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112-689: During the COVID-19 pandemic, the Saint-Antoine hospital participated in therapeutic research, in particular the Corimuno-plasm ( plasma therapy ) clinical trial, with Karine Lacombe's team. 48°50′55″N 2°22′57″E  /  48.8485623°N 2.3824305°E  / 48.8485623; 2.3824305 This article about a hospital in Europe is a stub . You can help Misplaced Pages by expanding it . COVID-19 Coronavirus disease 2019 ( COVID-19 )

224-491: A growing human population . According to Peter Daszak, the chair of the group who produced the report, "there is no great mystery about the cause of the Covid-19 pandemic, or of any modern pandemic. The same human activities that drive climate change and biodiversity loss also drive pandemic risk through their impacts on our environment." Stanford biological anthropologist James Holland Jones notes that humanity has "engineer[ed]

336-494: A strain of coronavirus known as "severe acute respiratory syndrome coronavirus 2" ( SARS-CoV-2 ). COVID-19 is mainly transmitted when people breathe in air contaminated by droplets / aerosols and small airborne particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing. Transmission is more likely the closer people are. However, infection can occur over longer distances, particularly indoors. The transmission of

448-497: A systemic inflammatory response syndrome . Among healthy adults not exposed to SARS-CoV-2, about 35% have CD4 T cells that recognise the SARS-CoV-2 S protein (particularly the S2 subunit) and about 50% react to other proteins of the virus, suggesting cross-reactivity from previous common colds caused by other coronaviruses. Pandemic prevention Pandemic prevention is

560-419: A certain critical size, generally thought to be <100μm diameter, evaporate faster than they settle; due to that fact, they form respiratory aerosol particles that remain airborne for a long period of time over extensive distances. Infectivity can begin four to five days before the onset of symptoms. Infected people can spread the disease even if they are pre-symptomatic or asymptomatic . Most commonly,

672-404: A critical health policy issue for the current generation of scientists and policymakers to address. A 2007 study warns that "the presence of a large reservoir of SARS-CoV-like viruses in horseshoe bats, together with the culture of eating exotic mammals in southern China, is a time bomb. The possibility of the reemergence of SARS and other novel viruses from animals or laboratories and therefore

784-542: A high discovery-rate is important. For instance, this is the reason why no thermal scanners with a low discovery-rate were used in airports for containment during the 2009 swine flu pandemic . Coverage may also be important. (See also: pooled COVID-19 populations testing , possibly based on CRISPR ) Wastewater surveillance likely cannot replace large-scale diagnostic testing, but could "complement clinical surveillance by providing early signs of potential transmission for more active public health responses". Some argue that

896-434: A high enduring protection against the variants. One approach to solve this problem are pan-virus vaccines that protect against many strains (in this case a pan-SARS-CoV-2-like/variant-coronavirus vaccine), possibly including variants that do not yet exist. A 2014 analysis asserts that "the window of opportunity to deal with pandemics as a global community is within the next 27 years. Pandemic prevention therefore should be

1008-422: A higher risk of developing severe symptoms. Some complications result in death. Some people continue to experience a range of effects ( long COVID ) for months or years after infection, and damage to organs has been observed. Multi-year studies are underway to further investigate the long-term effects of the disease. COVID‑19 transmission occurs when infectious particles are breathed in or come into contact with

1120-517: A highly favorable cost-benefit ratio. A second study affirms that if policy priorities were refocused from disease control to prevention, implementing such proactive actions would "cost a very small fraction of the reconstruction budgets". Some experts link pandemic prevention with environmental policy and caution that environmental destruction as well as climate change drives wildlife to live close to people . The WHO projects that climate change will also affect infectious disease occurrence. It

1232-532: A new kind of CRISPR-Cas13d screening platform for effective guide RNA design to target RNA . They used their model to predict optimized Cas13 guide RNAs for all protein-coding RNA-transcripts of the human genome 's DNA . Their technology could be used in molecular biology and in medical applications such as for better targeting of virus RNA or human RNA. Targeting human RNA after it's been transcribed from DNA, rather than DNA, would allow for more temporary effects than permanent changes to human genomes. The technology

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1344-448: A pandemic is with deeper surveillance of symptoms that fit the virus' profile. The scientific and technological ways of quickly detecting a spillover could be improved so that an outbreak can be isolated before it becomes an epidemic or pandemic. David Quammen states that he heard about the idea to develop technology to screen people at airport security points for whether or not they carry an infectious disease ten years ago and thought it

1456-568: A pandemic threat could enable high-resolution "syndromic surveillance" as an early warning system . In 1947, the World Health Organization established such a global network of some hospitals. Such sharing and off-site evaluation of symptoms and possibly related medical data may have complementary benefits such as improving livelihoods of workers who work with livestock and improving the accuracy, timeliness and costs of disease prognoses. The WHO Hub for Pandemic and Epidemic Intelligence

1568-645: A portable virus capture device, coupled with label-free Raman spectroscopy for identification of newly emerging or circulating viruses as a major first step toward managing the public health response to potential outbreaks. It could rapidly obtain the Raman signature of a virus and use machine learning to recognize the virus based on its weighted combination Raman spectrum fingerprint, being able to distinguish between influenza virus type A versus type B. Monitoring people who are exposed to animals in viral hotspots – including via virus monitoring stations – can register viruses at

1680-415: A potential zoonotic threat in its original animal reservoir. This warrants monitoring and reporting of suspicious cases of atypical pneumonia. Effective isolation of patients was enough to control spread because infected individuals usually do not transmit the virus until several days after symptoms begin and are most infectious only after developing severe symptoms. Nevertheless several studies warned about

1792-423: A range of effects, such as fatigue , for prolonged periods after an initial COVID-19 infection. This is the result of a condition called long COVID , which can be described as a range of persistent symptoms that continue for months or years. Long-term damage to organs has been observed after the onset of COVID-19. Multi-year studies are underway to further investigate the protracted effects of long COVID. Reducing

1904-450: A reliable real-time option for taxonomic classification of novel pathogens. Timely use and development of quick testing systems for novel virus in combination with other measures might (possibly) make it possible to end transmission lines of outbreaks before they become pandemics. After an outbreak there may be a certain window of time during which a pandemic can still be prevented. A key difficulty with early detection and containment

2016-503: A scientist concluded that probably permafrost per se shouldn't host more pathogens than any other environment. Nevertheless, the risk from permafrost pathogens is unknown and viruses from the very first humans to populate the Arctic could emerge. Moreover, researchers have suggested more work on microbes soon to be released from melting glaciers across the world to identify and understand potential threats in advance. Studies have shown that

2128-533: A small change. In an editorial published in February 2020 another group of scientists claimed that they have implemented a flexible and efficient approach for targeting RNA with CRISPR-Cas13d which they have put under review and propose that the system can be used to also target SARS-CoV-2 in specific. There have also been earlier successful efforts in fighting viruses with CRISPR-based technology in human cells. In March 2020 researchers reported that they have developed

2240-472: A theoretical 'MERS-CoV-2' that, like SARS-CoV-2 , can use humans' ACE2 receptor. The theoretical virus could also have a high mortality burden, since MERS-CoV had a case fatality rate of around 35%. This 'MERS-CoV-2' therefore represents a risk to biosafety and potential zoonotic spillover. The study emphasized the need for pathogen/spillover surveillance to further understand any possible threat from related viruses. The WHO stated that further study

2352-537: A world where emerging infectious diseases are both more likely and more likely to be consequential", referring to the modern world's prevalent highly mobile lifestyles, increasingly dense cities, various kinds of human interactions with wildlife and alterations of the natural world. Furthermore, when multiple species that are not usually next to each other are driven to live closely together new diseases may emerge. Research shows that abundant animals, plants, insects, and microbes living in complex, mature ecosystems can limit

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2464-630: Is a contagious disease caused by the coronavirus SARS-CoV-2 . The first known case was identified in Wuhan , China, in December 2019. Most scientists believe the SARS-CoV-2 virus entered into human populations through natural zoonosis , similar to the SARS-CoV-1 and MERS-CoV outbreaks, and consistent with other pandemics in human history. Social and environmental factors including climate change , natural ecosystem destruction and wildlife trade increased

2576-686: Is a novel severe acute respiratory syndrome coronavirus. It was first isolated from three people with pneumonia connected to the cluster of acute respiratory illness cases in Wuhan. All structural features of the novel SARS-CoV-2 virus particle occur in related coronaviruses in nature, particularly in Rhinolophus sinicus (Chinese horseshoe bats). Outside the human body, the virus is destroyed by household soap which bursts its protective bubble . Hospital disinfectants, alcohols, heat, povidone-iodine , and ultraviolet -C (UV-C) irradiation are also effective disinfection methods for surfaces. SARS-CoV-2

2688-706: Is an early-warning center that attempts to aggregate data and quickly analyze it to predict, prevent, detect, prepare for, and respond to outbreaks and was set up Berlin in September 2021. It uses machine learning and may analyze data about animal health, unusual symptoms in humans, migration and other related developments that may contain detectable patterns. In December 2020 during the COVID-19 pandemic, national and international officials reported mutated variants of SARS-CoV-2 , including some with higher transmissibility and worldwide spread. While mutations are common for viruses and

2800-571: Is associated with COVID-19 and is reported in as many as 88% of symptomatic cases. Published data on the neuropathological changes related with COVID-19 have been limited and contentious, with neuropathological descriptions ranging from moderate to severe hemorrhagic and hypoxia phenotypes , thrombotic consequences, changes in acute disseminated encephalomyelitis (ADEM-type), encephalitis and meningitis . Many COVID-19 patients with co-morbidities have hypoxia and have been in intensive care for varying lengths of time, confounding interpretation of

2912-433: Is available, guidelines and recommendations for hypertensive patients remain. The effect of the virus on ACE2 cell surfaces leads to leukocytic infiltration, increased blood vessel permeability, alveolar wall permeability, as well as decreased secretion of lung surfactants. These effects cause the majority of the respiratory symptoms. However, the aggravation of local inflammation causes a cytokine storm eventually leading to

3024-402: Is because pregnant women with COVID‑19 appear to be more likely to develop respiratory and obstetric complications that can lead to miscarriage , premature delivery and intrauterine growth restriction . Fungal infections such as aspergillosis , candidiasis , cryptococcosis and mucormycosis have been recorded in patients recovering from COVID‑19. COVID‑19 is caused by infection with

3136-522: Is closely related to the original SARS-CoV . It is thought to have an animal ( zoonotic ) origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus Betacoronavirus , in subgenus Sarbecovirus (lineage B) together with two bat-derived strains. It is 96% identical at the whole genome level to other bat coronavirus samples (BatCov RaTG13 ). The structural proteins of SARS-CoV-2 include membrane glycoprotein (M), envelope protein (E), nucleocapsid protein (N), and

3248-543: Is it ready for significantly expanded challenges in the future". Toby Ord , author of the book The Precipice: Existential Risk and the Future of Humanity which addresses the issue, puts into question whether current public health and international conventions, and self-regulation by biotechnology companies and scientists are adequate. As of 2017, there is "no concerted international approach to identify, collect, analyze, and disseminate lessons and best practices in strengthening

3360-520: Is made available to researchers through an interactive website and free and open source software and is accompanied by a guide on how to create guide RNAs to target the SARS-CoV-2 RNA genome. Scientists report to be able to identify the genomic pathogen signature of all 29 different SARS-CoV-2 RNA sequences available to them using machine learning and a dataset of 5000 unique viral genomic sequences. They suggest that their approach can be used as

3472-592: Is needed to find out "whether the virus detected in the study will pose a risk for humans". On 21 May 2022, the WHO reported on the international 2022 monkeypox outbreak in non-endemic countries which involved an unprecedented number of cases detected outside of Africa. The first of these cases was detected on 6 May 2022. The main method used for early containment ( see below ) is ' ring vaccination ' – vaccinating close contacts of positive cases via already-existing vaccines alongside pre-exposure vaccination of members of

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3584-565: Is not building such databases or not collecting dangerous sequences in the first place. A 2014 study proposed safer "alternatives to experiments with novel potential pandemic pathogens" than some of the current methods. In a 2012 study it is claimed that "new mathematical modelling, diagnostic, communications, and informatics technologies can identify and report hitherto unknown microbes in other species, and thus new risk assessment approaches are needed to identify microbes most likely to cause human disease". The study investigates challenges in moving

3696-452: Is projected that interspecies viral sharing, that can lead to novel viral spillovers , will increase due to ongoing climate change-caused geographic range-shifts of mammals (most importantly bats). Risk hotspots would mainly be located at "high elevations, in biodiversity hotspots, and in areas of high human population density in Asia and Africa". A 2016 study reviews literature on the evidences for

3808-572: Is that in the globalized and urbanized world, pathogens can spread rapidly to several regions worldwide via travel, before it may be possible to notice them and e.g. initiate contact-tracing and containment measures. Rapid communication of data for health systems to implement any public intervention measures may be important. A "'One Health' global network for proactive surveillance, rapid detection, and prevention of MERS-CoV and other epidemic infectious diseases threats" has been proposed in 2016. Moreover, there are several issues with tests. For example,

3920-595: Is the cause of the bud release and the formation of the viral envelope. The N and E protein are accessory proteins that interfere with the host's immune response. Human angiotensin converting enzyme 2 (hACE2) is the host factor that SARS-CoV-2 virus targets causing COVID‑19. Theoretically, the usage of angiotensin receptor blockers (ARB) and ACE inhibitors upregulating ACE2 expression might increase morbidity with COVID‑19, though animal data suggest some potential protective effect of ARB; however no clinical studies have proven susceptibility or outcomes. Until further data

4032-465: Is the viral component that attaches to the host receptor via the ACE2 receptors. It includes two subunits: S1 and S2. Studies have shown that S1 domain induced IgG and IgA antibody levels at a much higher capacity. It is the focus spike proteins expression that are involved in many effective COVID‑19 vaccines. The M protein is the viral protein responsible for the transmembrane transport of nutrients. It

4144-433: Is to "maintain a database with hashes of deadly and dangerous sequences" which don't contain data with a potential for danger (depending on various factors) and also "can't be reverse-engineered to learn the dangerous original sequence if you don't already know it". This would theoretically enable checking sequences against a database of recorded pathogens without maintaining a database of deadly sequences. Another approach

4256-896: The Alpha variant (B.1.1.7, formerly called the UK variant), first found in London and Kent, the Beta variant (B.1.351, formerly called the South Africa variant), the Gamma variant (P.1, formerly called the Brazil variant), the Delta variant (B.1.617.2, formerly called the India variant), and the Omicron variant (B.1.1.529), which had spread to 57 countries as of 7 December. On December 19, 2023,

4368-719: The Centre for the Study of Existential Risk (CSER) convened policy-makers and academics to identify challenges for the Biological Weapons Convention (BWC) in 2017. A key issue identified was that the rapid rate of progress in relevant sciences and technologies has made it very difficult for governance bodies including the BWC to keep pace. Luke Kemp , a member of CSER, notes that "just a few key countries [are] blocking regulation of catastrophic hazards" and that "[f]or biological weapons it

4480-572: The Spanish flu , Middle East respiratory syndrome , and Zika virus . In January 2020, the World Health Organization (WHO) recommended 2019-nCoV and 2019-nCoV acute respiratory disease as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations or groups of people in disease and virus names to prevent social stigma . The official names COVID‑19 and SARS-CoV-2 were issued by

4592-509: The impact of climate change on human infectious disease, suggests a number of proactive measures for controlling health impacts of climate change and finds that climate change impacts human infectious disease via alterations to pathogen, host and transmission. Another way climate change may affect pandemic risks, is by pathogens in thawing permafrost (e.g. in the Arctic) that may have infected now-extinct ancestral humans in such regions. However,

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4704-482: The small intestine . The virus can cause acute myocardial injury and chronic damage to the cardiovascular system . An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China, and is more frequent in severe disease. Rates of cardiovascular symptoms are high, owing to the systemic inflammatory response and immune system disorders during disease progression, but acute myocardial injuries may also be related to ACE2 receptors in

4816-705: The spike protein (S). The M protein of SARS-CoV-2 is about 98% similar to the M protein of bat SARS-CoV, maintains around 98% homology with pangolin SARS-CoV, and has 90% homology with the M protein of SARS-CoV; whereas, the similarity is only around 38% with the M protein of MERS-CoV . The many thousands of SARS-CoV-2 variants are grouped into either clades or lineages . The WHO, in collaboration with partners, expert networks, national authorities, institutions and researchers, have established nomenclature systems for naming and tracking SARS-CoV-2 genetic lineages by GISAID , Nextstrain and Pango . The expert group convened by

4928-493: The 'era of pandemics' by 22 experts in a variety of fields, and concluded that anthropogenic destruction of biodiversity is paving the way to the pandemic era, and could result in as many as 850,000 viruses being transmitted from animals – in particular birds and mammals – to humans. The increased pressure on ecosystems is being driven by the "exponential rise" in consumption and trade of commodities such as meat, palm oil, and metals, largely facilitated by developed nations, and by

5040-607: The 26 categories which contained more than 10 species includes: In a paywalled article, American scientists proposed policy -based measures to reduce large risks from life sciences research – including pandemics through accident or misapplication. Risk management measures may include novel international guidelines and standards of conduct, effective oversight, improvement of US policies to influence policies globally, and identification of gaps in biosecurity policies along with potential approaches to address them. Concerning systematic comprehensive identification of challenges,

5152-538: The B.1 lineage. Several notable variants of SARS-CoV-2 emerged throughout 2020. Cluster 5 emerged among minks and mink farmers in Denmark . After strict quarantines and the slaughter of all the country's mink , the cluster was assessed to no longer be circulating among humans in Denmark as of 1 February 2021. As of December 2021 , there are five dominant variants of SARS-CoV-2 spreading among global populations:

5264-539: The CNS, possibly within an infected white blood cell. Research conducted when Alpha was the dominant variant has suggested COVID-19 may cause brain damage. Later research showed that all variants studied (including Omicron) killed brain cells, but the exact cells killed varied by variant. It is unknown if such damage is temporary or permanent. Observed individuals infected with COVID-19 (most with mild cases) experienced an additional 0.2% to 2% of brain tissue lost in regions of

5376-506: The COVID-19 infection may have different symptoms, and their symptoms may change over time. Three common clusters of symptoms have been identified: a respiratory symptom cluster with cough, sputum , shortness of breath , and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; and a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhea. In people without prior ear, nose, or throat disorders, loss of taste combined with loss of smell

5488-690: The E.U. could address this issue. Rapid regional, possibly also national, capacities in terms of e.g. means, mobile laboratories or diagnostics, personnel, technologies, financial insurances and coordination may also be important. In cases where vaccines already exist a major method for early containment is ' ring vaccination ' – vaccinating close contacts of positive cases (and/or geographical areas) via existing vaccines as well as pre-exposure vaccination of people at higher risk. There are also precautionary vaccine stockpiles. Production capacities may also be important. See also: vaccine-to-variant adjustment for SARS-CoV-2 Omicron Researchers have developed

5600-508: The Global Virome Project stated that the " extractive industry — oil and gas and minerals, and the expansion of agriculture, especially cattle" are the biggest predictors of where spillovers can be seen. A study proposes that policy responses "addressing zoonotic threats should include ecosystem regeneration ". In the 2000s, a WHO spokesperson summarized the animal-related aspects of pandemics, stating "the whole relationship between

5712-504: The United States' PREDICT government research program that sought to identify animal pathogens that might infect humans and to prevent new pandemics was cut in 2019. Funding for United States' CDC programs that trained workers in outbreak detection and strengthened laboratory and emergency response systems in countries where disease risks are greatest to stop outbreaks at the source was cut by 80% in 2018. In 2022, researchers reported

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5824-472: The WHO declared that another distinctive variant, JN.1, had emerged as a "variant of interest". Though the WHO expected an increase in cases globally, particularly for countries entering winter, the overall global health risk was considered low. The SARS-CoV-2 virus can infect a wide range of cells and systems of the body. COVID‑19 is most known for affecting the upper respiratory tract (sinuses, nose, and throat) and

5936-759: The WHO on 11 February 2020 with COVID-19 being shorthand for "coronavirus disease 2019". The WHO additionally uses "the COVID‑19 virus" and "the virus responsible for COVID‑19" in public communications. The symptoms of COVID-19 are variable depending on the type of variant contracted, ranging from mild symptoms to a potentially fatal illness. Common symptoms include coughing , fever , loss of smell (anosmia) and taste (ageusia), with less common ones including headaches , nasal congestion and runny nose , muscle pain , sore throat , diarrhea , eye irritation , and toes swelling or turning purple, and in moderate to severe cases, breathing difficulties . People with

6048-547: The WHO recommended the labelling of variants using letters of the Greek alphabet , for example, Alpha , Beta , Delta , and Gamma , giving the justification that they "will be easier and more practical to discussed by non-scientific audiences". Nextstrain divides the variants into five clades (19A, 19B, 20A, 20B, and 20C), while GISAID divides them into seven (L, O, V, S, G, GH, and GR). The Pango tool groups variants into lineages , with many circulating lineages being classed under

6160-506: The actual SARS-CoV-2 , use a targeting-mechanism that uses only a very limited RNA -region, haven't developed a system to deliver it into human cells and would need a lot of time until another version of it or a potential successor system might pass clinical trials . In the study published as a preprint they write that it could be used prophylactically as well as therapeutically. The CRISPR-Cas13d -based system could be agnostic to which virus it's fighting so novel viruses would only require

6272-1052: The animal kingdom and the human kingdom is coming under stress". The integrated, unifying approach of One Health addresses health of people, animals and the environment at once. It could "boost risk identification, reduction, and surveillance in animals and at the human-animal-environment interface". A study which was published in April 2020 and is part of the PREDICT program found that "virus transmission risk has been highest from animal species that have increased in abundance and even expanded their range by adapting to human-dominated landscapes", identifying domesticated species, primates and bats as having more zoonotic viruses than other species and "provide further evidence that exploitation, as well as anthropogenic activities that have caused losses in wildlife habitat quality, have increased opportunities for animal–human interactions and facilitated zoonotic disease transmission". An UN Environment report presents

6384-537: The anthropogenic destruction of ecosystems for the purpose of expanding agriculture and human settlements reduces biodiversity and allows for smaller animals such as bats and rats, who are more adaptable to human pressures and also carry the most zoonotic diseases, to proliferate. This in turn can result in more pandemics. In October 2020, the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services published its report on

6496-604: The best forms of prevention for natural nonsynthetic viruses would be stopping the viruses from spilling into humans in the first place, rather than trying to contain outbreaks. The German program InfectControl 2020 seeks to develop strategies for prevention, early recognition and control of infectious diseases. In one of its projects "HyFly" partners of industry and research work on strategies to contain chains of transmission in air traffic, to establish preventive countermeasures and to create concrete recommendations for actions of airport operators and airline companies. One approach of

6608-515: The brain connected to the sense of smell compared with uninfected individuals, and the overall effect on the brain was equivalent on average to at least one extra year of normal ageing; infected individuals also scored lower on several cognitive tests. All effects were more pronounced among older ages. The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the glandular cells of gastric , duodenal and rectal epithelium as well as endothelial cells and enterocytes of

6720-591: The brain found as complications leading to death in people infected with COVID‑19. Infection may initiate a chain of vasoconstrictive responses within the body, including pulmonary vasoconstriction – a possible mechanism in which oxygenation decreases during pneumonia. Furthermore, damage of arterioles and capillaries was found in brain tissue samples of people who died from COVID‑19. COVID‑19 may also cause substantial structural changes to blood cells , sometimes persisting for months after hospital discharge. A low level of blood lymphocytess may result from

6832-428: The brains of those who have died from COVID‑19, but these results need to be confirmed. While virus has been detected in cerebrospinal fluid of autopsies, the exact mechanism by which it invades the CNS remains unclear and may first involve invasion of peripheral nerves given the low levels of ACE2 in the brain. The virus may also enter the bloodstream from the lungs and cross the blood–brain barrier to gain access to

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6944-628: The causes of the emerging diseases with a large share being environmental: The report also lists some of the latest emerging diseases and their environmental causes: According to a 2001 study and its criteria a total of 1415 species of infectious agents in 472 different genera have been reported to date to cause disease in humans. Out of these reviewed emerging pathogen species 75% are zoonotic. A total of 175 species of infectious agents from 96 different genera are associated with emerging diseases according its criteria. Some of these pathogens can be transmitted by more than one route. Data on 19 categories of

7056-409: The clear jelly liquid found in lung autopsies of people who died of COVID-19. One possibility addressed in medical research is that hyuralonic acid (HA) could be the leading factor for this observation of the clear jelly liquid found in the lungs, in what could be hyuralonic storm, in conjunction with cytokine storm . One common symptom, loss of smell, results from infection of the support cells of

7168-438: The construction of an early warning system which could make use of artificial intelligence surveillance and outbreak investigation. Edward Rubin notes that after sufficient data has been gathered artificial intelligence could be used to identify common features and develop countermeasures and vaccines against whole categories of viruses. It might be possible to predict viral evolution using machine learning . In April 2020 it

7280-406: The data. Of people who show symptoms, 81% develop only mild to moderate symptoms (up to mild pneumonia ), while 14% develop severe symptoms ( dyspnea , hypoxia , or more than 50% lung involvement on imaging) that require hospitalization, and 5% of patients develop critical symptoms ( respiratory failure , septic shock , or multiorgan dysfunction ) requiring ICU admission. At least a third of

7392-417: The development of an ultra-high-throughput sequence alignment technology that enables searching the planetary collection of nucleic acid sequences . The open source supercomputing -based Serratus Project identified over 130,000 RNA-based viruses, including 9 coronaviruses. While such and related endeavors and data are reportedly risky themselves as of 2021, the project aims to improve pathogen surveillance,

7504-489: The exploitation of resources (including non-timber forest products such as game animals , fur-bearers , ...). An article by the World Economic Forum states that studies have shown that deforestation and loss of wildlife cause increases in infectious diseases and concludes that the recovery from the COVID-19 pandemic should be linked to nature recovery, which it considers economically beneficial. Dennis Caroll of

7616-716: The expression of ACE-2, thereby facilitating the SARS-Cov2 virus to enter cells and to replicate. A competition of negative feedback loops (via protective effects of interferon alpha) and positive feedback loops (via upregulation of ACE-2) is assumed to determine the fate of patients suffering from COVID-19. Additionally, people with COVID‑19 and acute respiratory distress syndrome (ARDS) have classical serum biomarkers of CRS, including elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer , and ferritin . Systemic inflammation results in vasodilation , allowing inflammatory lymphocytic and monocytic infiltration of

7728-428: The eyes, nose, or mouth. The risk is highest when people are in close proximity, but small airborne particles containing the virus can remain suspended in the air and travel over longer distances, particularly indoors. Transmission can also occur when people touch their eyes, nose or mouth after touching surfaces or objects that have been contaminated by the virus. People remain contagious for up to 20 days and can spread

7840-521: The face. While drugs have been developed to inhibit the virus, the primary treatment is still symptomatic , managing the disease through supportive care , isolation , and experimental measures . During the initial outbreak in Wuhan , the virus and disease were commonly referred to as "coronavirus" and "Wuhan coronavirus", with the disease sometimes called "Wuhan pneumonia". In the past, many diseases have been named after geographical locations, such as

7952-517: The fight against a monkeypox outbreak in Nigeria. Improving "frontline healthcare provision and testing capacity for deprived communities around the world" could enable detecting, identifying and controlling outbreaks without delays (see above ) . Expert on infectious diseases at the Johns Hopkins Center for Health Security , Amesh Adalja states that the most immediate way to predict

8064-517: The first time. According to Kate Jones , chair of ecology and biodiversity at University College London , the disruption of pristine forests driven by logging, mining, road building through remote places, rapid urbanisation and population growth is bringing people into closer contact with animal species they may never have been near before, resulting in transmission of diseases from wildlife to humans. An August 2020 study published in Nature concludes that

8176-594: The global pandemic strategy from response to pre-emption. Some scientists are screening blood samples from wildlife for new viruses. The international Global Virome Project (GVP) aims to identify the causes of fatal new diseases before emergence in human hosts by genetically characterizing viruses found in wild animals. The project aims to enlist an international network of scientists to collect hundreds of thousands of viruses, map their genomes, characterize and risk-stratify them to identify which ones to pay attention to. However, some infectious disease experts have criticized

8288-523: The heart. ACE2 receptors are highly expressed in the heart and are involved in heart function. A high incidence of thrombosis and venous thromboembolism occurs in people transferred to intensive care units with COVID‑19 infections, and may be related to poor prognosis. Blood vessel dysfunction and clot formation (as suggested by high D-dimer levels caused by blood clots) may have a significant role in mortality, incidents of clots leading to pulmonary embolisms , and ischaemic events (strokes) within

8400-500: The host cell. Following viral entry, COVID‑19 infects the ciliated epithelium of the nasopharynx and upper airways. Autopsies of people who died of COVID‑19 have found diffuse alveolar damage , and lymphocyte-containing inflammatory infiltrates within the lung. From the CT scans of COVID-19 infected lungs, white patches were observed containing fluid known as ground-glass opacity (GGO) or simply ground glass. This tended to correlate with

8512-522: The infection, children may develop paediatric multisystem inflammatory syndrome , which has symptoms similar to Kawasaki disease , which can be fatal. In very rare cases, acute encephalopathy can occur, and it can be considered in those who have been diagnosed with COVID‑19 and have an altered mental status. According to the US Centers for Disease Control and Prevention , pregnant women are at increased risk of becoming seriously ill from COVID‑19. This

8624-800: The likelihood of such zoonotic spillover . The disease quickly spread worldwide, resulting in the COVID-19 pandemic . The symptoms of COVID‑19 are variable but often include fever, fatigue, cough, breathing difficulties , loss of smell , and loss of taste . Symptoms may begin one to fourteen days after exposure to the virus. At least a third of people who are infected do not develop noticeable symptoms . Of those who develop symptoms noticeable enough to be classified as patients, most (81%) develop mild to moderate symptoms (up to mild pneumonia ), while 14% develop severe symptoms ( dyspnea , hypoxia , or more than 50% lung involvement on imaging), and 5% develop critical symptoms ( respiratory failure , shock , or multiorgan dysfunction ). Older people are at

8736-450: The lower respiratory tract (windpipe and lungs). The lungs are the organs most affected by COVID‑19 because the virus accesses host cells via the receptor for the enzyme angiotensin-converting enzyme 2 (ACE2), which is most abundant on the surface of type II alveolar cells of the lungs. The virus uses a special surface glycoprotein called a " spike " to connect to the ACE2 receptor and enter

8848-409: The lung and the heart. In particular, pathogenic GM-CSF-secreting T cells were shown to correlate with the recruitment of inflammatory IL-6-secreting monocytes and severe lung pathology in people with COVID‑19. Lymphocytic infiltrates have also been reported at autopsy. Multiple viral and host factors affect the pathogenesis of the virus. The S-protein , otherwise known as the spike protein,

8960-447: The moment a person first becomes infected and the appearance of the first symptoms. The median delay for COVID-19 is four to five days possibly being infectious on 1–4 of those days. Most symptomatic people experience symptoms within two to seven days after exposure, and almost all will experience at least one symptom within 12 days. Most people recover from the acute phase of the disease. However, some people continue to experience

9072-702: The moment they enter human populations - this might enable prevention of pandemics. The most important transmission pathways often vary per underlying driver of emerging infectious diseases such as the vector-borne pathway and direct animal contact for land-use change – the leading driver for emerging zoonoses by number of emergence events as defined by Jones et al. (2008). 75% of the reviewed 1415 species of infectious organisms known to be pathogenic to humans account for zoonoses by 2001. Genomics could be used to precisely monitor virus evolution and transmission in real time across large, diverse populations by combining pathogen genomics with data about host genetics and about

9184-529: The need for preparedness should not be ignored". The US' National Security Council Directorate for Global Health Security and Biodefense, which worked on preparing for the next disease outbreak and preventing it from becoming an epidemic or pandemic, was closed in 2018. A study concluded that the three practical actions "better surveillance of pathogen spillover and development of global databases of virus genomics and serology, better management of wildlife trade, and substantial reduction of deforestation" would have

9296-480: The olfactory epithelium , with subsequent damage to the olfactory neurons . The involvement of both the central and peripheral nervous system in COVID‑19 has been reported in many medical publications. It is clear that many people with COVID-19 exhibit neurological or mental health issues . The virus is not detected in the central nervous system (CNS) of the majority of COVID-19 patients with neurological issues . However, SARS-CoV-2 has been detected at low levels in

9408-695: The organization and management of preventive measures against pandemics . Those include measures to reduce causes of new infectious diseases and measures to prevent outbreaks and epidemics from becoming pandemics. It is not to be mistaken for pandemic preparedness or mitigation (e.g. against COVID-19 ) which largely seek to mitigate the magnitude of negative effects of pandemics, although the topics may overlap with pandemic prevention in some respects. Some biosafety and public health researchers contend that certain pandemic prevention efforts themselves carry risk of triggering pandemics (e.g. wildlife virus sampling), though not engaging in any form of sampling also carries

9520-562: The organizational culture of life sciences research laboratories worldwide" in terms of biosafety, biosecurity, and responsible conduct, albeit a number of international treaties and partnerships do exist. Around 2022, the International Biosecurity and Biosafety Initiative for Science (IBBIS) was set up by the NTI to improve biosecurity and biosafety, calling i.a. for tighter controls on custom-order DNA companies. The WHO has published

9632-964: The pathogen. A good global infrastructure, consequent information exchange, minimal delays due to bureaucracy and effective, targeted treatment measures can be prepared. In 2012 it has been proposed to consider pandemic prevention as an aspect of international development in terms of health-care infrastructure and changes to the pathogen-related dynamics between humans and their environment including animals. Often local authority carers or doctors in Africa, Asia or Latin America register uncommon accumulations (or clusterings) of symptoms but lack options for more detailed investigations. Scientists state that "research relevant to countries with weaker surveillance, lab facilities and health systems should be prioritized" and that "in those regions, vaccine supply routes should not rely on refrigeration, and diagnostics should be available at

9744-488: The peak viral load in upper respiratory tract samples occurs close to the time of symptom onset and declines after the first week after symptoms begin. Current evidence suggests a duration of viral shedding and the period of infectiousness of up to ten days following symptom onset for people with mild to moderate COVID-19, and up to 20 days for persons with severe COVID-19, including immunocompromised people. Severe acute respiratory syndrome coronavirus   2 (SARS-CoV-2)

9856-411: The people who are infected with the virus do not develop noticeable symptoms at any point in time. These asymptomatic carriers tend not to get tested and can still spread the disease. Other infected people will develop symptoms later (called "pre-symptomatic") or have very mild symptoms and can also spread the virus. As is common with infections, there is a delay, or incubation period , between

9968-489: The point of care". Two researchers have suggested that public health systems "in each country" need to be capable of detecting contagion early, diagnosing it accurately, implementing effective disease control measures, and fully collaborating with the relevant international authorities at each stage ( see below ). U.S. officials have proposed a range of reforms to international health regulations and global institutions for global health security. The "entire architecture of

10080-473: The possible pandemic threat posed by coronaviruses . In January 2022, Chinese scientists at the Wuhan University and other institutions reported in a preprint the detection of the closest MERS-CoV relative in bats to date, NeoCoV, and another virus, PDF-2180-CoV, that can efficiently use bats' ACE2 for cell entry. The study, now published in Nature found that one mutation could result in

10192-557: The project as too broad and expensive due to limited global scientific and financial resources and because only a small percentage of the world's zoonotic viruses may cross into humans and pose a threat. They argue for prioritizing rapidly detecting diseases when they cross into humans and an improving the understanding of their mechanisms. A successful prevention of a pandemic from specific viruses may also require ensuring that it does not re-emerge – for instance by sustaining itself in domestic animals. Pathogen detection mechanisms may allow

10304-482: The project is to detect infections without molecular-biological methods during passenger screening. For this researchers of the Fraunhofer-Institut for cell therapy and immunology are developing a non-invasive procedure based on ion-mobility spectrometry (IMS). Incentives for countries to report new viruses may be important for sufficiently fast detection and for avoiding cover-ups. A global treaty proposed by

10416-433: The public at higher risk. Robust, collaborating public health systems that have the capacity for active surveillance for early detection of cases and to mobilize their health care coordination capacity may be required to be able stop contagion promptly. After an outbreak there is a certain window of time during which a pandemic can still be stopped by the competent authorities isolating the first infected and/or fighting

10528-418: The public, like vaccines. In terms of pandemic prevention, it may be especially useful for vaccine-preventable diseases. A problem with the surveillance for mutated variants during the COVID-19 pandemic was that entities don't have sufficient incentives (and/or requirements) to report such variants. A global treaty proposed by the E.U. includes such incentives. A further issue was that vaccines did not provide

10640-416: The respiratory tract, people with severe COVID‑19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated IL‑2 , IL‑6 , IL‑7 , as well as the following suggest an underlying immunopathology: Interferon alpha plays a complex, Janus-faced role in the pathogenesis of COVID-19. Although it promotes the elimination of virus-infected cells, it also upregulates

10752-1077: The response to epidemics" may need to get adapted, evolving "from crisis response during discrete outbreaks to an integrated cycle of preparation, response and recovery" ( see also #International coordination ). Potential policies that support global biosafety could make use of various technologies, including but not limited to laboratory containment technologies – for example, tools could promote compliance with existing and novel biosecurity norms and standards. Proposals to increase biosafety in terms of laboratories, scientific field work and research and development-related activities include: Efforts of pandemic prevention and related endeavors reportedly risk triggering pandemics themselves as of 2021. These risk include, but are not limited to, unwitting laboratory escape and accidents such as spillovers during field interventions/experiments like field collection, and misuse of its results due to e.g. insecure commercial sales of required equipment and/or materials and/or data. One approach to mitigate risks from pandemic prevention

10864-452: The risk of being unprepared for future spillover events and being unaware of future pandemic pathogens. On 6 May 2024, the White House released an official policy to more safely manage medical research projects involving potentially hazardous pathogens , including viruses and bacteria , that may pose a risk of a pandemic . During the 2002–2004 SARS outbreak , the SARS-CoV-1 virus

10976-483: The risk of disease outbreaks can increase substantially after forests are cleared . The likelihood of human-nonhuman primates contact events is increased jointly by forest landscape fragmentation and certain smallholders' behaviors in forest patches. A study identified the mechanistic connections among habitat loss, climate, and increased bat virus spillover risk. Loss of biodiversity may remove natural regulation of viruses and make fleeing animals meet other species for

11088-859: The risk of long COVID includes staying up to date on the most recent COVID-19 vaccine, practicing good hygiene, maintaining clean indoor air, and physical distancing from people infected with a respiratory virus. Complications may include pneumonia , acute respiratory distress syndrome (ARDS), multi-organ failure , septic shock , and death. Cardiovascular complications may include heart failure, arrhythmias (including atrial fibrillation ), heart inflammation , thrombosis , particularly venous thromboembolism , and endothelial cell injury and dysfunction. Approximately 20–30% of people who present with COVID‑19 have elevated liver enzymes , reflecting liver injury. Neurologic manifestations include seizure , stroke, encephalitis , and Guillain–Barré syndrome (which includes loss of motor functions ). Following

11200-462: The spread of disease from animals to people. The United Nations is formulating nature-focused action plans that could help to stop the next pandemic before it starts. These strategies include conserving ecosystems and wilderness that are still untouched by human activity, and restoring and protecting significant areas of land and ocean (i.e. through protected areas ). Protected areas (which may hold wildlife) also limits human presence and/or limits

11312-564: The spread of some of the virus' mutations have been tracked earlier, mutations that make it more transmittable or severe can be problematic. Resources for disease surveillance have improved during the pandemic so that medical systems around the world are starting to be equipped to detect such mutations with genomic surveillance in a manner relevant to pandemic mitigation and the prevention of sub-pandemics of specific variants or types of variants. As of December 2020, contemporary measures such as COVID-19 vaccines and medications seem to be effective in

11424-498: The study, would have been capable of predicting SARS-CoV-2 as a high-risk strain without prior knowledge of zoonotic SARS-related coronaviruses. An artificial "global immune system"-like technological system that includes pathogen detection may be able to substantially reduce the time required to take on a biothreat agent. A system of that sort would also include a network of well-trained epidemiologists who could be rapidly deployed to investigate and contain an outbreak. Funding for

11536-574: The treatment of infections with the tracked mutated variants compared to earlier forms that are closer to the original virus/es. Tools used in the pandemized outbreak of COVID-19 included PANGOLIN and Nextstrain . In July 2021, scientists reported the detection of anomalous unnamed unknown-host SARS-CoV-2 lineages via wastewater surveillance . Genomic surveillance refers to monitoring pathogens and analyzing their genetic similarities and differences, which may enable (early) alerts and tailoring interventions, countermeasures and recommendations for

11648-559: The understanding of viral evolutionary origins and enable quickly connecting strange emerging illnesses to recorded viruses. Despite recent advances in pandemic modeling, experts using mostly experience and intuition are still more accurate in predicting the spread of disease than strictly mathematical models. In March 2020 scientists of Stanford University presented a CRISPR -based system, called PAC-MAN (Prophylactic Antiviral Crispr in huMAN cells), that can find and destroy viruses in vitro . However, they weren't able to test PAC-MAN on

11760-542: The unique transcriptional signature of infection. The "Surveillance, Outbreak Response Management and Analysis System" (SORMAS) of the German Helmholtz-Zentrum für Infektionsforschung (HZI) and Deutsches Zentrum für Infektionsforschung (DZIF), who collaborate with Nigerian researchers, gathers and analyzes data during an outbreak, detects potential threats and allows to initiate protective measures early. It's meant specifically for poorer regions and has been used for

11872-507: The virus acting through ACE2-related entry into lymphocytes. Another common cause of death is complications related to the kidneys . Early reports show that up to 30% of hospitalised patients both in China and in New York have experienced some injury to their kidneys, including some persons with no previous kidney problems. Although SARS-CoV-2 has a tropism for ACE2-expressing epithelial cells of

11984-752: The virus even if they do not develop symptoms. Testing methods for COVID-19 to detect the virus's nucleic acid include real-time reverse transcription polymerase chain reaction (RT‑PCR), transcription-mediated amplification , and reverse transcription loop-mediated isothermal amplification (RT‑LAMP) from a nasopharyngeal swab . Several COVID-19 vaccines have been approved and distributed in various countries, many of which have initiated mass vaccination campaigns . Other preventive measures include physical or social distancing , quarantining , ventilation of indoor spaces, use of face masks or coverings in public, covering coughs and sneezes, hand washing , and keeping unwashed hands away from

12096-509: The virus is carried out through virus-laden fluid particles, or droplets, which are created in the respiratory tract, and they are expelled by the mouth and the nose. There are three types of transmission: "droplet" and "contact", which are associated with large droplets, and "airborne", which is associated with small droplets. If the droplets are above a certain critical size, they settle faster than they evaporate , and therefore they contaminate surfaces surrounding them. Droplets that are below

12208-453: Was going to be done by now. Thermometers whose measurement data is directly shared via the Internet and medical guidance apps have been used to plot and map unusual fever levels to detect anomalous outbreaks. Various forms of data-sharing could be added to health care institutions such as hospitals so that e.g. anonymized data about symptoms and incidences found to be unusual or characteristic of

12320-464: Was prevented from causing a pandemic of Severe acute respiratory syndrome (SARS). Rapid action by national and international health authorities such as the World Health Organization helped to slow transmission and eventually broke the chain of transmission, which ended the localized epidemics before they could become a pandemic. Human-to-human transmission of SARS may be considered eradicated, however, it could re-emerge as SARS-CoV-1 probably persists as

12432-615: Was reported that researchers developed a predictive algorithm which can show in visualizations how combinations of genetic mutations can make proteins highly effective or ineffective in organisms – including for viral evolution for viruses like SARS-CoV-2 . In 2021, pathogen researchers reported the development of machine learning models for genome-based early detection and prioritization of high-risk potential zoonotic viruses in animals prior to spillover to humans which could be used for virus surveillance for (i.a.) measures of "early investigation and outbreak preparedness" and, according to

12544-541: Was the US who was the primary culprit in preventing the adoption of a global verification scheme under the Biological Weapons Convention" and suggests that "attempts at regulation are often delayed, distorted or destroyed". A 2021 Nuclear Threat Initiative (NTI) report concluded that "[t]he international system for governing dual-use biological research is neither prepared to meet today’s security requirements, nor

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