A year ago, I wrote an article for The Conversation about a mysterious outbreak of pneumonia in the Chinese city of Wuhan, which was apparently the beginning of the COVID-19 pandemic.
At the time of writing, very little was known about the disease and the virus that causes it, but I have warned about the concerns about emerging coronaviruses and cite SARS, MERS and others as important examples.
Since then – and every day since then – we’re still learning so much about SARS-CoV-2 and COVID-19, and finding new ways to control the pandemic and no doubt keep us safer for decades to come.
This is what we have been learning since January last year and what we have yet to learn.
Lessons learned
Initially, the disease we now call COVID-19 was described in terms of pneumonia or pneumonia in older people. But we now know that SARS-CoV-2 infection can lead to a wide range of symptoms in people of all ages, ranging from no symptoms to systemic inflammation and death.
And then there are the persistent symptoms that many suffer from – so-called ‘long COVID’. We also begin to elucidate the different phases of the disease, the damage to organs (such as the heart and brain), and the role of co-infections with bacteria and fungi.
In January 2020, there was limited evidence of human-to-human transmission. If so, it is presumably similar to its cousin virus SARS-CoV-1, which causes SARS in that infection spreads relatively in the disease, when the symptoms are at their peak.
Yet early studies showed that the spread between humans was extremely effective for SARS-CoV-2, and that it could happen quickly and before the worst symptoms started. This makes it difficult to control without sensitive and specific tests using the now well-known PCR test.
Social distance, hygiene and masks can help limit the spread, along with isolation and quarantine.
Initially, there were no treatments or vaccines against COVID-19 other than support in the hospital, such as providing oxygen when patients had breathing problems or antibiotics when they got a secondary bacterial infection.
In the months after January, researchers quickly tested new therapies against COVID-19, which identify dexamethasone, and developed many safe and highly effective vaccines against COVID-19 that are now in use.
Future questions
Although we learn about COVID-19 on a daily basis, there remain several important scientific questions that will shape the future of SARS-CoV-2 and humanity for decades to come. The first is how will SARS-CoV-2 develop, adapt and change over the next year in light of natural or acquired immunity through vaccination?
A second, less academic point would be whether it matters. Our treatments and social measures will still work, but what about our vaccinations?
We continue to track, predict and understand SARS-CoV-2 evolution regarding vaccine ‘escape’, and all our available evidence indicates that it is minimal at best and that our current vaccine platforms are robust enough to make any changes. resist if necessary.
We also need to be vigilant for the chance that SARS-CoV-2 will establish itself in another species, such as mink.
Then there is the question of how SARS-CoV-2 interacts with the other viruses that spread in humans. The human respiratory tract houses several viruses that circulate together – often in a single person.
These viruses promote or inhibit the infection of other viruses. We now know that the spread of most of our respiratory viruses, such as influenza and RSV, is severely limited due to social distance.
How will they ‘react’ when mitigation measures, such as social distance, are terminated?
Finally, we need to identify the origin of SARS-CoV-2 to prevent the continued spread of SARS-CoV-2-like (or indeed other pathogenic coronaviruses) to humans.
We know that SARS-CoV-2 probably originated in Southeast Asia recently and that the virus was eventually in a horseshoe. But the biological and ecological steps it has taken to reach humans remain obscure.
Solving this puzzle will help protect our health for decades to come, similar to what has been achieved for swine and bird flu infections.
As I said in my article a year ago, these epidemics are a constant reminder of the need to invest in research on emerging viral biology and evolution, and to finally identify safe and effective remedies for treating serious diseases – or vaccinations to prevent. ‘ .
The COVID-19 pandemic has shown that science and scientists can and will deliver results, given the right financial and social support. How, then, will we apply the lessons of COVID-19 to other serious problems, such as emerging infections, antimicrobial resistance, and climate change?
Connor Bamford, Research Fellow, Virology, Queen’s University Belfast.
This article was published from The Conversation under a Creative Commons license. Read the original article.