What is the Coronavirus Disease of 2019 (COVID-19)?
A newly discovered virus, known as coronavirus, has caused a disease outbreak in almost all countries across the globe. Named after the crown-like structure of the virus, coronavirus consists of four proteins which make up its structure, identified as the spike, envelope, membrane and nucleocapsid. The virus belongs to the same family as the SARS virus, and has been named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is a single-stranded RNA virus, each of which is about 50-200 nanometres long in diameter. The disease caused by this virus was named as the coronavirus disease of 2019 or COVID-19.
On December 31, 2019, the first case of the disease was discovered in the city of Wuhan, Hubei province, in China.
The virus is believed to be of zoonotic origin, which means that initially, it must have spread from animals to humans. China was the epicentre of this outbreak when the outbreak began; however, it later shifted to Europe as the number of cases in the region surpassed that of China.
Coronavirus is similar to pneumonia in terms of its symptoms. The common symptoms of this disease include fever, cough, shortness of breath and pain in muscles which usually appear in an affected person in around 2-15 days of being infected with the virus; however some cases may be asymptomatic. The virus is mainly spread human-to-human through the respiratory secretions of an infected person to people within a 2 metre range of that person.
There is currently no vaccine for prevention or anti-viral medicines for the treatment of COVID-19. The best prevention method is isolation of people infected or suspected to be infected by the virus.
As of April 9, 2020, the World Health Organization (W.H.O.) reported a total of 1,436,198 confirmed coronavirus disease cases and 85,522 confirmed deaths from various countries, areas and union territories all around the world. On March 11, 2020, the W.H.O. had declared COVID-19 as a global pandemic.
How is the World Reacting to This?
The large number of COVID-19 cases which are increasing at a high rate have led to panic among people from all over the world. In order to isolate the infected people and prevent any further transmission, governments from all over the world have been taking various measures by implementing nationwide curfews and providing quality healthcare services to the COVID-19 positive patients.
Current Scenario in North America
In the United States, the total cases reported as on March 20, 2020 were 15,219 and 201 deaths according to the Centres for Disease Prevention and Control. Out of these, 337 cases were travel-related cases, 321 cases occurred as a result of close contact, while the remaining 14,561 cases are still under investigation. The total number of cases and deaths witnessed a sudden spike in the United States after that. As on April 9, 2020, CDC reported a total of 427,460 cases and 14,696 deaths, out of which, 1,930 cases were travel related, 9,763 cases occurred through close contact and others are still under investigation. On February 24, 2020, about 1,336 medical and healthcare staff members of CDC were involved in the response against COVID-19. Out of these, 37% of the staff had been deployed to 39 locations across the United States, including the quarantine stations.
The control of transmission in Asia Pacific Region
China observed the highest prevalence of COVID-19 being the country of origin of the disease. According to the data by W.H.O., China had 81,498 total confirmed cases as on March 21, 2020, while the total deaths were 3,267. China was able to control any further transmission of the disease by observing complete containment for a month. This led to a rapid decline in the rate of new cases in the country. As of April 9, 2020, the total number of cases in China were 83,249 and 3,344 total deaths, displaying a significant reduction in further transmissions.
The Republic of Korea reported 10,423 confirmed cases and 204 total deaths as of April 9, 2020. In Australia, the total confirmed cases were 6,052 and total deaths were 50. The Government of Australia imposed certain travel restrictions for people entering from high risk countries and increased screening of travellers arriving in Australia. It further proposed the delivery of USD 17.6 billion economic support package for keeping people employed and encouraging investments along with USD 2.4 billion health packages to the citizens. According to Ministry of Health, Japan, a total of 4,768 cases were confirmed as on April 9, 2020. In order to control further spread, the government in Japan took certain border control measures involving inquiry and medical consultation from people entering the borders of Japan. Moreover, a total of 64,387 people were PCR tested in the country, out of which, 4,768 cases were tested positive.
Confirmed Cases and Deaths in Asia Pacific Region
Government Initiatives for Effective Treatment in Europe
As of April 9, 2020, the European Centre for Disease Prevention and Control reported 665,778 cases in the European Union and the UK in total. Out of these, Spain had the highest number of cases with 146,690 total cases and 14,555 deaths. Italy reported a total of 139,422 cases and 17,669 deaths. To prevent any further escalation of the illness, Italy banned any movement inside the country and imposed a nationwide lockdown, shutting down all non-essential businesses and manufacturing units. Germany reported 108,202 cases and 2,107 deaths; while 82,048 total cases and 10,869 deaths were reported in France. In the United Kingdom, the total number of cases were 60,733 and 7,097 deaths were reported. In Europe, the population belonging to older age groups as well as those with an underlying chronic medical condition were found to be at a higher risk of developing serious indications from the coronavirus disease as compared with the general population. The government in United Kingdom urged people to stay at home as the National Health Service (NHS) identified around 1.5 million people in the country to be at a high risk of contacting the disease.
Moderate Number of cases in Middle East & Africa
The highest number of cases in the Middle Eastern region was reported in Iran, with 64,586 total confirmed cases, 1,997 new cases and 3,993 deaths as on April 9, 2020. As per reports by the World Health Organization, South Africa had 1,845 total confirmed cases and 18 deaths as on April 9, 2020. The lower connectivity of the Africa region along with lesser number of people entering the region from other countries are some factors responsible for the lower number of cases being imported in the region from abroad.
Present COVID-19 situation in Latin America
In Latin America, the highest number of cases were recorded in Brazil, with a total of 13,717 confirmed cases and 667 deaths as on April 9, 2020 according to the W.H.O. Moreover, Chile reported 5,546 confirmed cases and Mexico reported 2,785 confirmed total cases.
What is the COVID-19 Treatment Outlook?
Coronavirus disease can be prevented easily if some basic hygiene measures are followed with a proper protocol. Since no medicine or vaccine has been developed for the treatment and prevention of coronavirus disease, it is important to avoid exposure to this virus. According to Centres for Disease Prevention and Control, people can protect themselves from being infected by washing hands with soap on a regular basis for 20 seconds. The use of alcohol-based hand sanitizer is another effective method of preventing the virus from entering the body. Further, touching of nose, mouth and eyes should be avoided as well. Close contact with sick people should be prevented.
The prevailing diagnostic method for this disease is by the reverse transcriptase polymerase chain reaction (rRT-PCR).
The International Federation of Pharmaceutical Manufacturers & Associations reported that the biopharmaceutical industry has been engaged in the research and development of vaccines and treatments for the new coronavirus disease, COVID-19. The potential treatments consist of immunotherapies as well as antiviral therapies.
According to the IFPMA, there are around 80 clinical trials as of March 2020 for experimental vaccines and treatments for coronaviruses including COVID-19.
Johnson & Johnson announced on February 18, 2020 that its subsidiary, Janssen Pharmaceutical Companies will partner with the Biomedical Advanced Research and Development Authority (BARDA) for developing a potential vaccine candidate for the treatment of COVID-19.
On March 4, 2020, Takeda Pharmaceutical Company Limited announced that the company would be initiating the development of an anti-SARS-CoV-2 polyclonal hyperimmune globulin (H-IG) for the treatment of patients who are at a high risk of developing COVID-19. Moreover, the company would be studying the effect of its currently marketed products for the treatment of the novel coronavirus disease of 2019.
On March 9, 2020, AbbVie announced partnership with global health authorities such as the U.S. Food and Drug Administration (FDA), National Institutes of Health, Centers for Disease Control and Prevention, the Biomedical Advanced Research and Development Authority and European health authorities for determining the antiviral activity and effectiveness of HIV drugs lopinavir/ritonavir against COVID-19.
Eli Lilly and AbCellera announced on March 12, 2020, that they will co-develop antibody products for treatment and prevention of COVID-19. AbCellera will utilize its rapid pandemic response platform while Lilly will develop, manufacture and distribute the therapeutic antibodies.
On March 13, 2020, AstraZeneca announced that it is providing assistance to various international health authorities including the World Health Organization (WHO) and the European Federation of Pharmaceutical Industries and Associations (EFPIA) through its science and technology expertise.
Novartis announced on March 17, 2020, various measures for supporting the global response to the coronavirus disease of 2019, consisting of creation of global fund for COVID-19 impacted communities and other R&D initiatives. The Novartis COVID-19 Response Fund aims to provide a grant of USD 20 million for public health initiatives for strengthening healthcare infrastructure, establishing digital healthcare platforms and creating new pandemic specific health programs.
On March 19, Roche announced that it has been working with the U.S. Food & Drug Administration (FDA) for a Phase-III clinical trial which is randomised, double-blind and placebo-controlled in association with the Biomedical Advanced Research and Development Authority (BARDA).
BARDA is a part of the U.S. Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR). The clinical trial will be aimed at assessing the safety as well as the efficacy of Actemra®/RoActemra® (tocilizumab). This trial will study the effect of the drug in people hospitalized with COVID-19 pneumonia. Further, on March 13, 2020, Roche received FDA Emergency Use Authorisation for the cobas® SARS-CoV-2 Test in order to detect the COVID-19 disease causing virus.
The U.S. Food and Drug Administration, an agency within the U.S. Department of Health and Human Services, announced on March 19, 2020, that it will continue to facilitate the medical countermeasures for treatment and prevention of COVID-19 and provide surveillance of medical devices and food supplies to monitor and prevent any shortages. Further, the FDA has been closely working with other government agencies and academic institutions for investigation of chloroquine, a drug approved for the treatment of diseases such as malaria, rheumatoid arthritis and lupus, for determining whether it is a potential drug for COVID-19. India is a major producer of this malarial drug, hydroxychloroquine, with 70% of total production coming in from the country. In order to protect the reserves of the drug to satisfy the requirements in the country, India banned the export of hydroxychloroquine. On April 8, 2020, the President of U.S., Mr Donald Trump, requested the Indian Prime Minister, Mr Narendra Modi, to lift the ban as the U.S. required the drug for testing and treating the rapidly increasing number of COVID-19 patients. Following this, the ban was lifted and Mr Trump thanked Mr Modi.
The drug will be exported to other countries as well. The Prime Minister of Israel, too, thanked PM Modi in a tweet for sending hydroxychloroquine tablets to the country. Several other ministers of various countries thanked the Indian Prime Minister for the support during this global pandemic.
Pfizer announced on April 9, 2020 that the company is working towards finding a cure for COVID-19 on multiple fronts by collaborating with various large to small pharmaceutical and biotechnology companies, as well as government agencies and academic institutions. For instance, the company recently confirmed the test results of an anti-viral compound screening as per which, a lead compound and its analogues were confirmed to be potential inhibitors of the SARS-CoV-2 3C-like (3CL) protease, and show antiviral activity against SARS-CoV-2.
The World Economic Forum reported that the new project for its COVID Action Platform, the COVID-19 Therapeutics Accelerator, was launched by The Bill & Melinda Gates Foundation, Mastercard and Wellcome Trust. The project received a seed funding of USD 125 million for identification, assessment, development and scaled-up treatments as a response to the COVID-19 pandemic.
How Can We Control Further Transmission and Flatten the Curve?
The transmission of the novel coronavirus disease of 2019 or COVID-19 can be further controlled by keeping people who are suspected to be infected in quarantine. People who might have come into contact with infected people may keep themselves under self-isolation for a few days and observe if the symptoms of the disease appear. As coronavirus is spreading at an exponential rate, it is important to ‘flatten the curve’ for ensuring minimum transmission of the disease. This means that community isolation measures are required so that the disease is spread at a slower rate and affects a minimum number of people.
COVID-19 – Flattening the Curve
It is always a good idea to monitor the occurrence of any possible symptoms and take preventive measures by wearing protective masks, especially for people with cold or flu symptoms. This would prevent any further transmission of the virus.
Impact of Coronavirus Epidemic on the Global Economy
The coronavirus disease outbreak in 2020 has had a highly negative impact on the economy all around the world. The financial markets have crashed globally due to complete stoppage of major businesses such as airlines, transportation, and several others. The quick development of an effective vaccine and treatment method for COVID-19 along with its proper distribution across all countries globally is the need of the hour.