast Asia, Western Europe, and North America. The resulting chain reaction accounts for most of the more than 8000 cases worldwide (NCBI, 2004). From Hong Kong, the infection spread to 5 countries within 24 hours, and to more than 30 countries on 6 continents within the following 6 months (WHO, 2003). The rapid spread was made possible by the ease of globalized travel from Hong Kong, a major airline hub, despite the virus having a lower transmission rate (R0) than many other infectious diseases. | ||
| + | <box 60%| > | ||
| + | {{ :sars_hk_epidemic_curve.png?600 |}} | ||
| + | </box| Figure 4: Epidemic curve by infection cluster for the 2003 SARS outbreak in Hong Kong (Leung et al., 2004).> | ||
| ===== Middle East Respiratory Syndrome (MERS) ===== | ===== Middle East Respiratory Syndrome (MERS) ===== | ||
| Line 73: | Line 85: | ||
| <box 80%| > | <box 80%| > | ||
| {{ :mers-epicurve-july-2019.png?650 |}} | {{ :mers-epicurve-july-2019.png?650 |}} | ||
| - | </box| Figure 2: Epidemic Curve of MERS-CoV cases as of June 30, 2018. Graph representation of all reported cases of MERS-CoV since 2012 (WHO, 2018).> | + | </box| Figure 5: Epidemic Curve of MERS-CoV cases as of June 30, 2018. Graph representation of all reported cases of MERS-CoV since 2012 (WHO, 2018).> |
| ==== Symptoms ==== | ==== Symptoms ==== | ||
| Line 94: | Line 106: | ||
| Like SARS, MERS-CoV most likely spreads from an infected patients’ respiratory secretions like coughing and large droplets of bodily fluids (Zumla et al.,2015). Unlike SARS-CoV and Covid-19, MERS-CoV has a different receptor, DDP4, which further leads to transcription in the body (Zumla et al.,2015). All MERS-CoV cases have been linked to countries near the Arabian Peninsula (CDC, 2019). Most patients either lived in the Arabian Peninsula or traveled to Arabian Peninsula. 27 countries have been reported to have cases or MERS-CoV in their countries. However, the reproductive rate (R0) of MERS-CoV was relatively low, R0=0.7. This is substantially lower than the epidemic potential (R0=1)(World Health Organization, 2019). Therefore, the only country that was heavily affected by MERS was South Korea in 2015 with 186 confirmed cases and 38 deaths (largest outbreak outside of Arabian Peninsula)(Kim et al.,2017). | Like SARS, MERS-CoV most likely spreads from an infected patients’ respiratory secretions like coughing and large droplets of bodily fluids (Zumla et al.,2015). Unlike SARS-CoV and Covid-19, MERS-CoV has a different receptor, DDP4, which further leads to transcription in the body (Zumla et al.,2015). All MERS-CoV cases have been linked to countries near the Arabian Peninsula (CDC, 2019). Most patients either lived in the Arabian Peninsula or traveled to Arabian Peninsula. 27 countries have been reported to have cases or MERS-CoV in their countries. However, the reproductive rate (R0) of MERS-CoV was relatively low, R0=0.7. This is substantially lower than the epidemic potential (R0=1)(World Health Organization, 2019). Therefore, the only country that was heavily affected by MERS was South Korea in 2015 with 186 confirmed cases and 38 deaths (largest outbreak outside of Arabian Peninsula)(Kim et al.,2017). | ||
| - | <box 30% round right| > | + | <box 45% round right| > |
| - | {{ ::screen_shot_2020-02-24_at_1.53.01_am.png?300 |}} | + | {{ ::screen_shot_2020-02-24_at_1.53.01_am.png?450 |}} |
| - | </box| Figure 3: Distribution of MERS cases around the world, Orange label represents camel to camel transmission, blue label represents human to human transmission and red label represents camel to human transmission (WHO,2018).> | + | </box| Figure 6: Distribution of MERS cases around the world, Orange label represents camel to camel transmission, blue label represents human to human transmission and red label represents camel to human transmission (WHO,2018).> |
| === Four different transmission patterns in MERS === | === Four different transmission patterns in MERS === | ||
| Line 110: | Line 122: | ||
| ===== Covid-19 ===== | ===== Covid-19 ===== | ||
| + | |||
| + | <box 25% round right | > | ||
| + | {{ :r0_comparison_1.png?250|}} | ||
| + | </box| Figure 7: Chart comparison of the R0 values of several types of infectious diseases to visualize how contagious they respectively are (Belluz, 2020).> | ||
| The disease caused by the 2019-2020 coronavirus outbreak has officially been named Covid-19, while the strain of coronavirus is now known as SARS-Cov-2. | The disease caused by the 2019-2020 coronavirus outbreak has officially been named Covid-19, while the strain of coronavirus is now known as SARS-Cov-2. | ||
| Line 115: | Line 131: | ||
| ==== Source of Infection ==== | ==== Source of Infection ==== | ||
| - | SARS-Cov-2 bears genetic resemblance to SARS and is increasingly believed to be an evolved and mutated version of SARS. Nevertheless, the current SARS-Cov-2 and the 2003 SARS are still confirmed as two distinct strains of coronavirus. | + | SARS-Cov-2 bears genetic resemblance to SARS and is increasingly believed to be an evolved and mutated version of SARS (Achenbach, 2020). Nevertheless, the current SARS-Cov-2 and the 2003 SARS are still confirmed as two distinct strains of coronavirus. |
| Genetically, SARS-Cov-2 is most closely related to a bat-derived coronavirus sample from Eastern China, at 88% similarity. This indicates that bats are likely the original host of the virus before humans became susceptible, making Covid-19 another zoonotic infectious disease. SARS-Cov-2 is 79% similar to the SARS virus and 50% similar to the MERS virus (Lu et al., 2020). | Genetically, SARS-Cov-2 is most closely related to a bat-derived coronavirus sample from Eastern China, at 88% similarity. This indicates that bats are likely the original host of the virus before humans became susceptible, making Covid-19 another zoonotic infectious disease. SARS-Cov-2 is 79% similar to the SARS virus and 50% similar to the MERS virus (Lu et al., 2020). | ||
| Line 128: | Line 144: | ||
| * Fever, cough, shortness of breath (CDC, 2020) | * Fever, cough, shortness of breath (CDC, 2020) | ||
| * Dyspnoea/breathing difficulty in 55% of patients, one week after onset of symptoms (Huang et al., 2020) | * Dyspnoea/breathing difficulty in 55% of patients, one week after onset of symptoms (Huang et al., 2020) | ||
| - | |||
| - | <box 30% round right | > | ||
| - | {{ :covid_spread_edited.png?300|}} | ||
| - | </box| Figure 4: Spread of Covid-19 from Wuhan, the provincial capital of Hubei Province, to the rest of China as of Jan. 30, 2020 (China National Health Commission & BBC, 2020).> | ||
| ==== Epidemiology ==== | ==== Epidemiology ==== | ||
| Significant epidemiological features of Covid-19 are summarized as follows: | Significant epidemiological features of Covid-19 are summarized as follows: | ||
| - | * Covid-19 has a median incubation period of 3 days, though individual cases range from 1 to 24 days, as reported by top Chinese epidemiologist Dr. Nanshan Zhong, who is widely credited for discovering the SARS virus. However, a new case confirmed on February 22 involves a 70-year-old man who started experiencing symptoms 27 days after getting infected, raising concerns that the mean incubation period could be longer than 14 days (Reuters, 2020). | + | |
| + | <box 35% round right | > | ||
| + | {{ :covid_spread_edited.png?350|}} | ||
| + | </box| Figure 8: Spread of Covid-19 from Wuhan, the provincial capital of Hubei Province, to the rest of China as of Jan. 30, 2020 (China National Health Commission & BBC, 2020).> | ||
| + | |||
| + | * Covid-19 has a median incubation period of 3 days, though individual cases range from 1 to 24 days, as reported by top Chinese epidemiologist Dr. Nanshan Zhong, who is widely credited for discovering the SARS virus. | ||
| + | * However, a new case confirmed on February 22 involves a 70-year-old man who started experiencing symptoms 27 days after getting infected, raising concerns that the mean incubation period could be longer than 14 days (Reuters, 2020). | ||
| * Males older than 60 years of age with comorbidities are most susceptible to the disease (Chen et al., 2020). | * Males older than 60 years of age with comorbidities are most susceptible to the disease (Chen et al., 2020). | ||
| * The epidemic doubling time, meaning the time it takes for the number of cases to double, is 6.4 days (Wu et al., 2020). | * The epidemic doubling time, meaning the time it takes for the number of cases to double, is 6.4 days (Wu et al., 2020). | ||
| Line 146: | Line 164: | ||
| The Chinese government imposed a lockdown on Hubei province, effectively putting 60 million residents into quarantine, the largest yet of its kind known to the world (Bloomberg, 2020). Stringent travel restrictions both within the province and along provincial borders were put into effect starting on January 23, 2020. Body temperature checks are implemented at all highway checkpoints, public venues, and gates to residential compounds within the province. | The Chinese government imposed a lockdown on Hubei province, effectively putting 60 million residents into quarantine, the largest yet of its kind known to the world (Bloomberg, 2020). Stringent travel restrictions both within the province and along provincial borders were put into effect starting on January 23, 2020. Body temperature checks are implemented at all highway checkpoints, public venues, and gates to residential compounds within the province. | ||
| - | In the provincial capital Wuhan, a megacity of 11 million people, all travel by air, train, subway, and public buses were suspended until further notice on January 23. Private vehicles were banned from downtown areas starting on January 25. In the neighboring city of Huanggang, which has 7.5 million residents, one person from each family is allowed to shop in the streets every two days. | + | In the provincial capital Wuhan, a megacity of 11 million people, all travel by air, train, subway, and public buses were suspended until further notice on January 23. Private vehicles were banned from downtown areas starting on January 25. In the neighboring city of Huanggang, which has 7.5 million residents, one person from each family is allowed to shop in the streets every two days (Bloomberg, 2020). |
| + | |||
| + | ==== Covid-19 Talk with Dr. Matthew Miller ==== | ||
| + | Dr. Matter Miller is an Associate Professor of Biochemistry and Biomedical Sciences at McMaster University. Dr. Miller was asked about the current coronavirus outbreak occurring around the world. He does not think that the public should be worried as both, the World Health Organization, as well as other health authorities in Canada, are hopeful that the spread is limited. When asked about a potential treatment/ cure, he responded with, "The unfortunate reality of these new virus outbreaks is that we don't have a vaccine to protect us against this virus and we don't really have great drugs to treat against this infection But, there are lots of labs around the world that have started attempting to make a vaccine but it is a lengthy process since vaccines have to be tested in model system before advancing to clinical trials" (Donovan, 2020). | ||
| ===== Covid-19 vs. SARS ===== | ===== Covid-19 vs. SARS ===== | ||
| + | |||
| + | <box 20% round right | > | ||
| + | {{ :animal_source.jpg?200|}} | ||
| + | </box| Figure 9: Animal sources of different coronaviruses prior to human infection (Sheahan, 2020).> | ||
| <box 30% round right | > | <box 30% round right | > | ||
| {{ :compare_number_of_cases.png?300|}} | {{ :compare_number_of_cases.png?300|}} | ||
| - | </box| Figure 5: Compare number of confirmed cases and deaths resulting from Covid-19, SARS, and MERS as of Feb. 23, 2020 (WHO & BBC, 2020).> | + | </box| Figure 10: Compare number of confirmed cases and deaths resulting from Covid-19, SARS, and MERS as of Feb. 23, 2020 (WHO & BBC, 2020).> |
| ==== Similarities ==== | ==== Similarities ==== | ||
| === Cause & Timing === | === Cause & Timing === | ||
| - | Both are zoonotic diseases, meaning they spread from wild animals to humans (Achenbach, 2020). Bats were the original host of SARS, from which the virus jumped to civet cats before reaching humans (Hui and Zumla, 2019). For Covid-19, most scientists suspect bats as the original host and pangolins as the intermediary carrier. | + | Both are zoonotic diseases, meaning they spread from wild animals to humans (Achenbach, 2020). Bats were the original host of SARS, from which the virus jumped to civet cats before reaching humans. For Covid-19, most scientists suspect bats as the original host and pangolins as the intermediary carrier (Hui and Zumla, 2019). |
| Both epidemic outbreaks coincided with Chinese New Year, often dubbed as the world’s largest annual human migration, during which almost 3 billion trips were made across the country in 2019 (CNN, 2019). Population density and mobility are critical to determining if an infectious disease can become an epidemic (Achenbach, 2020) | Both epidemic outbreaks coincided with Chinese New Year, often dubbed as the world’s largest annual human migration, during which almost 3 billion trips were made across the country in 2019 (CNN, 2019). Population density and mobility are critical to determining if an infectious disease can become an epidemic (Achenbach, 2020) | ||
| Line 164: | Line 189: | ||
| === Transmission === | === Transmission === | ||
| Both infections are transmitted primarily through airborne respiratory droplets, produced when patients cough or sneeze. The droplets usually infect the mucous membranes of the mouth and nose upon contact. However, the respiratory tract is not the only transmission route. Both strains of coronavirus are also able to infect the ocular membrane, specifically the conjunctiva, of people not wearing protective eyewear (Lu et al., 2020). | Both infections are transmitted primarily through airborne respiratory droplets, produced when patients cough or sneeze. The droplets usually infect the mucous membranes of the mouth and nose upon contact. However, the respiratory tract is not the only transmission route. Both strains of coronavirus are also able to infect the ocular membrane, specifically the conjunctiva, of people not wearing protective eyewear (Lu et al., 2020). | ||
| - | |||
| - | <box 30% round right | > | ||
| - | {{ :cases_outside_china.png?300|}} | ||
| - | </box| Figure 6: Number of confirmed cases of Covid-19 worldwide as of Feb. 1, 2020 (WHO & BBC, 2020).> | ||
| === Clinical Manifestation === | === Clinical Manifestation === | ||
| - | SARS and SARS-Cov-2 belong to the same family of virus, coronavirus, which invades the respiratory tract and causes atypical pneumonia. Patients develop breathing difficulties due to inflamed alveoli of the lungs (Cleveland Clinic, 2019). Atypical pneumonia, also known as walking pneumonia, differs from typical pneumonia as it is caused by viral agents or atypical bacteria that lack normal cell structure. Patients with atypical pneumonia experience milder symptoms and resistance to normal antibacterial medications. | + | SARS and SARS-Cov-2 belong to the same family of virus, coronavirus, which invades the respiratory tract and causes atypical pneumonia. Patients develop breathing difficulties due to inflamed alveoli of the lungs. Atypical pneumonia, also known as walking pneumonia, differs from typical pneumonia as it is caused by viral agents or atypical bacteria that lack normal cell structure. Patients with atypical pneumonia experience milder symptoms and resistance to normal antibacterial medications (Cleveland Clinic, 2019). |
| + | |||
| + | <box 40% round right | > | ||
| + | {{ :cases_outside_china.png?400|}} | ||
| + | </box| Figure 11: Number of confirmed cases of Covid-19 worldwide as of Feb. 21, 2020 (WHO & BBC, 2020).> | ||
| ==== Differences ==== | ==== Differences ==== | ||
| === Incubation Period === | === Incubation Period === | ||
| - | * SARS: mean incubation period ranges from 1-5 days, which allows for faster diagnosis and medical isolation. | + | * SARS: mean incubation period ranges from 1-5 days, which allows for faster diagnosis and medical isolation (NCBI, 2004). |
| - | * Covid-19: longer mean incubation period that goes up to 14 days, during which infected individuals do not exhibit any symptoms. More difficult for detection and diagnosis. | + | * Covid-19: longer mean incubation period that goes up to 14 days, during which infected individuals do not exhibit any symptoms (Zhong et al., 2020). More difficult for detection and diagnosis. |
| * Covid-19: A 70-year-old Hubei resident started experiencing symptoms 27 days after getting infected, raising concerns that the mean incubation period could be longer than 14 days (Reuters, 2020). | * Covid-19: A 70-year-old Hubei resident started experiencing symptoms 27 days after getting infected, raising concerns that the mean incubation period could be longer than 14 days (Reuters, 2020). | ||
| Line 188: | Line 214: | ||
| === Transmission Rate and Mortality === | === Transmission Rate and Mortality === | ||
| Covid-19 is less fatal, but likely more contagious. | Covid-19 is less fatal, but likely more contagious. | ||
| - | * R0 (R-naught) is used as a measure of transmission rate that shows the average number of people a single patient can infect. | + | * R0 (R-naught) is used as a measure of transmission rate that shows the average number of people a single patient can infect (Stieg, 2020). |
| * The Chinese Academy of Sciences puts the R0 of Covid-19 at 4.08, higher than that of SARS which was approximately 3 (WHO, 2003). However, a study published by the University of Hong Kong estimates the R0 for Covid-19 at 2.68 (Wu et al., 2020). | * The Chinese Academy of Sciences puts the R0 of Covid-19 at 4.08, higher than that of SARS which was approximately 3 (WHO, 2003). However, a study published by the University of Hong Kong estimates the R0 for Covid-19 at 2.68 (Wu et al., 2020). | ||
| * As of Feb 12, the case fatality rate of Covid-19 in China is 3.2% (China National Health Commission, 2020), compared to the overall SARS fatality at 9.6% (WHO, 2004). | * As of Feb 12, the case fatality rate of Covid-19 in China is 3.2% (China National Health Commission, 2020), compared to the overall SARS fatality at 9.6% (WHO, 2004). | ||
| Line 200: | Line 226: | ||
| <box 45% round left| > | <box 45% round left| > | ||
| {{ ::screen_shot_2020-02-27_at_3.16.47_pm.png?400 |}} | {{ ::screen_shot_2020-02-27_at_3.16.47_pm.png?400 |}} | ||
| - | </box| Figure 7: The size distribution of coughing droplet (without mask) (Yang, Lee, Chen, Wu, & Yu, 2007).> | + | </box| Figure 12: The size distribution of coughing droplet (without mask) (Yang, Lee, Chen, Wu, & Yu, 2007).> |
| <box 45% round right| > | <box 45% round right| > | ||
| {{ ::screen_shot_2020-02-27_at_3.17.06_pm.png?400 |}} | {{ ::screen_shot_2020-02-27_at_3.17.06_pm.png?400 |}} | ||
| - | </box| Figure 8: The concentration of coughing droplet for different gender and age group (Yang, Lee, Chen, Wu, & Yu, 2007).> | + | </box| Figure 13: The concentration of coughing droplet for different gender and age group (Yang, Lee, Chen, Wu, & Yu, 2007).> |
| Line 211: | Line 237: | ||
| <box 25% round right| > | <box 25% round right| > | ||
| {{ ::screen_shot_2020-02-21_at_10.36.12_pm.png?200|}} | {{ ::screen_shot_2020-02-21_at_10.36.12_pm.png?200|}} | ||
| - | </box| Figure 9: The filtration mechanisms of masks (Brosseau & Brosseau 2009).> | + | </box| Figure 14: The filtration mechanisms of masks (Brosseau & Brosseau 2009).> |
| To prevent contact with these droplets that contain viruses, wearing a mask is certainly a good idea. The multilayer structure of the mask can effectively block large particles, the smaller particles can be attracted to an oppositely charged fiber in the mask (fig. 9). | To prevent contact with these droplets that contain viruses, wearing a mask is certainly a good idea. The multilayer structure of the mask can effectively block large particles, the smaller particles can be attracted to an oppositely charged fiber in the mask (fig. 9). | ||
| Line 223: | Line 249: | ||
| If we plot the particle diameter on x-axis, and the filtration efficiency on the y-axis, the filtration effects of masks exhibit as U-shaped curves (fig. 10). The hardest particles to filter are the ones around 0.3 micrometers. Which is why most masks use 0.3 micrometers as a performance indicator(Brosseau & Brosseau 2009). | If we plot the particle diameter on x-axis, and the filtration efficiency on the y-axis, the filtration effects of masks exhibit as U-shaped curves (fig. 10). The hardest particles to filter are the ones around 0.3 micrometers. Which is why most masks use 0.3 micrometers as a performance indicator(Brosseau & Brosseau 2009). | ||
| - | <box 65%| > | + | <box 50%| > |
| - | {{ ::screen_shot_2020-02-21_at_9.14.02_pm.png?600 |}} | + | {{ ::screen_shot_2020-02-21_at_9.14.02_pm.png?500 |}} |
| - | </box| Figure 10: The filtration efficiency of masks(Brosseau & Brosseau 2009).> | + | </box| Figure 15: The filtration efficiency of masks(Brosseau & Brosseau 2009).> |
| To protect against most coughed droplets, a regular medical mask is enough. In a randomized clinical trial with more than 2800 influenza health care providers, the flu infection rates of those who wore N95 masks and regular medical masks actually showed no significant differences, if compare the total outcomes of both masks in fig. 11. (Radonovich, et al., 2019). | To protect against most coughed droplets, a regular medical mask is enough. In a randomized clinical trial with more than 2800 influenza health care providers, the flu infection rates of those who wore N95 masks and regular medical masks actually showed no significant differences, if compare the total outcomes of both masks in fig. 11. (Radonovich, et al., 2019). | ||
| - | <box 65%| > | + | <box 60%| > |
| {{ ::screen_shot_2020-02-21_at_9.31.20_pm.png?600 |}} | {{ ::screen_shot_2020-02-21_at_9.31.20_pm.png?600 |}} | ||
| - | </box| Figure 11: The effect of N95 masks vs medical masks in clinical settings (Radonovich, et al., 2019).> | + | </box| Figure 16: The effect of N95 masks vs medical masks in clinical settings (Radonovich, et al., 2019).> |
| === Personal Hygiene === | === Personal Hygiene === | ||
| - | What’s more important than whether you wear a N95 or not, is did you wash your hands? Washing hands are critical because your hands can carry live coronavirus from the contaminated surfaces. When you rub your eyes and pick your nose with your hands, the viruses can complete the infection. So, please take your time to wash your hands and avoid touching eyes, nose and mouth (World Health Organization, 2020). | ||
| - | <box 45%| > | + | <box 33% round right| > |
| - | {{ :screen_shot_2020-02-21_at_9.50.24_pm.png?400 |}} | + | {{ :protection_measures.png?330|}} |
| - | </box| Figure 12: How to wash your hands? (World Health Organization, 2020).> | + | </box| Figure 17: Protective measures that reduce risk of coronavirus infection (WHO & BBC, 2020).> |
| + | What’s more important than whether you wear a N95 or not, is did you wash your hands? Washing hands are critical because your hands can carry live coronavirus from the contaminated surfaces. When you rub your eyes and pick your nose with your hands, the viruses can complete the infection. So, please take your time to wash your hands and avoid touching eyes, nose and mouth (World Health Organization, 2020). | ||
| + | <box 30% round left| > | ||
| + | {{ :screen_shot_2020-02-21_at_9.50.24_pm.png?300 |}} | ||
| + | </box| Figure 18: How to wash your hands? (World Health Organization, 2020).> | ||
| Line 246: | Line 275: | ||
| During the SARS epidemic in 2003, hospitalized patients received the same treatment as recommended for severe atypical pneumonia (CDC, 2005). Antiviral medications are sometimes given to reduce the swelling of the lungs but there are no studies that prove this is effective for every individual affected by SARS. No effective pharmacological interventions against the virus exists at this time. However, antiviral medications were later developed to combat the MERS outbreak in 2012. | During the SARS epidemic in 2003, hospitalized patients received the same treatment as recommended for severe atypical pneumonia (CDC, 2005). Antiviral medications are sometimes given to reduce the swelling of the lungs but there are no studies that prove this is effective for every individual affected by SARS. No effective pharmacological interventions against the virus exists at this time. However, antiviral medications were later developed to combat the MERS outbreak in 2012. | ||
| + | |||
| + | <box 30% round right| > | ||
| + | {{::unnamed.png?300|}} | ||
| + | </box| Figure 19: Possible receptors on the coronavirus that can be targeted by antiviral drugs (“Coronavirus – Simple Precautions to Take care for loved ones,” 2020).> | ||
| ==== Remdesivir ==== | ==== Remdesivir ==== | ||
| - | |||
| - | <box 25% round right| > | ||
| - | {{::unnamed.png?250|}} | ||
| - | </box| Figure 3: Distribution of MERS cases around the world, Orange label represents camel to camel transmission, blue label represents human to human transmission and red label represents camel to human transmission (WHO,2018).> | ||
| - | |||
| Remdesivir is known to be an effective drug against the coronavirus, specifically the one related to the Middle Eastern Respiratory Syndrome (MERS-CoV). Studies in the past have shown that Remdesivir prevented MERS in monkeys when it was administered before exposing the monkeys to the virus. Furthermore, when the drug was administered after the infection, it reduced the severity of the disease, virus replication and the amount of damage to the lungs (Wit et al., 2020). | Remdesivir is known to be an effective drug against the coronavirus, specifically the one related to the Middle Eastern Respiratory Syndrome (MERS-CoV). Studies in the past have shown that Remdesivir prevented MERS in monkeys when it was administered before exposing the monkeys to the virus. Furthermore, when the drug was administered after the infection, it reduced the severity of the disease, virus replication and the amount of damage to the lungs (Wit et al., 2020). | ||
| - | |||
| Remdesivir functions by inhibiting the replication of MERS-CoV in respiratory tissues and preventing the formation of lung lesions. In vitro studies involving mice infected with the hepatitis virus suggests that Remdesivir works against the coronavirus by interfering with the viral polymerase responsible for replication to occur (Wit et al., 2020). | Remdesivir functions by inhibiting the replication of MERS-CoV in respiratory tissues and preventing the formation of lung lesions. In vitro studies involving mice infected with the hepatitis virus suggests that Remdesivir works against the coronavirus by interfering with the viral polymerase responsible for replication to occur (Wit et al., 2020). | ||
| Line 268: | Line 295: | ||
| ===== Conclusion ===== | ===== Conclusion ===== | ||
| + | In conclusion, coronavirus is an ongoing concern. Although treatments are being developed through research, it will be a long process until an effective solution is reached. Therefore, preventative methods should be taken seriously. With the current outbreak slowly becoming a concern on a global scale, it is crucial to wash hands thoroughly and maintain overall personal hygiene. The best way to receive appropriate medical care is to seek treatment as early as possible for any display of symptoms. | ||
| + | |||
| + | ===== Presentation Slides ===== | ||
| + | {{:coronavirus.pdf|}} | ||
| ===== References ===== | ===== References ===== | ||
| - | Arabi, Y. M., Alothman, A., Balkhy, H. H., Al-Dawood, A., AlJohani, S., Al Harbi, S., Kojan, S., Al Jeraisy, M., Deeb, A. M., Assiri, A. M., Al-Hameed, F., AlSaedi, A., Mandourah, Y., Almekhlafi, G. A., Sherbeeni, N. M., Elzein, F. E., Memon, J., Taha, Y., Almotairi, A., … And the MIRACLE trial group. (2018). Treatment of Middle East Respiratory Syndrome with a combination of lopinavir-ritonavir and interferon-β1b (MIRACLE trial): Study protocol for a randomized controlled trial. Trials, 19(1), 81. https://doi.org/10.1186/s13063-017-2427-0 | + | Adam, K. (2020, February 11). British coronavirus 'superspreader' may have infected at least 11 |
| + | people in three countries. Retrieved February 20, 2020, from | ||
| + | https://www.washingtonpost.com/world/europe/british-coronavirus-super-spreader-may-h | ||
| + | ave-infected-at-least-11-people-in-three-countries/2020/02/10/016e9842-4c14-11ea-967b | ||
| + | -e074d302c7d4_story.html | ||
| - | Coronavirus Treatment- HIV Protease Inhibitors. (n.d.). Retrieved February 26, 2020, from http://www.natap.org/2020/newsUpdates/020420_02.htm | + | Advice for public. (n.d.). Retrieved from |
| + | https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public | ||
| + | |||
| + | Arabi, Y. M., Alothman, A., Balkhy, H. H., Al-Dawood, A., AlJohani, S., Al Harbi, S., Kojan, S., | ||
| + | Al Jeraisy, M., Deeb, A. M., Assiri, A. M., Al-Hameed, F., AlSaedi, A., Mandourah, Y., Almekhlafi, G. A., Sherbeeni, N. M., Elzein, F. E., Memon, J., Taha, Y., Almotairi, A., … And the MIRACLE trial group. (2018). Treatment of Middle East Respiratory Syndrome with a combination of lopinavir-ritonavir and interferon-β1b (MIRACLE trial): Study protocol for a randomized controlled trial. Trials, 19(1), 81. https://doi.org/10.1186/s13063-017-2427-0 | ||
| + | |||
| + | Arabi, Y. M., Balkhy, H. H., Hayden, F. G., Bouchama, A., Luke, T., Baillie, J. K., Al-Omari, A., | ||
| + | Hajeer, A. H., Senga, M., Denison, M. R., Nguyen-Van-Tam, J. S., Shindo, N., | ||
| + | Bermingham, A., Chappell, J. D., Van Kerkhove, M. D., & Fowler, R. A. (2017). Middle | ||
| + | East Respiratory Syndrome. The New England journal of medicine, 376(6), 584–594. | ||
| + | https://doi.org/10.1056/NEJMsr1408795 | ||
| + | |||
| + | BBC, & WHO. (2020, February 13). Coronavirus: Sharp increase in deaths and cases in Hubei. | ||
| + | Retrieved February 18, 2020, from | ||
| + | https://www.bbc.com/news/world-asia-china-51482994 | ||
| + | |||
| + | BBC, & WHO. (2020, February 10). The global fight against coronavirus. Retrieved February | ||
| + | 20, 2020, from | ||
| + | https://www.bbc.com/future/article/20200210-coronavirus-finding-a-cure-to-fight-the-sy | ||
| + | mptoms | ||
| + | |||
| + | Belluz, J. (2020, February 18). These 2 questions will determine if the coronavirus becomes a | ||
| + | deadly pandemic. Retrieved February 22, 2020, from | ||
| + | https://www.vox.com/2020/2/18/21142009/coronavirus-covid19-china-wuhan-deaths-pa | ||
| + | demic | ||
| + | |||
| + | Bloomberg News. (2020, February 5). China Sacrifices a Province to Save the World From | ||
| + | Coronavirus. Retrieved February 17, 2020, from | ||
| + | https://www.bloomberg.com/news/articles/2020-02-05/china-sacrifices-a-province-to-sa | ||
| + | e-the-world-from-coronavirus?fbclid=IwAR3dhbI8DaIh1gAsxGvcvrRW6AVv3f1xOA6 | ||
| + | PiV2F4ai7RW41DjCKUeivII | ||
| + | |||
| + | Brosseau, Lisa Berry, and Roland Berry Brosseau. “N95 Respirators and Surgical Masks.” | ||
| + | Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 14 Oct. 2009, blogs.cdc.gov/niosh-science-blog/2009/10/14/n95/. | ||
| + | |||
| + | CDC. (2020, January 25). About Coronavirus Disease 2019 (COVID-19). Retrieved February | ||
| + | 20, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/about/index.html | ||
| + | |||
| + | CDC. (2005, May 3). Frequently Asked Questions About SARS. Retrieved February 15, 2020, | ||
| + | from https://www.cdc.gov/sars/about/faq.html | ||
| + | |||
| + | Cleveland Clinic. (2019, September 10). Atypical (Walking) Pneumonia: Treatment & | ||
| + | Management. Retrieved February 15, 2020, from https://my.clevelandclinic.org/health/diseases/15744-pneumonia-atypical-walking-pneumonia | ||
| + | |||
| + | CNN. (2019, January 22). World's largest annual human migration now underway in China. | ||
| + | Retrieved February 16, 2020, from https://www.cnn.com/travel/article/lunar-new-year-travel-rush-2019/index.html | ||
| + | |||
| + | Coronavirus Treatment- HIV Protease Inhibitors. (n.d.). Retrieved February 26, 2020, from | ||
| + | http://www.natap.org/2020/newsUpdates/020420_02.htm | ||
| + | |||
| + | Donovan, M. (2020, January 24). Explaining the coronavirus. Retrived from | ||
| + | https://brighterworld.mcmaster.ca/articles/coronavirus-explanations-from-an-expert/. | ||
| + | |||
| + | Hajjar, S. A., Memish, Z. A., & Mcintosh, K. (2013). Middle East Respiratory Syndromw | ||
| + | Coronavirus (MERS-CoV): A Perpetual Challenge. Annals of Saudi Medicine, 33(5), | ||
| + | 427–436. doi: 10.5144/0256-4947.2013.427 | ||
| + | |||
| + | Achenbach, J. (2020, February 7). Coronavirus came from bats or possibly pangolins amid | ||
| + | 'acceleration' of new zoonotic infections. Retrieved February 20, 2020, from https://www.washingtonpost.com/health/coronavirus-came-from-bats-or-possibly-pangolins-amid-acceleration-of-new-zoonotic-infections/2020/02/07/11eb7f3a-4379-11ea-b503-2b077c436617_story.html | ||
| + | |||
| + | Kim, K., Tandi, T., Choi, J., Moon, J., & Kim, M. (2017). Middle East respiratory syndrome | ||
| + | coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics | ||
| + | and public health implications. Journal of Hospital Infection, 95(2), 207–213. doi: | ||
| + | 10.1016/j.jhin.2016.10.008 | ||
| + | |||
| + | Leung, G. M., Hedley, A. J., Ho, L.-M., & Chau, P. (2004). The Epidemiology of Severe Acute | ||
| + | Respiratory Syndrome in the 2003 Hong Kong Epidemic: An Analysis of All 1755 | ||
| + | Patients. Annals of Internal Medicine, 141, 662–673. doi: | ||
| + | 10.7326/0003-4819-141-9-200411020-00006 | ||
| + | |||
| + | Lu, C.-W., Liu, X.-F., & Jia, Z.-F. (2020). 2019-nCoV transmission through the ocular surface | ||
| + | must not be ignored. The Lancet, 395(10224). doi: 10.1016/s0140-6736(20)30313-5 | ||
| + | |||
| + | Lu, R., Zhao, X., Li, J., Niu, P., Yang, B., Wu, H., … Tan, W. (2020). Genomic characterisation | ||
| + | and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor | ||
| + | binding. The Lancet, 395(10224), 565–574. doi: 10.1016/s0140-6736(20)30251-8 | ||
| + | |||
| + | Middle East respiratory syndrome coronavirus (MERS-CoV). (n.d.). Retrieved February 24, | ||
| + | 2020, from | ||
| + | https://www.who.int/en/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-c | ||
| + | oronavirus-(mers-cov) | ||
| + | |||
| + | Memish, Z., & Al-Tawfiq, J. (2014). Middle East respiratory syndrome coronavirus: | ||
| + | epidemiology and disease control measures. Infection and Drug Resistance, 281. doi: 10.2147/idr.s51283 | ||
| + | |||
| + | MERS Symptoms & Complications. (2019, August 2). Retrieved February 24, 2020, from | ||
| + | https://www.cdc.gov/coronavirus/mers/about/symptoms.html | ||
| + | |||
| + | MERS Transmission. (2019, August 2). Retrieved from | ||
| + | https://www.cdc.gov/coronavirus/mers/about/transmission.html | ||
| + | |||
| + | NCBI. (2004, August 20). Overview of the SARS Epidemic. Retrieved February 15, 2020, from | ||
| + | https://www.ncbi.nlm.nih.gov/books/NBK92478/ | ||
| + | |||
| + | Otter, J., Donskey, C., Yezli, S., Douthwaite, S., Goldenberg, S., & Weber, D. (2016). | ||
| + | Transmission of SARS and MERS coronaviruses and influenza virus in healthcare | ||
| + | settings: the possible role of dry surface contamination. Journal of Hospital Infection, | ||
| + | 92(3), 235–250. doi: 10.1016/j.jhin.2015.08.027 | ||
| + | |||
| + | Reuters. (2020, February 22). Coronavirus incubation could be as long as 27 days, Chinese | ||
| + | provincial government says. Retrieved February 26, 2020, from https://www.reuters.com/article/us-china-health-incubation/coronavirus-incubation-could-be-as-long-as-27-days-chinese-provincial-government-says-idUSKCN20G06W | ||
| + | |||
| + | Radonovich, L. J., Simberkoff, M. S., Bessesen, M. T., Brown, A. C., Cummings, D. A. T., | ||
| + | Gaydos, C. A., … Perl, T. M. (2019). N95 Respirators vs Medical Masks for Preventing | ||
| + | Influenza Among Health Care Personnel. Jama, 322(9), 824. doi: | ||
| + | 10.1001/jama.2019.11645 | ||
| + | |||
| + | Soucheray, S. (2020, January 29). Scientists warn nCoV more infectious than SARS, but experts | ||
| + | have doubts. Retrieved February 20, 2020, from | ||
| + | http://www.cidrap.umn.edu/news-perspective/2020/01/scientists-warn-ncov-more-infecti | ||
| + | ous-sars-experts-have-doubts | ||
| + | |||
| + | Stieg, C. (2020, February 11). A coronavirus 'super spreader' was identified-what that means and | ||
| + | what you need to know. Retrieved February 20, 2020, from https://www.cnbc.com/2020/02/11/what-is-a-coronavirus-covid-19-super-spreader-infections-explained.html | ||
| + | |||
| + | Wit, E. de, Feldmann, F., Cronin, J., Jordan, R., Okumura, A., Thomas, T., Scott, D., Cihlar, T., | ||
| + | & Feldmann, H. (2020). Prophylactic and therapeutic remdesivir (GS-5734) treatment in | ||
| + | the rhesus macaque model of MERS-CoV infection. Proceedings of the National | ||
| + | Academy of Sciences. https://doi.org/10.1073/pnas.1922083117 | ||
| + | |||
| + | WHO MERS-CoV Global Summary and Assessment of Risk (2018.). Retrieved from | ||
| + | https://www.who.int/csr/disease/coronavirus_infections/archive_updates/en/ | ||
| + | |||
| + | Yang, S., Lee, G. W., Chen, C.-M., Wu, C.-C., & Yu, K.-P. (2007). The Size and Concentration | ||
| + | of Droplets Generated by Coughing in Human Subjects. Journal of Aerosol Medicine, | ||
| + | 20(4), 484–494. doi: 10.1089/jam.2007.0610 | ||
| + | |||
| + | Zhu, S., Kato, S., & Yang, J.-H. (2006). Study on transport characteristics of saliva droplets | ||
| + | produced by coughing in a calm indoor environment. Building and Environment, 41(12), | ||
| + | 1691–1702. doi: 10.1016/j.buildenv.2005.06.024 | ||
| + | |||
| + | Zumla, A., Hui, D. S., & Perlman, S. (2015). Middle East respiratory syndrome. The Lancet, | ||
| + | 386(9997), 995–1007. doi: 10.1016/s0140-6736(15)60454-8 | ||
| - | Wit, E. de, Feldmann, F., Cronin, J., Jordan, R., Okumura, A., Thomas, T., Scott, D., Cihlar, T., & Feldmann, H. (2020). Prophylactic and therapeutic remdesivir (GS-5734) treatment in the rhesus macaque model of MERS-CoV infection. Proceedings of the National Academy of Sciences. https://doi.org/10.1073/pnas.1922083117 | ||
| - | ===== Presentation ===== | ||
| - | {{:coronavirus.pdf|}} | ||
