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Persuasive Essay Guide

Persuasive Essay About Covid19

How to Write a Persuasive Essay About Covid19 | Examples & Tips

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Steps to Write a Persuasive Essay About Covid-19

Here are the steps to help you write a persuasive essay on this topic, along with an example essay:

Step 1: Choose a Specific Thesis Statement

Your thesis statement should clearly state your position on a specific aspect of COVID-19. It should be debatable and clear. For example:

Step 2: Research and Gather Information

Collect reliable and up-to-date information from reputable sources to support your thesis statement. This may include statistics, expert opinions, and scientific studies. For instance:

COVID-19 vaccination effectiveness data
Information on vaccine mandates in different countries
Expert statements from health organizations like the WHO or CDC

Step 3: Outline Your Essay

Create a clear and organized outline to structure your essay. A persuasive essay typically follows this structure:

Introduction
Background Information
Body Paragraphs (with supporting evidence)
Counterarguments (addressing opposing views)

Step 4: Write the Introduction

In the introduction, grab your reader's attention and present your thesis statement. For example:

Step 5: Provide Background Information

Offer context and background information to help your readers understand the issue better. For instance:

Step 6: Develop Body Paragraphs

Each body paragraph should present a single point or piece of evidence that supports your thesis statement. Use clear topic sentences, evidence, and analysis. Here's an example:

Step 7: Address Counterarguments

Acknowledge opposing viewpoints and refute them with strong counterarguments. This demonstrates that you've considered different perspectives. For example:

Step 8: Write the Conclusion

Summarize your main points and restate your thesis statement in the conclusion. End with a strong call to action or thought-provoking statement. For instance:

Step 9: Revise and Proofread

Edit your essay for clarity, coherence, grammar, and spelling errors. Ensure that your argument flows logically.

Step 10: Cite Your Sources

Include proper citations and a bibliography page to give credit to your sources.

Remember to adjust your approach and arguments based on your target audience and the specific angle you want to take in your persuasive essay about COVID-19.

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Examples of Persuasive Essay About Covid19

When writing a persuasive essay about the Covid-19 pandemic, it’s important to consider how you want to present your argument. To help you get started, here are some example essays for you to read:

Check out some more PDF examples below:

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

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Examples of Persuasive Essay About Covid-19 Vaccine

Covid19 vaccines are one of the ways to prevent the spread of Covid-19, but they have been a source of controversy. Different sides argue about the benefits or dangers of the new vaccines. Whatever your point of view is, writing a persuasive essay about it is a good way of organizing your thoughts and persuading others.

A persuasive essay about the Covid-19 vaccine could consider the benefits of getting vaccinated as well as the potential side effects.

Below are some examples of persuasive essays on getting vaccinated for Covid-19.

Covid19 Vaccine Persuasive Essay

Persuasive Essay on Covid Vaccines

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Examples of Persuasive Essay About Covid-19 Integration

Covid19 has drastically changed the way people interact in schools, markets, and workplaces. In short, it has affected all aspects of life. However, people have started to learn to live with Covid19.

Writing a persuasive essay about it shouldn't be stressful. Read the sample essay below to get idea for your own essay about Covid19 integration.

Persuasive Essay About Working From Home During Covid19

Searching for the topic of Online Education? Our persuasive essay about online education is a must-read.

Examples of Argumentative Essay About Covid 19

Covid-19 has been an ever-evolving issue, with new developments and discoveries being made on a daily basis.

Writing an argumentative essay about such an issue is both interesting and challenging. It allows you to evaluate different aspects of the pandemic, as well as consider potential solutions.

Here are some examples of argumentative essays on Covid19.

Argumentative Essay About Covid19 Sample

Argumentative Essay About Covid19 With Introduction Body and Conclusion

Looking for a persuasive take on the topic of smoking? You'll find it all related arguments in out Persuasive Essay About Smoking blog!

Examples of Persuasive Speeches About Covid-19

Do you need to prepare a speech about Covid19 and need examples? We have them for you!

Persuasive speeches about Covid-19 can provide the audience with valuable insights on how to best handle the pandemic. They can be used to advocate for specific changes in policies or simply raise awareness about the virus.

Check out some examples of persuasive speeches on Covid-19:

Persuasive Speech About Covid-19 Example

Persuasive Speech About Vaccine For Covid-19

You can also read persuasive essay examples on other topics to master your persuasive techniques!

Tips to Write a Persuasive Essay About Covid-19

Writing a persuasive essay about COVID-19 requires a thoughtful approach to present your arguments effectively.

Here are some tips to help you craft a compelling persuasive essay on this topic:

Choose a Specific Angle

Start by narrowing down your focus. COVID-19 is a broad topic, so selecting a specific aspect or issue related to it will make your essay more persuasive and manageable. For example, you could focus on vaccination, public health measures, the economic impact, or misinformation.

Provide Credible Sources

Support your arguments with credible sources such as scientific studies, government reports, and reputable news outlets. Reliable sources enhance the credibility of your essay.

Use Persuasive Language

Employ persuasive techniques, such as ethos (establishing credibility), pathos (appealing to emotions), and logos (using logic and evidence). Use vivid examples and anecdotes to make your points relatable.

Organize Your Essay

Structure your essay involves creating a persuasive essay outline and establishing a logical flow from one point to the next. Each paragraph should focus on a single point, and transitions between paragraphs should be smooth and logical.

Emphasize Benefits

Highlight the benefits of your proposed actions or viewpoints. Explain how your suggestions can improve public health, safety, or well-being. Make it clear why your audience should support your position.

Use Visuals -H3

Incorporate graphs, charts, and statistics when applicable. Visual aids can reinforce your arguments and make complex data more accessible to your readers.

Call to Action

End your essay with a strong call to action. Encourage your readers to take a specific step or consider your viewpoint. Make it clear what you want them to do or think after reading your essay.

Revise and Edit

Proofread your essay for grammar, spelling, and clarity. Make sure your arguments are well-structured and that your writing flows smoothly.

Seek Feedback

Have someone else read your essay to get feedback. They may offer valuable insights and help you identify areas where your persuasive techniques can be improved.

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Common Topics for a Persuasive Essay on COVID-19

Here are some persuasive essay topics on COVID-19:

The Importance of Vaccination Mandates for COVID-19 Control
Balancing Public Health and Personal Freedom During a Pandemic
The Economic Impact of Lockdowns vs. Public Health Benefits
The Role of Misinformation in Fueling Vaccine Hesitancy
Remote Learning vs. In-Person Education: What's Best for Students?
The Ethics of Vaccine Distribution: Prioritizing Vulnerable Populations
The Mental Health Crisis Amidst the COVID-19 Pandemic
The Long-Term Effects of COVID-19 on Healthcare Systems
Global Cooperation vs. Vaccine Nationalism in Fighting the Pandemic
The Future of Telemedicine: Expanding Healthcare Access Post-COVID-19

In search of more inspiring topics for your next persuasive essay? Our persuasive essay topics blog has plenty of ideas!

To sum it up,

You have read good sample essays and got some helpful tips. You now have the tools you needed to write a persuasive essay about Covid-19. So don't let the doubts stop you, start writing!

If you need professional writing help, don't worry! We've got that for you as well.

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Frequently Asked Questions

Are there any ethical considerations when writing a persuasive essay about covid-19.

Yes, there are ethical considerations when writing a persuasive essay about COVID-19. It's essential to ensure the information is accurate, not contribute to misinformation, and be sensitive to the pandemic's impact on individuals and communities. Additionally, respecting diverse viewpoints and emphasizing public health benefits can promote ethical communication.

What impact does COVID-19 have on society?

The impact of COVID-19 on society is far-reaching. It has led to job and economic losses, an increase in stress and mental health disorders, and changes in education systems. It has also had a negative effect on social interactions, as people have been asked to limit their contact with others.

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How to Write About Coronavirus in a College Essay

Students can share how they navigated life during the coronavirus pandemic in a full-length essay or an optional supplement.

Writing About COVID-19 in College Essays

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Experts say students should be honest and not limit themselves to merely their experiences with the pandemic.

The global impact of COVID-19, the disease caused by the novel coronavirus, means colleges and prospective students alike are in for an admissions cycle like no other. Both face unprecedented challenges and questions as they grapple with their respective futures amid the ongoing fallout of the pandemic.

Colleges must examine applicants without the aid of standardized test scores for many – a factor that prompted many schools to go test-optional for now . Even grades, a significant component of a college application, may be hard to interpret with some high schools adopting pass-fail classes last spring due to the pandemic. Major college admissions factors are suddenly skewed.

"I can't help but think other (admissions) factors are going to matter more," says Ethan Sawyer, founder of the College Essay Guy, a website that offers free and paid essay-writing resources.

College essays and letters of recommendation , Sawyer says, are likely to carry more weight than ever in this admissions cycle. And many essays will likely focus on how the pandemic shaped students' lives throughout an often tumultuous 2020.

But before writing a college essay focused on the coronavirus, students should explore whether it's the best topic for them.

Writing About COVID-19 for a College Application

Much of daily life has been colored by the coronavirus. Virtual learning is the norm at many colleges and high schools, many extracurriculars have vanished and social lives have stalled for students complying with measures to stop the spread of COVID-19.

"For some young people, the pandemic took away what they envisioned as their senior year," says Robert Alexander, dean of admissions, financial aid and enrollment management at the University of Rochester in New York. "Maybe that's a spot on a varsity athletic team or the lead role in the fall play. And it's OK for them to mourn what should have been and what they feel like they lost, but more important is how are they making the most of the opportunities they do have?"

That question, Alexander says, is what colleges want answered if students choose to address COVID-19 in their college essay.

But the question of whether a student should write about the coronavirus is tricky. The answer depends largely on the student.

"In general, I don't think students should write about COVID-19 in their main personal statement for their application," Robin Miller, master college admissions counselor at IvyWise, a college counseling company, wrote in an email.

"Certainly, there may be exceptions to this based on a student's individual experience, but since the personal essay is the main place in the application where the student can really allow their voice to be heard and share insight into who they are as an individual, there are likely many other topics they can choose to write about that are more distinctive and unique than COVID-19," Miller says.

Opinions among admissions experts vary on whether to write about the likely popular topic of the pandemic.

"If your essay communicates something positive, unique, and compelling about you in an interesting and eloquent way, go for it," Carolyn Pippen, principal college admissions counselor at IvyWise, wrote in an email. She adds that students shouldn't be dissuaded from writing about a topic merely because it's common, noting that "topics are bound to repeat, no matter how hard we try to avoid it."

Above all, she urges honesty.

"If your experience within the context of the pandemic has been truly unique, then write about that experience, and the standing out will take care of itself," Pippen says. "If your experience has been generally the same as most other students in your context, then trying to find a unique angle can easily cross the line into exploiting a tragedy, or at least appearing as though you have."

But focusing entirely on the pandemic can limit a student to a single story and narrow who they are in an application, Sawyer says. "There are so many wonderful possibilities for what you can say about yourself outside of your experience within the pandemic."

He notes that passions, strengths, career interests and personal identity are among the multitude of essay topic options available to applicants and encourages them to probe their values to help determine the topic that matters most to them – and write about it.

That doesn't mean the pandemic experience has to be ignored if applicants feel the need to write about it.

Writing About Coronavirus in Main and Supplemental Essays

Students can choose to write a full-length college essay on the coronavirus or summarize their experience in a shorter form.

To help students explain how the pandemic affected them, The Common App has added an optional section to address this topic. Applicants have 250 words to describe their pandemic experience and the personal and academic impact of COVID-19.

"That's not a trick question, and there's no right or wrong answer," Alexander says. Colleges want to know, he adds, how students navigated the pandemic, how they prioritized their time, what responsibilities they took on and what they learned along the way.

If students can distill all of the above information into 250 words, there's likely no need to write about it in a full-length college essay, experts say. And applicants whose lives were not heavily altered by the pandemic may even choose to skip the optional COVID-19 question.

"This space is best used to discuss hardship and/or significant challenges that the student and/or the student's family experienced as a result of COVID-19 and how they have responded to those difficulties," Miller notes. Using the section to acknowledge a lack of impact, she adds, "could be perceived as trite and lacking insight, despite the good intentions of the applicant."

To guard against this lack of awareness, Sawyer encourages students to tap someone they trust to review their writing , whether it's the 250-word Common App response or the full-length essay.

Experts tend to agree that the short-form approach to this as an essay topic works better, but there are exceptions. And if a student does have a coronavirus story that he or she feels must be told, Alexander encourages the writer to be authentic in the essay.

"My advice for an essay about COVID-19 is the same as my advice about an essay for any topic – and that is, don't write what you think we want to read or hear," Alexander says. "Write what really changed you and that story that now is yours and yours alone to tell."

Sawyer urges students to ask themselves, "What's the sentence that only I can write?" He also encourages students to remember that the pandemic is only a chapter of their lives and not the whole book.

Miller, who cautions against writing a full-length essay on the coronavirus, says that if students choose to do so they should have a conversation with their high school counselor about whether that's the right move. And if students choose to proceed with COVID-19 as a topic, she says they need to be clear, detailed and insightful about what they learned and how they adapted along the way.

"Approaching the essay in this manner will provide important balance while demonstrating personal growth and vulnerability," Miller says.

Pippen encourages students to remember that they are in an unprecedented time for college admissions.

"It is important to keep in mind with all of these (admission) factors that no colleges have ever had to consider them this way in the selection process, if at all," Pippen says. "They have had very little time to calibrate their evaluations of different application components within their offices, let alone across institutions. This means that colleges will all be handling the admissions process a little bit differently, and their approaches may even evolve over the course of the admissions cycle."

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COVID-19 photo essay: We’re all in this together

About the author, department of global communications.

The United Nations Department of Global Communications (DGC) promotes global awareness and understanding of the work of the United Nations.

23 June 2020 – The COVID-19 pandemic has demonstrated the interconnected nature of our world – and that no one is safe until everyone is safe. Only by acting in solidarity can communities save lives and overcome the devastating socio-economic impacts of the virus. In partnership with the United Nations, people around the world are showing acts of humanity, inspiring hope for a better future.

Everyone can do something

Rauf Salem, a volunteer, instructs children on the right way to wash their hands, in Sana'a, Yemen. Simple measures, such as maintaining physical distance, washing hands frequently and wearing a mask are imperative if the fight against COVID-19 is to be won. Photo: UNICEF/UNI341697

Creating hope

man with guitar in front of colorful poster

Venezuelan refugee Juan Batista Ramos, 69, plays guitar in front of a mural he painted at the Tancredo Neves temporary shelter in Boa Vista, Brazil to help lift COVID-19 quarantine blues. “Now, everywhere you look you will see a landscape to remind us that there is beauty in the world,” he says. Ramos is among the many artists around the world using the power of culture to inspire hope and solidarity during the pandemic. Photo: UNHCR/Allana Ferreira

Inclusive solutions

woman models a transparent face mask designed to help the hard of hearing

Wendy Schellemans, an education assistant at the Royal Woluwe Institute in Brussels, models a transparent face mask designed to help the hard of hearing. The United Nations and partners are working to ensure that responses to COVID-19 leave no one behind. Photo courtesy of Royal Woluwe Institute

Humanity at its best

woman in protective gear sews face masks

Maryna, a community worker at the Arts Centre for Children and Youth in Chasiv Yar village, Ukraine, makes face masks on a sewing machine donated by the Office of the United Nations High Commissioner for Refugees (UNHCR) and civil society partner, Proliska. She is among the many people around the world who are voluntarily addressing the shortage of masks on the market. Photo: UNHCR/Artem Hetman

Keep future leaders learning

A mother helps her daughter Ange, 8, take classes on television at home in Man, Côte d'Ivoire. Since the COVID-19 pandemic began, caregivers and educators have responded in stride and have been instrumental in finding ways to keep children learning. In Côte d'Ivoire, the United Nations Children’s Fund (UNICEF) partnered with the Ministry of Education on a ‘school at home’ initiative, which includes taping lessons to be aired on national TV and radio. Ange says: “I like to study at home. My mum is a teacher and helps me a lot. Of course, I miss my friends, but I can sleep a bit longer in the morning. Later I want to become a lawyer or judge." Photo: UNICEF/UNI320749

Global solidarity

People in Nigeria’s Lagos State simulate sneezing into their elbows during a coronavirus prevention campaign. Many African countries do not have strong health care systems. “Global solidarity with Africa is an imperative – now and for recovering better,” said United Nations Secretary-General António Guterres. “Ending the pandemic in Africa is essential for ending it across the world.” Photo: UNICEF Nigeria/2020/Ojo

A new way of working

Henri Abued Manzano, a tour guide at the United Nations Information Service (UNIS) in Vienna, speaks from his apartment. COVID-19 upended the way people work, but they can be creative while in quarantine. “We quickly decided that if visitors can’t come to us, we will have to come to them,” says Johanna Kleinert, Chief of the UNIS Visitors Service in Vienna. Photo courtesy of Kevin Kühn

Life goes on

Hundreds of millions of babies are expected to be born during the COVID-19 pandemic. Fionn, son of Chloe O'Doherty and her husband Patrick, is among them. The couple says: “It's all over. We did it. Brought life into the world at a time when everything is so uncertain. The relief and love are palpable. Nothing else matters.” Photo: UNICEF/UNI321984/Bopape

Putting meals on the table

Sudanese refugee Halima, in Tripoli, Libya, says food assistance is making her life better. COVID-19 is exacerbating the existing hunger crisis. Globally, 6 million more people could be pushed into extreme poverty unless the international community acts now. United Nations aid agencies are appealing for more funding to reach vulnerable populations. Photo: UNHCR

Supporting the frontlines

woman handing down box from airplane to WFP employee

The United Nations Air Service, run by the World Food Programme (WFP), distributes protective gear donated by the Jack Ma Foundation and Alibaba Group, in Somalia. The United Nations is using its supply chain capacity to rapidly move badly needed personal protective equipment, such as medical masks, gloves, gowns and face-shields to the frontline of the battle against COVID-19. Photo: WFP/Jama Hassan

S7-Episode 2: Bringing Health to the World

“You see, we're not doing this work to make ourselves feel better. That sort of conventional notion of what a do-gooder is. We're doing this work because we are totally convinced that it's not necessary in today's wealthy world for so many people to be experiencing discomfort, for so many people to be experiencing hardship, for so many people to have their lives and their livelihoods imperiled.”

Dr. David Nabarro has dedicated his life to global health. After a long career that’s taken him from the horrors of war torn Iraq, to the devastating aftermath of the Indian Ocean tsunami, he is still spurred to action by the tremendous inequalities in global access to medical care.

“The thing that keeps me awake most at night is the rampant inequities in our world…We see an awful lot of needless suffering.”

:: David Nabarro interviewed by Melissa Fleming

Ballet Manguinhos resumes performing after a COVID-19 hiatus with “Woman: Power and Resistance”. Photo courtesy Ana Silva/Ballet Manguinhos

Brazilian ballet pirouettes during pandemic

Ballet Manguinhos, named for its favela in Rio de Janeiro, returns to the stage after a long absence during the COVID-19 pandemic. It counts 250 children and teenagers from the favela as its performers. The ballet group provides social support in a community where poverty, hunger and teen pregnancy are constant issues.

Nazira Inoyatova is a radio host and the creative/programme director at Avtoradio FM 102.0 in Tashkent, Uzbekistan. Photo courtesy Azamat Abbasov

Radio journalist gives the facts on COVID-19 in Uzbekistan

The pandemic has put many people to the test, and journalists are no exception. Coronavirus has waged war not only against people's lives and well-being but has also spawned countless hoaxes and scientific falsehoods.

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What you need to know about covid-19 vaccines, answers to the most common questions about coronavirus vaccines..

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Vaccines save millions of lives each year. The development of safe and effective COVID-19 vaccines are a crucial step in helping us get back to doing more of the things we enjoy with the people we love.

We’ve gathered the latest expert information to answer some of the most common questions about COVID-19 vaccines. Keep checking back as we will update this article as more information becomes available.

What are the benefits of getting vaccinated?

Vaccines save millions of lives each year and a COVID-19 vaccine could save yours. The COVID-19 vaccines are safe and effective, providing strong protection against serious illness and death. WHO reports that unvaccinated people have at least 10 times higher risk of death from COVID-19 than someone who has been vaccinated.

It is important to be vaccinated as soon as it’s your turn, even if you already had COVID-19. Getting vaccinated is a safer way for you to develop immunity from COVID-19 than getting infected.

The COVID-19 vaccines are highly effective, but no vaccine provides 100 per cent protection. Some people will still get ill from COVID-19 after vaccination or pass the virus onto someone else.

Therefore, it is important to continue practicing safety precautions to protect yourself and others, including avoiding crowded spaces, physical distancing, hand washing and wearing a mask.

Who should be vaccinated first?

Each country must identify priority populations, which WHO recommends are frontline health workers (to protect health systems) and those at highest risk of death due to COVID-19, such as older adults and people with certain medical conditions. Other essential workers, such as teachers and social workers, should then be prioritized, followed by additional groups as more vaccine doses become available.

The risk of severe illness from COVID-19 is very low amongst healthy children and adolescents, so unless they are part of a group at higher risk of severe COVID-19, it is less urgent to vaccinate them than these priority groups.

Children and adolescents who are at higher risk of developing severe illness from COVID-19, such as those with underlying illnesses, should be prioritized for COVID-19 vaccines.

When shouldn’t you be vaccinated against COVID-19?

If you have any questions about whether you should receive a COVID-19 vaccine, speak to your healthcare provider. At present, people with the following health conditions should not receive a COVID-19 vaccine to avoid any possible adverse effects:

If you have a history of severe allergic reactions to any ingredients of a COVID-19 vaccine.
If you are currently sick or experiencing symptoms of COVID-19 (although you can get vaccinated once you have recovered and your doctor has approved).

Should I get vaccinated if I already had COVID-19?

Yes, you should get vaccinated even if you’ve previously had COVID-19. While people who recover from COVID-19 may develop natural immunity to the virus, it is still not certain how long that immunity lasts or how well it protects you against COVID-19 reinfection. Vaccines offer more reliable protection, especially against severe illness and death. Vaccination policies after COVID-19 infection vary by country. Check with your health care provider on the recommendation where you live.

Which COVID-19 vaccine is best for me?

All WHO-approved vaccines have been shown to be highly effective at protecting you against severe illness and death from COVID-19. The best vaccine to get is the one most readily available to you.

You can find a list of those approved vaccines on WHO’s site . 

Remember, if your vaccination involves two doses, it’s important to receive both to have the maximum protection.

How do COVID-19 vaccines work?

Vaccines work by mimicking an infectious agent – viruses, bacteria or other microorganisms that can cause a disease. This ‘teaches’ our immune system to rapidly and effectively respond against it.

Traditionally, vaccines have done this by introducing a weakened form of an infectious agent that allows our immune system to build a memory of it. This way, our immune system can quickly recognize and fight it before it makes us ill. That’s how some of the COVID-19 vaccines have been designed.

Other COVID-19 vaccines have been developed using new approaches, which are called messenger RNA, or mRNA, vaccines. Instead of introducing antigens (a substance that causes your immune system to produce antibodies), mRNA vaccines give our body the genetic code it needs to allow our immune system to produce the antigen itself. mRNA vaccine technology has been studied for several decades. They contain no live virus and do not interfere with human DNA.

For more information on how vaccines work, please visit WHO .

Are COVID-19 vaccines safe?

Yes, COVID-19 vaccines have been safely used to vaccinate billions of people. The COVID-19 vaccines were developed as rapidly as possible, but they had to go through rigorous testing in clinical trials to prove that they meet internationally agreed benchmarks for safety and effectiveness. Only if they meet these standards can a vaccine receive validation from WHO and national regulatory agencies.

UNICEF only procures and supplies COVID-19 vaccines that meet WHO’s established safety and efficacy criteria and that have received the required regulatory approval.

How were COVID-19 vaccines developed so quickly?

Scientists were able to develop safe effective vaccines in a relatively short amount of time due to a combination of factors that allowed them to scale up research and production without compromising safety:

Because of the global pandemic, there was a larger sample size to study and tens of thousands of volunteers stepped forward
Advancements in technology (like mRNA vaccines) that were years in the making
Governments and other bodies came together to remove the obstacle of funding research and development
Manufacturing of the vaccines occurred in parallel to the clinical trials to speed up production

Though they were developed quickly, all COVID-19 vaccines approved for use by the WHO are safe and effective.

What are the side effects of COVID-19 vaccines?

Vaccines are designed to give you immunity without the dangers of getting the disease. Not everyone does, but it’s common to experience some mild-to-moderate side effects that go away within a few days on their own.

Some of the mild-to-moderate side effects you may experience after vaccination include:

Arm soreness at the injection site
Muscle or joint aches

You can manage any side effects with rest, staying hydrated and taking medication to manage pain and fever, if needed.

If any symptoms continue for more than a few days then contact your healthcare provider for advice. More serious side effects are extremely rare, but if you experience a more severe reaction, then contact your healthcare provider immediately.

>> Read: What you need to know before, during and after receiving a COVID-19 vaccine

How do I find out more about a particular COVID-19 vaccine?

You can find out more about COVID-19 vaccines on WHO’s website .

Can I stop taking precautions after being vaccinated?

Keep taking precautions to protect yourself, family and friends if there is still COVID-19 in your area, even after getting vaccinated. The COVID-19 vaccines are highly effective against serious illness and death, but no vaccine is 100% effective.  

The vaccines offer less protection against infection from the Omicron variant, which is now the dominant variant globally, but remain highly effective in preventing hospitalization, severe disease, and death. In addition to vaccination, it remains important to continue practicing safety precautions to protect yourself and others. These precautions include avoiding crowded spaces, physical distancing, hand washing, and wearing a mask (as per local policies). 

Can I still get COVID-19 after I have been vaccinated? What are ‘breakthrough cases’?

A number of vaccinated people may get infected with COVID-19, which is called a breakthrough infection. In such cases, people are much more likely to only have milder symptoms. Vaccine protection against serious illness and death remains strong.

With more infectious virus variants such as Omicron, there have been more breakthrough infections. That’s why it's recommended to continue taking precautions such as avoiding crowded spaces, wearing a mask and washing your hands regularly, even if you are vaccinated.

And remember, it’s important to receive all of the recommended doses of vaccines to have the maximum protection.

How long does protection from COVID-19 vaccines last?

According to WHO, the effectiveness of COVID-19 vaccines wanes around 4-6 months after the primary series of vaccination has been completed. Taking a booster to strengthen your protection against serious disease is recommended if it is available to you.

Do the COVID-19 vaccines protect against variants?

The WHO-approved COVID-19 vaccines continue to be highly effective at preventing severe illness and death.

However, the vaccines offer less protection against infection from Omicron, which is the dominant variant globally. That's why it's important to get vaccinated and continue measures to reduce the spread of the virus – which helps to reduce the chances for the virus to mutate – including physical distancing, mask wearing, good ventilation, regular handwashing and seeking care early if you have symptoms.

Do I need to get a booster shot?  

Booster doses play an important role in protecting against severe disease, hospitalization and death.

WHO recommends that you take all COVID-19 vaccine doses recommended to you by your health authority as soon as it is your turn, including a booster dose if recommended.

Booster shots should be given first to high priority groups. Data shows that a booster shot plays a significant role in boosting waning immunity and protecting against severe disease from highly transmissible variants like Omicron.

If available, an additional second booster shot is also recommended for some groups of people, 4-6 months after the first booster. That includes older people, those who have weakened immune systems, pregnant women and healthcare workers.

Check with your local health authorities for guidance and the availability of booster shots where you live. 

What do we know about the bivalent COVID-19 booster doses that have been developed to target Omicron?

Bivalent COVID-19 booster shots have now been developed with both the original strain of the coronavirus and a strain of Omicron. These have been designed to better match the Omicron subvariants that have proven to be particularly transmissible. Lab studies have shown that these doses help you to mount a higher antibody response against Omicron. Both Moderna and Pfizer have developed these bivalent vaccines, and some countries have now approved their use.

Check with your local health authorities for information about the availability of these doses and who can get them where you live. And it’s important to note that the original COVID-19 vaccines continue to work very well and provide strong protection against severe illness from Omicron.

Can I receive different types of COVID-19 vaccines?  

Yes, however, policies on mixing vaccines vary by country. Some countries have used different vaccines for the primary vaccine series and the booster. Check with your local health authorities for guidance where you live and speak with your healthcare provider if you have any questions on what is best for you.

I’m pregnant. Can I get vaccinated against COVID-19?

Yes, you can get vaccinated if you are pregnant. COVID-19 during pregnancy puts you at higher risk of becoming severely ill and of giving birth prematurely.

Many people around the world have been vaccinated against COVID-19 while pregnant or breastfeeding. No safety concerns have been identified for them or their babies. Getting vaccinated while pregnant helps to protect your baby. For more information about receiving a COVID-19 vaccination while pregnant, speak to your healthcare provider.

>> Read: Navigating pregnancy during the COVID-19 pandemic

I’m breastfeeding. Should I get vaccinated against COVID-19?

Yes, if you are breastfeeding you should take the vaccine as soon as it is available to you. It is very safe and there is no risk to the mother or baby. None of the current COVID-19 vaccines have live virus in them, so there is no risk of you transmitting COVID-19 to your baby through your breastmilk from the vaccine. In fact, the antibodies that you have after vaccination may go through the breast milk and help protect your baby. >> Read: Breastfeeding safely during the COVID-19 pandemic

Can COVID-19 vaccines affect fertility?

No, you may have seen false claims on social media, but there is no evidence that any vaccine, including COVID-19 vaccines, can affect fertility in women or men. You should get vaccinated if you are currently trying to become pregnant.

Could a COVID-19 vaccine disrupt my menstrual cycle?

Some people have reported experiencing a disruption to their menstrual cycle after getting vaccinated against COVID-19. Although data is still limited, research is ongoing into the impact of vaccines on menstrual cycles.

Speak to your healthcare provider if you have concerns or questions about your periods.

Should my child or teen get a COVID-19 vaccine?

An increasing number of vaccines have been approved for use in children. They’ve been made available after examining the data on the safety and efficacy of these vaccines, and millions of children have been safely vaccinated around the world. Some COVID-19 vaccines have been approved for children from the age of 6 months old. Check with your local health authorities on what vaccines are authorized and available for children and adolescents where you live.

Children and adolescents tend to have milder disease compared to adults, so unless they are part of a group at higher risk of severe COVID-19, it is less urgent to vaccinate them than older people, those with chronic health conditions and health workers.

Remind your children of the importance of us all taking precautions to protect each other, such as avoiding crowded spaces, physical distancing, hand washing and wearing a mask.

It is critical that children continue to receive the recommended childhood vaccines.

How do I talk to my kids about COVID-19 vaccines?

News about COVID-19 vaccines is flooding our daily lives and it is only natural that curious young minds will have questions – lots of them. Read our explainer article for help explaining what can be a complicated topic in simple and reassuring terms.

It’s important to note that from the millions of children that have so far been vaccinated against COVID-19 globally, we know that side effects are very rare. Just like adults, children and adolescents might experience mild symptoms after receiving a dose, such as a slight fever and body aches. But these symptoms typically last for just a day or two. The authorized vaccines for adolescents and children are very safe.

My friend or family member is against COVID-19 vaccines. How do I talk to them?

The development of safe and effective COVID-19 vaccines is a huge step forward in our global effort to end the pandemic. This is exciting news, but there are still some people who are skeptical or hesitant about COVID-19 vaccines. Chances are you know a person who falls into this category.

We spoke to Dr. Saad Omer, Director at the Yale Institute for Global Health, to get his tips on how to navigate these challenging conversations. >> Read the interview

How can I protect my family until we are all vaccinated?

Safe and effective vaccines are a game changer, but even once vaccinated we need to continue taking precautions for the time being to protect ourselves and others. Variants like Omicron have proven that although COVID-19 vaccines are very effective at preventing severe disease, they’re not enough to stop the spread of the virus alone. The most important thing you can do is reduce your risk of exposure to the virus. To protect yourself and your loved ones, make sure to:

Wear a mask where physical distancing from others is not possible.
Keep a physical distance from others in public places.
Avoid poorly ventilated or crowded spaces.
Open windows to improve ventilation indoors.
Try and focus on outdoor activities if possible.
Wash your hands regularly with soap and water or an alcohol-based hand rub.

If you or a family member has a fever, cough or difficulty breathing, seek medical care early and avoid mixing with other children and adults.

Can COVID-19 vaccines affect your DNA?

No, none of the COVID-19 vaccines affect or interact with your DNA in any way. Messenger RNA, or mRNA, vaccines teach the cells how to make a protein that triggers an immune response inside the body. This response produces antibodies which keep you protected against the virus. mRNA is different from DNA and only stays inside the cell for about 72 hours before degrading. However, it never enters the nucleus of the cell, where DNA is kept.

Do the COVID-19 vaccines contain any animal products in them?

No, none of the WHO-approved COVID-19 vaccines contain animal products.

I’ve seen inaccurate information online about COVID-19 vaccines. What should I do?

Sadly, there is a lot of inaccurate information online about the COVID-19 virus and vaccines. A lot of what we’re experiencing is new to all of us, so there may be some occasions where information is shared, in a non-malicious way, that turns out to be inaccurate.

Misinformation in a health crisis can spread paranoia, fear and stigmatization. It can also result in people being left unprotected or more vulnerable to the virus. Get verified facts and advice from trusted sources like your local health authority, the UN, UNICEF, WHO.

If you see content online that you believe to be false or misleading, you can help stop it spreading by reporting it to the social media platform.

What is COVAX?

COVAX is a global effort committed to the development, production and equitable distribution of vaccines around the world. No country will be safe from COVID-19 until all countries are protected.

There are 190 countries and territories engaged in the COVAX Facility, which account for over 90 per cent of the world’s population. Working with CEPI, GAVI, WHO and other partners, UNICEF is leading efforts to procure and supply COVID-19 vaccines on behalf of COVAX.

Learn more about COVAX .

This article was last updated on 25 October 2022. It will continue to be updated to reflect the latest information.

How to talk to your children about COVID-19 vaccines

Tips for navigating the conversation

How to talk to friends and family about vaccines

Tips for handling tough conversations with your loved ones

COVAX information centre

UNICEF and partners led the largest vaccine procurement and supply operation in history

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Plan, Prepare & Make the Best Career Choices

2 Minute Speech on Covid-19 (CoronaVirus) for Students

The year, 2019, saw the discovery of a previously unknown coronavirus illness, Covid-19 . The Coronavirus has affected the way we go about our everyday lives. This pandemic has devastated millions of people, either unwell or passed away due to the sickness. The most common symptoms of this viral illness include a high temperature, a cough, bone pain, and difficulties with the respiratory system. In addition to these symptoms, patients infected with the coronavirus may also feel weariness, a sore throat, muscular discomfort, and a loss of taste or smell.

10 Lines Speech on Covid-19 for Students

The Coronavirus is a member of a family of viruses that may infect their hosts exceptionally quickly.

Humans created the Coronavirus in the city of Wuhan in China, where it first appeared.

The first confirmed case of the Coronavirus was found in India in January in the year 2020.

Protecting ourselves against the coronavirus is essential by covering our mouths and noses when we cough or sneeze to prevent the infection from spreading.

We must constantly wash our hands with antibacterial soap and face masks to protect ourselves.

To ensure our safety, the government has ordered the whole nation's closure to halt the virus's spread.

The Coronavirus forced all our classes to be taken online, as schools and institutions were shut down.

Due to the coronavirus, everyone was instructed to stay indoors throughout the lockdown.

During this period, I spent a lot of time playing games with family members.

Even though the cases of COVID-19 are a lot less now, we should still take precautions.

Short 2-Minute Speech on Covid 19 for Students

The coronavirus, also known as Covid - 19 , causes a severe illness. Those who are exposed to it become sick in their lungs. A brand-new virus is having a devastating effect throughout the globe. It's being passed from person to person via social interaction.

The first instance of Covid - 19 was discovered in December 2019 in Wuhan, China . The World Health Organization proclaimed the covid - 19 pandemic in March 2020. It has now reached every country in the globe. Droplets produced by an infected person's cough or sneeze might infect those nearby.

The severity of Covid-19 symptoms varies widely. Symptoms aren't always present. The typical symptoms are high temperatures, a dry cough, and difficulty breathing. Covid - 19 individuals also exhibit other symptoms such as weakness, a sore throat, muscular soreness, and a diminished sense of smell and taste.

Vaccination has been produced by many countries but the effectiveness of them is different for every individual. The only treatment then is to avoid contracting in the first place. We can accomplish that by following these protocols—

Put on a mask to hide your face. Use soap and hand sanitiser often to keep germs at bay.

Keep a distance of 5 to 6 feet at all times.

Never put your fingers in your mouth or nose.

Long 2-Minute Speech on Covid 19 for Students

As students, it's important for us to understand the gravity of the situation regarding the Covid-19 pandemic and the impact it has on our communities and the world at large. In this speech, I will discuss the real-world examples of the effects of the pandemic and its impact on various aspects of our lives.

Impact on Economy | The Covid-19 pandemic has had a significant impact on the global economy. We have seen how businesses have been forced to close their doors, leading to widespread job loss and economic hardship. Many individuals and families have been struggling to make ends meet, and this has led to a rise in poverty and inequality.

Impact on Healthcare Systems | The pandemic has also put a strain on healthcare systems around the world. Hospitals have been overwhelmed with patients, and healthcare workers have been stretched to their limits. This has highlighted the importance of investing in healthcare systems and ensuring that they are prepared for future crises.

Impact on Education | The pandemic has also affected the education system, with schools and universities being closed around the world. This has led to a shift towards online learning and the use of technology to continue education remotely. However, it has also highlighted the digital divide, with many students from low-income backgrounds facing difficulties in accessing online learning.

Impact on Mental Health | The pandemic has not only affected our physical health but also our mental health. We have seen how the isolation and uncertainty caused by the pandemic have led to an increase in stress, anxiety, and depression. It's important that we take care of our mental health and support each other during this difficult time.

Real-life Story of a Student

John is a high school student who was determined to succeed despite the struggles brought on by the Covid-19 pandemic.

John's school closed down in the early days of the pandemic, and he quickly found himself struggling to adjust to online learning. Without the structure and support of in-person classes, John found it difficult to stay focused and motivated. He also faced challenges at home, as his parents were both essential workers and were often not available to help him with his schoolwork.

Despite these struggles, John refused to let the pandemic defeat him. He made a schedule for himself, to stay on top of his assignments and set goals for himself. He also reached out to his teachers for additional support, and they were more than happy to help.

John also found ways to stay connected with his classmates and friends, even though they were physically apart. They formed a study group and would meet regularly over Zoom to discuss their assignments and provide each other with support.

Thanks to his hard work and determination, John was able to maintain good grades and even improved in some subjects. He graduated high school on time, and was even accepted into his first-choice college.

John's story is a testament to the resilience and determination of students everywhere. Despite the challenges brought on by the pandemic, he was able to succeed and achieve his goals. He shows us that with hard work, determination, and support, we can overcome even the toughest of obstacles.

Explore Career Options (By Industry)

Construction
Entertainment
Manufacturing
Information Technology

Bio Medical Engineer

The field of biomedical engineering opens up a universe of expert chances. An Individual in the biomedical engineering career path work in the field of engineering as well as medicine, in order to find out solutions to common problems of the two fields. The biomedical engineering job opportunities are to collaborate with doctors and researchers to develop medical systems, equipment, or devices that can solve clinical problems. Here we will be discussing jobs after biomedical engineering, how to get a job in biomedical engineering, biomedical engineering scope, and salary.

Data Administrator

Database professionals use software to store and organise data such as financial information, and customer shipping records. Individuals who opt for a career as data administrators ensure that data is available for users and secured from unauthorised sales. DB administrators may work in various types of industries. It may involve computer systems design, service firms, insurance companies, banks and hospitals.

Ethical Hacker

A career as ethical hacker involves various challenges and provides lucrative opportunities in the digital era where every giant business and startup owns its cyberspace on the world wide web. Individuals in the ethical hacker career path try to find the vulnerabilities in the cyber system to get its authority. If he or she succeeds in it then he or she gets its illegal authority. Individuals in the ethical hacker career path then steal information or delete the file that could affect the business, functioning, or services of the organization.

Data Analyst

The invention of the database has given fresh breath to the people involved in the data analytics career path. Analysis refers to splitting up a whole into its individual components for individual analysis. Data analysis is a method through which raw data are processed and transformed into information that would be beneficial for user strategic thinking.

Data are collected and examined to respond to questions, evaluate hypotheses or contradict theories. It is a tool for analyzing, transforming, modeling, and arranging data with useful knowledge, to assist in decision-making and methods, encompassing various strategies, and is used in different fields of business, research, and social science.

Geothermal Engineer

Individuals who opt for a career as geothermal engineers are the professionals involved in the processing of geothermal energy. The responsibilities of geothermal engineers may vary depending on the workplace location. Those who work in fields design facilities to process and distribute geothermal energy. They oversee the functioning of machinery used in the field.

Remote Sensing Technician

Individuals who opt for a career as a remote sensing technician possess unique personalities. Remote sensing analysts seem to be rational human beings, they are strong, independent, persistent, sincere, realistic and resourceful. Some of them are analytical as well, which means they are intelligent, introspective and inquisitive.

Remote sensing scientists use remote sensing technology to support scientists in fields such as community planning, flight planning or the management of natural resources. Analysing data collected from aircraft, satellites or ground-based platforms using statistical analysis software, image analysis software or Geographic Information Systems (GIS) is a significant part of their work. Do you want to learn how to become remote sensing technician? There's no need to be concerned; we've devised a simple remote sensing technician career path for you. Scroll through the pages and read.

Geotechnical engineer

The role of geotechnical engineer starts with reviewing the projects needed to define the required material properties. The work responsibilities are followed by a site investigation of rock, soil, fault distribution and bedrock properties on and below an area of interest. The investigation is aimed to improve the ground engineering design and determine their engineering properties that include how they will interact with, on or in a proposed construction.

The role of geotechnical engineer in mining includes designing and determining the type of foundations, earthworks, and or pavement subgrades required for the intended man-made structures to be made. Geotechnical engineering jobs are involved in earthen and concrete dam construction projects, working under a range of normal and extreme loading conditions.

Cartographer

How fascinating it is to represent the whole world on just a piece of paper or a sphere. With the help of maps, we are able to represent the real world on a much smaller scale. Individuals who opt for a career as a cartographer are those who make maps. But, cartography is not just limited to maps, it is about a mixture of art , science , and technology. As a cartographer, not only you will create maps but use various geodetic surveys and remote sensing systems to measure, analyse, and create different maps for political, cultural or educational purposes.

Budget Analyst

Budget analysis, in a nutshell, entails thoroughly analyzing the details of a financial budget. The budget analysis aims to better understand and manage revenue. Budget analysts assist in the achievement of financial targets, the preservation of profitability, and the pursuit of long-term growth for a business. Budget analysts generally have a bachelor's degree in accounting, finance, economics, or a closely related field. Knowledge of Financial Management is of prime importance in this career.

Product Manager

A Product Manager is a professional responsible for product planning and marketing. He or she manages the product throughout the Product Life Cycle, gathering and prioritising the product. A product manager job description includes defining the product vision and working closely with team members of other departments to deliver winning products.

Underwriter

An underwriter is a person who assesses and evaluates the risk of insurance in his or her field like mortgage, loan, health policy, investment, and so on and so forth. The underwriter career path does involve risks as analysing the risks means finding out if there is a way for the insurance underwriter jobs to recover the money from its clients. If the risk turns out to be too much for the company then in the future it is an underwriter who will be held accountable for it. Therefore, one must carry out his or her job with a lot of attention and diligence.

Finance Executive

Operations manager.

Individuals in the operations manager jobs are responsible for ensuring the efficiency of each department to acquire its optimal goal. They plan the use of resources and distribution of materials. The operations manager's job description includes managing budgets, negotiating contracts, and performing administrative tasks.

Bank Probationary Officer (PO)

Investment director.

An investment director is a person who helps corporations and individuals manage their finances. They can help them develop a strategy to achieve their goals, including paying off debts and investing in the future. In addition, he or she can help individuals make informed decisions.

Welding Engineer

Welding Engineer Job Description: A Welding Engineer work involves managing welding projects and supervising welding teams. He or she is responsible for reviewing welding procedures, processes and documentation. A career as Welding Engineer involves conducting failure analyses and causes on welding issues.

Transportation Planner

A career as Transportation Planner requires technical application of science and technology in engineering, particularly the concepts, equipment and technologies involved in the production of products and services. In fields like land use, infrastructure review, ecological standards and street design, he or she considers issues of health, environment and performance. A Transportation Planner assigns resources for implementing and designing programmes. He or she is responsible for assessing needs, preparing plans and forecasts and compliance with regulations.

An expert in plumbing is aware of building regulations and safety standards and works to make sure these standards are upheld. Testing pipes for leakage using air pressure and other gauges, and also the ability to construct new pipe systems by cutting, fitting, measuring and threading pipes are some of the other more involved aspects of plumbing. Individuals in the plumber career path are self-employed or work for a small business employing less than ten people, though some might find working for larger entities or the government more desirable.

Construction Manager

Individuals who opt for a career as construction managers have a senior-level management role offered in construction firms. Responsibilities in the construction management career path are assigning tasks to workers, inspecting their work, and coordinating with other professionals including architects, subcontractors, and building services engineers.

Urban Planner

Urban Planning careers revolve around the idea of developing a plan to use the land optimally, without affecting the environment. Urban planning jobs are offered to those candidates who are skilled in making the right use of land to distribute the growing population, to create various communities.

Urban planning careers come with the opportunity to make changes to the existing cities and towns. They identify various community needs and make short and long-term plans accordingly.

Highway Engineer

Highway Engineer Job Description: A Highway Engineer is a civil engineer who specialises in planning and building thousands of miles of roads that support connectivity and allow transportation across the country. He or she ensures that traffic management schemes are effectively planned concerning economic sustainability and successful implementation.

Environmental Engineer

Individuals who opt for a career as an environmental engineer are construction professionals who utilise the skills and knowledge of biology, soil science, chemistry and the concept of engineering to design and develop projects that serve as solutions to various environmental problems.

Naval Architect

A Naval Architect is a professional who designs, produces and repairs safe and sea-worthy surfaces or underwater structures. A Naval Architect stays involved in creating and designing ships, ferries, submarines and yachts with implementation of various principles such as gravity, ideal hull form, buoyancy and stability.

Orthotist and Prosthetist

Orthotists and Prosthetists are professionals who provide aid to patients with disabilities. They fix them to artificial limbs (prosthetics) and help them to regain stability. There are times when people lose their limbs in an accident. In some other occasions, they are born without a limb or orthopaedic impairment. Orthotists and prosthetists play a crucial role in their lives with fixing them to assistive devices and provide mobility.

Veterinary Doctor

Pathologist.

A career in pathology in India is filled with several responsibilities as it is a medical branch and affects human lives. The demand for pathologists has been increasing over the past few years as people are getting more aware of different diseases. Not only that, but an increase in population and lifestyle changes have also contributed to the increase in a pathologist’s demand. The pathology careers provide an extremely huge number of opportunities and if you want to be a part of the medical field you can consider being a pathologist. If you want to know more about a career in pathology in India then continue reading this article.

Speech Therapist

Gynaecologist.

Gynaecology can be defined as the study of the female body. The job outlook for gynaecology is excellent since there is evergreen demand for one because of their responsibility of dealing with not only women’s health but also fertility and pregnancy issues. Although most women prefer to have a women obstetrician gynaecologist as their doctor, men also explore a career as a gynaecologist and there are ample amounts of male doctors in the field who are gynaecologists and aid women during delivery and childbirth.

An oncologist is a specialised doctor responsible for providing medical care to patients diagnosed with cancer. He or she uses several therapies to control the cancer and its effect on the human body such as chemotherapy, immunotherapy, radiation therapy and biopsy. An oncologist designs a treatment plan based on a pathology report after diagnosing the type of cancer and where it is spreading inside the body.

Audiologist

The audiologist career involves audiology professionals who are responsible to treat hearing loss and proactively preventing the relevant damage. Individuals who opt for a career as an audiologist use various testing strategies with the aim to determine if someone has a normal sensitivity to sounds or not. After the identification of hearing loss, a hearing doctor is required to determine which sections of the hearing are affected, to what extent they are affected, and where the wound causing the hearing loss is found. As soon as the hearing loss is identified, the patients are provided with recommendations for interventions and rehabilitation such as hearing aids, cochlear implants, and appropriate medical referrals. While audiology is a branch of science that studies and researches hearing, balance, and related disorders.

Hospital Administrator

The hospital Administrator is in charge of organising and supervising the daily operations of medical services and facilities. This organising includes managing of organisation’s staff and its members in service, budgets, service reports, departmental reporting and taking reminders of patient care and services.

For an individual who opts for a career as an actor, the primary responsibility is to completely speak to the character he or she is playing and to persuade the crowd that the character is genuine by connecting with them and bringing them into the story. This applies to significant roles and littler parts, as all roles join to make an effective creation. Here in this article, we will discuss how to become an actor in India, actor exams, actor salary in India, and actor jobs.

Individuals who opt for a career as acrobats create and direct original routines for themselves, in addition to developing interpretations of existing routines. The work of circus acrobats can be seen in a variety of performance settings, including circus, reality shows, sports events like the Olympics, movies and commercials. Individuals who opt for a career as acrobats must be prepared to face rejections and intermittent periods of work. The creativity of acrobats may extend to other aspects of the performance. For example, acrobats in the circus may work with gym trainers, celebrities or collaborate with other professionals to enhance such performance elements as costume and or maybe at the teaching end of the career.

Video Game Designer

Career as a video game designer is filled with excitement as well as responsibilities. A video game designer is someone who is involved in the process of creating a game from day one. He or she is responsible for fulfilling duties like designing the character of the game, the several levels involved, plot, art and similar other elements. Individuals who opt for a career as a video game designer may also write the codes for the game using different programming languages.

Depending on the video game designer job description and experience they may also have to lead a team and do the early testing of the game in order to suggest changes and find loopholes.

Radio Jockey

Radio Jockey is an exciting, promising career and a great challenge for music lovers. If you are really interested in a career as radio jockey, then it is very important for an RJ to have an automatic, fun, and friendly personality. If you want to get a job done in this field, a strong command of the language and a good voice are always good things. Apart from this, in order to be a good radio jockey, you will also listen to good radio jockeys so that you can understand their style and later make your own by practicing.

A career as radio jockey has a lot to offer to deserving candidates. If you want to know more about a career as radio jockey, and how to become a radio jockey then continue reading the article.

Choreographer

The word “choreography" actually comes from Greek words that mean “dance writing." Individuals who opt for a career as a choreographer create and direct original dances, in addition to developing interpretations of existing dances. A Choreographer dances and utilises his or her creativity in other aspects of dance performance. For example, he or she may work with the music director to select music or collaborate with other famous choreographers to enhance such performance elements as lighting, costume and set design.

Videographer

Multimedia specialist.

A multimedia specialist is a media professional who creates, audio, videos, graphic image files, computer animations for multimedia applications. He or she is responsible for planning, producing, and maintaining websites and applications.

Social Media Manager

A career as social media manager involves implementing the company’s or brand’s marketing plan across all social media channels. Social media managers help in building or improving a brand’s or a company’s website traffic, build brand awareness, create and implement marketing and brand strategy. Social media managers are key to important social communication as well.

Copy Writer

In a career as a copywriter, one has to consult with the client and understand the brief well. A career as a copywriter has a lot to offer to deserving candidates. Several new mediums of advertising are opening therefore making it a lucrative career choice. Students can pursue various copywriter courses such as Journalism , Advertising , Marketing Management . Here, we have discussed how to become a freelance copywriter, copywriter career path, how to become a copywriter in India, and copywriting career outlook.

Careers in journalism are filled with excitement as well as responsibilities. One cannot afford to miss out on the details. As it is the small details that provide insights into a story. Depending on those insights a journalist goes about writing a news article. A journalism career can be stressful at times but if you are someone who is passionate about it then it is the right choice for you. If you want to know more about the media field and journalist career then continue reading this article.

For publishing books, newspapers, magazines and digital material, editorial and commercial strategies are set by publishers. Individuals in publishing career paths make choices about the markets their businesses will reach and the type of content that their audience will be served. Individuals in book publisher careers collaborate with editorial staff, designers, authors, and freelance contributors who develop and manage the creation of content.

In a career as a vlogger, one generally works for himself or herself. However, once an individual has gained viewership there are several brands and companies that approach them for paid collaboration. It is one of those fields where an individual can earn well while following his or her passion.

Ever since internet costs got reduced the viewership for these types of content has increased on a large scale. Therefore, a career as a vlogger has a lot to offer. If you want to know more about the Vlogger eligibility, roles and responsibilities then continue reading the article.

Individuals in the editor career path is an unsung hero of the news industry who polishes the language of the news stories provided by stringers, reporters, copywriters and content writers and also news agencies. Individuals who opt for a career as an editor make it more persuasive, concise and clear for readers. In this article, we will discuss the details of the editor's career path such as how to become an editor in India, editor salary in India and editor skills and qualities.

Linguistic meaning is related to language or Linguistics which is the study of languages. A career as a linguistic meaning, a profession that is based on the scientific study of language, and it's a very broad field with many specialities. Famous linguists work in academia, researching and teaching different areas of language, such as phonetics (sounds), syntax (word order) and semantics (meaning).

Other researchers focus on specialities like computational linguistics, which seeks to better match human and computer language capacities, or applied linguistics, which is concerned with improving language education. Still, others work as language experts for the government, advertising companies, dictionary publishers and various other private enterprises. Some might work from home as freelance linguists. Philologist, phonologist, and dialectician are some of Linguist synonym. Linguists can study French , German , Italian .

Public Relation Executive

Travel journalist.

The career of a travel journalist is full of passion, excitement and responsibility. Journalism as a career could be challenging at times, but if you're someone who has been genuinely enthusiastic about all this, then it is the best decision for you. Travel journalism jobs are all about insightful, artfully written, informative narratives designed to cover the travel industry. Travel Journalist is someone who explores, gathers and presents information as a news article.

Quality Controller

A quality controller plays a crucial role in an organisation. He or she is responsible for performing quality checks on manufactured products. He or she identifies the defects in a product and rejects the product.

A quality controller records detailed information about products with defects and sends it to the supervisor or plant manager to take necessary actions to improve the production process.

Production Manager

Merchandiser.

A QA Lead is in charge of the QA Team. The role of QA Lead comes with the responsibility of assessing services and products in order to determine that he or she meets the quality standards. He or she develops, implements and manages test plans.

Metallurgical Engineer

A metallurgical engineer is a professional who studies and produces materials that bring power to our world. He or she extracts metals from ores and rocks and transforms them into alloys, high-purity metals and other materials used in developing infrastructure, transportation and healthcare equipment.

Azure Administrator

An Azure Administrator is a professional responsible for implementing, monitoring, and maintaining Azure Solutions. He or she manages cloud infrastructure service instances and various cloud servers as well as sets up public and private cloud systems.

AWS Solution Architect

An AWS Solution Architect is someone who specializes in developing and implementing cloud computing systems. He or she has a good understanding of the various aspects of cloud computing and can confidently deploy and manage their systems. He or she troubleshoots the issues and evaluates the risk from the third party.

Computer Programmer

Careers in computer programming primarily refer to the systematic act of writing code and moreover include wider computer science areas. The word 'programmer' or 'coder' has entered into practice with the growing number of newly self-taught tech enthusiasts. Computer programming careers involve the use of designs created by software developers and engineers and transforming them into commands that can be implemented by computers. These commands result in regular usage of social media sites, word-processing applications and browsers.

ITSM Manager

Information security manager.

Individuals in the information security manager career path involves in overseeing and controlling all aspects of computer security. The IT security manager job description includes planning and carrying out security measures to protect the business data and information from corruption, theft, unauthorised access, and deliberate attack

Business Intelligence Developer

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The White House 1600 Pennsylvania Ave NW Washington, DC 20500

Remarks by President Biden on Fighting the COVID- ⁠ 19 Pandemic

5:02 P.M. EDT THE PRESIDENT: Good evening, my fellow Americans. I want to talk to you about where we are in the battle against COVID-19, the progress we’ve made, and the work we have left to do. And it starts with understanding this: Even as the Delta variant 19 [sic] has — COVID-19 — has been hitting this country hard, we have the tools to combat the virus, if we can come together as a country and use those tools. If we raise our vaccination rate, protect ourselves and others with masking and expanded testing, and identify people who are infected, we can and we will turn the tide on COVID-19. It will take a lot of hard work, and it’s going to take some time. Many of us are frustrated with the nearly 80 million Americans who are still not vaccinated, even though the vaccine is safe, effective, and free. You might be confused about what is true and what is false about COVID-19. So before I outline the new steps to fight COVID-19 that I’m going to be announcing tonight, let me give you some clear information about where we stand. First, we have cons- — we have made considerable progress in battling COVID-19. When I became President, about 2 million Americans were fully vaccinated. Today, over 175 million Americans have that protection. Before I took office, we hadn’t ordered enough vaccine for every American. Just weeks in office, we did. The week before I took office, on January 20th of this year, over 25,000 Americans died that week from COVID-19. Last week, that grim weekly toll was down 70 percent. And in the three months before I took office, our economy was faltering, creating just 50,000 jobs a month. We’re now averaging 700,000 new jobs a month in the past three months. This progress is real. But while America is in much better shape than it was seven months ago when I took office, I need to tell you a second fact. We’re in a tough stretch, and it could last for a while. The highly contagious Delta variant that I began to warn America about back in July spread in late summer like it did in other countries before us. While the vaccines provide strong protections for the vaccinated, we read about, we hear about, and we see the stories of hospitalized people, people on their death beds, among the unvaccinated over these past few weeks. This is a pandemic of the unvaccinated. And it’s caused by the fact that despite America having an unprecedented and successful vaccination program, despite the fact that for almost five months free vaccines have been available in 80,000 different locations, we still have nearly 80 million Americans who have failed to get the shot. And to make matters worse, there are elected officials actively working to undermine the fight against COVID-19. Instead of encouraging people to get vaccinated and mask up, they’re ordering mobile morgues for the unvaccinated dying from COVID in their communities. This is totally unacceptable. Third, if you wonder how all this adds up, here’s the math: The vast majority of Americans are doing the right thing. Nearly three quarters of the eligible have gotten at least one shot, but one quarter has not gotten any. That’s nearly 80 million Americans not vaccinated. And in a country as large as ours, that’s 25 percent minority. That 25 percent can cause a lot of damage — and they are. The unvaccinated overcrowd our hospitals, are overrunning the emergency rooms and intensive care units, leaving no room for someone with a heart attack, or pancreitis [pancreatitis], or cancer. And fourth, I want to emphasize that the vaccines provide very strong protection from severe illness from COVID-19. I know there’s a lot of confusion and misinformation. But the world’s leading scientists confirm that if you are fully vaccinated, your risk of severe illness from COVID-19 is very low. In fact, based on available data from the summer, only one of out of every 160,000 fully vaccinated Americans was hospitalized for COVID per day. These are the facts. So here’s where we stand: The path ahead, even with the Delta variant, is not nearly as bad as last winter. But what makes it incredibly more frustrating is that we have the tools to combat COVID-19, and a distinct minority of Americans –supported by a distinct minority of elected officials — are keeping us from turning the corner. These pandemic politics, as I refer to, are making people sick, causing unvaccinated people to die. We cannot allow these actions to stand in the way of protecting the large majority of Americans who have done their part and want to get back to life as normal. As your President, I’m announcing tonight a new plan to require more Americans to be vaccinated, to combat those blocking public health. My plan also increases testing, protects our economy, and will make our kids safer in schools. It consists of six broad areas of action and many specific measures in each that — and each of those actions that you can read more about at WhiteHouse.gov. WhiteHouse.gov. The measures — these are going to take time to have full impact. But if we implement them, I believe and the scientists indicate, that in the months ahead we can reduce the number of unvaccinated Americans, decrease hospitalizations and deaths, and allow our children to go to school safely and keep our economy strong by keeping businesses open. First, we must increase vaccinations among the unvaccinated with new vaccination requirements. Of the nearly 80 million eligible Americans who have not gotten vaccinated, many said they were waiting for approval from the Food and Drug Administration — the FDA. Well, last month, the FDA granted that approval. So, the time for waiting is over. This summer, we made progress through the combination of vaccine requirements and incentives, as well as the FDA approval. Four million more people got their first shot in August than they did in July. But we need to do more. This is not about freedom or personal choice. It’s about protecting yourself and those around you — the people you work with, the people you care about, the people you love. My job as President is to protect all Americans. So, tonight, I’m announcing that the Department of Labor is developing an emergency rule to require all employers with 100 or more employees, that together employ over 80 million workers, to ensure their workforces are fully vaccinated or show a negative test at least once a week. Some of the biggest companies are already requiring this: United Airlines, Disney, Tysons Food, and even Fox News. The bottom line: We’re going to protect vaccinated workers from unvaccinated co-workers. We’re going to reduce the spread of COVID-19 by increasing the share of the workforce that is vaccinated in businesses all across America. My plan will extend the vaccination requirements that I previously issued in the healthcare field. Already, I’ve announced, we’ll be requiring vaccinations that all nursing home workers who treat patients on Medicare and Medicaid, because I have that federal authority. Tonight, I’m using that same authority to expand that to cover those who work in hospitals, home healthcare facilities, or other medical facilities –- a total of 17 million healthcare workers. If you’re seeking care at a health facility, you should be able to know that the people treating you are vaccinated. Simple. Straightforward. Period. Next, I will sign an executive order that will now require all executive branch federal employees to be vaccinated — all. And I’ve signed another executive order that will require federal contractors to do the same. If you want to work with the federal government and do business with us, get vaccinated. If you want to do business with the federal government, vaccinate your workforce. And tonight, I’m removing one of the last remaining obstacles that make it difficult for you to get vaccinated. The Department of Labor will require employers with 100 or more workers to give those workers paid time off to get vaccinated. No one should lose pay in order to get vaccinated or take a loved one to get vaccinated. Today, in total, the vaccine requirements in my plan will affect about 100 million Americans –- two thirds of all workers. And for other sectors, I issue this appeal: To those of you running large entertainment venues — from sports arenas to concert venues to movie theaters — please require folks to get vaccinated or show a negative test as a condition of entry. And to the nation’s family physicians, pediatricians, GPs — general practitioners –- you’re the most trusted medical voice to your patients. You may be the one person who can get someone to change their mind about being vaccinated. Tonight, I’m asking each of you to reach out to your unvaccinated patients over the next two weeks and make a personal appeal to them to get the shot. America needs your personal involvement in this critical effort. And my message to unvaccinated Americans is this: What more is there to wait for? What more do you need to see? We’ve made vaccinations free, safe, and convenient. The vaccine has FDA approval. Over 200 million Americans have gotten at least one shot. We’ve been patient, but our patience is wearing thin. And your refusal has cost all of us. So, please, do the right thing. But just don’t take it from me; listen to the voices of unvaccinated Americans who are lying in hospital beds, taking their final breaths, saying, “If only I had gotten vaccinated.” “If only.” It’s a tragedy. Please don’t let it become yours. The second piece of my plan is continuing to protect the vaccinated. For the vast majority of you who have gotten vaccinated, I understand your anger at those who haven’t gotten vaccinated. I understand the anxiety about getting a “breakthrough” case. But as the science makes clear, if you’re fully vaccinated, you’re highly protected from severe illness, even if you get COVID-19. In fact, recent data indicates there is only one confirmed positive case per 5,000 fully vaccinated Americans per day. You’re as safe as possible, and we’re doing everything we can to keep it that way — keep it that way, keep you safe. That’s where boosters come in — the shots that give you even more protection than after your second shot. Now, I know there’s been some confusion about boosters. So, let me be clear: Last month, our top government doctors announced an initial plan for booster shots for vaccinated Americans. They believe that a booster is likely to provide the highest level of protection yet. Of course, the decision of which booster shots to give, when to start them, and who will give them, will be left completely to the scientists at the FDA and the Centers for Disease Control. But while we wait, we’ve done our part. We’ve bought enough boosters — enough booster shots — and the distribution system is ready to administer them. As soon as they are authorized, those eligible will be able to get a booster right away in tens of thousands of site across the — sites across the country for most Americans, at your nearby drug store, and for free. The third piece of my plan is keeping — and maybe the most important — is keeping our children safe and our schools open. For any parent, it doesn’t matter how low the risk of any illness or accident is when it comes to your child or grandchild. Trust me, I know. So, let me speak to you directly. Let me speak to you directly to help ease some of your worries. It comes down to two separate categories: children ages 12 and older who are eligible for a vaccine now, and children ages 11 and under who are not are yet eligible. The safest thing for your child 12 and older is to get them vaccinated. They get vaccinated for a lot of things. That’s it. Get them vaccinated. As with adults, almost all the serious COVID-19 cases we’re seeing among adolescents are in unvaccinated 12- to 17-year-olds — an age group that lags behind in vaccination rates. So, parents, please get your teenager vaccinated. What about children under the age of 12 who can’t get vaccinated yet? Well, the best way for a parent to protect their child under the age of 12 starts at home. Every parent, every teen sibling, every caregiver around them should be vaccinated. Children have four times higher chance of getting hospitalized if they live in a state with low vaccination rates rather than the states with high vaccination rates. Now, if you’re a parent of a young child, you’re wondering when will it be — when will it be — the vaccine available for them. I strongly support an independent scientific review for vaccine uses for children under 12. We can’t take shortcuts with that scientific work. But I’ve made it clear I will do everything within my power to support the FDA with any resource it needs to continue to do this as safely and as quickly as possible, and our nation’s top doctors are committed to keeping the public at large updated on the process so parents can plan. Now to the schools. We know that if schools follow the science and implement the safety measures — like testing, masking, adequate ventilation systems that we provided the money for, social distancing, and vaccinations — then children can be safe from COVID-19 in schools. Today, about 90 percent of school staff and teachers are vaccinated. We should get that to 100 percent. My administration has already acquired teachers at the schools run by the Defense Department — because I have the authority as President in the federal system — the Defense Department and the Interior Department — to get vaccinated. That’s authority I possess. Tonight, I’m announcing that we’ll require all of nearly 300,000 educators in the federal paid program, Head Start program, must be vaccinated as well to protect your youngest — our youngest — most precious Americans and give parents the comfort. And tonight, I’m calling on all governors to require vaccination for all teachers and staff. Some already have done so, but we need more to step up. Vaccination requirements in schools are nothing new. They work. They’re overwhelmingly supported by educators and their unions. And to all school officials trying to do the right thing by our children: I’ll always be on your side. Let me be blunt. My plan also takes on elected officials and states that are undermining you and these lifesaving actions. Right now, local school officials are trying to keep children safe in a pandemic while their governor picks a fight with them and even threatens their salaries or their jobs. Talk about bullying in schools. If they’ll not help — if these governors won’t help us beat the pandemic, I’ll use my power as President to get them out of the way. The Department of Education has already begun to take legal action against states undermining protection that local school officials have ordered. Any teacher or school official whose pay is withheld for doing the right thing, we will have that pay restored by the federal government 100 percent. I promise you I will have your back. The fourth piece of my plan is increasing testing and masking. From the start, America has failed to do enough COVID-19 testing. In order to better detect and control the Delta variant, I’m taking steps tonight to make testing more available, more affordable, and more convenient. I’ll use the Defense Production Act to increase production of rapid tests, including those that you can use at home. While that production is ramping up, my administration has worked with top retailers, like Walmart, Amazon, and Kroger’s, and tonight we’re announcing that, no later than next week, each of these outlets will start to sell at-home rapid test kits at cost for the next three months. This is an immediate price reduction for at-home test kits for up to 35 percent reduction. We’ll also expand — expand free testing at 10,000 pharmacies around the country. And we’ll commit — we’re committing $2 billion to purchase nearly 300 million rapid tests for distribution to community health centers, food banks, schools, so that every American, no matter their income, can access free and convenient tests. This is important to everyone, particularly for a parent or a child — with a child not old enough to be vaccinated. You’ll be able to test them at home and test those around them. In addition to testing, we know masking helps stop the spread of COVID-19. That’s why when I came into office, I required masks for all federal buildings and on federal lands, on airlines, and other modes of transportation. Today — tonight, I’m announcing that the Transportation Safety Administration — the TSA — will double the fines on travelers that refuse to mask. If you break the rules, be prepared to pay. And, by the way, show some respect. The anger you see on television toward flight attendants and others doing their job is wrong; it’s ugly. The fifth piece of my plan is protecting our economic recovery. Because of our vaccination program and the American Rescue Plan, which we passed early in my administration, we’ve had record job creation for a new administration, economic growth unmatched in 40 years. We cannot let unvaccinated do this progress — undo it, turn it back. So tonight, I’m announcing additional steps to strengthen our economic recovery. We’ll be expanding COVID-19 Economic Injury Disaster Loan programs. That’s a program that’s going to allow small businesses to borrow up to $2 million from the current $500,000 to keep going if COVID-19 impacts on their sales. These low-interest, long-term loans require no repayment for two years and be can used to hire and retain workers, purchase inventory, or even pay down higher cost debt racked up since the pandemic began. I’ll also be taking additional steps to help small businesses stay afloat during the pandemic. Sixth, we’re going to continue to improve the care of those who do get COVID-19. In early July, I announced the deployment of surge response teams. These are teams comprised of experts from the Department of Health and Human Services, the CDC, the Defense Department, and the Federal Emergency Management Agency — FEMA — to areas in the country that need help to stem the spread of COVID-19. Since then, the federal government has deployed nearly 1,000 staff, including doctors, nurses, paramedics, into 18 states. Today, I’m announcing that the Defense Department will double the number of military health teams that they’ll deploy to help their fellow Americans in hospitals around the country. Additionally, we’re increasing the availability of new medicines recommended by real doctors, not conspir- — conspiracy theorists. The monoclonal antibody treatments have been shown to reduce the risk of hospitalization by up to 70 percent for unvaccinated people at risk of developing sefe- — severe disease. We’ve already distributed 1.4 million courses of these treatments to save lives and reduce the strain on hospitals. Tonight, I’m announcing we will increase the average pace of shipment across the country of free monoclonal antibody treatments by another 50 percent. Before I close, let me say this: Communities of color are disproportionately impacted by this virus. And as we continue to battle COVID-19, we will ensure that equity continues to be at the center of our response. We’ll ensure that everyone is reached. My first responsibility as President is to protect the American people and make sure we have enough vaccine for every American, including enough boosters for every American who’s approved to get one. We also know this virus transcends borders. That’s why, even as we execute this plan at home, we need to continue fighting the virus overseas, continue to be the arsenal of vaccines. We’re proud to have donated nearly 140 million vaccines over 90 countries, more than all other countries combined, including Europe, China, and Russia combined. That’s American leadership on a global stage, and that’s just the beginning. We’ve also now started to ship another 500 million COVID vaccines — Pfizer vaccines — purchased to donate to 100 lower-income countries in need of vaccines. And I’ll be announcing additional steps to help the rest of the world later this month. As I recently released the key parts of my pandemic preparedness plan so that America isn’t caught flat-footed when a new pandemic comes again — as it will — next month, I’m also going to release the plan in greater detail. So let me close with this: We have so- — we’ve made so much progress during the past seven months of this pandemic. The recent increases in vaccinations in August already are having an impact in some states where case counts are dropping in recent days. Even so, we remain at a critical moment, a critical time. We have the tools. Now we just have to finish the job with truth, with science, with confidence, and together as one nation. Look, we’re the United States of America. There’s nothing — not a single thing — we’re unable to do if we do it together. So let’s stay together. God bless you all and all those who continue to serve on the frontlines of this pandemic. And may God protect our troops. Get vaccinated. 5:28 P.M. EDT

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About COVID-19

What is covid-19.

COVID-19 (coronavirus disease 2019) is a disease caused by a virus named SARS-CoV-2. It can be very contagious and spreads quickly. Over one million people have died from COVID-19 in the United States.

COVID-19 most often causes respiratory symptoms that can feel much like a cold, the flu, or pneumonia. COVID-19 may attack more than your lungs and respiratory system. Other parts of your body may also be affected by the disease. Most people with COVID-19 have mild symptoms, but some people become severely ill.

Some people including those with minor or no symptoms will develop Post-COVID Conditions – also called “Long COVID.”

How does COVID-19 spread?

COVID-19 spreads when an infected person breathes out droplets and very small particles that contain the virus. Other people can breathe in these droplets and particles, or these droplets and particles can land on their eyes, nose, or mouth. In some circumstances, these droplets may contaminate surfaces they touch.

Anyone infected with COVID-19 can spread it, even if they do NOT have symptoms.

The risk of animals spreading the virus that causes COVID-19 to people is low. The virus can spread from people to animals during close contact. People with suspected or confirmed COVID-19 should avoid contact with animals.

What are antibodies and how do they help protect me?

Antibodies are proteins your immune system makes to help fight infection and protect you from getting sick in the future. A positive antibody test result can help identify someone who has had COVID-19 in the past or has been vaccinated against COVID-19. Studies show that people who have antibodies from an infection with the virus that causes COVID-19 can improve their level of protection by getting vaccinated.

What are ways to prevent COVID-19?

There are many actions you can take to help protect you, your household, and your community from COVID-19. CDC’s COVID-19 hospital admission levels help individuals and communities decide when to take action to protect yourself and others based on the latest data and information from your area.

In addition to staying up to date with COVID-19 vaccines and basic health and hygiene practices like handwashing , CDC recommends some prevention actions at all COVID-19 hospital admission levels.

Who is at risk of severe illness from COVID-19?

Some people are more likely than others to get very sick if they get COVID-19. This includes people who are older, are immunocompromised, have certain disabilities , or have underlying health conditions . Understanding your COVID-19 risk and the risks that might affect others can help you make decisions to protect yourself and others .

What are variants of COVID-19?

Viruses are constantly changing, including the virus that causes COVID-19. These changes occur over time and can lead to new strains of the virus or variants of COVID-19 . Slowing the spread of the virus, by protecting yourself and others , can help slow new variants from developing. CDC is working with state and local public health officials to monitor the spread of all variants, including Omicron.

COVID-19 Testing
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Remarks by Commissioner Stephen Hahn, M.D. — The COVID-19 Pandemic — Finding Solutions, Applying Lessons Learned - 06/01/2020

Speech | Virtual

Event Title Remarks by Commissioner Stephen Hahn, M.D. — The COVID-19 Pandemic — Finding Solutions, Applying Lessons Learned June 1, 2020

The COVID-19 Pandemic — Finding Solutions, Applying Lessons Learned

(Remarks as prepared for delivery. The text and video of this speech are slightly, though not substantively different from the version presented by Dr. Hahn on June 1 to the Alliance for a Stronger FDA, via audio broadcast only. Because of evolving scheduling challenges, it was not clear whether Dr. Hahn would be able to present the speech live and so it was recorded by video earlier. Ultimately, he did give the speech live to the Alliance, but only via an audio link. Given the minimal changes in the live version, we are posting the video version and the accompanying text.)

One of the most frustrating challenges each of us can face is the inability to control the events that affect our lives. Often, we are thrust into situations not of our own making. It’s no surprise that one of the most familiar adages concerns the best laid plans of mice and men going awry.

And yet, to borrow another often-used saying, necessity is the mother of invention. History teaches us that crises often lead to accelerated change and innovations and new discoveries.

This dynamic has been on my mind a great deal recently. It wasn’t too long ago – last December, to be exact -- that I had the distinction of being confirmed as the 24th Commissioner of the Food and Drug Administration.

This is the greatest honor of my life. I have long cherished the critical role the FDA plays in protecting and promoting the public health, and I’ve relied on the Agency’s expertise throughout my professional life.

So, I eagerly embraced my new responsibilities and the chance to make a real difference in public health. I was especially conscious that we live in a time of extraordinary scientific achievement, especially in oncology, with unprecedented opportunities to help make the lives of American patients and consumers healthier and safer.

I quickly immersed myself in the Agency’s broad and complex responsibilities, seizing every opportunity to learn about the FDA, both those areas with which I’d previously had minimum involvement, such as food policy, and those with which I had more familiarity, like cancer treatments and innovative clinical trial design.

I began to work with, and learn from, the agency’s extraordinary leadership team. I learned very quickly that the principles that have guided me throughout my life, such as my commitment to relying only on the best medical science and most rigorous data in support of advancing innovation and discovery, and my fundamental belief in promoting integrity and transparency in the scientific process, are the same principles that guide the FDA in both science and regulation.

So, I was in the midst of transitioning from being Chief Medical Executive at MD Anderson Cancer Center to being Commissioner of FDA when our entire world was turned upside down with the appearance of the novel COVID-19 coronavirus.

I certainly did not anticipate a public health emergency of this magnitude when I joined the agency. And I could not have imagined how significantly my new role would change and be shaped by this pandemic. I definitely could not have known that discussions about personal protective equipment (or PPE) or face masks or nasal swabs would be central to my work as Commissioner.

One thing was apparent: I would need to manage this evolving situation even as I was still learning about FDA.

From the very start I knew that even in a crisis situation – or perhaps especially because we are in a crisis situation – it is imperative that we maintain FDA’s high standards for evaluating products and making sure that the benefits outweigh potential harms.

To maintain our standard, I pledged to myself and emphasized to my new colleagues at FDA that our decisions would always be rooted in science. Having spent my entire career as a physician and scientist caring for patients with cancer, I’ve always valued highly a commitment to good data and sound science. I feel comfortable working with the scientists at FDA because I know they not only share that value, that commitment, but that they will tolerate nothing less. So, it was critical to me, as the pandemic escalated that this be reinforced as the guidepost for all of our decisions.

It may have been trial by fire, but I have the good fortune to work with an enormous number of talented individuals and teams who are helping guide us through this crisis. Every day they show extraordinary expertise, commitment, and resilience.

I also was able to call on many from outside the agency, including former FDA leaders as well as colleagues from the medical community.

What struck me was the uniformity of their advice. Those who formerly worked at FDA urged me to rely upon the FDA staff, many of whom have the experience to help manage a pandemic. My friends from outside the agency urged that we move quickly to make decisions, set direction and to be transparent about what we are doing. I have tried to follow all of this excellent advice.

Protecting the Food Supply

Since this crisis and the actions of the FDA have evolved so rapidly, let me summarize what we have done. I am confident that the FDA has measured up to this unprecedented challenge.

I want to start with the first word in the FDA’s name – food. Most of us take food safety for granted. But it takes a lot of hard work to maintain a safe food supply. This was true even before the COVID-19 pandemic but is especially challenging during an ongoing international crisis.

During the pandemic, through the collaboration of the FDA, the food industry and our federal and state partners, we have been able to maintain the safety of the nation’s food supply. Our Coordinated Outbreak Response and Evaluation team remained on the job, monitoring for signs of foodborne illness outbreaks and prepared to take action when needed.

And along with our federal partners, including CDC and USDA, we also have provided best practices for food workers, industry, and consumers on how to stay safe and keep food safe.

Diagnosing and Developing Treatments

On the medical side, we immediately committed to facilitating efforts to develop diagnostic tests, treatments and vaccines for the disease. We have helped facilitate increases in our national testing capacity, have helped ensure continued access to necessary medical products, and have sought to prevent the sale of fraudulent products.

If there’s one thing that’s been reaffirmed during this crisis, it’s the essential role of medical devices, including diagnostics, to countering this pandemic.

From the earliest days of our response, we worked to ensure that we had the essential medical devices, including personal protective equipment, to help treat those who are ill and to ensure that health care workers and others on the front line are properly protected.

To be sure, there were bumps along the road, but today we have an adequate supply of the devices that have been in unprecedented high demand such as PPE, ventilators, and others.

We’ve reviewed and issued emergency use authorizations for medical devices for COVID-19 at an incredibly fast pace.

And we’ve worked closely with many companies that don’t regularly make medical products but wanted to pitch in by making hand sanitizer, ventilators, or PPE.

There was a special focus on the development and availability of accurate and reliable COVID-19 tests. We need to know who has the disease and who has had it. This is essential if we are to understand this virus and return to a more normal lifestyle.

Since January, we’ve worked with hundreds of test developers, many of whom have submitted emergency use authorization requests to FDA for tests that detect the virus or antibodies to the virus.

As you have seen reported, early in the crisis we provided regulatory flexibility for developers with validated tests as outlined in our policies because public health needs dictated that we do as much testing as possible. But as the process has matured, we have helped increase the number of authorized tests, and we have adapted some of our policies to best serve the public need.

Today, if evidence arises that raises questions about a particular test’s reliability, we will take appropriate action to protect consumers from inaccurate tests. This is a dynamic process that is continually being informed by new data and evidence.

We’ve used a similar dynamic process in the search for therapeutic treatments and vaccines.

We are working closely with partners throughout the government and academia, and with drug and vaccine developers to explore, expedite, and incentivize the development of these products.

More than 90 drugs are being studied, and FDA is actively working with numerous vaccine sponsors, including three sponsors who have announced they have vaccine candidates that are now in clinical trials in the U.S. More than 144 clinical trials have been initiated for therapeutic agents, with hundreds more in the pipeline. We don’t have a cure or vaccine yet, but we’re on our way, at unprecedented speed.

Ultimately, of course, the way we’ll eventually defeat this virus is with a vaccine. FDA is working closely to provide technical assistance to federal partners, vaccine developers, researchers, manufacturers, and experts across the globe and exploring all possible options to advance the most efficient and timely development of vaccines, while at the same time maintaining regulatory independence.

Communicating and Educating

There is much more to do going forward, and that includes research, exploration and discovery, and communicating what we know.

As the country starts to reopen, it’s essential that the public understands what they need to do to continue to protect themselves. There has been a proliferation of information, and misinformation, on the internet and in other sources. Consumers need to understand that this virus is still with us and that we, as individuals and communities working together, need to take steps to continue to contain its spread.

The FDA has an important part to play in communicating public information to all populations in the U.S. FDA has increased outreach by developing and disseminating COVID-19 health education materials for consumers in multiple languages to diverse communities and the public overall. Everyone should have a clear understanding of why hand-washing and social distancing remain essential. Consumers need to think about how to shop for food safely. People need to know when to call their doctors and when to ask about getting tested. Health care professionals need to know how to manage their patients in this new environment, and how best to apply telemedicine, the use of which is rapidly accelerating.

I want the FDA to serve as a national resource for the public and health care community. I regard educating the public and providing accurate, reliable, up-to-date information as not just an Agency priority, but one of my own personal responsibilities as Commissioner. I will be out in public and in the media talking about how individuals can help us contain and conquer this virus.

I believe my personal experience with being self-quarantined will make me a better communicator. Being quarantined for 14 days in May was certainly no fun, but because we at FDA were already functioning very effectively virtually, I was able to continue to be fully engaged, and provide direction and leadership. And it made me even more focused on making sure consumers have all the information they need about self-protection.

We now need to look forward. A major strength of the FDA is not just in our response to a crisis, but in our ability to learn from the work we do and apply that experience in the future.

As this pandemic evolved, it was clear that some FDA processes needed to be adjusted to accommodate the urgency of the pandemic. I think the entire FDA team has now seen first-hand that we need to look at some of our processes and policies. I have instructed my staff to identify the lessons learned from this pandemic and what adjustments may be needed, not just to manage this or future emergencies, but to make FDA itself more efficient in carrying out our regulatory responsibilities.

I am committed to making sure that some of the lessons learned from managing this pandemic will lead to permanent improvements at the FDA in processes and policies.

For example, in facilitating the development of new treatments, we streamlined some of our processes.

We have taken a fresh look at how clinical trials should be designed and conducted. In a pandemic we knew we needed to get answers more quickly. For instance, early on, the FDA, National Institutes of Health, and industry worked together to facilitate the implementation of a “master protocol” that can be used in multiple clinical trials and allows for the study of more than one promising new drug for COVID-19 at a time. And we have used expanded access to meet the needs of patients who are not eligible or who are unable to participate in randomized clinical trials.

Many of the permanent changes that we will implement really represent an acceleration of where we were headed before. For example, the concept of decentralized clinical trials, in which trial procedures are conducted near the patient’s home and through use of local health care providers or local laboratories has been discussed before, and laid the foundation for some of the trials for COVID-19 products.

Another area where our pre-COVID work has informed our response to the pandemic involves the use of Real World Evidence (RWE).

In recent years, the agency has taken steps to leverage modern, rigorous analyses of real-world data—such as data from electronic health records, insurance claims, patient registries and lab results.

As the pandemic brought an urgency to these efforts, the FDA advanced collaborations with public and private partners to collect and analyze a variety of real-world data sources, using our Sentinel system and other resources.

Evaluation of real-world data has the potential to provide a wealth of rapid, actionable information to better understand disease symptoms, describe and measure immunity, and use available medical product supplies to help mitigate potential shortages. These data can also inform ongoing work to evaluate potential therapies, vaccines or diagnostics for COVID-19. The more experience we have with real world evidence, the more confidence we will have in using it for product decisions.

I mention real world evidence, but in reality, we have so many examples of how lessons learned from the pandemic will affect FDA in the future.

To the extent that the innovations and adaptations we implemented during the pandemic crisis worked and would be appropriate to implement outside of a pandemic situation, we will incorporate them into standard FDA procedures. And to the extent that we identified unnecessary barriers, we will remove them. This is one of my top priorities. Permanent change where needed will take place, and will make FDA an even stronger agency.

As I mentioned before, anything that enables quicker reviews and authorizations we will seek to make permanent.

But make no mistake. We will not cut corners on safety or effectiveness. I said this before, and I say it again. Good science as the basis for decision making has been a hallmark of my career, and is a value that I hold deeply. The American public must have confidence in the products regulated by the FDA.

Speed is important, but so are safety, accuracy and effectiveness.

FDA’s commitment to good science and rigorous data is unwavering, even as we look at how we can learn from this pandemic.

I am hopeful that this is a once-in-a-lifetime experience for all of us. An unprecedented historic event that has required an unprecedented response from us and everyone around the world.

That said, I am pleased that throughout this crisis the rest of the FDA’s work has continued, with relatively few interruptions. New drugs and devices have been authorized. Our food safety surveillance has adapted and our outbreak response resources have been maintained. Our oversight of tobacco products, including e-cigarettes, has gone on. The Agency has measured up to the challenge in all ways.

And we are well positioned as we move into a new phase, that is, transitioning back to what has come to be known as the “new normal.” Our staff has done a phenomenal job of adapting to this new normal. And I am confident that they are ready to deal with any additional upcoming challenges.

I will close with something I’ve seen reaffirmed time and time again over the past few months. That is the essential role that the FDA plays in consumer protection and beyond in advancing public health.

Before coming to the FDA, I had heard about the extraordinary dedication of the agency’s workforce. Working side by side with my colleagues in response to this pandemic, I’ve seen that characterization validated over and over.

It is my great honor to serve with so many highly skilled and committed professionals. And the American people can be assured that this agency is working around the clock for them, doing whatever is necessary to fulfill our mission to protect and promote the health of the American public.

I encourage you all to stay safe, aware, and focused as we continue to respond to the challenges of this public health emergency.

MINI REVIEW article

Covid-19: emergence, spread, possible treatments, and global burden.

$\nRaghuvir Keni$

1 Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
2 Department of Health Sciences, School of Education and Health, Cape Breton University, Sydney, NS, Canada

The Coronavirus (CoV) is a large family of viruses known to cause illnesses ranging from the common cold to acute respiratory tract infection. The severity of the infection may be visible as pneumonia, acute respiratory syndrome, and even death. Until the outbreak of SARS, this group of viruses was greatly overlooked. However, since the SARS and MERS outbreaks, these viruses have been studied in greater detail, propelling the vaccine research. On December 31, 2019, mysterious cases of pneumonia were detected in the city of Wuhan in China's Hubei Province. On January 7, 2020, the causative agent was identified as a new coronavirus (2019-nCoV), and the disease was later named as COVID-19 by the WHO. The virus spread extensively in the Wuhan region of China and has gained entry to over 210 countries and territories. Though experts suspected that the virus is transmitted from animals to humans, there are mixed reports on the origin of the virus. There are no treatment options available for the virus as such, limited to the use of anti-HIV drugs and/or other antivirals such as Remdesivir and Galidesivir. For the containment of the virus, it is recommended to quarantine the infected and to follow good hygiene practices. The virus has had a significant socio-economic impact globally. Economically, China is likely to experience a greater setback than other countries from the pandemic due to added trade war pressure, which have been discussed in this paper.

Introduction

Coronaviridae is a family of viruses with a positive-sense RNA that possess an outer viral coat. When looked at with the help of an electron microscope, there appears to be a unique corona around it. This family of viruses mainly cause respiratory diseases in humans, in the forms of common cold or pneumonia as well as respiratory infections. These viruses can infect animals as well ( 1 , 2 ). Up until the year 2003, coronavirus (CoV) had attracted limited interest from researchers. However, after the SARS (severe acute respiratory syndrome) outbreak caused by the SARS-CoV, the coronavirus was looked at with renewed interest ( 3 , 4 ). This also happened to be the first epidemic of the 21st century originating in the Guangdong province of China. Almost 10 years later, there was a MERS (Middle East respiratory syndrome) outbreak in 2012, which was caused by the MERS-CoV ( 5 , 6 ). Both SARS and MERS have a zoonotic origin and originated from bats. A unique feature of these viruses is the ability to mutate rapidly and adapt to a new host. The zoonotic origin of these viruses allows them to jump from host to host. Coronaviruses are known to use the angiotensin-converting enzyme-2 (ACE-2) receptor or the dipeptidyl peptidase IV (DPP-4) protein to gain entry into cells for replication ( 7 – 10 ).

In December 2019, almost seven years after the MERS 2012 outbreak, a novel Coronavirus (2019-nCoV) surfaced in Wuhan in the Hubei region of China. The outbreak rapidly grew and spread to neighboring countries. However, rapid communication of information and the increasing scale of events led to quick quarantine and screening of travelers, thus containing the spread of the infection. The major part of the infection was restricted to China, and a second cluster was found on a cruise ship called the Diamond Princess docked in Japan ( 11 , 12 ).

The new virus was identified to be a novel Coronavirus and was thus initially named 2019-nCoV; later, it was renamed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ( 13 ), and the disease it causes is now referred to as Coronavirus Disease-2019 (COVID-19) by the WHO. The virus was suspected to have begun its spread in the Huanan seafood wholesale market in the Wuhan region. It is possible that an animal that was carrying the virus was brought into or sold in the market, causing the spread of the virus in the crowded marketplace. One of the first claims made was in an article published in the Journal of Medical Virology ( 14 ), which identified snakes as the possible host. A second possibility was that pangolins could be the wild host of SARS-CoV-2 ( 15 ), though the most likely possibility is that the virus originated from bats ( 13 , 16 – 19 ). Increasing evidence and experts are now collectively concluding the virus had a natural origin in bats, as with previous such respiratory viruses ( 2 , 20 – 24 ).

Similarly, SARS and MERS were also suspected to originate from bats. In the case of MERS, the dromedary camel is an intermediate host ( 5 , 10 ). Bats have been known to harbor coronaviruses for quite some time now. Just as in the case of avian flu, SARS, MERS, and possibly even HIV, with increasing selection and ecological pressure due to human activities, the virus made the jump from animal to man. Humans have been encroaching increasingly into forests, and this is true over much of China, as in Africa. Combined with additional ecological pressure due to climate change, such zoonotic spillovers are now more common than ever. It is likely that the next disease X will also have such an origin ( 25 ). We have learned the importance of identification of the source organism due to the Ebola virus pandemic. Viruses are unstable organisms genetically, constantly mutating by genetic shift or drift. It is not possible to predict when a cross-species jump may occur and when a seemingly harmless variant form of the virus may turn into a deadly strain. Such an incident occurred in Reston, USA, with the Reston virus ( 26 ), an alarming reminder of this possibility. The identification of the original host helps us to contain future spreads as well as to learn about the mechanism of transmission of viruses. Until the virus is isolated from a wild animal host, in this case, mostly bats, the zoonotic origin will remain hypothetical, though likely. It should further be noted that the virus has acquired several mutations, as noted by a group in China, indicating that there are more than two strains of the virus, which may have had an impact on its pathogenicity. However, this claim remains unproven, and many experts have argued otherwise; data proving this are not yet available ( 27 ). A similar finding was reported from Italy and India independently, where they found two strains ( 28 , 29 ). These findings need to be further cross-verified by similar analyses globally. If true, this finding could effectively explain why some nations are more affected than others.

Transmission

When the spread of COVID-19 began ( Figure 1 ), the virus appeared to be contained within China and the cruise ship “Diamond Princess,” which formed the major clusters of the virus. However, as of April 2020, over 210 countries and territories are affected by the virus, with Europe, the USA, and Iran forming the new cluster of the virus. The USA ( Figure 2 ) has the highest number of confirmed COVID-19 cases, whereas India and China, despite being among the most population-dense countries in the world, have managed to constrain the infection rate by the implementation of a complete lockdown with arrangements in place to manage the confirmed cases. Similarly, the UK has also managed to maintain a low curve of the graph by implementing similar measures, though it was not strictly enforced. Reports have indicated that the presence of different strains or strands of the virus may have had an effect on the management of the infection rate of the virus ( 27 – 29 ). The disease is spread by droplet transmission. As of April 2020, the total number of infected individuals stands at around 3 million, with ~200,000 deaths and more than 1 million recoveries globally ( 30 , 34 ). The virus thus has a fatality rate of around 2% and an R 0 of 3 based on current data. However, a more recent report from the CDC, Atlanta, USA, claims that the R 0 could be as high as 5.7 ( 35 ). It has also been observed from data available from China and India that individuals likely to be infected by the virus from both these countries belong to the age groups of 20–50 years ( 36 , 37 ). In both of these countries, the working class mostly belongs to this age group, making exposure more likely. Germany and Singapore are great examples of countries with a high number of cases but low fatalities as compared to their immediate neighbors. Singapore is one of the few countries that had developed a detailed plan of action after the previous SARS outbreak to deal with a similar situation in the future, and this worked in their favor during this outbreak. Both countries took swift action after the outbreak began, with Singapore banning Chinese travelers and implementing screening and quarantine measures at a time when the WHO recommended none. They ordered the elderly and the vulnerable to strictly stay at home, and they ensured that lifesaving equipment and large-scale testing facilities were available immediately ( 38 , 39 ). Germany took similar measures by ramping up testing capacity quite early and by ensuring that all individuals had equal opportunity to get tested. This meant that young, old, and at-risk people all got tested, thus ensuring positive results early during disease progression and that most cases were mild like in Singapore, thus maintaining a lower death percentage ( 40 ). It allowed infected individuals to be identified and quarantined before they even had symptoms. Testing was carried out at multiple labs, reducing the load and providing massive scale, something which countries such as the USA did quite late and India restricted to select government and private labs. The German government also banned large gatherings and advocated social distancing to further reduce the spread, though unlike India and the USA, this was done quite late. South Korea is another example of how a nation has managed to contain the spread and transmission of the infection. South Korea and the USA both reported their first COVID-19 cases on the same day; however, the US administration downplayed the risks of the disease, unlike South Korean officials, who constantly informed their citizens about the developments of the disease using the media and a centralized messaging system. They also employed the Trace, Test, and Treat protocol to identify and isolate patients fast, whereas the USA restricted this to patients with severe infection and only later broadened this criterion, like many European countries as well as India. Unlike the USA, South Korea also has universal healthcare, ensuring free diagnostic testing.

Figure 1 . Timeline of COVID-19 progression ( 30 – 32 ).

Figure 2 . Total confirmed COVID 19 cases as of May 2020 ( 33 ).

The main mode of transmission of 2019-nCoV is human to human. As of now, animal-to-human transfer has not yet been confirmed. Asymptomatic carriers of the virus are at major risk of being superinfectors with this disease, as all those infected may not develop the disease ( 41 ). This is a concern that has been raised by nations globally, with the Indian government raising concerns on how to identify and contain asymptomatic carriers, who could account for 80% of those infected ( 42 ). Since current resources are directed towards understanding the hospitalized individuals showing symptoms, there is still a vast amount of information about asymptomatic individuals that has yet to be studied. For example, some questions that need to be answered include: Do asymptomatic individuals develop the disease at any point in time at all? Do they eventually develop antibodies? How long do they shed the virus for? Can any tissue of these individuals store the virus in a dormant state? Asymptomatic transmission is a gray area that encompasses major unknowns in COVID-19.

The main route of human-to-human transmission is by droplets, which are generated during coughing, talking, or sneezing and are then inhaled by a healthy individual. They can also be indirectly transmitted to a person when they land on surfaces that are touched by a healthy individual who may then touch their nose, mouth, or eyes, allowing the virus entry into the body. Fomites are also a common issue in such diseases ( 43 ).

Aerosol-based transmission of the virus has not yet been confirmed ( 43 ). Stool-based transmission via the fecal-oral route may also be possible since the SARS-CoV-2 has been found in patient feces ( 44 , 45 ). Some patients with COVID-19 tend to develop diarrhea, which can become a major route of transmission if proper sanitation and personal hygiene needs are not met. There is no evidence currently available to suggest intrauterine vertical transmission of the disease in pregnant women ( 46 ).

More investigation is necessary of whether climate has played any role in the containment of the infection in countries such as India, Singapore, China, and Israel, as these are significantly warmer countries as compared with the UK, the USA, and Canada ( Figure 2 ). Ideally, a warm climate should prevent the virus from surviving for longer periods of time on surfaces, reducing transmissibility.

Pathophysiology

On gaining entry via any of the mucus membranes, the single-stranded RNA-based virus enters the host cell using type 2 transmembrane serine protease (TMPRSS2) and ACE2 receptor protein, leading to fusion and endocytosis with the host cell ( 47 – 49 ). The uncoated RNA is then translated, and viral proteins are synthesized. With the help of RNA-dependant RNA polymerase, new RNA is produced for the new virions. The cell then undergoes lysis, releasing a load of new virions into the patients' body. The resultant infection causes a massive release of pro-inflammatory cytokines that causes a cytokine storm.

Clinical Presentation

The clinical presentation of the disease resembles beta coronavirus infections. The virus has an incubation time of 2–14 days, which is the reason why most patients suspected to have the illness or contact with an individual having the illness remain in quarantine for the said amount of time. Infection with SARS-CoV-2 causes severe pneumonia, intermittent fever, and cough ( 50 , 51 ). Symptoms of rhinorrhoea, pharyngitis, and sneezing have been less commonly seen. Patients often develop acute respiratory distress syndrome within 2 days of hospital admission, requiring ventilatory support. It has been observed that during this phase, the mortality tends to be high. Chest CT will show indicators of pneumonia and ground-glass opacity, a feature that has helped to improve the preliminary diagnosis ( 51 ). The primary method of diagnosis for SARS-CoV-2 is with the help of PCR. For the PCR testing, the US CDC recommends testing for the N gene, whereas the Chinese CDC recommends the use of ORF lab and N gene of the viral genome for testing. Some also rely on the radiological findings for preliminary screening ( 52 ). Additionally, immunodiagnostic tests based on the presence of antibodies can also play a role in testing. While the WHO recommends the use of these tests for research use, many countries have pre-emptively deployed the use of these tests in the hope of ramping up the rate and speed of testing ( 52 – 54 ). Later, they noticed variations among the results, causing them to stop the use of such kits; there was also debate among the experts about the sensitivity and specificity of the tests. For immunological tests, it is beneficial to test for antibodies against the virus produced by the body rather than to test for the presence of the viral proteins, since the antibodies can be present in larger titers for a longer span of time. However, the cross-reactivity of these tests with other coronavirus antibodies is something that needs verification. Biochemical parameters such as D-dimer, C-reactive protein, and variations in neutrophil and lymphocyte counts are some other parameters that can be used to make a preliminary diagnosis; however, these parameters vary in a number of diseases and thus cannot be relied upon conclusively ( 51 ). Patients with pre-existing diseases such as asthma or similar lung disorder are at higher risk, requiring life support, as are those with other diseases such as diabetes, hypertension, or obesity. Those above the age of 60 have displayed the highest mortality rate in China, a finding that is mirrored in other nations as well ( Figure 3 ) ( 55 ). If we cross-verify these findings with the population share that is above the age of 70, we find that Italy, the United Kingdom, Canada, and the USA have one of the highest elderly populations as compared to countries such as India and China ( Figure 4 ), and this also reflects the case fatality rates accordingly ( Figure 5 ) ( 33 ). This is a clear indicator that aside from comorbidities, age is also an independent risk factor for death in those infected by COVID-19. Also, in the US, it was seen that the rates of African American deaths were higher. This is probably due to the fact that the prevalence of hypertension and obesity in this community is higher than in Caucasians ( 56 , 57 ). In late April 2020, there are also claims in the US media that young patients in the US with COVID-19 may be at increased risk of stroke; however, this is yet to be proven. We know that coagulopathy is a feature of COVID-19, and thus stroke is likely in this condition ( 58 , 59 ). The main cause of death in COVID-19 patients was acute respiratory distress due to the inflammation in the linings of the lungs caused by the cytokine storm, which is seen in all non-survival cases and in respiratory failure. The resultant inflammation in the lungs, served as an entry point of further infection, associated with coagulopathy end-organ failure, septic shock, and secondary infections leading to death ( 60 – 63 ).

Figure 3 . Case fatality rate by age in selected countries as of April 2020 ( 33 ).

Figure 4 . Case fatality rate in selected countries ( 33 ).

Figure 5 . Population share above 70 years of age ( 33 ).

For COVID-19, there is no specific treatment available. The WHO announced the organization of a trial dubbed the “Solidarity” clinical trial for COVID-19 treatments ( 64 ). This is an international collaborative study that investigates the use of a few prime candidate drugs for use against COVID-19, which are discussed below. The study is designed to reduce the time taken for an RCT by over 80%. There are over 1087 studies ( Supplementary Data 1 ) for COVID-19 registered at clinicaltrials.gov , of which 657 are interventional studies ( Supplementary Data 2 ) ( 65 ). The primary focus of the interventional studies for COVID-19 has been on antimalarial drugs and antiviral agents ( Table 1 ), while over 200 studies deal with the use of different forms of oxygen therapy. Most trials focus on improvement of clinical status, reduction of viral load, time to improvement, and reduction of mortality rates. These studies cover both severe and mild cases.

Table 1 . List of therapeutic drugs under study for COVID-19 as per clinical trials registered under clinicaltrials.gov .

Use of Antimalarial Drugs Against SARS-CoV-2

The use of chloroquine for the treatment of corona virus-based infection has shown some benefit in the prevention of viral replication in the cases of SARS and MERS. However, it was not validated on a large scale in the form of a randomized control trial ( 50 , 66 – 68 ). The drugs of choice among antimalarials are Chloroquine (CQ) and Hydroxychloroquine (HCQ). The use of CQ for COVID-19 was brought to light by the Chinese, especially by the publication of a letter to the editor of Bioscience Trends by Gao et al. ( 69 ). The letter claimed that several studies found CQ to be effective against COVID-19; however, the letter did not provide many details. Immediately, over a short span of time, interest in these two agents grew globally. Early in vitro data have revealed that chloroquine can inhibit the viral replication ( 70 , 71 ).

HCQ and CQ work by raising the pH of the lysosome, the cellular organelle that is responsible for phagocytic degradation. Its function is to combine with cell contents that have been phagocytosed and break them down eventually, in some immune cells, as a downstream process to display some of the broken proteins as antigens, thus further enhancing the immune recruitment against an antigen/pathogen. The drug was to be administered alone or with azithromycin. The use of azithromycin may be advocated by the fact that it has been seen previously to have some immunomodulatory role in airway-related disease. It appears to reduce the release of pro-inflammatory cytokines in respiratory illnesses ( 72 ). However, HCQ and azithromycin are known to have a major drug interaction when co-administered, which increases the risk of QT interval prolongation ( 73 ). Quinine-based drugs are known to have adverse effects such as QT prolongation, retinal damage, hypoglycemia, and hemolysis of blood in patients with G-6-PD deficiency ( 66 ). Several preprints, including, a metanalysis now indicate that HCQ may have no benefit for severe or critically ill patients who have COVID-19 where the outcome is need for ventilation or death ( 74 , 75 ). As of April 21, 2020, after having pre-emptively recommended their use for SARS-CoV-2 infection, the US now advocates against the use of these two drugs based on the new data that has become available.

Use of Antiviral Drugs Against SARS-CoV-2

The antiviral agents are mainly those used in the case of HIV/AIDS, these being Lopinavir and Ritonavir. Other agents such as nucleoside analogs like Favipiravir, Ribavirin, Remdesivir, and Galidesivir have been tested for possible activity in the prevention of viral RNA synthesis ( 76 ). Among these drugs, Lopinavir, Ritonavir, and Remdesivir are listed in the Solidarity trial by the WHO.

Remdesivir is a nucleotide analog for adenosine that gets incorporated into the viral RNA, hindering its replication and causing chain termination. This agent was originally developed for Ebola Virus Disease ( 77 ). A study was conducted with rhesus macaques infected with SARS-CoV-2 ( 78 ). In that study, after 12 h of infection, the monkeys were treated with either Remdesivir or vehicle. The drug showed good distribution in the lungs, and the animals treated with the drug showed a better clinical score than the vehicle group. The radiological findings of the study also indicated that the animals treated with Remdesivir have less lung damage. There was a reduction in viral replication but not in virus shedding. Furthermore, there were no mutations found in the RNA polymerase sequences. A randomized clinical control study that became available in late April 2020 ( 79 ), having 158 on the Remdesivir arm and 79 on the placebo arm, found that Remdesivir reduced the time to recovery in the Remdesivir-treated arm to 11 days, while the placebo-arm recovery time was 15 days. Though this was not found to be statistically significant, the agent provided a basis for further studies. The 28-days mortality was found to be similar for both groups. This has now provided us with a basis on which to develop future molecules. The study has been supported by the National Institute of Health, USA. The authors of the study advocated for more clinical trials with Remdesivir with a larger population. Such larger studies are already in progress, and their results are awaited. Remdesivir is currently one of the drugs that hold most promise against COVID-19.

An early trial in China with Lopinavir and Ritonavir showed no benefit compared with standard clinical care ( 80 ). More studies with this drug are currently underway, including one in India ( 81 , 82 ).

Use of Convalescent Patient Plasma

Another possible option would be the use of serum from convalescent individuals, as this is known to contain antibodies that can neutralize the virus and aid in its elimination. This has been tried previously for other coronavirus infections ( 83 ). Early emerging case reports in this aspect look promising compared to other therapies that have been tried ( 84 – 87 ). A report from China indicates that five patients treated with plasma recovered and were eventually weaned off ventilators ( 84 ). They exhibited reductions in fever and viral load and improved oxygenation. The virus was not detected in the patients after 12 days of plasma transfusion. The US FDA has provided detailed recommendations for investigational COVID-19 Convalescent Plasma use ( 88 ). One of the benefits of this approach is that it can also be used for post-exposure prophylaxis. This approach is now beginning to be increasingly adopted in other countries, with over 95 trials registered on clinicaltrials.gov alone, of which at least 75 are interventional ( 89 ). The use of convalescent patient plasma, though mostly for research purposes, appears to be the best and, so far, the only successful option for treatment available.

From a future perspective, the use of monoclonal antibodies for the inhibition of the attachment of the virus to the ACE-2 receptor may be the best bet. Aside from this, ACE-2-like molecules could also be utilized to attach and inactivate the viral proteins, since inhibition of the ACE-2 receptor would not be advisable due to its negative repercussions physiologically. In the absence of drug regimens and a vaccine, the treatment is symptomatic and involves the use of non-invasive ventilation or intubation where necessary for respiratory failure patients. Patients that may go into septic shock should be managed as per existing guidelines with hemodynamic support as well as antibiotics where necessary.

The WHO has recommended that simple personal hygiene practices can be sufficient for the prevention of spread and containment of the disease ( 90 ). Practices such as frequent washing of soiled hands or the use of sanitizer for unsoiled hands help reduce transmission. Covering of mouth while sneezing and coughing, and disinfection of surfaces that are frequently touched, such as tabletops, doorknobs, and switches with 70% isopropyl alcohol or other disinfectants are broadly recommended. It is recommended that all individuals afflicted by the disease, as well as those caring for the infected, wear a mask to avoid transmission. Healthcare works are advised to wear a complete set of personal protective equipment as per WHO-provided guidelines. Fumigation of dormitories, quarantine rooms, and washing of clothes and other fomites with detergent and warm water can help get rid of the virus. Parcels and goods are not known to transmit the virus, as per information provided by the WHO, since the virus is not able to survive sufficiently in an open, exposed environment. Quarantine of infected individuals and those who have come into contact with an infected individual is necessary to further prevent transmission of the virus ( 91 ). Quarantine is an age-old archaic practice that continues to hold relevance even today for disease containment. With the quarantine being implemented on such a large scale in some countries, taking the form of a national lockdown, the question arises of its impact on the mental health of all individuals. This topic needs to be addressed, especially in countries such as India and China, where it is still a matter of partial taboo to talk about it openly within the society.

In India, the Ministry of Ayurveda, Yoga, and Naturopathy, Unani, Siddha and Homeopathy (AYUSH), which deals with the alternative forms of medicine, issued a press release that the homeopathic, drug Arsenicum album 30, can be taken on an empty stomach for 3 days to provide protection against the infection ( 92 ). It also provided a list of herbal drugs in the same press release as per Ayurvedic and Unani systems of medicine that can boost the immune system to deal with the virus. However, there is currently no evidence to support the use of these systems of medicine against COVID-19, and they need to be tested.

The prevention of the disease with the use of a vaccine would provide a more viable solution. There are no vaccines available for any of the coronaviruses, which includes SARS and MERS. The development of a vaccine, however, is in progress at a rapid pace, though it could take about a year or two. As of April 2020, no vaccine has completed the development and testing process. A popular approach has been with the use of mRNA-based vaccine ( 93 – 96 ). mRNA vaccines have the advantage over conventional vaccines in terms of production, since they can be manufactured easily and do not have to be cultured, as a virus would need to be. Alternative conventional approaches to making a vaccine against SARS-CoV-2 would include the use of live attenuated virus as well as using the isolated spike proteins of the virus. Both of these approaches are in progress for vaccine development ( 97 ). Governments across the world have poured in resources and made changes in their legislation to ensure rapid development, testing, and deployment of a vaccine.

Barriers to Treatment

Lack of transparency and poor media relations.

The lack of government transparency and poor reporting by the media have hampered the measures that could have been taken by healthcare systems globally to deal with the COVID-19 threat. The CDC, as well as the US administration, downplayed the threat and thus failed to stock up on essential supplies, ventilators, and test kits. An early warning system, if implemented, would have caused borders to be shut and early lockdowns. The WHO also delayed its response in sounding the alarm regarding the severity of the outbreak to allow nations globally to prepare for a pandemic. Singapore is a prime example where, despite the WHO not raising concerns and banning travel to and from China, a country banned travelers and took early measures, thus managing the outbreak quite well. South Korea is another example of how things may have played out had those measures by agencies been taken with transparency. Increased transparency would have allowed the healthcare sector to better prepare and reduced the load of patients they had to deal with, helping flatten the curve. The increased patient load and confusion among citizens arising from not following these practices has proved to be a barrier to providing effective treatments to patients with the disease elsewhere in the world.

Lack of Preparedness and Protocols

Despite the previous SARS outbreak teaching us important lessons and providing us with data on a potential outbreak, many nations did not take the important measures needed for a future outbreak. There was no allocation of sufficient funds for such an event. Many countries experienced severe lack of PPE, and the lockdown precautions hampered the logistics of supply and manufacturing of such essential equipment. Singapore and South Korea had protocols in place and were able to implement them at a moment's notice. The spurt of cases that Korea experienced was managed well, providing evidence to this effect. The lack of preparedness and lack of protocol in other nations has resulted in confusion as to how the treatment may be administered safely to the large volume of patients while dealing with diagnostics. Both of these factors have limited the accessibility to healthcare services due to sheer volume.

Socio-Economic Impact

During the SARS epidemic, China faced an economic setback, and experts were unsure if any recovery would be made. However, the global and domestic situation was then in China's favor, as it had a lower debt, allowing it to make a speedy recovery. This is not the case now. Global experts have a pessimistic outlook on the outcome of this outbreak ( 98 ). The fear of COVID-19 disease, lack of proper understanding of the dangers of the virus, and the misinformation spread on the social media ( 99 ) have caused a breakdown of the economic flow globally ( 100 ). An example of this is Indonesia, where a great amount of fear was expressed in responses to a survey when the nation was still free of COVID-19 ( 101 ). The pandemic has resulted in over 2.6 billion people being put under lockdown. This lockdown and the cancellation of the lunar year celebration has affected business at the local level. Hundreds of flights have been canceled, and tourism globally has been affected. Japan and Indonesia are estimated to lose over 2.44 billion dollars due to this ( 102 , 103 ). Workers are not able to work in factories, transportation in all forms is restricted, and goods are not produced or moved. The transport of finished products and raw materials out of China is low. The Economist has published US stock market details indicating that companies in the US that have Chinese roots fell, on average, 5 points on the stock market as compared to the S&P 500 index ( 104 ). Companies such as Starbucks have had to close over 4,000 outlets due to the outbreak as a precaution. Tech and pharma companies are at higher risk since they rely on China for the supply of raw materials and active pharmaceutical ingredients. Paracetamol, for one, has reported a price increase of over 40% in India ( 104 – 106 ). Mass hysteria in the market has caused selling of shares of these companies, causing a tumble in the Indian stock market. Though long-term investors will not be significantly affected, short-term traders will find themselves in soup. Politically, however, this has further bolstered support for world leaders in countries such as India, Germany, and the UK, who are achieving good approval ratings, with citizens being satisfied with the government's approach. In contrast, the ratings of US President Donald Trump have dropped due to the manner in which the COVID-19 pandemic was handled. These minor impacts may be of temporary significance, and the worst and direct impact will be on China itself ( 107 – 109 ), as the looming trade war with the USA had a negative impact on the Chinese and Asian markets. The longer production of goods continues to remain suspended, the more adversely it will affect the Chinese economy and the global markets dependent on it ( 110 ). If this disease is not contained, more and more lockdowns by multiple nations will severely affect the economy and lead to many social complications.

The appearance of the 2019 Novel Coronavirus has added and will continue to add to our understanding of viruses. The pandemic has once again tested the world's preparedness for dealing with such outbreaks. It has provided an outlook on how a massive-scale biological event can cause a socio-economic disturbance through misinformation and social media. In the coming months and years, we can expect to gain further insights into SARS-CoV-2 and COVID-19.

Author Contributions

KN: conceptualization. RK, AA, JM, and KN: investigation. RK and AA: writing—original draft preparation. KN, PN, and JM: writing—review and editing. KN: supervision.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

The authors would like to acknowledge the contributions made by Dr. Piya Paul Mudgal, Assistant Professor, Manipal Institute of Virology, Manipal Academy of Higher Education towards inputs provided by her during the drafting of the manuscript.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2020.00216/full#supplementary-material

Supplementary Data 1, 2. List of all studies registered for COVID-19 on clinicaltrials.gov .

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Keywords: 2019-nCoV, COVID-19, SARS-CoV-2, coronavirus, pandemic, SARS

Citation: Keni R, Alexander A, Nayak PG, Mudgal J and Nandakumar K (2020) COVID-19: Emergence, Spread, Possible Treatments, and Global Burden. Front. Public Health 8:216. doi: 10.3389/fpubh.2020.00216

Received: 21 February 2020; Accepted: 11 May 2020; Published: 28 May 2020.

Reviewed by:

Copyright © 2020 Keni, Alexander, Nayak, Mudgal and Nandakumar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Krishnadas Nandakumar, mailnandakumar77@gmail.com

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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COVID-19 pandemic crisis—a complete outline of SARS-CoV-2

Sana saffiruddin shaikh.

1 Y. B. Chavan College of Pharmacy, Dr. Rafiq Zakaria Campus, Aurangabad, 431001 India

Anooja P. Jose

2 Government College of Pharmacy, Aurangabad, 431001 India

Disha Anil Nerkar

Midhuna vijaykumar kv, saquib khaleel shaikh, associated data.

The data and material are available upon request. The graphs and figures used in the manuscript were generated and analyzed and are not used anywhere else before.

Coronavirus (SARS-CoV-2), the cause of COVID-19, a fatal disease emerged from Wuhan, a large city in the Chinese province of Hubei in December 2019.

Main body of abstract

The World Health Organization declared COVID-19 as a pandemic due to its spread to other countries inside and outside Asia. Initial confirmation of the pandemic shows patient exposure to the Huanan seafood market. Bats might be a significant host for the spread of coronaviruses via an unknown intermediate host. The human-to-human transfer has become a significant concern due to one of the significant reasons that is asymptomatic carriers or silent spreaders. No data is obtained regarding prophylactic treatment for COVID-19, although many clinical trials are underway.

The most effective weapon is prevention and precaution to avoid the spread of the pandemic. In this current review, we outline pathogenesis, diagnosis, treatment, ongoing clinical trials, prevention, and precautions. We have also highlighted the impact of pandemic worldwide and challenges that can help to overcome the fatal disease in the future.

Coronaviruses (CoVs) are a large family of RNA viruses; they show discrete point-like projections over their surface. They show the presence of an unusually large RNA genome and a distinctive replication strategy. The term “coronavirus” is acquired from the “crown”-like morphology. Coronaviruses show potential fatal human respiratory infections and cause a variety of diseases in animals and birds [ 1 ]. Coronavirus primarily targets the human respiratory system [ 2 ]. The World Health Organization (WHO) named the latest virus as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on 12 January 2020 [ 3 ]. The COVID-19 or the SARS-CoV-2 is rapidly unfurling from Wuhan in Hubei Province of China to worldwide [ 4 ].

Initial confirmation of the pandemic was carried out by conducting studies on 99 patients with COVID-19 pneumonia, from which 49% of patients exhibited a history of subjection to the Huanan seafood market. The patient examined had a clinical manifestation of fever, cough, shortness of breath, muscle ache, and sore throat-like symptoms [ 5 ]. COVID-19 has infected several hundreds of humans and has caused many fatal cases [ 6 ]. Worldwide, there have been 3,925,815 confirmed cases, including 274,488 deaths of COVID-19 as of 6:37 pm CEST 10 May 2020 reported to WHO [ 7 ].

This article outlines and gives a complete overview of SARS-CoV-2, including its pathogenesis, diagnosis, treatment, prevention, and precautions. This article also provides the current scenario of the pandemic worldwide, since new findings are rapidly evolving and can help the readers in upgrading their knowledge about the COVID-19. It also emphasizes the challenges faced by giving an idea about future strategies in fighting and preventing recurrence.

History and origin

Coronaviruses were not expected to be highly infectious to humans, but the outburst of a severe acute respiratory syndrome (SARS) in Guangdong province China in the years 2002 and 2003 proved to be devastating. SARS-CoV is the contributory agent of the SARS, also known as “atypical pneumonia”. The coronaviruses that spread before that time in humans mostly caused mild infections in immune-competent people. But after the emergence of SARS, another highly infectious coronavirus, MERS-CoV, appeared in Middle Eastern countries [ 8 , 9 ]. Research has shown that SARS-CoV-2 shows similarities with SARS-CoV and MERS-CoV. (Table (Table1) 1 ) depicts a comparison of SARS-CoV-2 with SARS-CoV and MERS-CoV [ 10 – 16 ]. Several disseminating strains of coronaviruses were identified and were considered harmless pathogens, causing common cold and mild upper respiratory illness [ 17 ]. HCoV-229E [ 18 ] strain was isolated in 1966. HCoV-NL63 was first isolated from the Netherlands during late 2004. In 2012, MERS-CoV was first identified from the lung of a 60-year-old patient who was suffering from acute pneumonia and renal failure in Saudi Arabia [ 19 ]. About 8000 cases and 800 deaths worldwide were observed due to the outbreak of SARS first human pandemic in the dawn of the twenty-first century [ 20 ].

Comparison of coronaviruses

Note: despite the lower case fatality rate observed in COVID-19, the overall number of death far outweighs that from SARS and MERS

The α-CoVs HCoV-229E and HCoV-NL63 and β-CoVs HCoV-HKU1 and HCoV-OC43 are identified as a human susceptible virus with low pathogenicity and cause mild respiratory symptoms similar to common cold [ 21 ]. SARS-CoV and MERS-CoV result in severe respiratory tract infections [ 22 , 23 ]. COVID-19 was recently reported from Wuhan (China), which has cases in Thailand, Japan, South Korea, and the USA, which has been confirmed as a new coronavirus [ 24 ].

The coronavirus genera, which mostly infect mammals, are alpha-coronavirus and beta-coronavirus. Out of 15 presently assigned viral species, seven were isolated from bats. The research proposed that bats are significant hosts for alpha-coronaviruses and beta-coronaviruses and play an essential role as the gene source in the evolution of these two coronavirus genera SARS and MERS [ 25 ]. The genome sequence was found to be 96.2% identical to a bat CoV RaTG13, whereas it shares 79.5% identity to SARS-CoV. The virus genome sequencing outcomes and evolutionary analysis show that bat can be a natural host from virus source, and SARS-CoV-2 might be transferred from bats through unspecified intermediate hosts to infect humans [ 26 ]. It is found that SARS-CoV-2 affects males more than females [ 27 ]. The spread of SARS-CoV-2 emerged like a wild forest fire in many countries worldwide. Table ( (2) 2 ) [ 28 ] gives a brief of the first identified cases of COVID-19 in different countries.

First confirmed case

The first confirmed case was reported in China, and since then, there was a widespread of coronavirus in other countries worldwide. Table Table1 1 shows the first confirmed case with dates

Coronaviruses are spherical to pleomorphic enveloped particles [ 29 ]. The size ranges from 80 to 120 nm in diameter. The maximum size is as small as 50 nm and as large as 200 nm are also seen [ 30 ]. There are four types of main structural proteins observed in the coronaviruses: the spike (S), membrane (M), envelope (E), and nucleocapsid (N) proteins, which are encoded within the viral genome (Table (Table3). 3 ). In thin sections, the virion envelope may be visualized as inner and outer shells separated by a translucent space [ 31 ]. The virion envelope contains phospholipids, glycolipids, cholesterol, di- and triglycerides, and free fatty acids in proportions. The complexed genome RNA is with the basic nucleocapsid (N) protein, which forms a helical capsid established within the viral membrane. The enclosed glycoproteins are responsible for attachment to the host cells [ 32 ].

Structural proteins of coronavirus and their functions

According to the recent studies, it is observed that coronavirus which lacks envelope protein (E) serves as a good candidate in vaccine designing

The coronavirus genomes are among the most massive mature RNA molecules as compared to other eukaryotic RNAs (Fig. (Fig.1) 1 ) [ 33 ]. The genome of these viruses contains multiple ORFS. A typical CoV consists of at least 6 ORFs in its genome. Several studies have confirmed the genetic resemblance between SARS-CoV-2 and a bat CoV.

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Structure of novel coronavirus

A study conducted to compare the genetic mutations of COVID showed genomic mutations among viruses from different countries, wherein a sequence obtained from Nepal showed minimum to no variations. In contrast, the maximum number of modifications was obtained from one derived from the Indian series located in ORF1-ab nsp2 nsp3 helicase ORF8 and spike surface glycoprotein. Also, host antiviral mRNAs play a critical part in the regulation of immune response to virus infection, depending upon the viral agent. The unique host mRNAs could be explored in the development of novel antiviral therapies. The club-like surface projections or peplomers of coronaviruses are about 17–20 nm from the virion surface. It has a subtle base that swells to a width of about 10 nm at the distal extremity. Some coronaviruses that exhibit the second set of projections about 5–10-nm long are present beneath the significant projections. These shorter spikes are now known as hemagglutinin-esterase (HE) protein, an additional membrane protein found in a subset of group 2 coronaviruses. The primary role of this non-essential protein is to aid in viral entry and pathogenesis in vivo. It configures short projections that bind to N-acetyl-9-O-acetlyneuramic acid or N-glycolylneuraminic acid and have esterase [ 34 – 39 ]. Figure Figure2 2 shows the primary classification of coronavirus.

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Classification of coronavirus

Lifecycle of coronavirus

The life cycle of the virus with the host consists of the following four steps: attachment, penetration, biosynthesis, maturation, and release (Fig. (Fig.3). 3 ). Once the virus binds to the host receptor, they enter host cells through endocytosis or membrane fusion. Once the viral contents are released inside the host cells, viral RNA enters the nucleus for replication. Viral mRNA is used to make viral proteins and is further proceeded by maturation and release [ 40 , 41 ].

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Attachment and entry

The virion attachment with the host cell is initiated by interaction between S protein and its receptors, which is also a primary determinant for coronavirus infection. The S protein undergoes acid-dependent proteolytic cleavage, which results in exposure of fusion peptide. This fusion is followed by the formation of a six-helix bundle (bundle formation helps in combining viral and cellular membrane) and release of the viral genome into the cytoplasm.

Replicase protein expression

The process of translation of replicase gene ORFs1a and ORFs1b and translation of polyprotein pp1a and pp1ab takes place. Assembly of nsps into replicase-transcriptase complex (RTC) leads to viral RNA synthesis (replication and transcription of subgenomic RNAs).

Replication and transcription

In the replication process, the viral RNA synthesis is followed by the production of genomic and sub-genomic RNAs (sub-genomic mRNAs), which further leads to recombination of the virus.

Assembly and release

The insertion and translation of viral structure protein S, E, and M takes place into the endoplasmic reticulum (ER), which is followed by the movement of proteins along the secretory pathway into ERGIC (endoplasmic reticulum Golgi intermediate compartment). The viral genome is encapsidated by N protein into the membrane of ERGIC. M and E protein expression give rise to the formation of virus-like particles (VLPs). After the assembly of the virion and its transportation to cell surface vesicles, exocytosis takes place. Finally, it results in viral release (E protein helps by altering the host secretory pathway).

The incubation period is the period between the entry of the virus into the host and appearance of signs and symptoms in the host or the period between the earliest date of contact of the transmission source and the most initial time of symptom onset (i.e., cough, fever, fatigue, or myalgia) [ 42 ]. The incubation period of COVID-19 is vital as the disease could be transmitted during this phase through asymptomatic as well as symptomatic carriers (Table (Table4). 4 ). The inhaled virus SARS-CoV-2 binds to the epithelial cells present in the nasal cavity and starts replicating.

Incubation period of coronaviruses

On the basis of studies conducted and data findings, virologists points out that incubation period extends to 14 days, with a median time of 4–5 days from exposure to symptom onset. One study reported that 97.5% of persons with COVID-19 who develop symptoms will do so within 11.5 days of SARS-CoV-2 infection

ACE2 is the primary receptor for both SARS-CoV-2 and SARS-CoV, which is an asymptomatic state (initial 1–2 days of infection). Upper airway and conducting airway response are seen the next few days. The disease is mild and mostly restricted only to the upper conducting airways for about 80% of the infected patients [ 43 ].

The incubation period is required to create more productive quarantine systems for people infected with the virus. The incubation period for the COVID-19 is between 2 and 14 days after exposure. A newly infected person shows symptoms in the about 5 days after contact with a sick patient. In most patients, symptoms appeared after 12–14 days of infection

The average incubation period was approximated to be 5.1 days, and 97.5% of those who develop symptoms will do so within 11.5 days of infection. In Wuhan’s return patients, the average incubation period is found to be 6.4 days. In a case reported by Hubei province, local government on 22 February showed an incubation period of 27 days. In another case, an incubation period of 19 days was observed. Therefore a 24-day observation period is considered in suspected cases by the Chinese government and also by WHO [ 44 – 51 ]. The frequency of cases is increasing day by day, and it is essential to keep a check over it. Figure Figure4 4 gives a glance of confirmed cases cumulative and death overtime cumulative from 10 January onwards up to 25 May.

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a Graph of confirmed (cumulative) cases overtime in various countries . b Graph of death (cumulative) overtime in various countries

Pathogenesis

Like other CoVs, the SARS-CoV-2 is transmitted primarily via respiratory droplets and possible faeco-oral transmission routes [ 52 ]. Figure Figure5 5 gives a complete outline of the pathogenesis of coronavirus. On infection, primary viral replication is expected to occur in the mucosal epithelium of the upper respiratory tract with further multiplication into the lower respiratory tract and GI mucosa, giving rise to mild viremia. The virus enters the host cells through two methods either:

I. Direct entry
II. Endocytosis

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Complete pathogenesis of coronavirus

These are positive sense ss-RNA viruses that can cause respiratory, enteric, hepatic, and neurologic diseases. High binding capacity with SARS-CoV-2 was observed by molecular biological analysis [ 53 ]. The ACE2 gene encodes the angiotensin-converting enzyme-2 receptor for both the SARS-CoV and the human respiratory coronavirus NL63. Recent studies show that ACE2 could be the host receptor for the novel coronavirus 2019-nCoV/SARS-CoV-2 [ 54 ].

Human angiotensin-converting enzyme 2 (hACE2), which was the binding receptor of SARS-CoV, is analogous to SARS-CoV-2. These hACE2 are type 1 membrane proteins expressed in various cells of the nasal mucosa, lung, bronchus, heart, kidney, intestines, bladder, stomach, esophagus, and ileum. It functions as an enzyme in the RAS and is, therefore, mainly associated with cardiovascular diseases [ 55 ].

The zinc peptidase ACE2 has also expressed in the alveolar type 2 pneumocytes, which explains its role in lung damage due to SARS-CoV. The SARS-CoV-2 shows 10–12-fold more affinity towards the proteins than the other SARS-CoV. Pathophysiology and virulence of the virus link to the function of its nsps and structural proteins. The nsp can block the host’s innate mechanism response while the virus envelope increases the pathogenicity as it assists the assembly and release of the virus [ 56 ].

The CoV spike glycoproteins comprise of three segments—a large ectodomain, a single-pass transmembrane anchor, and a small intracellular tail. The ectodomain is composed of the receptor-binding domain (RBD)—the S1 and the membrane fusion subunit S2. The two significant areas in s1, N-terminal domain (NTD) and the c-terminal domain (CTD), have been identified. The S1 NTDs are essential for binding to the sugar receptors, and the s1 CTDs are responsible for binding receptors ACE2, SPN, and DPP4 [ 57 ]. The S proteins undergo a considerable structural rearrangement to fuse with the viral membrane of the host cell membrane. The s1 subunit shedding and the s2 subunit transition to a highly stable conformation is the initial step in the fusion process [ 58 ]. The ACE2 consists of the N-terminal peptidase domain (NPD) and the C-terminal collectrin-like domain (CCTD) that ends with a single transmembrane helix and a 40 residue intracellular segment. It provides a direct binding site for S protein of CoVs.

The enzymes which assist this virus attachment include the serine protease enzymes TMPRSS2. These enzymes, which are cell-surface proteases, facilitate entry. In endosomes, the S1 of s proteins is cleaved, and the fusion peptides S2 are exposed. This exposed S2 unit brings the HR1 and HR2 together, resulting in membrane fusion and thereby release of viral package into the host membrane [ 59 ].

The viral RNA enters the nucleus for replication after the viral contents are released. Viral mRNA is used to make viral proteins. Decreased expression of ACE2 in a host cell results in an attack on the airway epithelium by the virus. These lead to acute lung injury that triggers immune responses. The release of various pro-inflammatory and chemokines like IL-6, IFN- gamma, MCPI 1, and IL-10 leads to capillary permeability in alveolar sacs. Due to local inflammation in the lungs, the secretion of pro-inflammatory cytokines and chemokines increases into the blood circulation of the patient. It results in fluid filling and increased difficulty in the exchange of gases across the membrane. Viral replication and infection in airway epithelial cells could cause high levels of virus-linked pyroptosis with associated vascular leakage. IL-beta cytokine released during pyroptosis is a highly inflammatory form of programmed cell death, which is the trigger subsequent inflammatory response. The IgG antibodies against SARS-CoV-2 N protein can be detected in the serum in the early stages at the onset of the disease. The non-neutralizing antibodies result in ADE (antibody-dependent enhancement), which leads to an increased systematic inflammatory response.

The pro-inflammatory cytokines and chemokines are an indicator of T H cells. Secretions from such cytokines and chemokines attract immune cell monocytes and T lymphocytes. High levels of pro-inflammatory cytokines, including IL-2, IL-7, IL-10, IP-10, G-CSF, MCP-1, MIP-1A, and TNF alpha, were detected in the severe infection called cytokine storm or cytokine release syndrome as a crucial factor in the pathogenesis of COVID-19.

The cytokine storm increases the inflammatory response resulting in increased blood plasma levels of neutrophils IL-6, IL-10, granulocytes, MCP1, TNF, and decreased organ perfusion, which results in multiple organ failure. Cytokine storm and pulmonary edema due to ACE2 dysregulation result in acute respiratory distress syndrome. SARS-CoV-2 can also affect the CNS [ 60 ]. Myocardial damage increases the difficulty and complexity of patient treatment [ 61 ]. Clinical investigations have shown that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2-increasing drugs, including inhibitors and blockers, are at higher risk of getting infected with SARS-CoV2 [ 62 ]. Death results due to ARDS and multiple organ failure.

People with COVID-19 infection show symptoms ranging from mild to severe illness. Figure Figure6 6 shows a brief outline of various symptoms related to COVID-19. The warning signs and symptoms such as trouble breathing, constant pain or pressure in the chest, inability to wake or stay awake, and bluish lips or face are observed in patients [ 63 ]. Older people (65 years and older) are at higher risk of developing the disease.

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Symptoms for coronavirus

According to a study, people of all ages having asthma, diabetes, HIV, liver diseases, severe heart conditions, severe obesity (body mass index [BMI] of 40 or higher), and chronic kidney diseases undergoing dialysis show a higher mortality rate. The other populations with people showing disabilities, pregnancy, and breastfeeding and people experiencing homelessness, racial, and minority groups are at elevated risk of transmission of disease [ 64 ]. The crucial fact to know about coronavirus on surfaces is that they can easily be cleaned with ordinary household disinfectants that will kill the virus [ 65 ]. Studies have shown (Fig. (Fig.7) 7 ) that the COVID-19 virus can survive for up to 72 h on plastic and stainless steel, about 4 h on copper, and less than 24 h on cardboard [ 66 ].

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Survival of virus on various objects

Diagnosis: COVID-19

There are two categories of tests available for COVID-19:

Viral tests: a viral analysis indicates whether a person has a current infection.
Antibody tests: an antibody indicates whether a person had an infection.

The protection of getting infected again in a person showing the presence of antibodies to the virus is still unexplained [ 67 ].

Tests for current infection

A swab sample is collected (from the nose) to conclude that a person is currently infected with SARS-CoV-2. Some tests are called as point-of-care tests, which means their results may be available in less than an hour. Other test takes 1–2 days for analyzing after being received by the laboratory [ 68 ].

Test for past infection

Antibody tests analyze a blood sample for the presence of antibodies, which show if one had a previous infection with the virus. Antibody tests cannot be used to diagnose someone as being currently infected with COVID-19. Antibody tests are accessible through healthcare providers and laboratories [ 69 ]. In severe cases, clinical diagnosis is done based on the clinical manifestations of respiratory failure syndrome, increased liver function tests, blood tests indicating leukopenia, and high levels of ferritin. For such, a test for soluble CD-163 (sCD-163), showing the activation of macrophages, was suggested [ 70 ]. Laboratory diagnosis included genomic sequencing, reverse-transcription polymerase chain reaction (RT-PCR), and serological methods (such as enzyme-linked immunoassay [ELISA]). Because of the rapidly changing diversity found in the expression of the novel coronavirus, pneumonia became diverse and quickly changed. Other methods used are radiographic images for early observations and evaluation of disease severity [ 71 ].

Reverse-transcription polymerase chain reaction (RT-PCR) shows high sensitivity for new SARS cases. The suspected cases must be confirmed by using RT-PCR and other methods (slower methods) of detection such as serology or viral culture, isolation, and identification by electron microscopy, thereby causing a significant increase in the time required for an accurate diagnosis [ 72 ]. The samples are collected from upper and lower respiratory tracts through expectorated sputum, bronchoalveolar lavage, or endotracheal aspirate, which are then assessed by conducting polymerase chain reaction for viral RNA. It is recommended to repeat the test for reevaluation purposes in case of a positive result, and if the test is negative, a strong clinical impression also permits repeat testing [ 73 ].

An alternative diagnostic test to detect the SARS-CoV is mass spectroscopic identification of microbial nucleic acid signatures. Computed tomography images of the lungs showed 100% multiple patchy with fine mesh and consolidated shade distributed under the pleura. Nucleic acid tests were conducted in 187 patients, and all were positive to SARS-CoV-2. In the pulmonary CT images, 8% of them (15 cases) showed diffused lesions in either lungs or white lung. In the absorptive period, 98.9% showed fibrogenesis and diminished lesions. The CT imaging features differed from each follow-up showing different clinical symptoms [ 74 ]. The improvement in the detection of COVID-19 was found by the ELISA method. It is based on SARS r-CoV Rp3 nucleocapsid protein, which helps to detect the IgM and IgG against SARS-CoV-2. ELISA is a highly recommended method as the sampling blood is less stringent, and antibodies allow longer windows than oropharyngeal swabs for detecting viruses [ 75 ].

There is no particular treatment recommended for COVID-19. There is no data obtained regarding prophylactic treatment for COVID-19, only we can prevent from coming in contact with the pathogen. Confirmed cases are hospitalized and admitted in the same ward. Patients with mild symptoms may not require hospitalization [ 76 ]. They are isolated or self-isolated at home by following the doctor’s advice. Critically ill patients (respiratory shock, respiratory failure, septic shock, or other organ failures) should be admitted to ICU as soon as possible [ 77 ].

General treatment

The general treatment includes bed rest and supportive measures ensuring sufficient intake of calories, fluid, and electrolytes, and maintenance of acid-base homeostasis. Monitoring oxygen saturation and vital signs, keeping the respiratory tract unobstructed and inhaling oxygen, measuring C-reactive protein, hematology and biochemistry laboratory testing and ECG, blood gas analysis, and examining of chest images as when required and monitoring for any complications [ 78 ]. Patients having high body temperature above 38.5°C Celsius are administered with ibuprofen and acetaminophen orally.

Oxygen therapy

Patients with conditions of obstructed breathing, respiratory distress, shock, coma, and convulsions must receive oxygen therapy and airway management, targeting SpO2 more significant than 94%. Initiate O 2 treatment at 5 L/min and titrated to reach the target or use a face mask with a reservoir bag (10–15 L/min) if the patients are in critical condition.

Once stable, the target is 90% SpO2 in non-pregnant adults and 95% in pregnant adults. The use of nasal prongs or nasal cannula is preferred in young children, as they may be better tolerated. When oxygen therapy fails, mechanical ventilation is necessary. In a meta-analysis, the use of additional oxygen therapy (38.9%), non-invasive (7.1%) and invasive ventilation (28.7%), and even ECMO (0.9%) was surprisingly high among the 1876 patients in which any kind of pharmacological and supportive intervention was reported [ 79 ].

Antiviral agents

Remdesivir inhibits virus infection at the micromolar level (0.77–1.13 μM) and with high selectivity [ 80 ]. Remdesivir gets incorporated into viral RNA due to its adenosine analog nature and results in premature chain termination [ 81 ]. Remdesivir is not approved by the Food and Drug Administration (FDA). It is only recommended for mild or moderate COVID-19 conditions and the treatment of hospitalized adults and children in emergencies.

Chloroquine/hydroxychloroquine

Chloroquine increases endosomal pH, making the environment unfavorable for viral cell fusion. It also affects the glycosylation process of ACE-2. On administering chloroquine after 1 h of infection, gradual loss of antiviral activity was seen, though it affects the endosome fusion when administered shortly after the infection. When administered after 3–5 h after the infection, chloroquine was significantly effective against HCoV strain OC43 [ 82 ]. There is an excessive risk of toxicities due to high chloroquine doses; the recommended dose for chloroquine is 600 mg twice daily for 10 days for the treatment of COVID-19.

Interferon–alpha

Interferon-α is used in treating bronchiolitis; viral pneumonia; acute upper respiratory tract infection; hand, foot, and mouth disease; SARS; and other viral infections in children. According to the clinical research and experiences, the following usage is recommended for COVID-19

Interferon-α nebulization: interferon-α 200,000–400,000 IU/kg or 2–4 μg/kg in 2 mL sterile water, nebulization two times per day for 5–7 days
Interferon-α2b spray: applied for high-risk populations with close contact with suspected COVID-19 infected patients or those in the early phase with only upper respiratory tract symptoms.

Lopinavir/ritonavir

In a clinical trial among adult patients of or less than 18 years, it was observed that a combination of lopinavir/ritonavir, ribavirin, and interferon beta-1b would speed up the recovery, suppress the viral load, shorten hospitalization, and reduce mortality compared with lopinavir/ritonavir [ 83 ].

Immune-based therapy

Patients who show an inadequate response to initial therapy can get benefit from immunoglobulin [ 84 ]. Non-SARS-CoV-2-specific IVIG should not be used for COVID-19 except in case of clinical trials.

Corticosteroids

Corticosteroids are widely used in the symptomatic treatment of severe pneumonia. According to a detailed review and analysis, the result indicates that patients with severe conditions required corticosteroid therapy [ 85 ]. According to a systematic review of literature, daily use of corticosteroids in a COVID-19 patient is not encouraged; however, some studies suggest that methylprednisolone can reduce the mortality rate in more severe conditions, such as in ARDS [ 86 ].

Antimicrobial therapy

Patients with a mild type of bacterial infection can take oral antibiotics, such as cephalosporin or fluoroquinolones. Although a patient may be a suspect for COVID-19, appropriate antimicrobial agent should be administered within an hour of recognition of sepsis. Antibiotic therapy should be based on the clinical diagnosis of community-acquired pneumonia, healthcare-associated pneumonia, local epidemiology, susceptibility data, and national treatment guidelines. When there is the ongoing local circulation of seasonal influenza, this therapy with a neuraminidase inhibitor should be considered for the treatment for patients [ 87 ].

Tocilizumab

According to a review, 25 patients with laboratory-confirmed severe COVID-19 who received tocilizumab and completed 14 days of follow-up, 36% were discharged alive from the intensive care unit, and 12% died [ 88 ]. The biopsy specimen analysis suggested that increased alveolar exudates resulted from an immune response against an inflammatory cytokine storm. Probably an obstruction in alveolar gas exchange contributed to the high mortality rate of severe COVID-19 patients. A study identified that pathogenic T cells and inflammatory monocytes arouse an inflammatory storm with a large amount of interleukin 6. Tocilizumab blocks IL-6 receptors, which shows encouraging clinical results, including controlling temperature quickly and improved respiratory functions. Henceforth, tocilizumab is useful in the treatment of severe COVID-19 patients to calm the inflammatory storm and reduce mortality [ 89 ].

FDA-approved drug ivermectin for parasitic infection has a possibility for reprocessing and acts as an inhibitor of SARS-CoV-2 in vitro. A single therapy can affect approximately 500-fold reduction and effectual loss of substantially all viral material by 48 h [ 90 ]. A single of ivermectin, in combination with doxycycline, yielded the near-miraculous result in curing the patients with COVID-19 virtually.

Azithromycin

Azithromycin is used for patients with viral pneumonia from COVID-19. It can also work synergistically and coactively with other antiviral treatments. It has also shown antiviral activity against the Zika virus and rhinoviruses, which cause the common cold. Viral infection was significantly reduced in patients receiving hydroxychloroquine than those who did not. The virus elimination was efficient in patients who received both azithromycin and hydroxychloroquine [ 91 ]. (Table (Table5) 5 ) lists other supporting agents used in treatment [ 92 ].

Supporting agents used in treatment

The repurposing of available therapeutic drugs is being used as supporting agents in the treatment of COVID-19; however, the efficacy of these treatments should be verified by using designed clinical trials

Precautions and preventions

WHO declared the COVID-19 outbreak as a public health emergency of international concern on 30 January 2020. Unfortunately, no medication until now is approved by the FDA, and various trials are going on. Still, the most effective weapon the community has in hand is the prevention of spread. The following are some of the COVID-19 prevention measures.

Quarantine: self-quarantine, mandatory quarantine (private residence, hospital, public institution, etc.)
Other measures: avoiding crowding, hand hygiene, isolation, personal protective equipment, school/workplace measures/closures, social distancing [ 93 ].

Asymptomatic carriers as the “silent spreaders” are of great concern for the elimination of disease and its control. So, more attention should be given to them [ 94 ]. Hand hygiene with alcohol-based hand-rub is globally recommended as productive and economical procedures against SARS-CoV-2 cross-transmission [ 95 ]. The economic implications of hand hygiene have been established. It has been found that this cost under 1% of total HAI-related economics. It is better to invest not only in the materials needed but also in the people working there. This investment will lead to an increase in the health outcome [ 96 ]. The clinical presentation of COVID-19 is non-specific, so it needs a robust and accurate diagnosis. It has been suggested that before stopping the infection control measures, we have to be sure to exclude the diagnosis [ 97 ]. Prevention plays a vital role in treating and defeating the COVID-19 disaster.

The Centers for Disease Control and Prevention gives standard precautions (Fig. (Fig.8) 8 ) and recommends measures to prevent COVID-19. Wear personnel protective equipment (face shield, mask, gown, gloves, and closed-toed shoes) when evaluating persons at risk. N-95 masks are known to prevent up to 95% of small particles, including viruses [ 98 ]. Cover all coughs/sneezes with a tissue and then throw the tissue away. Regularly clean/disinfect frequently touched objects and surfaces with household cleaning spray and use a tissue when handling (e.g., doorknobs, sink taps, water fountain handles, elevator buttons, cross-walk buttons, and shopping carts). Avoid contact with infected people (recommended > 6 ft) and maintain an appropriate distance as much as possible and refrain from touching nose eyes and mouth [ 99 ]. Avoid well persons when you are ill. Wear a mask continuously if taking care of persons with respiratory illness. To turn on the tap, use a paper towel and then wash hands with soap and water for at least 30 s after going to the bathroom. Use hand sanitizer and carry whenever at a public venue. Activate community-based interventions (e.g., cancel sporting events, dismiss, termination of universities and schools, practice social distancing, create employee plans to work remotely) [ 100 ]. Create a household-ready plan. Cancel any non-essential travel [ 101 ]. Frequent disinfection and cleaning are advised for groups that are at risk of contracting the virus [ 102 ].

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Prevention and precaution

In an Indian study mathematical approach was used to address some questions related to intervention strategies to control the COVID-19 transmission in India. Some hypothetical epidemic curves helped to illustrate the critical findings [ 103 ]. Predication of spread and implications of prevention and control using the Maximum-Hasting (MH) parameter assessment method and the modified Susceptible Exposed Infectious Recovered (SEIR) model was done. Suppression, mitigation, and mildness were the three predicted outlines for the spread of infection in some African countries [ 104 ].

Infection control strategies that can be acquired in hospitals were accomplished in a Taiwanese hospital to tackle the COVID-19 pandemic. These included emergency vigilance and responses from the hospital administration, education, surveillance, patient flow arrangement, the partition of hospital zones, and the prevention of a systemic shutdown by using the “divided cabin, divided flow” strategy. These measures may not be universally appropriate [ 105 ]. The preventive measures implemented in China included countrywide health education campaigns. The Examine and Approve Policy on the continuation of work, working and living quarters, a health Quick Response code system, community screening, and social distancing policies were some of the preventive measures [ 106 ].

Based on the analysis of immigration population data, the Epidemic Risk Time Series Model was outlined to estimate the effectiveness of COVID-19 epidemic control and prevention among different regions in China. Compared to other methods, this model was able to issue early recognition more instantaneously. For the prevention and control of COVID-19, this model can be generalized and applied to other countries [ 107 ]. The majority of clinical trials involving COVID-19 vaccines or treatment are showing encouraging results. (Tables (Tables6 6 and and7) 7 ) show ongoing phase 3 and 4 clinical trials [ 108 ].

Ongoing clinical trials phase 3 studies

Ongoing clinical trials, phase 4 studies

Impact of COVID-19 on overall health of the people worldwide

The international response to COVID-19 has been more transparent and efficient when compared to the SARS outbreak [ 109 ].

The pandemic COVID-19, being a most severe strainer, is affecting the overall health system worldwide. There is a continuously increasing demand for healthcare facilities and associated workers, which is overstretching the ability to operate efficiently [ 110 ]. Some pieces of evidence are showing a destructive effect on maternal and child health. Some financial, educational, sanitation, and even clinical constraints are threatening the overall population of the children [ 111 ]. As coronavirus is sweeping across the world, the primary psychological impact is elevated in terms of stress and anxiety. The quarantine period is expected to raise cases involving suicidal behavior, substance abuse, self-harm, depression, and loneliness. WHO Department of Mental Health and Substance use has given some messages to overcome psychological impacts [ 112 ]. There is a relationship between human development and infectious diseases. Whichever changes (new technology, constructions of dams, deforestations, migration, increasing populations, the emergence of urban ghettoes, globalization of food, and increasing international travel) brought about by the development, are stretching the word into the mouth of such pandemics indirectly. This pandemic is having a significant impact on the global economy as the erosion of capacity and rise in poverty [ 113 , 114 ].

COVID-19 has affected the population differently based on gender. Significantly, this crisis is affecting the reproductive and sexual health of women. Another point is that there should be an equal contribution to both the genders in any healthcare body. There should be more distribution of decision-making power among them [ 115 ]. Protective measures can effectively prevent COVID-19 infection, including improving personal hygiene, wearing N95 masks, adequate rest, and proper ventilation [ 116 ].

Have to learn to live with COVID-19

The Health Ministry has said that we have to learn to survive with COVID-19. We cannot step ahead by carrying the burden of COVID-19 that could recur annually and kill so many people [ 117 ]. Governments are learning to strike a balance between controlling COVID-19 spread and allowing individual freedoms and economic activity. Measures such as lockdowns, arbitrary travel bans, widespread quarantines, intrusive screening of people crossing boundaries can be adopted for prevention. Virtual work will become much more common. Supplier close-downs, sudden employee truancy, and demand collapse caused by disease outbreaks will make the businesses able to withstand disruptions.

The government, industry, or specialist certification for disease control processes and standards similar to ISO 9001 or USFDA certificate will be a crucial part of many businesses. The cost of traveling will expand more due to the risk of infection and lockdown. At the same time, the responsibility of work airlines, hotels, and restaurants will be added to minimize infection risk. Delivery businesses will perform well, and “Contactless delivery” is already a thing.

The industries that provide products to help circumvent, control, diminish, or treat COVID-19 will flourish. The requirement for hospital rooms will increase tremendously, with an increasing need for reserves of equipment, supplies, and drugs. In the upcoming time, businesses are likely to face demand crisis as the world comes to terms with living in a state of medical beleaguerment [ 118 ]. It is just a prediction, but we can still aspire for the best [ 119 ]. The most destructive effects would be in countries with weak health systems, on-going disputes, or existing infectious disease epidemics.

In contrast, the health systems in high-income countries would be stretched out by the outbreak [ 120 ]. It has been seen that resources are limited in countries with poor scientific infrastructure, such as Nepal, where there was only one laboratory equipped to test for coronavirus infection. Fear and stigma is an evident feature of the COVID-19; it has affected the economic and social development of many countries worldwide [ 121 ].

The insufficiency of the trained workforce capable of performing experiments required to test for SARS-CoV-2 and interpret the results is another major limitation in the testing and confinement of COVID-19 in developing countries [ 122 ]. The virus has the potential to adapt and get through the different environmental conditions, which makes it quite difficult to identify its mode of survival [ 123 ]. Another crucial impediment in a research project is a suitable model to investigate in vivo mechanism associated with the pathogenesis of SARS-CoV-2 [ 124 – 126 ].

Current screening approaches for COVID-19 are likely to miss approximately 50% of the infected cases, even in countries with sound health systems and available diagnostic capacities. Many symptoms correlated with COVID-19 are similar to malaria, such as fever, difficulty in breathing, fatigue, and headaches of acute onset. If symptoms alone are used to specify a case during the emergency period then, a malaria case may be misinterpreted as COVID-19. The symptoms for malaria are seen within 10–15 days after an infective bite; multi-organ failure is common in severe cases among adults, while respiratory distress is also expected in children [ 127 ].

COVID-19 has emerged as the most terrified and enormous viral infection. According to WHO, the coronavirus might become an endemic disease. Originating from China as a global pandemic, it has influenced people on a large scale. There is no clear end that can be seen for this contagious disease. The only possible cure for this pandemic is prevention. We have to face it as a global community and support each other. The amplification of positivity will have a tremendous impact on the whole society. It is the duty of each individual for self-supervision and to report COVID-19 status, and challenging for those who appear to be ill. The other measure which can be followed to tackle this pandemic is healthy nourishment, sanitation, and hygiene practices robust connection and communication among children, and counseling to face the situation. Special care should be given to older people and pregnant ladies. It is better to get information only from the trusted sources; it is vital to get the facts and not the misinformation or rumors. Healthcare servants should have excellent and accurate communication with the public and must provide emotional and practical support. The ongoing pandemic of COVID-19 has caused not only notable morbidity and mortality in the world but also revealed significant systematic problems in the control and prevention of infectious diseases.

Acknowledgements

The authors express their sincere thanks to Ms. Fatma Rafiq Zakaria, Chairman of Maulana Azad Educational Trust Aurangabad Maharashtra, for her endless encouragement and support and for providing necessary facilities to carry out the above research work.

Abbreviations

Authors’ contributions.

All authors participated in the work substantively and have approved the manuscript as submitted. The authors have no conflict of interest in the study. Drafting the article and critical revision of the article was carried out by SSS. Data collection for the formation of graphical abstract and various figures and tables was also contributed from her end. Conception or design of the work was carried out by SKS. He also contributed to the data collection for lifecycle, history, and origin. Data collection for pathogenesis and comparison of CoVs study was carried out by APJ. Data collection for diagnosis and treatment was carried out by MVKV. Data collection for clinical trials was carried out by DAN. Final approval of the version to be published was done by all the authors’ SSS, APJ, DAN, MVKV, and SKS. All the authors have read and approved the manuscript. Each author has agreed with the publication of the manuscript.

No funding was received for this work

Availability of data and materials

Ethics approval and consent to participate.

Not applicable

Consent for publication

Competing interests.

I, on behalf of all the authors, hereby declare that there is no significant financial, professional, or personal competing interest that might have influenced the performance or presentation of the work described in this manuscript.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

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How were COVID-19 vaccines developed so quickly?

What are the side effects of COVID-19 vaccines?

How do I find out more about a particular COVID-19 vaccine?

Can I stop taking precautions after being vaccinated?

Can I still get COVID-19 after I have been vaccinated? What are ‘breakthrough cases’?

How long does protection from COVID-19 vaccines last?

Do the COVID-19 vaccines protect against variants?

Do I need to get a booster shot?

What do we know about the bivalent COVID-19 booster doses that have been developed to target Omicron?

Can I receive different types of COVID-19 vaccines?

Do I need to get a booster shot?  

Can I receive different types of COVID-19 vaccines?  