Are There Many Unknowns Relating to COVID-19?

The many unknowns relating to COVID-19

Check out this answer from Consensus:

The COVID-19 pandemic has highlighted numerous unknowns in our understanding of infectious diseases. Addressing these gaps through continued research is essential for improving public health responses, developing effective treatments and vaccines, and mitigating the long-term impacts of the pandemic. As the scientific community works to unravel these mysteries, a collaborative and multidisciplinary approach will be crucial in overcoming the challenges posed by COVID-19.

The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has brought unprecedented challenges to global public health. Despite significant advancements in understanding and managing the disease, numerous unknowns persist, complicating efforts to control its spread and mitigate its impact. This article explores the various unknowns related to COVID-19, including its origin, transmission, treatment, and long-term effects.

Origin and Transmission

One of the primary unknowns about COVID-19 is its exact origin. While genomic analysis suggests that SARS-CoV-2 is closely related to bat coronaviruses, the intermediate host that facilitated its transfer to humans remains unidentified3 5. This gap in knowledge hinders efforts to prevent future zoonotic spillovers.

Human-to-human transmission of SARS-CoV-2 has been well-documented, even from asymptomatic carriers5. However, the mechanisms and factors influencing transmission rates, such as environmental conditions and viral mutations, are not fully understood. This uncertainty complicates the development of effective public health strategies to curb the spread of the virus.

Clinical Characteristics and Pathogenicity

COVID-19 presents a wide range of clinical manifestations, from asymptomatic cases to severe respiratory illness and death4. The factors determining the severity of the disease in different individuals are not entirely clear. While underlying health conditions and age are known risk factors, the role of genetic and immunological factors requires further investigation8.

The pathogenicity of SARS-CoV-2, including its ability to evade the immune system and cause severe inflammation, is another area with significant unknowns. Understanding these mechanisms is crucial for developing targeted therapies and vaccines3 4.

Treatment and Vaccination

Despite the rapid development and deployment of COVID-19 vaccines, several unknowns remain regarding their long-term efficacy and safety. Questions about the duration of immunity provided by the vaccines, their effectiveness against emerging variants, and potential long-term side effects are still being studied6. Additionally, the efficacy of vaccines in immunocompromised individuals and the best strategies for global vaccine distribution are ongoing challenges6.

Currently, there are no specific antiviral treatments approved for COVID-19, and management primarily involves supportive care and the use of broad-spectrum antivirals3 4. The development of effective antiviral drugs and therapeutic combinations is an urgent need, but the process is hindered by the limited understanding of the virus’s biology and its interaction with the human host4 5.

Long-term Effects and Socioeconomic Impact

The long-term health effects of COVID-19, often referred to as “long COVID,” are not fully understood. Patients report a range of persistent symptoms, including fatigue, respiratory issues, and neurological problems, but the underlying causes and the duration of these symptoms are still being researched6.

The socioeconomic impact of the pandemic is another area with many unknowns. The global response to COVID-19 has led to significant economic disruptions, increased poverty, and changes in lifestyle7. The long-term consequences of these changes on mental health, social structures, and economic stability are yet to be fully realized.

 

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Are there many unknowns relating to COVID-19?

Megan Ranney has answered Near Certain

An expert from Brown University in Medicine

Here’s a short list of things we do and don’t yet know about COVID-19:

1. We don’t yet know the true case fatality rate. (E.g.: if you catch it, how likely are you to die?) Scientists agree that the CDC’s numbers are likely underestimates; but it’s AT LEAST 4x more deadly than the flu, if infected; & will infect far more ppl. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2766121
2. We don’t yet know *exactly* how it’s transmitted. Definitely by droplets. But maybe aerosols? Maybe fomites?

—-> For now: best practice in the non-healthcare setting is mask, distance, and hand-washing cdc.gov/media/releases…

3. We don’t fully understand why & how it causes a wide variety of clinical syndromes. For example, although we have growing clinical knowledge, the new multi-inflammatory syndrome observed in kids is very much a black box. https://www.nejm.org/doi/full/10.1056/NEJMcp2009575
4. Relatedly, we don’t know what works to treat COVID-19

 Remdesivir may decrease length of hospitalization among very sick patients

Proning may decrease intubations.

Hydroxycholoroquine WORSENS outcomes.

Plasma from recovered pts: Maybe.

 That’s all we’ve got, folks. Still waiting on 100s of ongoing trials. 

5. We are not totally sure about the efficacy of those home-made masks.

We know that masks work, period. But what kind of fabric masks work, for whom, at what distance? Still TBD. (Wear them! But don’t feel immune) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185834/

6. We don’t yet know how long immunity lasts. Once you get it once, will you be immune for a month? A year? A lifetime? Will this be like the common cold, or like smallpox? We’re hoping for the latter. https://jamanetwork.com/journals/jama/fullarticle/2766097
7. We don’t know how long people are infectious.

https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030

8. And we of course don’t yet know when/whether we’ll have a safe and effective vaccine. 

(But PLEASE FOR THE LOVE OF GOD once we have one, GET VACCINATED!)

Now for a short list of things we DO know: 

1. We know the virus’ genome.

https://www.nejm.org/doi/full/10.1056/NEJMoa2001017

2. We know that to decrease transmission & deaths, we need a a combo of (a) Social distancing (b) Testing (c) Isolation & Contact Tracing of Sick People (d) Adequate PPE. https://www.cidrap.umn.edu/news-perspective/2020/04/study-contact-tracing-slowed-covid-19-spread-china

And if we can increase (b), (c), and (d) …. then (a) social distancing is not so necessary.

WITHOUT these standard public health measures, we’ll see new hot-spots emerge, watch infections & deaths balloon, & will be right back where we were in mid-March in the US.

3. We also know that if you’re close to someone who’s infected, inside, for a period of time, you too have a high risk of infection.

 And… 1 selfish person, who goes out & about when ill, can get a lot of other people really sick 🙁 https://www.cdc.gov/mmwr/volumes/69/wr/mm6920e2.htm

4. Lastly, we know that underlying social & economic inequalities worsen disease. https://www.newyorker.com/news/q-and-a/the-coronavirus-and-the-interwoven-threads-of-inequality-and-health

 (….that’s essentially it, folks. That’s what we KNOW about the virus, its transmission, and its prevention.) 

So where does that leave us?

1) Keep doing & funding science.

2) Insist that state & federal gov’ts increase testing so you can go back to work

3) Fund Public Health infrastructure

4) Until then… maintain masks & social distancing to keep yourself *and your community* safe

 

Are there many unknowns relating to COVID-19?

Adrian Esterman has answered Near Certain

An expert from University of South Australia in Epidemiology

Where do I start? Perhaps from the beginning.

We still do not know where the virus originated. Did it come from an animal like a bat and crossed over to humans? Or was it part of an experiment that got out of control at a Wuhan virus laboratory? The WHO investigation should eventually give us some clues, however, WHO is a political animal, and there is no guarantee the truth will come out.  

At the moment, perhaps the biggest unknown is whether and when a vaccine will become available. Coronaviruses are renowned for being difficult to create a vaccine against. They are sneaky little pathogens, able to get around our immune system. Many of the media reports have been optimistic, and I hope that they are right. However, even if the researchers are successful, it will certainly be well into 2021 that the vaccine becomes widely available.

The second biggest unknown is whether we can get a treatment of COVID-19 that actually works. We have already seen treatments like hydroxychloroquine touted by Donald Trump, failing to come up to expectations. The WHO is organising the international Solidarity trial of four different treatments. They are: Remdesvir; Lopinavir/Ritonavir; Lopinavir/Ritonavirwith Interferon beta-1a; and Hydroxyquinoline.

Apart from that, there is far more we don’t know about COVID-19 than we do know. For example, why do children not become infected easily, and if they are infected, why is the outcome usually good? If you are infected and recover, how good is your immunity? Why do people from certain ethnic groups have a much poorer outcome?