Running head: COVID-19: A GLOBAL THREAT
COVID-19: A Global Threat
Cameron Clegg
Holy Family University
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COVID-19: A GLOBAL THREAT
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During these unprecedented times, it is highly important to learn everything that is known
about the novel coronavirus, also known as Coronavirus Disease 2019 (COVID-19), up to this
point. Several common concerns regarding this novel virus might include: Who is affected? Am I
at risk for COVID-19? What can be done to protect myself? What should I do to prepare for this
virus? All of these questions, and many more, will be addressed in this research paper to help
you better understand COVID-19 and what you should do about it. The most important thing to
do during these extremely difficult times is to not panic. Panicking not only makes the situation
much worse but also strikes fear in those around you. It is necessary to note that no amount of
terror is going to deter the virus. Being smart, remaining calm, and staying alert, however, can
help to slow down the virus. As Franklin D. Roosevelt once said in his inauguration speech in
1933,
So, first of all, let me assert my firm belief that the only thing we have to fear is...fear
itself — nameless, unreasoning, unjustified terror which paralyzes needed efforts to
convert retreat into advance. In every dark hour of our national life, a leadership of
frankness and of vigor has met with that understanding and support of the people
themselves which is essential to victory. And I am convinced that you will again give that
support to leadership in these critical days.
What is COVID:19?
It is really important to learn about the structural/genetic characteristics of this virus and
the environmental factors that this pathogen needs for development before digging deep into
COVID-19 and addressing the above questions. COVID-19 is a respiratory disease that can
transmit from person to person. The virus that triggers this disease is a novel coronavirus that
COVID-19: A GLOBAL THREAT
was first reported and found during an epidemic investigation in the city of Wuhan, China
(Centers for Disease Control and Prevention [CDC], 2020). This novel coronavirus is a member
of the Coronavirinae subfamily in the family Coronaviridae and the order of viruses called
Nidovirales (Mousavizadeh & Ghasemi, 2020). In particular, COVID-19 appertains to the
Betacoronavirus genera according to its phylogenetic connections and genomic properties. This
virus was originally named 2019-nCoV. However, a group of experts in the International
Committee on Virus Taxonomy (ICTV) named it SARS-CoV-2, as it is quite close to the virus
that triggered the SARS-CoV epidemic (Cascella, Rajnik, Cuomo, Dulebohn, & Napoli, 2020).
These human Betacoronaviruses, including SARS-CoV-2 (Severe Acute Respiratory Syndrome
Coronavirus 2), SARS-CoV (Severe Acute Respiratory Syndrome Coronavirus), and MERSCoV (Middle East Respiratory Syndrome Coronavirus), have several parallels, but also differ in
their genomic and phenotypic structure that can affect their pathogenesis (Mousavizadeh &
Ghasemi, 2020).
As previously stated, SARS-CoV-2 has many similar aspects in terms of structure and
genetics as other strains of coronavirus. However, there are some differences in this particular
strain compared to the other types of coronavirus. In general, coronaviruses are typically
positive-stranded RNA viruses that have a crown-like structure under an electron microscope
owing to the inclusion of spike glycoproteins on the viral envelope (Cascella, Rajnik, Cuomo,
Dulebohn, & Napoli, 2020). The strain that induces COVID-19 has a circular or elliptical shape
and often has a pleomorphic structure. Furthermore, SARS-CoV-2 has a single-stranded RNA
that is associated with nucleoprotein inside a capsid composed of a matrix protein
(Mousavizadeh & Ghasemi, 2020). The diameter of SARS-CoV-2 is about 60-140 nanometers.
This coronavirus’ RNA also contains approximately 29,891 nucleotides, which encodes about
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9860 amino acids (Cascella, Rajnik, Cuomo, Dulebohn, & Napoli, 2020). This particular virus is
also different from other strains of coronavirus as the configuration of the nucleocapsid protein,
envelope protein, and membrane protein are different and specific amongst betacoronaviruses
(Mousavizadeh & Ghasemi, 2020).
Untranslated area, or UTR, in molecular genetics corresponds to two parts, one on either
side of a coding sequence on a mRNA strand (Wikipedia, 2020). The 5’UTR, or leader sequence,
is found on the 5’ end, whereas the 3’UTR, or trailer sequence, is found on the 3’ end
(Wikipedia, 2020). Both the 5’UTR and 3’UTR are implicated in intermolecular and
intramolecular connections and are important functionally for RNA-RNA interactions and for
viral and cellular protein binding (Mousavizadeh & Ghasemi, 2020). SARS-CoV-2 is known to
have a 30 kilobase (1 kilobase = 1000 base pairs of RNA) genome that encodes about 14 open
reading frames, or Orfs, of viral proteins (Steward, 2020). At the 5’ end of SARS-CoV-2 houses
a single Orf that encodes a polyprotein that automatically proteolytically splits into 16 nonstructural proteins creating the complex of replicase-transcriptase (Steward, 2020). Several
enzymes are a part of the 16 protein replicase-transcriptase that are extremely important for the
replication of the viral genome (Steward, 2020). It is believed that from the 3’ end of the viral
genome as many as 13 Orfs are produced, which include four main structural viral proteins:
Spike, Envelope, Membrane, and Nucleocapsid (Steward, 2020). These SARS-CoV-2 structural
proteins form the viral capsid that embodies the genome while also promoting entryway into
human cells via the human angiotensin-converting enzyme 2, or ACE2, receptor (Steward,
2020).
Viral replication and infection of human cells are extremely important for viruses since
they cannot replicate on their own. This is the prime reason why viruses, like SARS-CoV-2, are
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not considered living because they do not replicate in the same way that bacteria, fungi, and
protozoans replicate. The process of replication is much more complex for viruses as compared
to living microorganisms. Through the virus’ spikes, SARS-CoV-2 attaches to ACE2 which
helps it to penetrate and infect human cells (Mousavizadeh & Ghasemi, 2020). After the initial
phase of SARS-CoV-2 attaching to the cell, the spike protein needs to be activated by an enzyme
named protease in order for the virus to complete entryway into the cell (Mousavizadeh &
Ghasemi, 2020). SARS-CoV-2 is nearly identical to SARS-CoV in that they both use the
protease named Transmembrane protease serine 2 (TMPRSS2) to enter the human cell
(Mousavizadeh & Ghasemi, 2020). Once the virus has penetrated and entered the cell by
endocytosis, it releases its viral genome into the cell (Iqbal, Romero-Castillo, Bilal, & ParraSaldivar, 2020) The released viral genome containing RNA travel to the cytoplasm of the cell in
which they are assembled using translated polymerase proteins and replicated RNA (Iqbal,
Romero-Castillo, Bilal, & Parra-Saldivar, 2020). Next, sub-genomic transcription and translation
of each of the structural proteins, including the nucleocapsid, spike protein, membrane protein,
and envelope protein, take place at the endoplasmic reticulum (Iqbal, Romero-Castillo, Bilal, &
Parra-Saldivar, 2020). Once these structural proteins are translated, the virus’ spike, membrane,
and envelope proteins combine with the nucleocapsid containing the replicated RNA which
forms a mature virion (Iqbal, Romero-Castillo, Bilal, & Parra-Saldivar, 2020). According to
Merriam-Webster, a virion is “a complete virus particle that consists of an RNA or DNA core
with a protein coat sometimes with external envelopes and that is the extracellular infectious
form of a virus” (2020). Once this is achieved, the newly developed virion releases from the cell
by exocytosis to infect other cells of the body (Iqbal, Romero-Castillo, Bilal, & Parra-Saldivar,
2020). A picture of the entire process can be seen on the last page of this research paper.
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Just like any pathogen, SARS-CoV-2 has environmental conditions that are preferential
to this virus. Just like other coronaviruses, they are very sensitive to UV rays and also sensitive
to heat (Cascella, Rajnik, Cuomo, Dulebohn, & Napoli, 2020). In a study that was done to
determine the stability of the virus at different temperatures, it was found that the virus is
relatively stable at four degrees Celsius but highly prone to heat (Chin, et al., 2020). For
example, there was only about a 0.7 log-unit reduction of the contagious titer of the virus on the
fourteenth day (Chin, et al., 2020). Log reduction is a calculation of how strongly a
decontamination procedure reduces a contaminant’s concentration (Wikipedia, 2020). A log
reduction of 0 is seen as no reduction at all, so a log reduction of 0.7 is a very little reduction of
the virus in a cold environment. With the incubating temperature elevated to 70 degrees Celsius,
however, the virus inactivation period was decreased to only five minutes (Chin, et al., 2020).
This goes to show that the virus prefers a colder climate as compared to a much warmer
environment. This particular strain of the virus has only been around for a few months, though,
so further research and studies must be performed to fully understand the environmental
conditions that are required for its growth.
History of Coronaviruses
SARS-CoV-2, the virus that causes COVID-19, has gained a lot of popularity over the
past few months after being declared as a pandemic. For many people across the world, the
coronavirus is a new virus that they never heard of before. However, coronaviruses have been
around for decades and mainly gained popularity in recent years. Human coronaviruses started in
1965 when a group of scientists discovered a virus called B814 (Kahn & McIntosh, 2005). This
virus was observed in organ cultures of human embryonic trachea acquired from a person’s
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respiratory tract who suffered from severe cold (Kahn & McIntosh, 2005). Another group of
scientists found a virus called 229E with very similar aspects as B814. Such viruses were labeled
“OC” to signify being produced in organ cultures (Kahn & McIntosh, 2005). Given the intense
emphasis on these strains, it became evident that there were other strains very similar to these
two. Because of the crown-like appearance on the surface of the virus, this new genus was
officially named coronavirus (Kahn & McIntosh, 2005). The name derives from the Latin word
corōna meaning crown.
A total of seven coronaviruses have been discovered that cause human infection. In 2002,
the one that triggers SARS appeared in southern China and spread quickly to 28 other countries
(Bhargava, 2020). By July 2003 more than 8,000 people had been infected worldwide, and 774
people died. This strain of coronavirus triggered fever, headache, and issues with breathing, such
as coughing and loss of breath (Bhargava, 2020). Another outbreak occurred in Saudi Arabia in
the year 2012, known as MERS. Nearly 2,500 cases were reported in people who were residents
in the Middle East or in those who traveled there (Bhargava, 2020). It was known to cause the
same respiratory symptoms as SARS but may also induce kidney failure (Bhargava, 2020).
Epidemiology, Symptoms, and Transmission of COVID-19
At this current moment, COVID-19 has caused a total of 2,471,000 cases worldwide with
170,000 deaths which makes the SARS-CoV-2 strain the deadliest to date. This virus has also
spread to approximately 177 countries in the world (Soto, Hakim, & Boyd, 2020). SARS-CoV-2
is extremely infectious, with the case fatality rate at approximately 4.8% throughout the world
(Soto, Hakim, & Boyd, 2020). However, the fatality rate varies from country to country with
some countries having higher fatality rates than others. Those who are mainly affected by this
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virus are elderly people and those with immunodeficiencies or who are immune-compromised,
but cases and deaths in those who are young adults have also been found (Soto, Hakim, & Boyd,
2020). There have been rarely any deaths for infants infected with COVID-19, but one death has
been reported of an infant under one year old in the state of Illinois (Soto, Hakim, & Boyd,
2020). Among elderly patients, approximately 15% of deaths were from those who were 80+
years and about 8% of deaths were from those aged 70 to 79 (Cascella, Rajnik, Cuomo,
Dulebohn, & Napoli, 2020). Also, about half of critical patients that were impaired by preexisting health conditions, like heart disease, diabetes, chronic respiratory diseases, and
oncological disease, have died (Cascella, Rajnik, Cuomo, Dulebohn, & Napoli, 2020).
Those who are infected with this virus range from mild, moderate, and severe cases. In
terms of severe cases, people have experienced severe pneumonia, Acute Respiratory Distress
Syndrome (ARDS), sepsis, and septic shock (Cascella, Rajnik, Cuomo, Dulebohn, & Napoli,
2020). For patients with mild cases, symptoms that have been found include a small fever, dry
cough, sore throat, nasal congestion, malaise, headache, muscle pain, and/or fatigue (Cascella,
Rajnik, Cuomo, Dulebohn, & Napoli, 2020). Respiratory symptoms like cough and shortness of
breath have been observed in patients with moderate pneumonia without showing signs of
extreme pneumonia (Cascella, Rajnik, Cuomo, Dulebohn, & Napoli, 2020). Severe cases of
pneumonia have been found to have a fever, extreme dyspnea, struggles with breathing,
tachypnea, and hypoxia, along with cyanosis in children. The fever symptom, however, needs to
be closely understood because it may be a mild case of fever or absent even in extreme cases of
the disease (Cascella, Rajnik, Cuomo, Dulebohn, & Napoli, 2020). The diagnosis is clinical in
this case, and radiological testing is used to rule out risks. ARDS is another severe case of
COVID-19 that can potentially be fatal if not taken care of properly. ARDS is a form of
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respiratory failure which is identified by a rapid onset of lung inflammation (Cascella, Rajnik,
Cuomo, Dulebohn, & Napoli, 2020). Symptoms of this syndrome are shortness of breath and
rapid breathing. Another very serious and possibly fatal condition that COVID-19 patients can
experience is sepsis. Sepsis is, according to the International Consensus Definitions for Sepsis
and Septic Shock, a life-threatening organ malfunction triggered by a dysregulated host reaction
to suspected or confirmed infection (Cascella, Rajnik, Cuomo, Dulebohn, & Napoli, 2020).
Medical pictures of patients with COVID-19 and sepsis are especially very serious, marked by a
broad variety of signs and symptoms of multiple organs of the body. Such signs and symptoms
include respiratory problems like extreme dyspnea and hypoxemia, renal dysfunction with
decreased urinary output, impaired mental state, and physiological abnormalities of organs
manifested as lab data of hyperbilirubinemia, acidosis, elevated lactate, coagulopathy, and
thrombocytopenia (Cascella, Rajnik, Cuomo, Dulebohn, & Napoli, 2020). The most serious form
of sepsis is septic shock, which is also the most fatal condition of patients with COVID-19. This
is often associated with extremely low blood pressure which is deadly (Cascella, Rajnik, Cuomo,
Dulebohn, & Napoli, 2020). However, the most common symptoms that were reported from this
virus include fever (88%), dry cough (67.8%), fatigue (38%), respiratory problems like difficulty
breathing (18.7%), and muscle pains. If you have these symptoms, please talk to your doctor
immediately.
The transmission through respiratory droplets, as with many respiratory viruses like the
flu and the common cold, is assumed to occur by coughing and sneezing. In the event of
prolonged exposure to elevated aerosol concentrations in closed spaces, aerosol transmission is
also likely to occur (Cascella, Rajnik, Cuomo, Dulebohn, & Napoli, 2020). This is because the
virus can live up to 3-4 hours as an aerosol in the air around us (Soto, Hakim, & Boyd, 2020).
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The virus also often seems to be able to live for 72 hours as a fomite (Soto, Hakim, & Boyd,
2020). This means that transmitting this virus can be feasible even if a person who is infected
with COVID-19 has not been around for hours or days since the virus can live for hours in air
and days on inanimate objects or surfaces (Soto, Hakim, & Boyd, 2020). This is exactly why
being in direct or close contact with others, including family members and friends, can raise the
risk of transmitting the virus. The two main ways this virus spreads are through people who are
symptomatic and asymptomatic. Transmission through symptomatic people is the most common
way COVID-19 spreads. However, there are reports that the virus could be transmitted by
asymptomatic people, suggesting that the virus can spread even before symptoms show up
(Cascella, Rajnik, Cuomo, Dulebohn, & Napoli, 2020). Furthermore, COVID-19’s period of
incubation is about 4-5 days on average, with around 5 percent of the population not displaying
any symptoms for up to 14 days following initial contact with the virus (Soto, Hakim, & Boyd,
2020).
COVID-19 Diagnostic Procedures
To confirm that a patient has COVID-19, diagnosis by laboratory testing is needed. A
nasopharyngeal swab is a perfect test for the diagnosis of COVID-19 as stated by the CDC
guidelines. If nasopharyngeal swabs are not available, oropharyngeal, nasal mid-turbinate or
nasal swabs are suitable substitutes (Soto, Hakim, & Boyd, 2020). Real-time reverse
transcription-polymerase chain reaction, also known as RT-PCR, is used for outpatient analysis
of the nasopharyngeal or oropharyngeal aspirates collected from the swab (Ho, Hughes, Bozlu,
Kadıoğlu, & Somani, 2020). Lower respiratory extracts from sputum and/or endotracheal
aspiratory or bronchoalveolar lavage may be used in extreme situations (Ho, Hughes, Bozlu,
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Kadıoğlu, & Somani, 2020). If a patient with a strong COVID-19 suspicion index results with a
negative outcome, additional specimens, such as blood, stool, or urine, should be collected and
submitted. It is recommended that at least two consecutive tests should be performed to confirm
that a patient does or does not have COVID-19 (Ho, Hughes, Bozlu, Kadıoğlu, & Somani, 2020).
Some researchers believe that the RT-PCR test is faulty and that computed tomography
(CT) examinations are more accurate and efficient. CT analysis is required in the initial
screening for the auxiliary diagnosis (Dai, et al., 2020). The finding is then verified by positive
test results of blood specimens using RT-PCR or the nucleic acid amplification test (NAAT) of
the respiratory tract (Dai, et al., 2020). However, for several reasons, this diagnostic approach is
incredibly restricted. The identification rate is poor when the viral load is low, which contributes
to false-negative findings. Also, only a positive diagnosis can be found, and it is difficult to
determine the severity of COVID-19 and its development (Dai, et al., 2020). Unlike this, CT
images will show the development of the disease. Another major reason that this diagnostic test
is not as efficient as CT examinations is that it can take a day or more to receive the results (Dai,
et al., 2020). It is for these reasons that researchers believe the CT exam is a better diagnostic
procedure.
How to Stop the Spread of COVID-19
As previously stated on how COVID-19 spreads, it transmits from person to person
through respiratory droplets, through touching infected surfaces, and from being in close contact
with other people who may have the virus. There are many ways you can protect yourself from
this virus and avoid getting infected. For starters, wash your hands with soap and water for at
least 20 seconds, especially after coming into contact with outdoor surfaces, using the restroom,
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shaking hands with someone, and other interactions (Desai, 2020). If you’re in an area where
there is no soap and water available, it is a good idea to carry hand sanitizer with at least 60%
alcohol. Evite big crowds and establish at least 6 feet between yourself and others, particularly if
they are showing symptoms like coughing and/or sneezing (Desai, 2020). This 6-foot apart rule
is also known as social distancing and is one of the best things you can do, alongside washing
your hands frequently, to avoid infection. If you are older or have ongoing medical conditions, be
sure to avoid non-essential air travel or cruises (Desai, 2020). Avoid rubbing your eyes, nose,
and/or mouth with contaminated hands because it can transfer the virus to these places and cause
infection (Desai, 2020). If you are coughing or sneezing, make sure to cover your nose and
mouth and throw away any tissues after one usage. Disinfect surfaces which are used daily by
using disinfectant sprays or wipes (Desai, 2020). Lipid solvents, including 75% ether, ethanol,
chlorine-containing disinfectant, peroxyacetic acid, and chloroform, with the exception of
chlorhexidine, can also successfully inactivate the virus (Chin, et al., 2020). If you can, use a
medical mask while you are out in public. If you cannot find any masks, use any cloth instead
and maintain staying 6 feet apart from other people.
If you are currently sick and may be infected with COVID-19, there are steps you can
take to get better and prevent others from getting sick. At this current moment, there are no
proven treatments for this disease but there are things you can do to help your immune system
fight it off. The best thing you can do is stay home and get as much rest as possible. As stated by
the CDC, most people who are sick with COVID-19 only have a mild illness and can get better
by resting and staying hydrated (2020). It is also important to stay in contact with your doctor
and call him/her before getting medical care (CDC, 2020). If symptoms get worse and you start
experiencing difficulties with breathing or other severe symptoms, get help immediately. Stay
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away from family members and friends to avoid spreading. If available, it is a good idea to use a
separate bathroom (CDC, 2020). If for any reason you have to be around others, make sure to
cover your nose and mouth with a face mask or cloth, and wash your hands with soap or hand
sanitizer to avoid contaminating surfaces (CDC, 2020). Always remember to persistently monitor
your symptoms and follow any advice your doctor provides you.
Discussion/Thoughts on COVID-19
As we conclude on COVID-19, I would like to discuss my thought about this virus. There
is a major issue not just in our country, but all over the world with people taking this virus too
lightly. Many people around the world continue their daily lives pretending as if a global
pandemic does not exist. I get it, summer is right around the corner and the nice weather is the
perfect time to go out and enjoy fun activities. But by not listening to the experts and not caring
about this current COVID-19 pandemic, you could seriously be jeopardizing the lives of those
who are immune-compromised or elderly. This, however, does not mean you cannot do fun
activities. There are many ways to enjoy fun activities while in quarantine. Have an instrument
that you never have the time to practice? Well, now would be a great time to learn and practice.
Have some movies you wanted to watch but could not watch them because you were too busy
with work or school? Now is the perfect time to catch up on them. You can even study a new
language using various free apps on the internet. The list goes on and on, and if none of these
piques your interest, just simply look it up on the internet and find something that appeals to you.
I also believe that the news media is making this virus seem much worse than it is. Mainstream
media, such as CNN, Fox News, NBC News, and ABC News, are not trustworthy and credible
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news sources. The best thing to do is perform your own research, as I did in this research paper,
to find out facts about COVID-19.
There has been rumors and research performed by doctors stating that COVID-19 could
potentially be directly attacking oxygen in the bloodstream, rather than attacking tissues in the
lungs. Red blood cells are essential carriers of oxygen to the various cells inside the body
(Thailand Medical News, 2020). There is a protein called hemoglobin within each of the red
blood cells that includes heme groups. Any of these heme groups includes a molecular “ring,”
also known as porphyrin, that houses an iron ion. The iron ions allow for the carriage and
transportation of oxygen in red blood cells across the body, based on conditions of oxidation
(Thailand Medical News, 2020). Red blood cells usually pick up oxygen from the lungs that
were breathed in from the air around us and then transport the oxygen to cells throughout the
body. The belief is that instead of the virus attacking epithelial cells in the lungs, the virus hijacks
red blood cells and replaces the iron ions in the heme groups with themselves, making the
hemoglobin incapable of transporting oxygen (Thailand Medical News, 2020). They believe that
this is why ARDS and organ failure are frequent in very severe cases of COVID-19. Further
research and testing must be performed to confirm this belief/rumor. However, the most
important thing to do right now is not panic. As I stated at the beginning of this paper, it is vital
to remain calm and collective during these times. It is also important to always remember that
there is “nothing to fear, but fear itself.”
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