The Covid Crisis: Return of Fear and Uncertainty

Abstract

Covid-19 is the news once again making headlines and announcing its comeback. It has had a profound impact since its December 2019 emergence in Wuhan, China. The 2019 outbreak was a turning point affecting nearly every country with varying degrees of severity, has led to significant worldwide mortality and morbidity, causing millions of deaths and long lasting health complications for many. The rapid spread worldwide, led to the World Health Organization calling it a “global pandemic” on March 11, 2020. Covid-19 is a viral zoonotic disease which spreads from animals-to-humans and humansto-humans. It is caused by the novel SARS-CoV-2 coronavirus. Covid-19 is an enveloped, positive-sense single stranded RNA virus that attaches to the host cell through its spike protein that facilitates entry into the host cell via the ACE2 receptors. The virus primarily spreads through respiratory droplets
of an infected person when coughing, sneezing or talking. Asymptomatic or pre-symptomatic individuals can also spread the disease. Covid-19 has caused major social, economic, business and lifestyle disruptions. Covid-19 symptoms range from mild to severe and appear between 2-14 days after exposure. The most common symptoms include fever, cough, shortness of breath, fatigue, muscle or body aches, loss of taste or smell, headache, nausea or vomiting and diarrhea. In more severe cases, it can cause pneumonia, ARDS, organ failure and even death. Covid-19 diagnosis is mainly done by polymerase chain
reaction (PCR) - the gold standard of testing. Histologically, Covid-19 is responsible for many changes to the lungs, heart, kidneys, liver and GI tract. Symptoms lasting beyond the primary infection (“long-covid”) have shown to have a significant impact on an individual’s daily life. There are several factors that increase the risk of infection - individuals who are over 60 are at a higher risk versus younger individuals. Individuals with comorbidities, those who are immunocompromised, those who smoke, use alcohol, lack exercise or are unvaccinated have a higher risk of infection. Infected individuals with underlying health conditions can experience a host of complications such as mild to severe organ impairment (heart, liver, kidney, brain), diabetes, dementia, neurological, GI, hematological or muscular pain. The risk also increases for individuals who are lower on the socio-economic spectrum. The Centers for Disease Control and Prevention (CDC) recommends the use of vaccines, masks, social distancing, hygiene protocols, quarantine and isolation to reduce the transmission risk, prevent hospitalization, severe illness or death. The advent of highly efficacious vaccines using novel mRNA technology has seen the effects of the disease wane. Covid-19 infection rates are slowing and the pandemic is giving way to an endemic. However, one question remains - how well prepared are we for the next major outbreak?