It’s not just a vaccine. There are many reasons for hope in the fight against Covid | Corona Virus

orOn January 5, 2020, the World Health Organization sent a Note to governments Worldwide I have reported a small cluster of pneumonia-like cases in Wuhan, China. For many countries, the warning was like looking through fog. Every month, WHO picks up on average 3000 possible satisfactory indication 30 picks to investigate. In early January, global health scientists like me were trying to assess the outbreak Pneumonia in Wuhan, As it was called then, with huge gaps in our knowledge and great uncertainty: What was the virus or bacterial agent that caused this mass? How is it transmitted? What is the case fatality rate? Can it be contained?

The epidemic may seem to have gone on forever. As we approach the end of 2020, it is easy to lose sight of the progress science has made over the past 10 months. Since January, scientists have gained a much better understanding of the Covid-19 transmission, and have developed tools to manage the virus. Actually, while The next four months will be toughThe promising vaccines, better tests and treatments, and the greater knowledge we have now about how to control this virus will make the situation better by March.

Scientists have never moved so quickly from sequencing the virus to injecting a potential vaccine into the volunteer’s arm. exist 12 candidate vaccines In the Phase 3 trials that are being tested for safety and efficacy, many of them look very promising. After collecting more safety evidence, the next set of challenges will be to manufacture and deliver adequate doses, ensuring that people trust and get vaccinated. The biggest question concerns strategy: Will the vaccine be used to eliminate, suppress, or mitigate the virus? Countries will Take different paths, Based on their Covid situations.

But a vaccine is not the only area of ​​scientific progress. We understand now How does this virus spread Through droplets, small aerosol particles, and on surfaces And that aerosol is perhaps the most important method of transmission. It spreads significantly in Indoor, crowded and unventilated placesAnd even at a distance of two meters, you can still Injured insideThe virus can spread through the air and circulate for hours. Ventilation of indoor spaces, Wearing face coveringsAnd the distance and Exit All socialization and exercise are necessary to prevent transmission of the disease.

Unlike influenza, which is spread by outbreaks of the same size in different places, approximately 10% of people with COVID-19 are responsible 80% of new infections. Instead of going after every case, identifying these “high-prevalence” or “high-prevalence” events can help lower the numbers. We also know that symptom carriers are Achilles heel Control outbreaks: People may feel healthy and still be contagious. This is perhaps the most difficult challenge in the fight against Covid. Detecting disease based on people’s symptoms – the natural way to identify carriers of an infectious disease – means loss Case ratio.

this is the reason Comprehensive test In society is important, because it helps us identify as many people as possible who are infected with the infection, even if they are not showing symptoms. On January 10, the SARS-CoV-2 genome was sequenced It was shared publicly And the WHO shared interim guidelines In laboratory tests of suspected cases. Although laboratory tests are a reliable way to identify carriers, even at low viral doses, they are Time and labor intensive. Tests have gone a long way over the past 10 months, and we now have rapid antigen tests that can give results in 30 minutes for just £ 3.90 each. The Who got it already 120 million of these tests are for poor countries with poor laboratory capacity.

One of the main methods is testing Take control of this virus. The East Asia Pacific game’s guide, which has largely eliminated transmission and quickly dealt with flare-ups, includes testing, tracing, isolation, strict border measures, good voluntary guidance – and little use – of lockdowns.

In the UK, the government plans to implement it Comprehensive and cheap test In the coming months, this will help identify carriers of the virus who then need support to isolate them. Using rapid antigen tests, the Slovakia was tested 3.6 million people Within the weekend (nearly all of its residents are teens and adults) and plans to do it again several days later. One of the limitations of the test is that The incubation period Virus is long, up to 14 days – so testing people frequently will be essential to catch the infected.

We have now too Appropriate antibody tests It can determine if someone has recently contracted Covid. This showed us the response of the antibody to Covid It lasts about 12 weeks. Serum prevalence, the percentage of people who have antibodies, is Low in most countriesAnd even in certain areas of New York City With a reported spread of 50% + of antibodies, the epidemic continues to accelerate, dashing hopes that “herd immunity” can be achieved once a certain number of people are infected.

This is why it is so important to reduce the transmission now. Some have argued that imposing lockdown restrictions at the present time only means delaying the death toll in the future, but this ignores the role of scientific advances and treatments and vaccines that have become available. Now, if you were admitted to hospital with Covid, you would likely survive more than nine months ago. Every time we stop someone getting infected, it gives them a chance to live in an era when there are better treatments and treatments available.

Doctors have a much better understanding of Covid-19, which is not just a respiratory condition, but a disease Multisystem disease It can affect not only the lungs but also the heart, blood vessels, kidneys, and brain. Survival rates among patients getting better, We know that now Early access to treatment It leads to a much lower mortality rate. We also have treatments like Dexamethasone Improves survival rates for sicker patients, research into monoclonal antibody therapy and Remsiver Continuous. Some Covid patients can suffer for several months from “long Covid disease,” which appears to be one Autoimmune-like condition. The next step is to research potential treatments and rehabilitation for survivors.

Final An exit strategy for this pandemic will include a safe and effective vaccine, treatments for those who have Covid-19, and cheap mass testing. We already have some of these tools, with more expected in the coming months. Although winters will be challenging, with shorter and darker days, colder weather and grueling health service, the advancement of science means we will have a chance to break this devastating cycle of lockdown in the spring. That should give us reason for hope and optimism.

Professor Devi Sridhar is Head of the Department of Global Public Health at the University of Edinburgh

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