In late 2019, the coronavirus disease was first identified amid an outbreak of respiratory illness cases in Wuhan City, Hubei Province, China. Though the disease—which was later defined as an illness caused by a novel coronavirus, now referred to as SRS-CoV-2—was reported on December 31, 2019, it quickly continued to spread, making its way from China across the globe, spanning countries and affecting remote towns to bustling cities.
On January 30, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a global health emergency, and then, on March 11, 2020, WHO established COVID-19 was officially a full-blown global pandemic. This designation was the first to come after a long stretch of absence following the 2009 H1N1 influenza.
At the time of publication, the world remains deeply affected and wholly impacted by COVID-19. Its designation as a global pandemic has not been de-escalated.
The CDC reported on August 16th, 2020, a total of 5,566,632 confirmed cases and nearly 173,128 deaths in the United States alone. Worldwide, nearly 21.7 million cases have been reported, with 776,000 deaths and nearly 13.7 million who have recovered.
Despite the months punctuated by new cases and steep increases in COVID-19 related deaths, the disease continues to largely be a mystery. While questions have been answered about the spread, preventative measures, and its origins, the conversations surrounding treatment, therapy, and its inevitable progression continue to go unanswered.
While answers to these questions continue to evade us, there are some certainties we can build a foundation of understanding on—and that’s precisely the intent of this article. Continue reading to uncover a broad overview of COVID-19.
We’ll start with a brief breakdown into the characteristics and symptoms of this disease and slowly unravel what we know about the novel virus that causes this disease and further explore the questions we simply do not yet have the answers to.
Though it’s certainly a word none of us are unfamiliar with, it’s crucial to sit back and ourselves a vital question—what exactly is COVID-19, and more importantly, where does it come from?
COVID-19—an abbreviation for Coronavirus disease 2019—is an illness that is caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus. Often, this is referred to as SARS-CoV-2.
Here’s where things get specific. Coronaviruses themselves comprise an entire family of viruses—only a handful of them (7) are known to cause disease in humans while others invest animals. Coronaviruses can sometimes infect animals and then evolve as viruses that can affect humans.
SARS-CoV-2 is the most recent example of a coronavirus, but there have been a few instances in the past where a novel coronavirus has evolved and jumped from animals to humans, including severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). SARS affected about 8,000 people (about 800 died) before it was controlled in 2003. MERS, similarly, has had a total of 2,45 confirmed cases since 2012.
This unique disease is characterized by symptoms such as:
That being said, those who are infected with the virus that causes SARS-CoV-2 also have the potential to be asymptomatic or severely pre-symptomatic. Some individuals with confirmed cases of SARS-CoV-2 either do not ever show signs of being exposed or can feel and appear fine (without symptoms) for up to 14 days after being exposed. This characteristic of COVID-19 greatly contributes to its rapid, rampant transmission.
While the entirety of SARS-CoV-2 is not understood, scientists, researchers, and medical professionals have pinned down the most common transmission for this highly transmissible, passing from person to person in close contact through respiratory droplets—sneezing, coughing, talking, spitting, etc.
Viruses like these can easily infect others and while SARS-CoV-2 is considered to be potentially spreadable through fomite transmission (persisting on surfaces to varying degrees of infectivity), the riskiest, most common spread happens through infected respiratory droplets.
Close contact and exposure to respiratory droplets continue to be considered the main form of transmission of the virus, which is why several countries have enacted social distancing guidelines, advising that individuals not only use appropriate protective equipment (face masks, shields, gloves, etc.) but also aptly social distance and maintain at least 6 feet of distance from others when they must be in public.
One of the most puzzling—and dangerous—aspects of SARS-CoV-2 is a carrier’s ability to be asymptomatic or pre-symptomatic.
Every day, new cases of COVID-19 crop up. Despite some countries implementing strict regulations, the unique way each area of the world is handling prevention and precaution for this disease is dramatically affecting the spread, transmissibility, and infection rates.
As of March 26, 2020, the United States had more confirmed cases of the infection than any other country in the world (including China, where the disease originated, and Italy, a contender early on for being the virus “hot spot”).
The current confirmed case reports as well as death rates can be found on this map from the Coronavirus Resource Center at HealthSoul.
Unfortunately, because so much is unknown about this virus and its subsequent disease, there are only “best guesses” available about its epidemiology. In May of 2020, the CDC and the Office of the Assistant Secretary for Preparedness and Response (ASPR) released their guesses for viral transmissibility, asymptomatic disease transmission, and disease severity. Their data included guesses such as:
While people of all ages and conditions can be infected with this disease it’s estimated that older populations, those with weakened immune systems, and those who have pre-existing medical conditions like asthma, diabetes, and heart disease are typically the most susceptible to this disease, according to WHO.
As far as the virology of SARS-CoV-2, there are still questions in need of answers—but it has been reported that the virus mutated in early May of 2020. The full genome of SARS-CoV-2 was reported by the Chinese health authorities after the initial detection, the CDC analyzed the genome from the first US patient who developed the infection in late January and concluded it was identical.
But in May, a study reported the emergence of a SARS-CoV-2 mutation, and it is that mutated infection that has become the dominant viral lineage in North America, Europe, and Australia.
This mutation—called the D614G mutation—is even more poorly understood, making its transmissibility, virulence, potential treatment, and antigenicity even harder to pin down.
The complications associated with SARS-CoV-2 tend to be just as—if not more—problematic than SARS-CoV-2 itself. Unfortunately, reported complications of COVID-19 have included complications like acute respiratory distress syndrome, septic shock, acute kidney injury, multi-organ failure, pneumonia, cardiac injury, and more.
It’s reported that ARDS is one of the most notable, main complications in severe cases of COVID-19 affecting nearly 20-41% of hospitalized patients. As far as cardiac concerns, increasing data supports that cardiac injury in COVID-19 is a significant burden. The risk of cardiac injury was up to 22% in ICU patients.
Further, in a study of 5,4559 patients hospitalized with severe COVID-19 in New York, 36.6% developed acute kidney injury and 14.3% required dialysis.
As far as prevention goes for SARS-CoV-2, there is no current vaccine available—instead, avoidance is the principal method of deterrence.
General measures for preventing this type of infection include handwashing with soap and water for at least 20 seconds on a regular basis; avoiding touching eyes, nose, mouth, and unwashed hands; close contact with others (especially infected, sick people); sick people should stay home; coughs and sneezes should be covered, and surfaces should be disinfected frequently.
The CDC has implemented several regulations to help mitigate community spread—while these guidelines are not regulated everywhere, several countries have chosen to abide by them to help with the spread.
Facemasks and social distancing have been the key pieces of the mitigation puzzle. A 2020 study on the efficacy of facemasks in preventing acute respiratory infection found that masks reduced the detection of viral RNA in exhaled breaths and coughs.
No verifiable treatments or vaccinations have been found to help with SARS-CoV-2, however, exploratory, investigatory treatments are being uncovered and approach considerations are being considered.
For example, on May 1, 2020, based on preliminary data showing faster recovery times of hospitalized patients with severe disease, the antiviral drug remdesivir gained emergency use authorization from the FDA.
Presently, numerous collaborative efforts to discover and evaluate the effectiveness of antivirals, antibodies, vaccines, and immunotherapies have emerged, but as of yet, there is no certain treatment. Investigational antiviral agents, vaccines, anti-body directed therapies, drugs for Cytokine release, immunotherapies, and more are being explored as treatment options.
Information regarding COVID-19 is continually and rapidly evolving—as new information emerges, new guidelines, treatment options, and exploratory measures are being taken to better understand the virology and epidemiology of SARS-CoV-2.
During the early months of the pandemic in March and April, HealthSoul campaign to educate on COVID-19 reached 15 Million people across the world and making 36 million impressions. There are continuous updates published on HealthSoul COVID blog regarding treatment and vaccine options based on research studies. HealthSoul has created a dedicated map based on several resources to update its visitors about daily numbers. The map is updated every day based on various news channels and WHO. HealthSoul hopes to remain a useful resource for people to clarify their COVID-19 questions.