The COVID 19 Project tests the hypotheses that citizens, provided with information and tools can be trusted to address the complex problems in their community and nationally.
Get Involved
TAKE PART IN OUR EFFORT
Citizens and civil society organizations interested in supporting and joining the COVID 19 Project are welcome.
Join us for our online event at the occasion of the beginning of the Citizen Commission (Details to come)
Meet the Coronavirus
SARS-CoV-2
Citizen Brief
The COVID‑19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID‑19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). The outbreak was first identified in December 2019 in Wuhan, China.The World Health Organization declared the outbreak a Public Health Emergency of International Concern on 30 January 2020 and a pandemic on 11 March. As of 1 August 2020, more than 17.5 million cases of COVID‑19 have been reported in more than 188 countries and territories, resulting in more than 679,000 deaths; more than 10.3 million people have recovered.
In December 31, 2019, China reported a cluster of pneumonia cases of unknown cause that would later be identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1-3 Patients with the illness, called coronavirus disease 2019 (COVID-19), frequently present with fever, cough, and shortness of breath within 2 to 14 days after exposure.4
As of March 23, 2020, there had been 332,930 confirmed cases of COVID-19 reported globally, and 14,510 deaths had been reported.5 In recognition of the widespread global transmission of COVID-19, the World Health Organization declared COVID-19 to be a pandemic on March 11, 2020.6 The first case of COVID-19 in the United States was diagnosed on January 20, 2020, in Snohomish County, Washington, in a person who had recently traveled to Wuhan, China.7
TWiV Special: Coronavirus update with Mark Denison, MD March 26, 2020
Pediatric infectious disease physician and coronavirologist Mark Denison joins Vincent Racaniello for a discussion
How Coronavirus Mutates and Spreads
By Jonathan Corum and Carl ZimmerApril 30, 2020
COVID-19 and SARS-CoV-2 with an emphasis on antiviral therapeutics.
What the Coronavirus Image You’ve Seen a Million Times Really Shows
The illustration visualizes how the virus infects people
The proximal origin of SARS-CoV-2
Why the Coronavirus Is So Confusing A guide to making sense of a problem that is now too big for any one person to fully comprehend The Atlantic Ed Yong April 29, 2020
Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19)A Review W. Joost Wiersinga, MD, PhD1,2; Andrew Rhodes, MD, PhD3; Allen C. Cheng, MD, PhD JAMA July 10, 2020
My Background:
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Group of viruses that are common causes of upper respiratory infections
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6 coronaviruses previously known to cause disease in humans
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4 cause common cold symptoms
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SARS (Severe Acute Respiratory Syndrome) in 2002
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MERS (Middle East Respiratory Syndrome) in 2012
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Coronaviruses comprise a vast family of viruses, 7 of which are known to cause disease in humans. Some coronaviruses that typically infect animals have been known to evolve to infect humans. SARS-CoV-2 is likely one such virus, postulated to have originated in a large animal and seafood market. Recent cases involve individuals who reported no contact with animal markets, suggesting that the virus is now spreading from person to person. [27]
My Family
Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) are also caused by coronaviruses that “jumped” from animals to humans. More than 8,000 individuals developed SARS, nearly 800 of whom died of the illness (mortality rate of approximately 10%), before it was controlled in 2003. [28] MERS continues to resurface in sporadic cases. A total of 2,465 laboratory-confirmed cases of MERS have been reported since 2012, resulting in 850 deaths (mortality rate of 34.5%). [29]
My Stats
My Size: SARS-CoV-2 has a diameter of 60 nm to 140 nm and distinctive spikes, ranging from 9 nm to 12 nm, giving the virions the appearance of a solar corona
Basic reproduction number: (R0) — the number of people, on average, to whom one infected person will pass the virus
My Lethality:
Life span:
My Ancestors : Through genetic recombination and variation, coronaviruses can adapt to and infect new hosts. Bats are thought to be a natural reservoir for SARS-CoV-2, but it has been suggested that humans became infected with SARS-CoV-2 via an intermediate host, such as the pangolin.
What I do in the Human Body
Enter through the nasopharyngeal route. Often just stay in that area _ Impact smell,
The impact I have is direct viral (Multiplication)
Immunomodulators
ACE2, an enzyme that physiologically counters RAAS activation, is the functional receptor to SARS-CoV-2, the virus responsible for the COVID-19 pandemic
Inside the body, the coronavirus is even more sinister than scientists had realized Updated July 1, 2020
Viral Damage
Nasoprengeal
Immune response
Lungs
Transmission
Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurs primarily via respiratory droplets from face-to-face contact and, to a lesser degree, via contaminated surfaces. Aerosol spread may occur, but the role of aerosol spread in humans remains unclear. An estimated 48% to 62% of transmission may occur via presymptomatic carriers.
Ganyani T, Kremer C, Chen D, et al. Estimating the generation interval for coronavirus disease (COVID-19) based on symptom onset data, March 2020. Euro Surveill. 2020;25(17). doi:10.2807/1560-7917.ES.2020.25.17.2000257PubMedGoogle Scholar
WHO Q&A: How is COVID-19 transmitted?
CDC How COVID-19 Spreads Accessed August 28th, 2020
In a fast-moving viral pandemic, scientific understanding will inevitably change as research catches up to the speed at which the virus spreads. However, it seems clear that aerosols are more important when it comes to transmitting COVID-19 than we thought six months ago—and certainly more important than public health officials are currently making them out to be. The WHO and CDC, among others, must begin communicating the science suggesting aerosol spread of COVID-19—and the risk reduction strategies necessary as a result. If not, we hamper our ability to counter the growing health consequences and increasing death toll of COVID-19.
COVID-19 Is Transmitted Through Aerosols. We Have Enough Evidence, Now It Is Time to Act Time Jose-Luis Jimenez August 25, 2020
Common Symptoms
Common symptoms in hospitalized patients include fever (70%-90%), dry cough (60%-86%), shortness of breath (53%-80%), fatigue (38%), myalgias (15%-44%), nausea/vomiting or diarrhea (15%-39%), headache, weakness (25%), and rhinorrhea (7%). Anosmia or ageusia may be the sole presenting symptom in approximately 3% of individuals with COVID-19.
Mao R, Qiu Y, He JS, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5(7):667-678. doi:10.1016/S2468-1253(20)30126-6
Testing for the Coronavirus
How is the diagnosis made?
Diagnosis of COVID-19 is typically made by polymerase chain reaction testing of a nasopharyngeal swab. However, given the possibility of false-negative test results, clinical, laboratory, and imaging findings may also be used to make a presumptive diagnosis for individuals for whom there is a high index of clinical suspicion of infection.
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The testing provides an important tool to identify individuals who may be infected thus helping maintain people who are not infected so they continue to function and to limit resources necessary for fighting the epidemic.
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In Wuhan, where testing became widespread and more than seventy-two thousand coronavirus cases were identified, just one per cent never developed symptoms.
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Aboard the Diamond Princess cruise ship, where, following an outbreak, more than three thousand passengers and crew were quarantined and tested—allowing one of the most complete evaluations of any affected population—six hundred and thirty-four people proved to have the virus. Most had no symptoms at the time of testing, but they proved to be pre-symptomatic: over several days, they developed recognizable signs of the disease. Just eighteen per cent were persistently asymptomatic.
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What went wrong with the Coronavirus testing
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Challenges: The test is a one time picture of status of the patient tested
Laboratory abnormalities
Common laboratory abnormalities19 among hospitalized patients include lymphopenia (83%), elevated inflammatory markers (eg, erythrocyte sedimentation rate, C-reactive protein, ferritin, tumor necrosis factor-α, IL-1, IL-6), and abnormal coagulation parameters (eg, prolonged prothrombin time, thrombocytopenia, elevated D-dimer [46% of patients], low fibrinogen).
Common radiographic findings of individuals with COVID-19 include bilateral, lower-lobe predominate infiltrates on chest radiographic imaging and bilateral, peripheral, lower-lobe ground-glass opacities and/or consolidation on chest computed tomographic imaging.
Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020;7(6):e438-e440. doi:10.1016/S2352-3026(20)30145-9
COVID 19 Respiratory Symptoms
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Mild Respiratory
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Moderate Respiratory
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Severe Respiratory
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Pneumonia
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ARDS
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Well-being
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Home
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Hospital
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ICU
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Death
COVID 19 Complications
Common complications18,20-24 among hospitalized patients with COVID-19 include pneumonia (75%); acute respiratory distress syndrome (15%); acute liver injury, characterized by elevations in aspartate transaminase, alanine transaminase, and bilirubin (19%); cardiac injury, including troponin elevation (7%-17%), acute heart failure, dysrhythmias, and myocarditis; prothrombotic coagulopathy resulting in venous and arterial thromboembolic events (10%-25%); acute kidney injury (9%); neurologic manifestations, including impaired consciousness (8%) and acute cerebrovascular disease (3%); and shock (6%).
Rare complications among critically ill patients with COVID-19 include cytokine storm and macrophage activation syndrome (ie, secondary hemophagocytic lymphohistiocytosis)
Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. Published online April 18, 2020. doi:10.1016/j.ajem.2020.04.048
Evidence-based Treatments
What are current evidence-based treatments for individuals with COVID-19?
Supportive care, including supplemental oxygen, is the main treatment for most patients. Recent trials indicate that dexamethasone decreases mortality (subgroup analysis suggests benefit is limited to patients who require supplemental oxygen and who have symptoms for >7 d) and Remdesivir improves time to recovery (subgroup analysis suggests benefit is limited to patients not receiving mechanical ventilation).