Written by: Omar As’sadiq, Science Staff Writer
“It’s going to go away, hopefully at the end of the month. And, if not, hopefully it will be soon after that,” stated the President of the United States on March 31, 20201, two months after the first case of a novel respiratory-targeting virus was discovered in the Americas. Millions of infections and thousands of deaths later around the world, President Trump still promised that what the world labelled as the Coronavirus pandemic would disappear very soon. But what is the Coronavirus? And why has it still not disappeared as promised?
Coronavirus is the name given to a family of different strains of related RNA retroviruses that have crown-shaped spikes on their outer protein coat. To the surprise of many people, this is not the first time we encounter the coronavirus. In fact, the SARS pandemic in 2002 was also caused by a coronavirus strain called SARS-CoV2 which research shows evolved to manifest as SARS-CoV-2, the viral strain giving rise to the disease known as COVID-193 which forced the world to pause within a blink of an eye. One might wonder, how is this different from the common cold, and why are we not able to control it?
Mayo Clinic explains that even though the common cold and COVID-19 are both caused by viruses that spread in a similar way and lead to similar symptoms including cough and sore throats, there are key differences. For instance, COVID-19 usually causes fever, tiredness, and a loss of taste or smell which are not typical symptoms of common colds. Furthermore, a cold is usually harmless accompanied with a quick 3-10 day recovery period unlike COVID-19, which has an average of 10-20 day expected recovery after symptom onset.4
COVID-19 is characterized by its highly contagious nature mainly by human-to-human interactions, and by it directly attacking our lungs, classifying it as a severe acute respiratory syndrome (SARS). This pandemic hit like no other, causing tremendous physiological, psychological, and financial losses. According to a study by the Journal of Translational Medicine, anti-COVID spread measures including but not limited to strict lockdowns, strong PCR testing and contacting tracing reduces COVID-19 infections and community transmission tremendously.5
Social and Economical Implications of Strict Measures
The International Food Policy Research Institute estimated that in pre-pandemic days, 25% of the global population ‘survived on $3 or less per day’. To put this into perspective, a quarter of the world’s population is already under extreme poverty, famine, and as a result mortality from malnutrition.6 Recent studies by the research institute calculated that due to the pandemic, approximately an additional 140 million individuals will live on less than $1.90 per day vulnerable to extreme hunger and death.7 In nations where thousands die every year from poverty, lockdowns would be dangerous.8
Other important effects include an increase in poor mental health, suicide rates, and domestic violence incidents. QJM: An International Journal of Medicine discussed how the pandemic leads to feelings of social isolation, doubts, and financial stress that specifically targets vulnerable patients experiencing mental distress.9 Indefinitely, rises in anxiety, depression, stress, and addiction is prevalent during the pandemic leading to increased suicide rates.10
So is Herd Immunity the answer?
This headline is misleading as it suggests to a reader from a non-scientific background that the solution is to let everyone become infected with zero control measures to achieve immunity, allowing for the survival of the fittest. To put it shortly, herd immunity is the best answer to the end of the pandemic, but through vaccinations, and not by natural infections.
Herd immunity is defined as the process where a large portion of a community (the herd) becomes immune to a disease, achieved when the rate of spread of the virus through human-to-human contact becomes very unlikely. Simply, immune individuals will not be able to acquire the disease by spreading it to others, while the non-immune portion will be at a much lower risk of infection due to high community immunity. It is only when true herd immunity is reached, approximated at 70% of the population being immune, when the curve truly levels down, putting an end to the pandemic. Though, one might question that if we need to gain immunity to beat this virus, is it not better to achieve this through natural infections rather than by using vaccines still in development?
Vaccines: What are they and for how long will we need them?
Humans have evolved a sophisticated highly regulated system which works to fight off pathogens that venture past the physical skin barriers. This system provides an immunological memory after recovery from primary infections that remembers the specific shape of the microorganism to quickly fight it off during a secondary infection. This phenomenon is what we refer to as immunity. An oversimplification of the process is the production of memory cells from B cells after the release of protein antibodies that work to bind to the complementary protein (antigen) on the pathogen fighting it off. These memory cells would act faster and stronger to produce antibodies when re-exposed to the same antigen again.
Vaccines are injections containing antigens or a mechanism that produces specific antigens which allow for natural active immunity to be activated safely without causing disease or putting individuals at risk. The WHO classified most vaccines to be a killed or weakened forms of germs like viruses or bacteria referred to as attenuated pathogens. Other forms of vaccines include mRNA vaccines which provide cells with instructions to produce a harmless pathogenic antigen or protein that elicits an immunological response.12
Currently on the market, there are several COVID-19 vaccines developed which are already being distributed worldwide. However, there have been wide concerns regarding expected shortages in deliveries and inequity in distribution. Recently, Canada stirred controversy for taking a share of vaccines from the United Nations-led internationally funded COVAX initiative, founded to provide free accessible vaccines to developing countries. Procurement Minister Anita And stated, “Canada will take its share of vaccine doses from the internationally funded COVAX initiative and will not give any doses to other countries until all Canadians are vaccinated.” The federal government defended its decision by claiming that they are one of the largest contributors to the COVAX facility and thus, are entitled to a share of the vaccines.13
Will the pandemic ever end?
Have you ever wondered why you have to take new flu vaccines each year? The answer is mutations. When viruses and bacteria replicate their genetic material, random errors in the process occur every now and then forming a new mutated strain of the pathogen with different antigens and protein shapes that are no longer complementary to the antibodies produced by our immunological memory. There have already been multiple mutations of the SARS-CoV-2 strain including some that allowed the virus to become more contagious and disease-causing.
Pfizer, one of the largest producers of COVID-19 vaccines, says that the new South African variant could potentially reduce the efficacy of their vaccine, putting millions of vaccinated individuals at risk of infection and disease.14 Will all our efforts to produce and distribute vaccines be worthless? Not quite.
Until now, research shows that current vaccines have proven bright results when it comes to fighting off the new strains of COVID-19. However, one cannot predict what new mutations may occur soon allowing for the evolution of COVID-21, 22 and so on. The most likely scenario is that worldwide collaborations will occur to produce booster shots to be taken every few months or in yearly increments in order to co-evolve our immune system with the new mutant variants, which we hope end this pandemic once and for all.
References:
1. All of the times President Trump said Covid-19 will disappear. (2020). CNN. https://edition.cnn.com/interactive/2020/10/politics/covid-disappearing-trump-comment-tracker
2. Severe Acute Respiratory Syndrome (SARS). (2019, November 1). WHO. https://www.who.int/health-topics/severe-acute-respiratory-syndrome#:%7E:text=Severe%20acute%20respiratory%20syndrome%20(SARS)%20is%20a%20viral%20respiratory%20disease,spread%20to%204%20other%20countries.
3. Archived: WHO Timeline – COVID-19. (2020, April 28). WHO. https://www.who.int/news/item/27-04-2020-who-timeline—covid-19
4. COVID-19, cold, allergies and the flu: What are the differences? (2021, March 3). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/covid-19-cold-flu-and-allergies-differences/art-20503981#:%7E:text=What%27s%20the%20difference%20between%20COVID,the%20same%20signs%20and%20symptoms.
5. Pachetti, M., Marini, B., Giudici, F. et al. Impact of lockdown on Covid-19 case fatality rate and viral mutations spread in 7 countries in Europe and North America. J Transl Med 18, 338 (2020). https://doi.org/10.1186/s12967-020-02501-x
6. Jamison, J. C. (2020). Lockdowns will starve people in low-income countries. The Washington Post.
7. Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality. The Lancent. (2020). https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)31647-0.pdf.
8. As’sadiq, O., Times, T., Times, T., Times, T., & Times, T. (2020, October 15). The True Global Implications of COVID-19 Measures. Trinity Times. https://trintimes.ca/science/the-true-global-implications-of-covid-19-measures/
9. Leo Sher, The impact of the COVID-19 pandemic on suicide rates, QJM: An International Journal of Medicine, Volume 113, Issue 10, October 2020, Pages 707–712, https://doi.org/10.1093/qjmed/hcaa202
10. Chidambaram, P., Munana, C. 2020. The Implications of COVID-19 for Mental Health and Substance Use. https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/
11. Roesch Elisabeth, Amin Avni, Gupta Jhumka, García-Moreno Claudia. Violence against women during covid-19 pandemic restrictions BMJ 2020; 369 :m1712. https://www.bmj.com/content/369/bmj.m1712
12. Vaccines and Immunizations Q&A Detail. (2020). WHO. https://www.who.int/news-room/q-a-detail/vaccines-and-immunization-what-is-vaccination?adgroupsurvey=%7badgroupsurvey%7d&gclid=EAIaIQobChMInYG30tHW7wIV0uR3Ch24XgeVEAAYASAAEgKH3PD_BwE
13. Canada to take COVAX vaccines, won’t share doses until every Canadian is inoculated: Anand. (2021). CBC. https://www.cbc.ca/news/politics/covax-anand-vaccine-timetable-1.5939270
14. Erman, M. (2021, February 18). Pfizer says South African variant could significantly reduce protective antibodies. Reuters. https://www.reuters.com/article/us-health-coronavirus-vaccines-variants-idUSKBN2AH2VG
