Introduction

Statements of the Problem

1. What are the risks of contracting COVID-19 and how contagious is it?
2. Where and how did COVID-19 originate?
3. What are the preventive measures taken to slow the spreading of COVID-19?
4. How fatal is the said virus to patients with COVID-19
5. What are the chances of recovery from COVID-19?

Move 1a

The novel coronavirus is spreading rapidly. More than 400,000 people are known to
be infected and over
19,000 deaths have been recorded worldwide as of writing of this research. The new
virus, officially called Covid-19, is dangerous, around 20 % of confirmed cases have been
classed as severe or critical. So far, around 15 to 20 % of hospital cases have been classed as
"severe" and the current death rate varies between 0.7 % and 3.4 % depending on the
location and, crucially, access to good hospital care. However, it can go as high as 8%
depending if the infection rate overwhelms the health care system like what’s happening
currently in Lombardy, Italy (Dr. Eric Feigl-Ding, 2020). What has been known so far about
the virus are its nature, its ability to transmit, prevention and where it is believed to have
originated. However, much remain unknown about COVID-19

According to The World Health Organization, Coronaviruses (CoV) are a large family
of viruses that cause illness ranging from the common cold to more severe diseases such
as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome
(SARS-CoV). The novel coronavirus (nCoV) is a new strain that has not been previously
identified in humans, being the 7th coronavirus out of 7 previously known
coronaviruses. Coronaviruses are zoonotic, meaning they are transmitted between animals
and people. Detailed investigations found that SARS-CoV was transmitted from civet cats to
humans and MERS-CoV from dromedary camels to humans. Several known coronaviruses
are circulating in animals that have not yet infected humans. Once a person is infected, signs
of infection include, cough, fever, difficulty breathing and the general feeling of being
unwell. Severe cases include pneumonia and kidney failure. And some don’t develop any
symptoms. This is the reason why health experts suggest that the best way to determine if a
person has been infected is to undergo swab testing from a medical facility.

For both medical and public health reasons, researchers want to figure out who’s
most at risk of being infected and who’s most at risk of developing severe or even lethal
illness. With that kind of information, clinicians would know whom to treat more
aggressively, government officials would have a better idea of steps to take, and everyone in
the community would know whether they need to take special, additional precautions. Here
is the summary of the analysis gathered by the China Center for Disease Control three
months into the outbreak: for the young people, only 8.1% of cases were 20’s, 1.2% were
teens, and 0.9% were 9 or younger. The World Health Organization mission to China found
that 78% of the cases reported as of February 20, were in people ages 30 to 69. For the old
people, the analysis of the data showed the fatality rate to be 14.8% in people 80 or older,
likely reflecting the presence of other diseases, a weaker immune system, or simply worse
overall health. By contrast, the fatality rate was 1.3% in their 50s, 0.4% in 40s, and 0.2% in
people 10 to 39. About half of the 109 Covid-19 patients (ages 22 to 94) treated at Central
Hospital of Wuhan, developed acute respiratory distress syndrome (ARDS), in which fluid
builds up in the small air sacs of the lungs, according to a research reported there. These
fluids restrict how much air the lungs can take in, reducing the oxygen supply to vital organs
that could sometimes go fatal; half of the patients that developed ARDS died, compared to
9% of patients who did not develop the syndrome. The data analysis concludes that older
people and those that have underlying health conditions are most likely to die and develop
severe illness from the novel coronavirus.

There will be a significant increased demand on health systems. It is estimated that

17% of infected people will need medical interventions. The health authorities should be
planning for this and the plans should include the full gamut of activities from how many
cases they expect, when and what their needs will be. A key determinant of impact will be
not just how many cases occur, but also whether they occur quickly in a wave that could
overwhelm services and affect workplaces. If containment (or viral, host or environmental
characteristics) result in a slower rate of spread, this means that the same number of cases
may occur over time but will be less disruptive and overwhelming. The health response
ranges from simple reassurance over a telephone hotline to needing a respirator, and for
some, body storage and funeral planning. The real concern is in countries with weak health
systems. As yet, Covid-19 has not emerged in countries with weak health systems in
significant numbers. However, even those countries that do have a better health systems
even struggle to cope with the alarming number of COVID-19 patients who are in need of
medical interventions. For example in Italy, which is the country with the worst COVID-19
outbreak outside of China, confirmed cases doubled from 10,000 to 20,000 in just four days
(March 11 to March 15), according to Brandon (2020) from an article by Live Science. This
rapid growth rate in Italy has already filled some hospitals there to capacity, forcing
emergency rooms to close their doors to new patients, hire hundreds of new doctors and
request emergency supplies of basic medical equipment, like respirator masks, from abroad.
This lack of resources contributes, in part, to the outsize COVID-19 death rate in Italy, which
is roughly 7% — double the global average, PBS (2020) reported.

In epidemiology, the idea of slowing a virus' spread so that fewer people need to
seek treatment at a short period of any given time is known as "flattening the curve." This
explains why so many countries are implementing "social distancing" guidelines. Yet the
speed at which the outbreak plays out matters hugely for its consequences. What
epidemiologists fear most is the health care system becoming overwhelmed by a sudden
explosion of illness that requires more people to be hospitalized than it can handle. That
scenario would lead more fatalities because there won’t be enough hospital beds or
ventilators to keep them alive. This scenario could be averted by implementing protective
measures to the public.
 The curve takes on different shapes, depending on the virus's infection rate. It could
be a steep curve, in which the virus spreads exponentially (case counts keep doubling at a
consistent rate), and the total number of cases skyrockets to its peak within a few weeks.
Infection curves with a steep rise also have a steep fall; after the virus infects the maximum
amount of population who can be infected, case numbers begin to drop exponentially,
too. The faster the infection curve rises, the quicker the local health care system gets
overloaded beyond its capacity to treat people. As we're seeing in Italy, more and more new
patients may be forced to go without ICU beds, and more and more hospitals may run out of
the basic supplies they need to respond to the outbreak.

Move 1b

Many studies have been conducted regarding this novel coronavirus. One study
suggests that people who have contracted the coronavirus are emitting, or “shedding,”
infectious viruses very early on, in fact sometimes even before they develop symptoms (Van
Kerkhove, 2020). If people can infect others even before they know they themselves are ill,
it makes it much more difficult to break the chains of transmission. This analysis could be
the reason why the figures of the infection rate is rising exponentially. “If you are feeling a
little bit unwell and you’re in your early stage of disease, you’re not necessarily in hospital. It
takes a few days for you to develop more severe disease and you wouldn’t necessarily seek
health care. So it does make sense in terms of what we’re seeing with the epidemiology”
Van Kerkhove said.

Another study from Genomic characterization and epidemiology

(Xiang Zhao MD., 2020), found the ten genome sequences of 2019-nCoV obtained from the
nine patients were extremely similar, exhibiting more than 99·98% sequence identity.
Notably, 2019-nCoV was closely related (with 88% identity) to two bat-derived severe acute
respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21,
collected in 2018 in Zhoushan, eastern China, but were more distant from SARS-CoV (about
79%) and MERS-CoV (about 50%). Phylogenetic analysis revealed that 2019-nCoV fell within
the subgenus Sarbecovirus of the genus Betacoronavirus, with a relatively long branch
length to its closest relatives bat-SL-CoVZC45 and bat-SL-CoVZXC21, and was genetically
distinct from SARS-CoV. Notably, homology modelling revealed that 2019-nCoV had a
similar receptor-binding domain structure to that of SARS-CoV, despite amino acid variation
at some key residues.

As the ongoing pandemic around the world continues, scientists around the world
are learning more and more about the mechanism of the novel coronavirus. A research
conducted at Westlake University in Hangzhou, China, had revealed how the new virus
attaches to a receptor on respiratory cells called angiotensin-converting enzyme 2, or ACE2
(Qiang Zhou, 2020). To infect a human host, viruses must be able to gain entry into
individual human cells. They use these cells' machinery to produce copies of themselves,
which then spill out and spread to new cells. A research team led by scientists at the
University of Texas at Austin, described the tiny molecular key on SARS-CoV-2 that gives the
virus entry into the cell. This key is called a spike protein, or S-protein. Zhou and his team
used a tool called cryo-electron microscopy, which employs deeply frozen samples and
electron beams to image the tiniest structures of biological molecules. The researchers
found that the molecular bond between SARS-CoV-2's spike protein and ACE2 looks fairly
similar to the binding pattern of the coronavirus that caused the outbreak of SARS in 2003.
There are some differences, however, in the precise amino acids used to bind SARS-CoV-2 to
that ACE2 receptor compared with the virus that causes SARS.
 A small study find that the effect of sex on susceptibility to Covid-19 is less clear than
the age effect, but preliminary data suggest men might be more susceptible. A study
conducted by China CDC found that 106 men had the disease for every 100 women, while
the WHO mission found that men make up 51% of the cases. A study of 1,099 Covid-19
patients in Wuhan through Jan. 29 found a greater imbalance: 58% were male, the China
Medical Treatment Expert Group for Covid-19 reported in the New England Journal of
Medicine. The difference is fatality rates, however, is real: 1.7% for women and 2.8% for
men, China CDC reported.

G. Kampf, D. Todt, S. Pfaender, E. Steinmann (2020) Human coronaviruses, such as

SARS and MERS, have been found to persist on inanimate surfaces, including metal, glass or
plastic surfaces, for as long as 9 days if that surface had not been disinfected, according to a
research published earlier in February in The Journal of Hospital Infection. A new research
involved analyzing 22 previously published studies on coronaviruses, which researchers
hope can help provide insight into the novel coronavirus. “Based on the current available
data, I would primarily rely on the data from SARS coronavirus, which is the closest relative
to the novel coronavirus (with 80% sequence similarity) among the coronaviruses tested.
For SARS coronavirus, the range of persistence on surfaces was less than five minutes to
nine days,” said Dr. Charles Chiu, an infectious disease professor at the University of
California, San Francisco, and director of the USCF-Abbott Viral Diagnostics and Discovery
Center, who was not involved in the new study.

Move 2

Since this pandemic is an emerging one, scientists around the world believe that
everyone needs to be prepared for the worse as the pandemic hasn’t reached its peak yet.
There are still much to learn about the mechanism of the virus. For example, medical
experts aren’t certain whether those cases that are mild or asymptomatic could still spread
the virus. Meanwhile, Charlotte Uetrech, a biochemist specializing in coronaviruses even
said in an interview by The European Research Council, “this is something we don’t really
understand yet. What is known already is that the new strain has a slight variation in its
surface protein. Scientists suspect that this is the reason why it can more readily enter our
cells and spread more easily. But the spreading is not directly related to deadliness, so there
must be other things. SARS and the current coronavirus are very similar, so we are looking
at subtle changes that make a difference. We need more research into the biology of these
viruses.” he said.

In short, more researches and data analysis about the coronavirus are needed in
order to understand more as there are still a lot that remain unknown about COVID-19.
There is no clarity on how long it takes for the virus to show symptoms, it is not yet known
whether or not it is prone to mutations and how fast it can mutate, and there’s still no cure
for the disease but clinical trials for many drugs are being given. Fortunately, 20 vaccines are
currently being developed by scientists around the world as cited by Hindustan Times.

Move 3

As an ongoing pandemic, it is definitely significant to know the origin, nature, and

prevention of COVID-19. A lot of speculation had been going around about this virus, one of
that is a comparison of the flu to the current coronavirus pandemic. The novel coronavirus
is more severe than the ordinary flu as many studies suggest, regarding the comparison
between the two. A statistic study from an article by Live Science found that: (a) 13.8% are
more likely to experience severe symptoms and 4.7% could be critical (China CDC Weekly,
2020), compared to the severity of the symptoms with the seasonal flu which stands at only
1% of the people in the United States according to Centers for Disease Control and
Prevention. (b) The death rate for COVID-19 appears to be higher than that of the flu. The
fatality rate for COVID-19 stands at 2.3%, though the exact figure is yet unclear but still most
research suggests it is higher than that of the seasonal flu which stands at 0.1%. (c)
Preliminary studies have estimated an R0 (basic reproduction number) value for the new
coronavirus to be between 2 and 3, according to the JAMA review study published on
February 28. This means each infected person has spread the virus to an average of 2 to 3
people, while the flu has an R0 value of about 1.3, according to The New York Times. This is
an estimate of the average number of people who could catch the virus from a single
infected person. (d) There is already a vaccine to protect against an infection of the flu,
while there’s no vaccine available yet for COVID-19. Fortunately, researchers at the U.S.
National Institutes of Health are in the early stages of developing one.
 So far, the novel coronavirus pandemic hasn’t killed as many people as on average
die from the ordinary flu in a single day. However, due to the fact that this novel coronavirus
is new, health experts still know very little about it, which causes authorities and experts
around the world to be worried. In an interview by the CBS news, Dr. Jon LaPook cited
clearly the differences between the two viruses: regarding the crisis of the novel
coronavirus, no one has the immunity from the virus yet, there’s no known treatment for
cure, no vaccine has been developed and the incubation period is longer than the ordinary
or seasonal flu.

Method

Research Design

This type of qualitative research is a case study on the nature, origin, observation
and prevention of the emerging disease called COVID-19. This long-time study aims to widen
the knowledge of everyone regarding the disease by going through preliminary studies
conducted by health organizations and researchers from across the globe. These preliminary
studies would help new researchers to tackle unanswered questions and fill up research
gaps on this subject, as this is still a current situation.

Participants

This study will be involving medical experts particularly but not limited to doctors or
nurses from Bahrain. Respondents that the researcher would consider are those that are
available in the medical field. They are the ones who can provide necessary information
relating to this study about COVID-19. Their answers would serve as an evidence to support
my standpoints from preliminary studies attached in this research.

Instruments

To gather information to support this tentative study about the novel coronavirus,
an interview comprising of a list of questions regarding the disease would be conducted by
the researcher to support this study. A recorder and a recording sheet will also be utilized by
the researcher for gathering of data. The questions are the following:
 1. What is the novel coronavirus? And how is it any different from any other strains
of coronaviruses?
2. Where did it possibly originate? And how does it transmit from one animal to
another?
3. How lethal can this disease get?
4. Who are more susceptible of developing a severe case?
5. What other rare symptoms can be developed by an infected person?
6. What is the best way to determine whether a person is infected by this novel
coronavirus?
7. How can we protect ourselves from contracting the said virus?
8. How contagious is this virus and why do you think it spread so fast across the
world in just three months?
9. When do you think is this pandemic going to stop?
10. When is the vaccine going to be available for utilization?

Procedure

The provided answers by the medical experts are aided by a recorder and a
recording sheet which would be then interpreted by the researcher. The interview session
would last for atleast 3-5 minutes of question and answer conversation. The researcher will
keep track of the time while still doing the interview and recording the necessary
information from the interviewees. The results will then be scanned through a separate
sheet of paper for formal presentation of datum in the study.

Sampling Method

For this research, expert sampling will be utilized by the researcher because a high
degree of knowledge is required in this particular study about the disease. This method of
sampling will come in handy for this particular study, as expert sampling is where the
researcher draws a sample from experts in the field that is being studied. The researcher will
be gathering opinions and assessments from the population from the medical field
regarding the ongoing pandemic.
Data Analysis

The datum gathered from the results in the interview will provide evidence to
support the topic of the case study. These results will then be interpreted based on the
preliminary datum that are gathered from health organizations before this disease was
declared a pandemic, and will be compiled by computing for the percentage (%) and the
mean (x̅) of the population from the medical field. The resulting answers testifies the
research gaps of the few related studies that are yet to be discovered concerning this topic
of the novel coronavirus.

References

Nicole Winfield (2020) ‘Not a wave, a tsunami.’ Italy hospitals at virus limit

https://www.pbs.org/newshour/health/not-a-wave-a-tsunami-italy-hospitals-at-virus-limit

Sarah Newey and Anne Gulland (2020) What is coronavirus, how did it start and could the
outbreak grow bigger?

https://www.telegraph.co.uk/news/2020/03/14/what-coronavirus-how-start-covid-19-
pandemic/

Graham Readfearn (2020) Coronavirus: what happens to people's lungs when they get
Covid-19?

https://www.theguardian.com/world/2020/mar/13/coronavirus-what-happens-to-peoples-
lungs-when-they-get-covid-19

Sharon Begley (2020) Who is getting sick, and how sick? A breakdown of coronavirus risk
by demographic factors

https://www.statnews.com/2020/03/03/who-is-getting-sick-and-how-sick-a-breakdown-of-
coronavirus-risk-by-demographic-factors/

HELEN BRANSWELL (2020) We’re learning a lot about the coronavirus. It will help us assess
risk

https://www.statnews.com/2020/03/06/were-learning-a-lot-about-the-coronavirus-it-will-
help-us-assess-risk/
Dylan Matthews (2020) 9 charts that explain the coronavirus pandemic

https://www.vox.com/future-perfect/2020/3/12/21172040/coronavirus-covid-19-virus-
charts

Nicoletta Lanese (2020) Coronavirus may be most infectious when symptoms are mildest,
small study finds

https://www.livescience.com/coronavirus-sheds-early-in-disease.html

Stephanie Pappas (2020) Scientists figure out how new coronavirus breaks into human
cells

https://www.livescience.com/how-coronavirus-infects-cells.html

Prof Roujian Lu, MSc, Xiang Zhao, MD, Juan Li, PhD, Peihua Niu, PhD, Bo Yang, MSc, and
Honglong Wu, MSc (2020) Genomic characterisation and epidemiology of 2019 novel
coronavirus: implications for virus origins and receptor binding

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30251-8/fulltext

Bundeswehr Institute of Microbiology, Munich, Germany (Roman Wölfel, M.D.; Sabine

Zange, M.D.; Patrick Vollmar, M.D.; Rosina Ehmann DVM; Katrin Zwirglmaier, Ph.D.) (2020)
Virological assessment of hospitalized cases of coronavirus disease 2019

https://www.medrxiv.org/content/10.1101/2020.03.05.20030502v1.full.pdf

CNN Wire (2020) This Is How Long Coronavirus May Linger on Contaminated Surfaces,
According to Science

https://ktla.com/news/nationworld/this-is-how-long-coronavirus-may-linger-on-
contaminated-surfaces-according-to-science/

Jackie Cameron (2020) Covid-19 facts: What scientists know, and DON’T KNOW, about
coronavirus – SA expert

https://www.biznews.com/thought-leaders/2020/03/06/covid-19-facts-coronavirus-sa-
expert

An interview with Charlotte Uetrecht and Philippe Lemey (2020) Coronavirus: What’s
beyond the science frontier

https://erc.europa.eu/news-events/magazine/coronavirus-what-s-beyond-science-frontier

Brian Resnick (2020) Covid-19 is not the flu. It’s worse.

https://www.vox.com/science-and-health/2020/3/13/21176735/covid-19-coronavirus-
worse-than-flu-comparison