Introduction: What is The Health Outcome/Issue
The first case ever reported to a hospital, was a man in his 50’s, in the middle of December 2019 in the Hubei Province of China. It wasn’t officially reported to the World Health Organization until December 31st, 2019 and that brings us to today. Almost three months into this novel Coronavirus, and there is no end in sight.
First known as 2019 novel Coronavirus, developed into SARS-CoV-2 (Situation Report 54 – WHO, 2020). This is the first virus that was unknown to the human since SARS and MERS, hence the novel. Slowly weeks passed, as genetic sequences of the virus was discovered in many areas: China, Hong Kong, Vietnam, and the U.S. A month has passed as many citizens started to panic. Wuhan, the epicenter for this disease, put its 14 million residents in quarantine: in hope to stop the spread of the disease, as we learn more about the disease itself. The rapid transmission came to a shock for everyone. Wuhan spread to its neighboring cities in the Hubei Province. Then due to travels spreading to so many other places in China: Beijing, Shanghai, and all neighboring areas in China were affected. We saw our first case in Snohomish county, a neighboring city to ours and the first in the United States (Holshue, Rothe, Guan, 2020). Spreading like wildfire, this Coronavirus made its mark in neighboring countries in Asia: South Korea, Japan, Twain, Vietnam, Thailand, and that’s not the end of it. As of Saturday March 14th, 2020, there is now 142,539 confirmed cases (9769 newly reported), 5393 deaths, affecting 146 countries and territories around the world and still counting (Situation Summary – CDC, 2020). It’s no longer a Public Health Emergency but as of Friday March 13th, 2020, its known as a Pandemic.
To have a better understand of this disease, we must learn about its morphology. The name Coronavirus stems from its large family of viruses that causes cold/flu like symptoms. This virus is actually very common in human, and many other species such as Camels who started MERS (2012), bats, civet cats who started SARS (2003), etc. With its DNA sequenced, this COVID-19 is known as a betacoronavirus, exactly like MERS-CoV and SARS-CoV we saw earlier in the past two decades. All these CoV has an origin from bats (Situation Summary – CDC, 2020). With all Coronavirus infections symptoms varies from person to person. Symptoms in some are mild, and could show up as a sore throat, some could just have a running nose, and others a dry cough. In severe cases, pneumonia develops leading to upper respiratory distress and eventually death (Zhu, Perlma, Holshue, Guan, 2020).
When talking about this COVID-19 how could someone, who is not educated in medicine be able to distinguish between subtle differences among COVID-19 and just a common cold? The key signs to look out for is a fever, cough, shortness of breath (difficulty breathing), persistent pain or pressure in the chest and any bluish in the lips or face (Situation Summary – CDC, 2020). Currently there is no vaccine that can be distributed to people but it’s in the stage of testing and clinical trials. There’s also no treatment currently, but rather just putting people on high oxygen, and supportive treatment with ventilators as aid when they get to that serious state. Even though people contracted COVID-19 develops pneumonia, regular pneumonia protocol can’t be employed. Since regular normal pneumonia that people get during the fall and winter seasons are bacterial infections of the air sacs in the lungs, that can then be treated with antibiotics. This pneumonia from COVID-19 is a viral infection, and there is currently no sets of anti-viral drugs that can kill this strain of viral infections (Zhu, Perlma, Holshue, Guan, 2020). So, when dealing with severe cases doctors and nurses can only put those patients on high oxygen to help ease the lungs or on ventilators when breathing becomes even more difficult.
Reason why pneumonia is so prevalence in this COVID-19 disease caused by the SARS-CoV-2 is how the virus is attacking our body to replicate itself. With the surface protein (spikes on the outside) it bonds to the receptors in our lungs, and once it enters the cells in the lung to replicate itself. It creates inflammation in the lung tissues and once the lung cells apoptose it ends up releasing all those replicated virus DNA to all other nearby cells in our bodies. Currently, President Trump announced as of Friday March 13th, 2020 this Coronavirus is now a National Emergency. Trying to funnel more funds to this Coronavirus research and aid for the people.
I must be honest with this situation right now, I’m currently in a state of fear. Fear, not of the virus itself, but the uneducated people of our country. Not knowing how this virus behaves, everyone is in a state of panic. Going to buy out the whole grocery stores, and not only that blaming all of these on Asian people. I’m fearful because of the safety of my family, when we go into the public. Fearing, hearing the news about Asian family’s cars and house being attacked and vandalized. Fearing of public attack like on subway trains in New York. I’m fearing to be a minority in this country at this stage of the virus outbreak. Being Asian-American I’m afraid to be in my own country, just because there’s the other part of me that people are currently discriminating against.
Application of a Theoretical Approach to the Health Issue
What is so prevalence right now in the world of Public Health is having people educated on this outbreak. We don’t need to panic. We should be focusing on understanding this virus and how to stop the spread of this infection. Once in for all, ending this Coronavirus. When looking at this Coronavirus through a Biocultural view, we need to first be educated about this virus itself. What is its genetic material? What is the mechanism of how it can enter and hijack our cells to replicate itself? It’s transmission rate? Incubation period? How long can it survive outside the body? Could we denature its genetic materials to make it not able to replicate anymore? Understanding the biology of this virus, can direct us to solutions to end this viral infection once in for all (Zhu, Perlma, Holshue, Guan, 2020).
Cultural aspect help us understand, how each culture deals with an outbreak like this. A lot of people praise China on their ability to get to the virus and contain it as fast as they could. Quarantining 14 million people in a city, creating hospitals to help with the overflowing of patients in a matter of a little more than a week. Being so quick on their feet, within a little over a month China was able to send its last infected patient home. I’m not going to say that China is perfect, because I feel like there were also flaws, in how they reported their findings to the World Health Organization. Tracking back and following all the information that was provided from “first patient” we don’t think he was the patient zero that we are looking for. Health reports shows that the first case of this patient zero came into a hospital back in early November of 2019.
Unable to understand this disease, China laid low on reporting this illness to the World Health Organization. Until middle of December when more people came into the hospital with the same type of symptoms to patient zero. With more and more cases with the same symptoms this illness was then reported to the World Health Organization on December 31st, 2019. With many talks going around about this virus, we can see that there was something off about the number of cases being reported in China. With one of the largest populations on this planet and the huge numbers of patients in news reports and interviews. How was the number in China of those infected so low? Could there be information that was withhold from the public like the case of SARS in 2003?
I don’t think that there is one perfect culture that can deal with what is happening right now. Since everyone in this whole world is constantly in a state of panic. Fighting over food, supplies and necessities. No one is thinking about others in this state of fear. With a state of fear, we develop hate and in this dark time already people are stigmatized Asians as this Coronavirus carriers. Vandalizing and hate speech all targeting the Asian communities. Different cultures around the world are blaming China for poor eating behaviors; of eating bats that why there is this spread of Coronavirus. Others are saying this is Biological Warfare that got out of control. When we’re in a struggling time, rather than uniting together to fight against things. We as human tend to separate and blame others to as an answer to the unknown.
Making Recommendations/Advocacy (How Do We Improve This Health Issue)
When looking at a Pandemic, we also must look at an Epidemic Curve. Epidemic Curve shows us the occurrence and the speed of the new diseases; the number of cases over time during an outbreak (Carroll,2020). Having a steep large curve in a short amount of time just overwhelms the health care system. What we can do to help flatten the Epidemic Curve and not have a huge influx of patients rushing into the hospital all at once due to this virus. But rather encouraging proper hand hygiene. When you don’t know what to do, wash your hands with soap and water for at least 20 seconds! Reframe from touching orifices on your face. Stay away from anyone who look sick or showing signs. Stay home yourself when you feel sick and public distancing at least 6 feet to slow this community transmission.
Physicians, nurses and health care workers are doing their best with this viral infection. But we also need to help with our part in this system. On average the United States have only 2.8 hospital beds for every 1,000 people and only 160,000 ventilators that are distributed through the nation (Carroll,2020). If we all rush into the hospital demanding testing and allowing fear to make us irrational. We’ll be taking valuable time away from the health care workers to accommodate those who are critically ill. If everyone rush into the hospital at once and a lot of them aren’t sick; they are also risking their chance of getting transmitted from a person who is currently infected. Stay clear of hospital, unless you show those signs: Fever, difficulty breathing/shortness of breath, cough and pressure and chest pain. Otherwise stay home and rest when you’re sick and mitigate interaction in large crowds.
With all this news reports going around every day, what you need to realize is. News outlet sensationalize every story to get more views. When keeping up with any news, take things with a grain of salt. Don’t just use one source to make your decisions, but rather watch everything. CNN, NBC, ABC, FOX all these networks have certain views on certain story they report. Some are conservative, some liberals, so be careful of your sources. The news will never report any recovery rate or have interviews with those who survived this infection. But would rather only talk about the infection rate and the death toll. I would advocate for those who want to know the truth, to watch thing from WHO, CDC, interviews of those who are infected and have recovered. Learning from and interactive map, NextStrain, which shows the morphology of the virus and its mutations and spreads (Hadfield, 2019). Being educated on different sources and truly understand this virus, is the only way to protect yourself and your family.
I’m currently work in the UW Virology Lab, and within these past few weeks when we started to take in patients’ samples for the COVID-19 my lab has been so hectic. Getting at least 1,000 samples a day for testing, this has overwhelmed everyone here in the lab. We need to stay calm during this National Emergency, in order to make wise decisions to help protect ourselves and our family. Understanding the biology of this virus can allow us to keep better hygiene, make sure we get ventilations in our house, clean up surfaces that we touch on the daily: phones especially. Having the best hygiene right now, might be the best prevention in a time of a viral infection. Also mitigating fear within our community. This is a scary situation that our nation is in right now. And, yes this infection can only get worst before it gets better. Facing this viral infection head on and knowing how to keep yourself calm and your love ones calm will make it better for everyone. I feel like fear is the thing that is harming our nation more than the virus itself. Since if we look at the R naught value (basic reproduction number) is 2.2 compared to the epidemic of SARS which was an R naught of 3 (Cascella, 2020). Yes, you still are transmitting to people when you yourself are not developing symptoms if you were infected yourself: hence the community transmission. That’s why it is best to have community distancing when possible.
We’ve been through worst Pandemic than this in the past and we’ve always came out of it in the end. Yes, we do lose a lot of people through it, but many situations gets worse before it can get better. We’ve now been through, Spanish Flu Pandemic, SARS in 2003, Swine Flu 2009, MERS in 2012, now COVID-19. No matter what, it takes time to get a better understanding on the virus and to fight it. We have better research facilities, and better resources than back in the days of the Spanish Flu Pandemic. And yet people still are in a panic and in fear of this killing everyone. It’s best to educate yourself and people around you on how to mitigate the spread of this virus. And, note this situation is serious but we can stop it, if we all learn better hygiene and ways to stop community transmission.
- Carroll, A. (2020, March 13). Flattening The Curve of Coronavirus Infections. Retrieved March 15, 2020, from https://www.youtube.com/watch?v=S3aT6hlGFw0
- Cascella, M. (2020, March 8). Features, Evaluation and Treatment Coronavirus (COVID-19). Retrieved March 15, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK554776/
- Hadfield, J. (2019, December). Genomic epidemiology of novel coronavirus (hCoV-19). Retrieved March 15, 2020, from https://nextstrain.org/ncov
- Holshue, M. L., Rothe, C., Guan, Holshue, M. L., & Epidemic Intelligence Service. (2020, March 5). First Case of 2019 Novel Coronavirus in the United States: NEJM. Retrieved March 15, 2020, from https://www.nejm.org/doi/full/10.1056/NEJMoa2001191
- Situation Report 54. (2020, March 14). Retrieved March 15, 2020, from https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200314-sitrep-54-covid-19.pdf?sfvrsn=dcd46351_6
- Situation Summary. (2020, March 11). Retrieved March 15, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html
- Zhu, Perlman, S., Holshue, M. L., Guan, Liu, W., China Novel Coronavirus Investigating and Research Team, & NHC Key Laboratory of Biosafety. (2020, February 20). A Novel Coronavirus from Patients with Pneumonia in China, 2019: NEJM. Retrieved March 15, 2020, from https://www.nejm.org/doi/full/10.1056/NEJMoa2001017