14 Medical Advancements During the COVID-19 Pandemic

Introduction

In late 2019, the first case of the Coronavirus was discovered in Wuhan, China. Since that first case, the number of COVID-19 victims grew at an exponential rate and hit the United States particularly hard. Now, in late 2020, we are still dealing with the effects of the Coronavirus and lack a vaccine to cure it and allow citizens around the world to return to life as normal. The novel Coronavirus has set forth challenges that are new to everyone around the world, especially for doctors and scientists working in the medical industry. However, through these trials and tribulations, many medical experts have come together to attempt to end the worst pandemic in recent history. Since the outbreak of the Coronavirus, there have been many medical studies and advancements that have helped lead to better treatment, better control of the disease, and a possible vaccine to cure it.

Connection to STS Theory

The Social Constructivist theory states that science and technology are inherently social. This theory has been proven by the medical advancements during the pandemic. There has been more of a push for medical advancement because of the social effect that COVID-19 has had. It is much in the self-interest of the people to try and overcome this virus, so that lives can be saved and life in general can return to normal. Almost all of the advancements in medical technology during the pandemic have been made through collaboration, which is an example of social constructivism. As a result of the social constructivism that has taken place, there has been more technology produced in both quality and quantity.

Controlling the Spread and its Symptoms

In the past year, there have been several studies that have led to new knowledge about COVID-19, its effects, and how to slow its spread. The first of which happened towards the early stages of the outbreak. This study was conducted in China in February 2020, and tested the effect of drug chloroquine phosphate. In this study conducted with over one hundred patients, chloroquine was discovered as a “superior” treatment of pneumonia and COVID-19 related symptoms. It works by interfering with the glycosylation of cellular receptors of SARS-CoV. Simply put, glycosylation is where a carbohydrate attaches to a protein or some other organic molecule. A major positive of this drug, which has been used for the past seventy years for the treatment of malaria, is that it is very cheap and very safe, so there is no real risk involved with using this as a treatment for COVID-19. Chloroquine has been recommended to be included in the next version of the Guidelines for the Prevention, Diagnosis, and Treatment of Pneumonia Caused by COVID-19 issued by the National Health Commission of the People’s Republic of China. In light of these studies, it is now known that chloroquine can be reliable in helping with the severity of symptoms that come with COVID-19 (Gao).

In addition, there have been studies that show suppressing RNA polymerase activity can help control the spread of the virus. Replication and transcription of Sars-Cov-2, which is the virus that causes COVID-19, is done through a complex process in which a polypeptide chain is formed. RNA polymerase is key in this process, so if this process can be suppressed, success can be achieved in slowing, and even stopping, the spread of the Coronavirus. RNA polymerase unit, also known as nsp12, is being studied to help develop viral inhibitors and create desmesvir, a drug currently in clinical trials for the treatment of COVID-19. Main protease and the spike proteins of Sars-Cov-2 are also being studied to develop inhibitors. Other non-structural proteins need to be used in the development of these inhibitors so that there is a large spectrum of treatment, but studies are definitely leading experts on the right track of creating successful treatment (Pandey et al.).

Metal ions have shown to be key in the suppressing of RNA polymerase on COVID-19, preventing it from spreading. According to one scientific study, different metal ions were tested for their suppresses properties of the 3CL protease protein found on the Coronavirus. Of those tested, mercury, zinc, and copper showed inhibitory properties, with zinc showing the most inhibition. Not only could these metals be used in different drugs, but they are also being explored for uses such as coating on hospital surfaces and personal protection equipment (Pandey et al.).

Drug repurposing has also shown to be promising through the results of several studies. With no current vaccine or antiviral drug therapy, it appears that drug repurposing is the most viable option until the vaccine is created. In essence, drug repurposing is modifying a drug so that it can perform a different use for a different disease. There are several advantages that come with drug repurposing: they are typically very safe, development will not take much time since preclinical trials, studies have already been completed on these drugs prior to repurposing, and there is less chance for failure since the unaltered drug has already been proven effective. Continued studies of drug repurposing could undoubtedly lead to some revolutionary medical breakthroughs during this pandemic (Pandey et al.).

In addition, stem cells have undergone studies for their treatment of COVID-19. The special significance of stem cells is that they can transform into more than two hundred different types of cells. Currently, different applications of stem cells include replacing injured tissue, stimulation of injured tissue, creating personalized medicine, and being the subject of study for human development. Many different types of stem cells, which are found in embryonic and adult cells exist. However, there are many ethical considerations that come into play when performing these studies, so adult cells are the subject of most of these studies. Mesenchymal stem cells, known in short as MSCs, are a type of adult stem cells that are being studied for treatment properties of COVID-19 because they have low immunogenicity (ability of foreign substance to create immunity) , minimized risk of teratoma (tumor) formation, and high expansion potential ex vivo (taking place outside of an organism). MSCs can be found throughout the body in bone marrow, blood, liver, and lungs. They were found by a study to reduce anti-inflammatory cytokines, which improved lung function. This shows that MSCs can play a large part in COVID-19 treatment, as it is a respiratory disease. MSC secretome is specifically being studied for its tissue generation and repair. The advantage of secretome is that it is constantly being created by the body, so there is not a large need for donors. Also, the research process for this MSC is particularly simpler and more concentrated in comparison to other stem cell research. Overall, recent studies on stem cells, particularly MSCs, have led medical professionals to make advanced treatment for COVID-19 and other diseases that will help lessen the severity of the COVID-19 pandemic (Brave & MacLoughlin).

Hope for a Vaccine

Encouraging recent studies have led experts to believe that we are on the brink of a vaccine for the Coronavirus. A vaccine would allow the immune system to create a “memory” of the virus so the body will be able to fight it off when the virus actually comes. It will work by latching onto the spike protein that makes the virus unique. While some people have shown resentment to vaccines and claim that they are harmful, there is actually no scientific data to support that claim. There are multiple vaccines that are being tested right now; one introduces genetic instructions into tiny fatty envelopes, while another vaccine uses weakened common cold virus. These potential vaccines must undergo several trial phases until they are approved for public and widespread use. The first phase tests the safety with patients. The second phase tests effectiveness of the vaccine at different doses, and this is done with patients numbering in the hundreds. The third and last phase tests both the safety and effectiveness with thousands of people (Neff).

In a recent interview with Fox News, Dr. Francis Collins, Director of the National Institutes of Health, discussed the COVID-19 vaccine and how he and other scientists are working toward developing it in the coming months. He has an optimistic view and trusts that they will continue to make medical advancements until there is a viable vaccine for everyone (“US Records Deadliest Day”). Similarly, Dr. Robert Kadlec, Department of Health and Human Services’ assistant secretary of preparedness and response, has stated that production of safe and effective vaccines is accelerating. He also states that a vaccine could be approved by the end of the year (Mendoza & Linderman). These statements are very encouraging, and it shows how medical studies and advancements have led to potential breakthroughs by the end of the year.

Improved Treatment and Technology

Through all the recent studies that have taken place, as well as the valued experience everyone has gained from living through this pandemic, treatment of COVID-19 has improved greatly. Increased proficiency of care is particularly going on in ICU centers.  Doctors and caregivers are learning how to take care of people better. Sometimes even simple advice, like telling a patient to lie on their stomach instead of back, has proven beneficial. An example of this is former COVID-19 patient Don Ramsayer, a fifty nine year old man from Cumming, Georgia. He was diagnosed with leukemia in November 2019, but when complications occurred later it was discovered that he had the Coronavirus. His symptoms got worse as time progressed, and he, along with his doctors, did not think that he was going to make it. After “throwing the kitchen sink at him” in terms of treatment options, they finally decided to give him the new antiviral drug remdesivir and experimental covalent plasma treatment. After this, he continued to improve, eventually overcame the disease and was able to return to life as normal. Now that the success of drugs like remdesivir and covalent plasma treatment have been proven, they can be used globally for treatment and save lives like that of patient Don Ramsayer. These are the types of medical advancements that are taking place as the months go on, and lives are being saved as a result. Statistically, there has been a decline in the mortality rate from twenty to fifty percent each month at Emory Hospital in Atlanta, Georgia (Harris).

Improved treatment has been used on the thousands of victims of the Coronavirus, and this is no exception to Donald Trump, president of the United States. Trump was given an antibody cocktail that mixes two antibodies that attack the key protein in COVID-19. One of the antibodies of the cocktail comes from a human who had once had the virus and defeated it, while the other antibody came from a mouse engineered to have a human immune system. The cocktail that he was given was still in a preliminary trial phase, but experiments in golden hamster and rhesus macaques showed that it could reduce symptoms. He was able to partake in this treatment due to an FDA regulation that approved “expanded access”. Since it was still in clinical trials, the treatment had not yet been approved for public access, but it was allowed by the FDA as a special case. He was also given the steroid dexamethasone, which is the only treatment that has shown to reduce mortality rates in severe COVID-19 cases. Through these new treatments, Donald Trump was able to recover undoubtedly quicker and easier than he would if these recent trials and discoveries had not been made (Cohen).

There have also been several philanthropic efforts through different people and organizations that have led others to have access to improved treatment. One such organization is the IAEA, or International Atomic Energy Agency. They are  distributing new equipment worldwide that detects the virus that causes COVID-19. This is a response to the requests of member countries to help aid them in controlling the spread of the virus.

In the past year, there have been many words and codes added in the Merriam-Webster dictionary and the Current Procedural Terminology (CPT) code set relating to COVID-19. This helps portray the amount of studies and new technologies that have been developed as a result of the pandemic. Coding has been made for SARS-CoV-2 testing as well as other testing like screening for diabetic retinopathy (Robeznieks).

Conclusion

The COVID-19 pandemic has presented unprecedented problems and situations for everyone around the globe. As of November 1, 2020, there have been approximately forty seven million cases and 1.2 million deaths (“COVID-19 CORONAVIRUS PANDEMIC”). The amount of deaths rank third all-time in United States wars and pandemics. However, with these newfound challenges there has been a relentless rally behind scientists and medical professionals to help better treatment, save lives, and end this pandemic. In this chapter, we discussed the studies and other measures taken that have led us to gain knowledge to achieve these necessary goals. As the progress continues, momentum continues to build as lives are being saved and hope for a vaccine arises.

References

Brave, Hosanna, and Ronan MacLoughlin. “State of the Art Review of Cell Therapy in the Treatment of Lung Disease, and the Potential for Aerosol Delivery.” International Journal of Molecular Sciences, vol. 21, no. 17, Sept. 2020, pp. 1-33, https://www.mdpi.com/1422-0067/21/17/6435.

Cohen, Jon. “Update: Here’s What Is Known about Trump’s COVID-19 Treatment.” Science Mag, 8 Oct. 2020, www.sciencemag.org/news/2020/10/heres-what-known-about-president-donald-trump-s-covid-19-treatment.

“COVID-19 CORONAVIRUS PANDEMIC.” WorldOMeter, 3 Nov. 2020, www.worldometers.info/coronavirus/.

Gao, Jianjun, et al. “Breakthrough: Chloroquine Phosphate Has Shown Apparent Efficacy in Treatment of COVID-19 Associated Pneumonia in Clinical Studies.” Bioscience Trends, vol. 14, no. 1, 2020, pp. 72-73. doi:10.5582/bst.2020.01047

Harris, Richard. “Advances In ICU Care Are Saving More Patients Who Have COVID-19.” NPR, 20 Sept. 2020, www.npr.org/sections/health-shots/2020/09/20/914374901/advances-in-icu-care-are-saving-more-patients-who-have-covid-19.

Mendoza , Martha, and Juliet Linderman. “Trump Official Says Coronavirus Vaccine Expected Starting in January.” kare11.Com, 10 Oct. 2020, www.kare11.com/article/news/health/coronavirus/trump-official-says-coronavirus-vaccine-expected-starting-in-january/507-737fb508-acb6-4130-8023-13a34ad907ce.

Neff, Todd. “Coronavirus Vaccines 101: What You Need to Know.” UCHealth Today, 18 Aug. 2020, www.uchealth.org/today/coronavirus-vaccines-101-what-you-need-to-know/.

Pandey, Abhjieet, et al. “Potential Therapeutic Targets for Combating SARS-CoV-2: Drug Repurposing, Clinical Trials and Recent Advancements.” Life Sciences, vol. 256, 2020, pp. 1-20, https://doi.org/10.1016/j.lfs.2020.117883.

Robeznieks, Andis. “2021 CPT Code Set Reflects Tech Innovation, COVID-19 Response.” American Medical Association, 3 Sept. 2020, https://www.ama-assn.org/practice-management/cpt/2021-cpt-code-set-reflects-tech-innovation-covid-19-response.

“US Records Deadliest Day of Summer during COVID-19 Pandemic.” Fox News, 14 Aug. 2020, video.foxnews.com/v/6181020712001

Images

“State Public Health Laboratory in Exton Tests for COVID-19” by Tom Wolfe is licensed under CC BY 4.0

“COVID-19 Equipment to Serbia”Scientific Veterinary Institute is licensed under CC BY 2.0