Christina Sutton

CSUCI: Biology 333

Final Project: SARS-CoV-2
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The Coronavirus outbreak, also known as SARS-CoV-2, ​was first reported in Wuhan,
Hubei Province, China in December, 2019. The Centers for Disease Control links the patients
reported with the coronavirus to have been in contact with a market that sells live animals and
seafood (Coronavirus Disease 2019, 2020). The World Health Organization states that they
received the first reports of the new illness on December 31, 2019. (Coronavirus Disease, 2020).
When comparing the Coronavirus to other similar viruses the CDC stated that, “The
SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV. All three of these
viruses have their origins in bats” (Coronavirus Disease 2019, 2020). Severe Acute Respiratory
Syndrome (SARS), Middle East Respiratory Syndrome (MERS) both consist of cough and fever
symptoms just as the Coronavirus does. All three of these illnesses can lead to lower respiratory
tract disease. An unusual symptom for SARS-CoV-2 is the loss of smell or taste (Symptoms of
Coronavirus, 2020). The total case-fatality-rate (CFR) for SARS is 9.6% and MARS has a CFR
of 34.4%. The Coronavirus only has a 2.3% CFR but has proven to be more fatal because there
have been a large number of total cases across the world as it spreads quickly. The difference in
Coronavirus is that it has a higher CFR for senior citizens; For people between the ages of 70 and
79 there is an 8% while seniors over the age of 80 have a rate of 14.6% (​Hua & Shaw, 2020)​.
After the SARS-CoV-2 was first reported in December 2019, it was soon declared ​a
public health emergency by the World Health Organization on January 31, 2020. ​February 24,
2020, for the first time, there were more cases outside of China than there were inside of China.
SARS-CoV-2 was then declared a Pandemic on March 11, 2020 (Hua & Shaw, 2020)​. As of
March 24, 2020, SARS-CoV-2 had infected 184 countries out of 195 ​(Hua & Shaw, 2020)​. On
April 26, 2020 the United States of America reached 38,509 cases reported, which was higher
than any other country’s daily report. On May 10, 2020 the United States experienced its highest
number of daily deaths reported which was 5,475 deaths. Total cases around the world have
reached 3,925,815 and there have been 274,488 deaths confirmed. The United States counts for
the highest number of cases compared to any other country. The World Health Organization
states that as of May 10, 2020, in the U.S, “there have been 1,245,775 confirmed cases of
COVID-19 with 75,364 deaths” . (WHO Coronavirus Disease (COVID-19) Dashboard, 2020).
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The CDC says that SARS-CoV-2 is spread through close contact with other people. The
virus spreads very quickly. “It took only 30 days to spread from one city to the entire country of
China” (​Hua & Shaw, 2020)​. In the American Association Advancement of Science Journal, an
article called, ​Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation ​talks
about a study done to look at the structure of the SARS-CoV-2 compared to SARS and found
that SARS-CoV-2 “appears to be more readily transmitted from human to human, spreading to
multiple continents”. This study also states that the SARS-CoV-2, “​protein binds at least 10
times more tightly than the corresponding spike protein of severe acute respiratory syndrome
(SARS)–CoV to their common host cell receptor” (2020).
Coronavirus spreads through “respiratory droplets produced when an infected person
coughs, sneezes or talks. These droplets can land in the mouths or noses of people who are
nearby or possibly be inhaled into the lungs” (How to Protect Yourself & Others, 2020). To
prevent the spread the CDC recommends social distancing; staying six feet apart from anyone
with which a person does not live with. The virus can be transferred onto surfaces that people
touch. If someone touches an infected surface they can then deliver the virus to their body by
touching their eyes, mouth or nose. This is why, to prevent the spread of the virus, the CDC
recommends washing hands for at least 20 seconds, especially after coughing or sneezing and
not touching your face. People may also use a hand sanitizer that contains 60% alcohol or higher.
When talking about the COVID-19, an article from Stanford Medicine called, ​What’s a virus,
anyway? How coronaviruses infect us and how viruses created us s​ tates that the virus is, ​“quite
stable outside of cells because spike-like proteins protruding from its envelope shield it from
direct contact, enabling it to survive on surfaces for relatively long periods” (​Goldman & Huber,
2020)​. The CDC recommends disinfecting commonly touched surfaces to prevent the spread of
the virus. ​The CDC states that “You could spread COVID-19 to others even if you do not feel
sick. Everyone should wear a ​cloth face cover​ when they have to go out in public.” (How to
Protect Yourself & Others, 2020). The CDC also announced that there is a small number of
reports that dogs and cats have tested positive for COVID-19 (If You Have Pets, 2020).
The CDC states that “Coronaviruses derive their name from the fact that under electron
microscopic examination, each virion is surrounded by a “corona,” or halo. This is due to the
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presence of viral spike peplomers emanating from each proteinaceous envelope” (MERS-CoV,
2019). In order for a person to be infected, the virus essentially sneaks into a cell. Cell
membranes are very specific and only let certain things pass through. In order for Coronavirus to
enter a cell, it uses its halo to attach to cell membranes and make its way through ​(​Goldman &
Huber, 2020). SARS-CoV-2 has an envelope that surrounds its genome. ​This envelope is “made
from stolen shards of the membranes of the last cell they infected” which help them get into cells
(​Goldman & Huber, 2020)​. This is why viruses cannot withstand soap. The soap destroys the
envelope, which is why washing your hands is an effective way of preventing the spread of
viruses. Once inside a cell, the virus is replicated and spread to other cells (​Goldman & Huber,
2020).
A textbook called, ​Human Anatomy and Physiology​, explains that an infected cell is blind
to the virus inside it. To get around this the human body has cells with glycoproteins called
major histocompatibility complex proteins (MHC class 1). MHC proteins help cells display parts
of the inside of the cell onto the surface of the cell. As part of the immune system, the human
body has Cytotoxic T cells that circulate through the blood and lymph systems of the body. A
Cytotoxic T cell will read the contents of the proteins displayed on a cell's surface. If it identifies
proteins from a virus it will kill the infected cell to prevent that virus from spreading to other
cells (Marieb & Hoehn, 2019, p. 807). Once infected, the immune system is the only way the
body has to cure itself of SARS-CoV-2. There are currently no vaccinations available. The CDC
recommends, for anyone who is sick to get lots of rest and drink a lot of water. They also say
acetaminophen (also known as Tylenol) may help with reducing symptoms such as fever
(COVID19 - Caring for someone at home, 2020).
The CDC lists of symptoms for Coronavirus includes: cough, shortness of breath, fever,
sore throat, loss of smell or taste, muscle pain and chills. Symptoms that are less common
include: vomiting, nausea or diarrhea. Emergency symptoms include: pain or pressure in chest,
trouble breathing, confusion, inability to stay awake and blue colored face or lips. If a person has
any of the emergency symptoms they should seek medical attention right away. Symptoms may
show up between 2 to 14 days after a person has been infected. People who have been infected
by the coronavirus may not show symptoms at all but can still spread the virus to other people
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(Symptoms of Coronavirus, 2020). The CDC states that “For ​most​ people, symptoms last a few
days, and people usually feel better after a week (COVID19 - Caring for someone at home,
2020).
Viruses mutate very quickly. Stanford medical journal states that, “ ​Benign coronavirus
variants, which like ​rhinoviruses ​can cause common colds, attach to cells in the ​upper​ respiratory
tract” (​Goldman & Huber, 2020). The common cold is not as bad, this has to do with how the
coronavirus mutated. ​The viral variant that's driving today's pandemic is dangerous specifically
because a recent mutation in its envelope-associated spike protein has enabled it to latch onto
cells in the ​lower​ respiratory tract- lung and bronchial cells” (​Goldman & Huber, 2020).
SARS-CoV-2 spike was 10 to 20 times more likely to bind ACE2 on human cells than the spike
from the SARS virus from 2002. This may enable SARS-CoV-2 to spread more easily from
person to person than the earlier virus” (Wrapp et al., 2020).
SARS-CoV-2 is an RNA Coronavirus. An article called ​Emerging SARS-CoV-2 mutation
hot spots include a novel RNA-dependent-RNA polymerase variant s​ tates that, “​RNA viruses are
characterized by a high mutation rate, up to a million times higher than that of their hosts”
(Pachetti et al., 2020). This study analyzed 220 genomic sequences and found 8 recurrent
mutations. (Pachetti et al., 2020). Another Study called, ​Decoding SARS-CoV-2 transmission,
evolution and ramification on COVID-19 diagnosis, vaccine, and medicine,​ claims the proteins
in SARS-CoV-2 have gone through many mutations which, “may seriously undermine ongoing
efforts on COVID-19 diagnostic testing, vaccine development, and drug discovery” (Wang et al.,
2020). This study also claims that, “it typically takes over one year to design and test a new
vaccine” and by that time multiple mutations could make one vaccine outdated (Wang et al.,
2020) These mutations can change the pathogenicity as a study in the Journal of the American
Medical Association found that SARS-CoV-2 is able to affect the cardiovascular system. The
study states, “Coronavirus disease 2019 is associated with a high inflammatory burden that can
induce vascular inflammation, myocarditis, and cardiac arrhythmias” (Madjid et al., 2020).
In conclusion, SARS-CoV-2 is a complicated zoonotic virus that easily spreads and
mutates quickly. The virus can be fatal and there is no vaccine. Therefore preventative
precautions should be taken to stop the spread and control the COVID-19 pandemic.
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Timeline of key events and public concern; (Source: ​Hua & Shaw, 2020).

Coronaviruses comparison: (Source: ​Madjid et al., 2020)

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References
Coronavirus Disease (COVID-19) - events as they happen. (2020, May 4). Retrieved from
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happe
n#:~:text=The outbreak was declared a,on 30 January 2020.
Coronavirus Disease 2019. (2020, April 19). Retrieved from
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html#:~:text=Early
on, many of,to-person spread.
COVID19 - Caring for someone at home. (2020, May 8). Retrieved from
https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/care-for-someone.html
Goldman, B., & Huber, J. (2020, May 9). What's a virus, anyway? Part 1: The bare-bones basics.
Retrieved from
https://scopeblog.stanford.edu/2020/04/02/whats-a-virus-anyway-part-1-the-bare-bones-b
asics/
Goldman, B., & Huber, J. (2020, May 9). What's a virus, anyway? Part 2: How coronaviruses
infect us - and how viruses created us. Retrieved from
https://scopeblog.stanford.edu/2020/04/03/how-coronaviruses-infect-us-how-infectious-v
iruses-created-us/
How to Protect Yourself & Others. (2020, April 24). Retrieved from
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html#:~:text
=The virus.
If You Have Pets. (2020, April 30). Retrieved from
https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/pets.html
Jinling Hua, & Rajib Shaw. (2020). Coronavirus (COVID-19) “Infodemic” and Emerging Issues
through a Data Lens: The Case of China. International Journal of Environmental
Research and Public Health, 17(7), 2309.
Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential Effects of Coronaviruses on the
Cardiovascular System: A Review. ​JAMA Cardiol.​ Published online March 27, 2020.
doi:10.1001/jamacardio.2020.1286
Marieb, E. N., & Hoehn, K. (2019). ​Human anatomy & physiology​. Hoboken, NJ: Pearson.
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MERS-CoV . (2019, August 2). Retrieved from

https://www.cdc.gov/coronavirus/mers/photos.html#:~:text=Coronaviruses derive their
name from,,” or halo.
Pachetti, M., Marini, B., Benedetti, F., Giudici, F., Mauro, E., Storici, P., … Ippodrino, R.
(2020). Emerging SARS-CoV-2 mutation hot spots include a novel
RNA-dependent-RNA polymerase variant. ​Journal of Translational Medicine​, ​18​(1),
1–9. doi: 10.21203/rs.3.rs-20304/v1
Symptoms of Coronavirus. (2020, May 8). Retrieved from
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
Wang, R., Hozumi, Y., Yin, C., & Wei, G. (2020). Decoding SARS-CoV-2 transmission,
evolution and ramification on COVID-19 diagnosis, vaccine, and medicine.
WHO Coronavirus Disease (COVID-19) Dashboard. (2020, May 10). Retrieved from
https://covid19.who.int/
Wrapp, D., Wang, N., Corbett, K. S., Goldsmith, J. A., Hsieh, C.-L., Abiona, O., … Mclellan, J.
S. (2020). Cryo-EM Structure of the 2019-nCoV Spike in the Prefusion Conformation.
American Association for the Advancement of Science,​ ​367,(​ 6483), 1260–1263. doi:
10.1101/2020.02.11.944462
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COVID-19 Outbreak: Strategic Plan

Worldwide, as of May 10, 2020, the World Health ORganization has reported 3,935,815
confirmed SARS-CoV-2 cases and 274,488 confirmed deaths ​(WHO Coronavirus Disease
(COVID-19) Dashboard, 2020). The United States has the highest number of cases and deaths
even compared to China, where SARS-CoV-2 was first reported. On April 26, 2020 the United
States reported their daily amount of cases to be 38,509, which is higher than any daily case
report from any other country. Since May 10, 2020 the World Health Organization reported that
the United States has 1,245,775 confirmed cases resulting in 75,364 deaths which is higher than
any other country (WHO Coronavirus Disease (COVID-19) Dashboard, 2020). An article in
Forbes called, ​Which Countries Are Handling The COVID-19 Crisis Best? New Public Opinion
Data Offer Answers ​shows a poll that was given to the American people. This poll found that
most American’s do not think the United States is handling the COVID-19 Pandemic very well.
The poll also reports that “​ 65% of Americans felt that the federal government was too slow to
take major steps to address the threat posed by COVID-19” (Travers, 2020).
The World Health Organization’s representative for China, Dr Gauden Galea, talked
about how China handled the SARS-CoV-2 extremely well. At the beginning China was
reporting 3800 new cases in a single day (China shows COVID-19 responses must be tailored to
the local context, 2020). On May 10, 2020 there were only 14 new cases in a single day (WHO
Coronavirus Disease (COVID-19) Dashboard, 2020). Dr. Gauden Galea speaks about how the
Chinese population was able to bring its number of cases down successfully through, “social
distancing, quarantine, and careful hand and respiratory hygiene” but he also warns that,
“Responses must be tailored carefully to the local context” (China shows COVID-19 responses
must be tailored to the local context, 2020).
The first death in the United States was reported on February 29, 2020 (CDC,
Washington State Report First COVID-19 Death, 2020). The University of Oxford created a data
system called ​Coronavirus Government Response Tracker. ​This system takes the responses from
countries such as enforcing closing schools, enforcing social distancing and canceling public
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events and created a score which was turned into a “​Stringency Index” which shows how strict a
country was when responding to COVID-19 ​(See figure 1 on page 11 of this report for a graph
on these results). ​This index shows that as of April 5, 2020, the United States had the least strict
response to COVID-19 (​Coronavirus Government Response Tracker, 2020). The World Health
Organization’s world case reports show that on April 5, 2020 the United States had 32,105 cases
which was a daily report higher than any other country. This proves that the United States had
the least strict regulations but the most number of cases compared to other countries. The daily
number of cases continued to rise until it peaked on April 26, 2020 with 38,509 confirmed cases
reported (WHO Coronavirus Disease (COVID-19) Dashboard, 2020).
The epidemiologic triangle consists of three components: the agent, host, and
environment. The agent is the SARS-CoV-2 virus. The Host is the human body. The
environment would be the air and commonly touched surfaces around us. In order to control this
pandemic the environment seems to be the only controllable option. We can not kill the virus and
no vaccine is created or readily available and we cannot harm people or take them from their
homes. We can stop the spread of SARS-CoV-2 if we all keep it from spreading in our
environment. This means social distancing and quarantining sick individuals in their homes. It
also means wearing masks and gloves whenever going out that can be disposed of before an
individual gets home.
Now knowing the above information I would make a plan for individuals to stay inside
until cases decrease to low numbers or diminish over all. As earlier introduced, a World Health
Organization Representative, Dr Gauden Galea, stated that, “the situation in each country –
sometimes even within countries – is different. Responses must be tailored carefully to the local
context” and he mentions that this has worked for China, Singapore and Korea (China shows
COVID-19 responses must be tailored to the local context, 2020). I would suggest mass tasting
to figure out where the majority of cases reside. In response to COVID-19 China created 17
specialty hospitals in Wuhan (Zhu et al., 2020). This is not something I would expect the United
States to do; instead there might be a more low cost option.
In the United States many people are worried about the economy. For this reason I
believe that all travel should be stopped (for anyone going somewhere where they do not
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currently reside permanently), even between county lines to control the spread of COVID-19.
This would allow counties who have test results showing extremely low cases to be allowed to
open and function normally while counties with a high number of cases would have a mandatory
quarantine. This could help keep some of the economy moving. Beaches, parks, and all
nonessential public places would close. Anyone who violates those regulations could be subject
to a heavy fine.
A program that could be put into place to create jobs and limit the spread of COVID-19
could be to create a food and necessities delivery system for anyone who has been confirmed
with COVID-19. This will keep anyone sick and anyone who lives with someone who is sick
from going out and infecting other people. A huge potential problem is funding for this program.
If certain areas that have no cases open, this would lower unemployment and those funds could
be put towards a food delivery system. Online donation websites can also be set up to raise more
money to pay for this system.
As China implemented very strict restrictions they were able to decrease cases very
rapidly. If these same strict rules of staying inside were implemented in the areas of the United
States where it was needed, we could diminish the number of cases as well. The faster we lock
down and have cases disappear the faster the economy can reopen and people can return to their
normal lives.
In summary, I would plan to mass test the people of the United States and quarantine
areas with an abundance of confirmed cases. I would also put into place a food delivery system
that would create less of a need for infected people to leave their house. Funding for these
programs could come from the unemployment not being used in certain areas due to certain
counties being open. Funding could also come from donations. The faster infected areas go on
lockdown the faster we can reduce the spread of the disease and return to normal life. The plan
will have been successful when cases are depleted. The most important thing we can do is keep
people from spreading the virus to others and prolonging the COVID-19 pandemic.
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Source: ​(​Coronavirus Government Response Tracker, 2020)

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References
CDC, Washington State Report First COVID-19 Death. (2020, February 29). Retrieved from
https://www.cdc.gov/media/releases/2020/s0229-COVID-19-first-death.html
"China shows COVID-19 responses must be tailored to the local context". (2020, April 3).
Retrieved from
http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news
/news/2020/4/china-shows-covid-19-responses-must-be-tailored-to-the-local-context
Coronavirus Government Response Tracker. (2020, April). Retrieved from
https://www.bsg.ox.ac.uk/research/research-projects/coronavirus-government-response-tr
acker
Travers, M. (2020, April 22). Which Countries Are Handling The COVID-19 Crisis Best? New
Public Opinion Data Offer Answers. Retrieved from
https://www.forbes.com/sites/traversmark/2020/04/22/which-countries-are-handling-the-
covid-19-crisis-best-new-public-opinion-data-offer-answers/#700de6952f4f
Zhu, W., Wang, Y., Xiao, K., Zhang, H., Tian, Y., Clifford, S. P., … Huang, J. (2020).
Establishing and Managing a Temporary Coronavirus Disease 2019 Specialty Hospital in
Wuhan, China. ​Anesthesiology,​ 1. doi: 10.1097/aln.0000000000003299