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While patients have been showing up to hospitals with signs of a pneumonic infection for weeks since mid-December, it was only until 31st Dec that the local Chinese government recognized that what they were dealing with wasn't seasonal influenza, but a pneumonic disease.
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After Chinese officials ruled out the possibility of a SARS/MERS relapse, they declare that this virus is a type of coronavirus that has never been identified before.
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Chinese government releases the full sequencing of the Covid-19 genome to the public. This allows for research, in many other countries, to start, especially in processes involved in vaccine and treatment development.
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In neighbouring countries like Japan, Thailand and South Korea.
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It was a 35 year-old resident of Snohomish County, Washington who travelled back to Wuhan, China to visit her family members caught the virus and brought it back.
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Wuhan, the city where the outbreak started, was officially quarantined by the Chinese government. All unnecessary movements out of the city were banned, along with the placement of trade restrictions on many companies. Residents are recommended to stay in their house at all times and to send in daily reports of their temperature and health status.
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Since fever is one of the main symptoms of Covid-19, airports start to use temperature screening technology.
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On 29th Jan, the Australian and New Zealand governments teamed up to evacuate any of their citizens from the Hubei Province of China. Following this, many other countries, like Singapore, Vietnam, and Mongolia, all started doing the same. These countries charted their own flights, either by using military aircraft or with flight companies (e.g Singapore and Scoot airline), and sent healthcare and quarantine personnel.
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After days of consideration, World Health Organisation (WHO) declares the Covid-19 outbreak (then still unnamed and referred to as Corona Virus) a public health emergency of international concern and urged the public to follow released guidelines (https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public)
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The first reported death caused by Covid-19 outside of China was a 44 year old man in the Phillipines.
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Two drugs, Abidol and Darunavir, have been confirmed to effectively inhibit the virus in vitro cell experiements. Vitro cell experiments mean that the studies have been done in a test tube, rather than in human cells/cell cultures, however, this is still an important step in developing a successful treatment. Li Lanjuan, a top epidemiologist in China, also reccommended to use these drugs instead of anti-HIV drugs that many hospitals had been using to treat severe patients.
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A cruise ship, operating under the company Diamond Princess, is quarantined at Yokohama, Japan as 44 cases of Covid-19 were found on board. Passengers are not allowed to leave their cabin - cruise workers come three times a day to provide meals. They are currently still under the two week quarantine period.
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Singapore places a travel ban on all foreign nationals (non-singaporeans and non-permenant residents) who have travelled to China within the past two weeks. Many other countries around this region follow suit.
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Many people took comfort in the fact that Covid-19 was not as lethal as SARS, but on Feb 10, the official death count (900 that day) passed that of SARS.
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Shanghai and Beijing, two of the most populous cities in China, have declared partial lockdown. New security measures are put into place - temperature screening when entering malls/public places, and compulsory mask-wearing. Many other cities in China have also done the same.
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WHO declared that the scientific research of Covid-19 is of utmost importance. Quoted from WHO Director-General Dr Tedros Adhanom Ghebreyesus, "We need to...bring our best science to the forefront to find shared answers to shared problems. Research is an integral part of the outbreak response". Many nations, including America, India, and China, have started working on a vaccine and possible treatments for the virus.
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China has recently developed a convalescent plasma therapy for Covid-19 patients. This therapy utilizes the antibodies created by those who have already recovered from Covid-19. Currently, it is still being developed and only being used for critically ill patients, but further research is being done in the hopes that it can be a widespread treatment.
(http://www.xinhuanet.com/english/2020-02/14/c_138783616.htm) -
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By successfully growing the SARS-CoV-2 virus in cell culture, this opens up the door for many further research studies on the virus, like antiviral treatments and vaccine development. The CDC has also sent samples of the virus to the Biodefense and Emerging Infections Research Resources Repositry, such that researchers and establishments can request and receive samples for free. Image shows a cell culture infected with influenza virus.
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WHO Dirtector General warns those at the Munich Security Conference about the threat of Covid-19, relating it to past epidemics, especially that of Ebola and the Spanish Flu, and urges all countries to start intensifying their preperation right now. “China has bought the world time. We don’t know how much time. All countries must be prepared for the arrival of cases, to treat patients with dignity and compassion, to prevent onward transmission, and to protect health workers.“
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Japan, being geographically close to the epicenter of the outbreak, has been reporting shockingly low cases, mostly due to mishandlement by the government. The Diamond Princess situation brought reality to the government, who afterwards, started taking precautionary movements like this to fight back.
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Iran faced a huge boom in cases ever since their first confirmed case on 21st Feb, and closed schools and other educational centers after their 6th reported death. At the time, Iran held the highest death count outside of China, and does not have the medical facilities to withstand an outbreak.
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Vir Biotechnology inc., a California based immunology research institute, announced a collaboration with WuXi Biologics, a Chinese research institute, to produce human monoclonal antibodies that target SARS-CoV-2 specifically. Vir has already identified multiple monoclonal antibodies, isolated from those whom have recovered from Covid-19, but have yet to test and start mass production on them.
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In an article published in Cell, german researchers state that “SARS-CoV-2 uses the SARS55 CoV receptor, ACE2, for entry and the serine protease TMPRSS2 for S protein priming. A TMPRSS2 inhibitor approved for clinical use blocked entry and might constitute a treatment option...Our results reveal important commonalities between SARS-CoV-2 and SARS-CoV infection and identify a potential target for antiviral intervention.”
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An antigenic shift - a virus jumping from one species to another, is what is suspected to have caused the emergence of this virus. The virus is speculated to have originated from a Chinese wet market in Wuhan, which supported the selling and consumption of wild, exotic animals, like pangolins and snakes. The banning of consumption of wild animals may be a cultural shock to the Chinese, but it is a necessary step to containing the spread of this virus, and potential future ones.
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Major funding of up to 125 million by Bill & Melinda Gates foundations, Wellcome and Mastercard to fund research, this effort is named the “COVID-19 Therapeutics Accelerator”. “The Accelerator will pursue several aspects of the development cycle to streamline the pathway from candidate product to clinical assessment, use, and manufacturing.” This major boost in funds serves to help accelerate the time taken to find a suitable treatment that can be massproduced efficiently.
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An article published in The Guardian identify Remdesivir, a drug originally used in the Ebola outbreak, as a potential treatment for all Covid-19 cases. The USA, China and Italy have all reported to using this drug in “compassionate amounts” on their most severe cases, and US biotech firm, Gilead, is boosting the production of this drug “in anticipation for future needs.”
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The United States, which is rising to become the country with the highest case count, released a new and stricter travel advisory in an attempt to control the number of imported cases and spread from foreigners. The new advisory can be found here: https://www.natlawreview.com/article/president-trump-signs-families-first-coronavirus-response-act-0
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"We have never before seen a pandemic sparked by a coronavirus. This is the first pandemic caused by a coronavirus. And we have never before seen a pandemic that can be controlled, at the same time."
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A list of countries, mainly Western countries like Spain, Hungary, France and many more close their international borders as an attempt to reduce the spread of the virus.
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“Regeneron (Regeneron Pharmaceuticals) scientists have now isolated hundreds of virus-neutralizing, fully human antibodies from the company's VelocImmune® mice, which have been genetically-modified to have a human immune system. Regeneron has also isolated antibodies from humans who have recovered from COVID-19,” The goal of the antibody is to bind to the spike protein, a glycoprotein that is present on the surface of all coronaviruses, and thus neutralise the virus.
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A major problem with this epidemic is the under-testing countries as without proper surveillance, the virus could be alot worse than reported. As such, WHO delivered more than 1.5 million test kits, releasing a statement saying "If we look forward in this epidemic, and we project ourselves forward a number of months, and the amount of testing that is going to be needed, we need to scale that up approximately 80 to 100 times.” Accurate testing is a necessary step that must be taken.
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With many countries and athletes choosing to boycott the Olympics, and the rising severity of the virus, Shinzo Abe had no choice but to postpone the Olympics to 2021. The controversy surrounding this is that the government had been reported to undertesting as an attempt to keep the Olympics, and that Japan's economy, with expected tourism, is set to tank without the event.
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"In an effort to save time, Vir’s lead development candidate was transferred at-risk to WuXi Biologics and Biogen Inc. several weeks ago, and Vir anticipates that human trials can begin within 3-5 months. The ability of this antibody to neutralize the SARS-CoV-2 live virus has been confirmed in two separate laboratories. The antibody binds to an epitope on SARS-CoV-2 that is shared with SARS-CoV-1, indicating that the epitope is highly conserved."
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Over 50,000 deaths
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Similar to the early treatments administered in Chinese hospitals, the FDA is leading two investigational therapies on the effects of convalescent plasma therapy and hyper-immune globulin therapy which are both anti-body rich blood products derived from those who have recovered from Covid-19. There is little research to show the effectiveness of these therapies, which is why the FDA stresses on the importance of these investigations.
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Three major pharmaceutical companies announce the start of phase 2 drug testing with various drugs.
Alexion Pharmaceuticals:
https://www.pharmaceutical-technology.com/comment/alexion-to-start-soliris-in-covid-19-phase-ii-trial/
Cytodyn:
https://www.cytodyn.com/newsroom/press-releases/detail/411/novant-health-initiates-phase-2-covid-19-trial-with
Karyopharm:
https://investors.karyopharm.com/news-releases/news-release-details/karyopharm-evaluate-low-dose-selinexor-potential-treatment -
Remdisvir was used in a study by Gilead on an international cohort, with results stating that, “The majority of patients in this international cohort demonstrated clinical improvement and no new safety signals were identified with remdesivir treatment.” This drug is one of the most used treatments currently, and more studies to prove its effectiveness would help us find a suitable treatment faster.
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Over 118,500 deaths and 500,000 recoveries
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The re-opening of America is one that is met with many differing opinions - the threat of economic instability with continued lockdown against the threat of a second wave. Trump has released a set of guidelines: https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-beginning-next-phase-fight-coronavirus-guidelines-opening-america/, to prepare for the re-opening of the country.
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"The German biotech company BioNTech will become the first European business to proceed with clinical trials of a Covid-19 vaccine, after receiving regulatory approval for accelerated testing." This is way ahead of the regular timeline of the production of a vaccine, and collaborating with Pfizer, an American pharmaceutical company, the same trials will take place in America as well.
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Over 233,000 deaths and 1,000,000 recoveries
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RNAi is one of the most promising upcoming biotechnologies, and by incorporating it into treatments, we are opening up a whole new frontier of biomedicine. "Alnylam synthesized over 350 small interfering RNAs (siRNAs) – the molecules that mediate RNAi – targeting highly conserved regions of the SARS-CoV-2 genome, which were then analyzed bioinformatically and assessed in in vitro potency assays." The potential of this treatment is tremendous, but more studies still have to be done.