informative essay about preventing covid 19 brainly

Masks Strongly Recommended but Not Required in Maryland, Starting Immediately

Due to the downward trend in respiratory viruses in Maryland, masking is no longer required but remains strongly recommended in Johns Hopkins Medicine clinical locations in Maryland. Read more .

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Staying Safe from COVID-19

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informative essay about preventing covid 19 brainly

Lisa Lockerd Maragakis, M.D., M.P.H.

The coronavirus that causes COVID-19 spreads primarily from person to person through respiratory droplets. This can happen when someone with the virus coughs, sneezes, sings or talks when close to others. By closely following a few safety measures, you can help protect yourself and others from getting sick.

Lisa Maragakis , senior director of infection prevention at Johns Hopkins, shares these guidelines:

Get vaccinated for COVID-19 and get a booster as soon as you’re eligible

Several COVID-19 vaccines have been approved or authorized by the U.S. Food and Drug Administration (FDA) for emergency use among specific age groups and recommended by the Centers for Disease Control and Prevention (CDC). Johns Hopkins Medicine views all authorized COVID-19 vaccines as highly effective at preventing serious disease, hospitalization and death from COVID-19.

Learn more about coronavirus vaccine safety and COVID-19 boosters .

Be aware of infection rates in your area

As more people get vaccinated, the rates of infection and hospitalization will vary in your area. For the foreseeable future, it’s a good idea to be familiar with the vaccination and COVID-19 data for your area and follow the local, state and federal safety guidelines.

Practice physical distancing

The coronavirus spreads mainly from person to person. If an infected person coughs or sneezes, their droplets can infect people nearby. People, including children, may be infected and have only mild symptoms, so physical distancing (staying at least 6 feet apart from others) is an important part of coronavirus protection.

Wear a mask

Wear a face mask in crowded, indoor situations since people carrying the SARS-CoV-2 virus and unvaccinated or vulnerable people might be present. Johns Hopkins Medicine and other health care institutions require all visitors, patients and staff to wear masks in all of their hospitals, treatment centers and offices. Learn more information about how masks help prevent the spread of COVID-19.

Practice hand hygiene

After being in public places and touching door handles, shopping carts, elevator buttons or handrails
After using the bathroom
Before preparing food or eating
If soap and water are not available, use hand sanitizer with at least 60% alcohol.
Avoid touching your eyes, nose or mouth, especially with unwashed hands.
If you cough or sneeze, do so in the bend of your elbow. If you use a tissue, throw it away immediately.

Take precautions if you are living with or caring for someone who is sick

Wear a mask if you are caring for someone who has respiratory symptoms.
Clean counters, door knobs, phones and tablets frequently, using disinfectant cleaners or wipes.

If you feel sick, follow these guidelines:

Stay home if you feel sick unless you are experiencing a medical emergency such as severe shortness of breath.
Take measures to keep others in your home safe, and follow precautions recommended by the CDC to avoid infecting others .
Call your doctor or urgent care facility and explain your symptoms over the phone.
If you leave your home to get medical care, wear a mask if you have respiratory symptoms.

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Coronavirus: Younger Adults Are at Risk, Too

How to Protect Yourself and Your Family from Coronavirus Disease 2019 (COVID-19)

Navigating covid-19.

Please refer to this helpful information about COVID-19 symptoms and what to do if your child is exposed to COVID-19 .

What can I do to prevent coronavirus disease 2019 (COVID-19)?

The best strategy to protect yourself and others from COVID-19 is to continue to follow the CDC’s recommended public health guidelines to help prevent transmission of COVID-19, including getting vaccinated if you are eligible ( see the latest vaccine guidelines from the CDC ), wearing a mask, practicing physical distancing, washing your hands frequently and avoiding crowds. Read more tips below.

Prepare and protect yourself from COVID-19

Here are some more steps everyone can take to help stop the spread of COVID-19:

Take safety precautions according to the level of COVID-19 in your community. Find out your county’s COVID-19 level here .
Wash your hands often with soap and clean, running water for at least 20 seconds.
If you don’t have access to soap and water, use an alcohol-based hand sanitizer often. Make sure it has at least 60% alcohol.
Don't touch your eyes, nose, or mouth unless you have clean hands.
If someone in your home has tested positive for COVID-19, follow the CDC’s instructions for cleaning and disinfection .
Cough or sneeze into a tissue, then throw the tissue into the trash. If you don't have tissues, cough or sneeze into the bend of your elbow.
Where community COVID-19 level is high, the CDC advises wearing a face mask in public. Your mask should have at least two layers, should fit snugly against your face and should cover both your mouth and nose.
Stay away from people who are sick.
Check your home supplies. Consider keeping a 2-week supply of medicines, food, and other needed household items.
Make a plan for childcare, work, and ways to stay in touch with others. Know who will help you if you get sick.
Don’t share eating or drinking utensils with sick people.
Don’t kiss or hug someone who is sick.

What to do if you have been exposed to someone with COVID-19

Follow CDC guidelines for more details about what to do if you’ve been exposed to COVID-19 .

What to do if you are sick with COVID-19 symptoms

Stay home. Call your healthcare provider and tell them you have symptoms of COVID-19. Follow your provider's instructions. You may be advised to isolate yourself at home. This is called self-isolation.
Stay away from work, school, and public places. Limit physical contact with family members and pets. Don't kiss anyone or share eating or drinking utensils. Clean surfaces you touch with disinfectant. This is to help prevent the virus from spreading.
Wear a face mask. This is to protect other people from your germs. If you are not able to wear a mask, your caregivers should when you are in the same room with them. Wear the mask so that it covers both the nose and mouth.
If you need to go into a hospital or clinic, expect that the healthcare staff will wear protective equipment such as masks, gowns, gloves, and eye protection. You may be put in a separate room. This is to prevent the possible virus from spreading.
Follow all instructions the healthcare staff give you.

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COVID-19 Resources for Parents

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Learn about the newly discovered multi-system inflammatory syndrome in children (MIS-C), including symptoms, causes, treatment and research at CHOP.

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Prevent COVID-19: How to Protect Yourself from the Coronavirus

Follow these simple precautions to reduce your chances of contracting covid-19..

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The COVID-19 pandemic has been a part of our daily lives since March 2020, but with about 151,000 new cases a day in the United States, it remains as important as ever to stay vigilant and know how to protect yourself from coronavirus.

According to the Centers for Disease Control and Prevention (CDC) , “The best way to prevent illness is to avoid being exposed to this virus.” As the vaccines continue their roll out, here are the simple steps you can take to help prevent the spread of COVID-19 and protect yourself and others.

Know how it spreads

Scientists are still learning about COVID-19, the disease caused by the coronavirus, but according to the CDC, this highly contagious virus appears to be most commonly spread during close (within 6 feet) person-to-person contact through respiratory droplets.

“The means of transmission can be through respiratory droplets produced when a person coughs or sneezes, or by direct physical contact with an infected person, such as shaking hands,” says Dr. David Goldberg , an internist and infectious disease specialist at NewYork-Presbyterian Medical Group Westchester and an assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons.

The CDC also notes that COVID-19 can spread by airborne transmission , although this is less common than close contact with a person. “Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours,” the CDC states. “These viruses may be able to infect people who are further than 6 feet away from the person who is infected or after that person has left the space. These transmissions occurred within enclosed spaces that had inadequate ventilation.”

Finally, it’s possible for coronavirus to spread through contaminated surfaces, but this is also less likely. According to the CDC, “Based on data from lab studies on COVID-19 and what we know about similar respiratory diseases, it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this isn’t thought to be the main way the virus spreads.”

Practice social distancing

Since close person-to-person contact appears to be the main source of transmission, social distancing remains a key way to mitigate spread. The CDC recommends maintaining a distance of approximately 6 feet from others in public places. This distance will help you avoid direct contact with respiratory droplets produced by coughing or sneezing.

In addition, studies have found that outdoor settings with enough space to distance and good ventilation will reduce risk of exposure. “There is up to 80% less transmission of the virus happening outdoors versus indoors,” says Dr. Ashwin Vasan , an assistant attending physician in the Department of Medicine at NewYork-Presbyterian/Columbia University Irving Medical Center and an assistant professor at the Mailman School of Public Health and Columbia University Vagelos College of Physicians and Surgeons. “One study found that of 318 outbreaks that accounted for 1,245 confirmed cases in China, only one outbreak occurred outdoors. That’s significant. I recommend spending time with others outside. We’re not talking about going to a sporting event or a concert. We’re talking about going for a walk or going to the park, or even having a conversation at a safe distance with someone outside.”

Wash your hands

Practicing good hygiene is an important habit that helps prevent the spread of COVID-19. Make these CDC recommendations part of your routine:

Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
Before eating or preparing food
Before touching your face
After using the restroom
After leaving a public place
After blowing your nose, coughing, or sneezing
After handling your mask
After changing a diaper
After caring for someone who’s sick
After touching animals or pets
If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands with the sanitizer and rub them together until they feel dry.
Avoid touching your eyes, nose, and mouth with unwashed hands.

Visit the CDC website for guidelines on how to properly wash your hands and use hand sanitizer . And see our video below on how soap kills the coronavirus. There’s plenty of science behind this basic habit. “Soap molecules disrupt the fatty layer or coat surrounding the virus, ” says Dr. Goldberg. “Once the viral coat is broken down, the virus is no longer able to function.”

In addition to hand-washing, disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.

Wear a mask

Face masks have become essential accessories in protecting yourself and others from contracting COVID-19. The CDC recommends that people wear face coverings in public settings, especially since studies have shown that individuals with the novel coronavirus could be asymptomatic or presymptomatic. (Face masks, however, do not replace social distancing recommendations.)

“Face masks are designed to provide a barrier between your airway and the outside world,” says Dr. Ole Vielemeyer , medical director of Weill Cornell ID Associates and Travel Medicine in the Division of Infectious Diseases at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. “By wearing a mask that covers your mouth and nose, you will reduce the risk of serving as the source of disease spread by trapping your own droplets in the mask, and also reduce the risk of getting sick via droplets that contain the coronavirus by blocking access to your own airways.”

Restrict your travel

Traveling can increase the spread of COVID-19 and put you at risk for contracting the disease. The CDC recommends avoiding non-essential travel to many international destinations during the pandemic. It also advises people to weigh the risks when it comes to domestic travel: “Travel increases your chance of getting and spreading COVID-19,” states the CDC. “Staying home is the best way to protect yourself and others from COVID-19.”

“For people at risk for the complications of COVID-19, such as those with underlying medical conditions or those who are older, it’s prudent to avoid travel,” says Dr. Goldberg.

If you must travel, take safety measures, consider your mode of transportation, and stay up to date on the restrictions that are in place at your destination. Adhering to your state’s quarantine rules after traveling will help prevent the spread of COVID-19.

Watch for symptoms

The symptoms of infection for the coronavirus are often similar to those of other respiratory virus infections, such as influenza. Symptoms can include:

Fever or chills
Shortness of breath or difficulty breathing
Muscle or body aches
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting

With the COVID-19 pandemic now coinciding with flu season, it’s important to recognize the differences in symptoms — as well as get a flu shot. “The medical community is concerned that if we have an increased number of influenza cases, it will strain the hospital system on top of what’s already going on with the COVID-19 pandemic,” says Dr. Ting Ting Wong , an attending physician and infectious disease specialist at NewYork-Presbyterian Brooklyn Methodist Hospital.

If you think you may have been exposed to a person with COVID-19 and have symptoms, call ahead to a doctor’s office to see if you can get tested. You can also use a virtual care platform, such as NewYork-Presbyterian’s NYP OnDemand, to meet with a healthcare professional by videoconference. Avoid contact with others and wear a face mask if you need to leave your home when you are sick.

How NewYork-Presbyterian is prepared

NewYork-Presbyterian continues to follow the situation closely and implement the recommendations provided by our local and state departments of health and the CDC. Our medical staff is trained to recognize patients who may have the virus and will help prevent COVID-19 from spreading.

We understand how important the support of loved ones and friends is to patients during their hospital stay. Stay up to date with NewYork-Presbyterian’s visitor guidelines . It’s our priority to keep patients and visitors safe from infection.

For more information on the evolving situation and how to protect yourself from coronavirus, visit the CDC and check NewYork-Presbyterian for more updates.

View all of our COVID-19 outbreak articles here .

Additional Resources

If you have concerns regarding COVID-19, please call NewYork-Presbyterian’s hotline at 646-697-4000. This hotline is available as a public service to provide information only and not diagnose, treat, or render a medical opinion.

If you are not feeling well, consider using NewYork-Presbyterian’s Virtual Urgent Care for non-life-threatening symptoms such as fever, cough, upset stomach, or nausea. Learn more by visiting nyp.org/urgentcare .

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How to protect yourself and others from COVID-19

Coronavirus disease 2019 (COVID-19) is a serious disease, mainly of the respiratory system, affecting many people around the globe. It can cause mild to severe illness and even death. COVID-19 spreads easily between people. Learn how to protect yourself and others from this illness.

Information

HOW COVID-19 SPREADS

COVID-19 is an illness caused by infection with the SARS-CoV-2 virus. COVID-19 most commonly spreads between people with close contact (about 6 feet or 2 meters). When someone with the illness coughs, sneezes, sings, talks, or breathes, droplets carrying the virus spray into the air. You can catch the illness if you breathe in these droplets or they get in your eyes.

In some instances, COVID-19 may spread through the air and infect people who are more than 6 feet away. Small droplets and particles can remain in the air for minutes to hours. This is called airborne (or aerosol) transmission, and it occurs mainly in enclosed spaces with poor ventilation. However, it is more common for COVID-19 to spread through close contact.

Less often, the illness can spread if you touch a surface with the virus on it, and then touch your eyes, nose, mouth, or face. But this is a much less common way the virus spreads.

HOW TO PREVENT COVID-19

You can spread COVID-19 before you show symptoms . Some people with the illness never have symptoms, but can still spread the disease. However, there are ways to protect yourself and others from getting COVID-19. These tips can help you and others stay safe:

Get an updated COVID-19 vaccine . Being vaccinated helps protect you from getting and spreading COVID-19. Being vaccinated can also help protect you from serious illness if you do get the virus.
Make sure children ages 6 months and older get the COVID-19 vaccine . Getting children and teens vaccinated helps prevent them from spreading COVID-19 to older relatives and young siblings and friends who can't or don't get the vaccine. It also helps protect children and teens from serious illness.
If you are vaccinated, and in an area where COVID-19 hospital admission rates are high, you can wear a face mask or respirator that fits well without gaps when you are indoors in public.
If you have a weakened immune system, you may want to wear a face mask indoors in public regardless of how active COVID-19 is in your community.
Avoid poorly ventilated indoor spaces and crowded areas, even if you are vaccinated. If you are indoors, open windows and doors and use fans to help bring in outdoor air, when possible. Use a portable high-efficiency particulate air (HEPA) cleaner. Spending time outdoors or in well-ventilated spaces can help reduce your exposure to respiratory droplets.
COVID-19 tests can help prevent the spread to others. You can use COVID-19 self-tests at home and get quick results whether or not you have symptoms.
Wash your hands many times a day with soap and running water for at least 20 seconds. In general, this is a good practice to help prevent the spread of germs. Do this before eating or preparing food, after using the toilet, and after coughing, sneezing, or blowing your nose. Use an alcohol-based hand sanitizer (at least 60% alcohol) if soap and water are not available.
Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing. Droplets that are released when a person sneezes or coughs are infectious. Throw away the tissue after use.
Avoid touching your face, eyes, nose, and mouth with unwashed hands.
Do not share personal items such as cups, eating utensils, towels, or bedding. Wash anything you have used in soap and water.
Know the symptoms of COVID-19. If you develop any symptoms, contact your health care provider.
Stay home if you think you have COVID-19 or test positive for the virus. Follow guidance for how long to stay away from others and when you can safely resume normal activities, as listed below.

WHAT TO DO IF YOU GET COVID-19

If you have COVID-19 or have symptoms of it, you must stay at home and avoid contact with other people , both inside and outside your home, to avoid spreading the illness.

Once you start to feel better, you can go back to your normal activities if BOTH of the following things are true:

For at least 24 hours, your symptoms have improved AND
You have not had a fever for at least 24 hours, and you are not using fever-reducing medicine

Even though you feel better, you may still be able to spread the virus to others for several days. For this reason, once you go back to your normal activities, continue to protect others from illness by taking these steps for 5 days:

Practice good hygiene by washing your hands and cleaning "high touch" areas around your home.
Take steps to bring cleaner air inside your home by opening windows and using exhaust fans.
Wear a mask around others.
Practice physical distancing by avoiding close contact and avoiding crowds.
Self-test for COVID-19 before being indoors with others.

You should also practice these steps for 5 days if you tested positive for COVID-19, but did not have any symptoms. Even though you have no symptoms, you can still spread the virus to others. Doing so will protect people at risk for serious illness, such as people who are immunocompromised.

If your fever returns after resuming normal activities, you should go back to staying home and away from others. Once your fever and symptoms improve for more than 24 hours, you can resume activities while taking steps to protect others for 5 more days.

Alternative Names

COVID-19 - Prevention; 2019 Novel Coronavirus - Prevention; SARS CoV 2 - Prevention

Centers for Disease Control and Prevention website. COVID-19: How COVID-19 spreads. www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html . Updated August 11, 2022. Accessed March 10, 2024.

Centers for Disease Control and Prevention website. COVID-19: How to protect yourself and others. www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html . Updated July 6, 2023. Accessed March 10, 2024.

Centers for Disease Control and Prevention website. COVID-19: Masks. www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/masks.html . Updated August 12, 2021. Accessed March 10, 2024.

Centers for Disease Control and Prevention website. COVID-19: Use and care of masks. www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html . Updated May 11, 2023. Accessed March 10, 2024.

Centers for Disease Control and Prevention website. Respiratory virus guidance. www.cdc.gov/respiratory-viruses/guidance/respiratory-virus-guidance.html . Updated March 1, 2024. Accessed March 10, 2024.

Centers for Disease Control and Prevention website. Stay up to date with COVID-19 vaccines. www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html . Updated March 7, 2024. Accessed March 10, 2024.

Review Date 2/22/2023

Updated by: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 03/12/2024.

The complexity of managing COVID-19: How important is good governance?

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Alaka m. basu , amb alaka m. basu professor, department of global development - cornell university, senior fellow - united nations foundation kaushik basu , and kaushik basu nonresident senior fellow - global economy and development @kaushikcbasu jose maria u. tapia jmut jose maria u. tapia student - cornell university.

November 17, 2020

13 min read

This essay is part of “ Reimagining the global economy: Building back better in a post-COVID-19 world ,” a collection of 12 essays presenting new ideas to guide policies and shape debates in a post-COVID-19 world.

The COVID-19 pandemic has exposed the inadequacy of public health systems worldwide, casting a shadow that we could not have imagined even a year ago. As the fog of confusion lifts and we begin to understand the rudiments of how the virus behaves, the end of the pandemic is nowhere in sight. The number of cases and the deaths continue to rise. The latter breached the 1 million mark a few weeks ago and it looks likely now that, in terms of severity, this pandemic will surpass the Asian Flu of 1957-58 and the Hong Kong Flu of 1968-69.

Moreover, a parallel problem may well exceed the direct death toll from the virus. We are referring to the growing economic crises globally, and the prospect that these may hit emerging economies especially hard.

The economic fall-out is not entirely the direct outcome of the COVID-19 pandemic but a result of how we have responded to it—what measures governments took and how ordinary people, workers, and firms reacted to the crisis. The government activism to contain the virus that we saw this time exceeds that in previous such crises, which may have dampened the spread of the COVID-19 but has extracted a toll from the economy.

This essay takes stock of the policies adopted by governments in emerging economies, and what effect these governance strategies may have had, and then speculates about what the future is likely to look like and what we may do here on.

Nations that build walls to keep out goods, people and talent will get out-competed by other nations in the product market.

It is becoming clear that the scramble among several emerging economies to imitate and outdo European and North American countries was a mistake. We get a glimpse of this by considering two nations continents apart, the economies of which have been among the hardest hit in the world, namely, Peru and India. During the second quarter of 2020, Peru saw an annual growth of -30.2 percent and India -23.9 percent. From the global Q2 data that have emerged thus far, Peru and India are among the four slowest growing economies in the world. Along with U.K and Tunisia these are the only nations that lost more than 20 percent of their GDP. 1

COVID-19-related mortality statistics, and, in particular, the Crude Mortality Rate (CMR), however imperfect, are the most telling indicator of the comparative scale of the pandemic in different countries. At first glance, from the end of October 2020, Peru, with 1039 COVID-19 deaths per million population looks bad by any standard and much worse than India with 88. Peru’s CMR is currently among the highest reported globally.

However, both Peru and India need to be placed in regional perspective. For reasons that are likely to do with the history of past diseases, there are striking regional differences in the lethality of the virus (Figure 11.1). South America is worse hit than any other world region, and Asia and Africa seem to have got it relatively lightly, in contrast to Europe and America. The stark regional difference cries out for more epidemiological analysis. But even as we await that, these are differences that cannot be ignored.

To understand the effect of policy interventions, it is therefore important to look at how these countries fare within their own regions, which have had similar histories of illnesses and viruses (Figure 11.2). Both Peru and India do much worse than the neighbors with whom they largely share their social, economic, ecological and demographic features. Peru’s COVID-19 mortality rate per million population, or CMR, of 1039 is ahead of the second highest, Brazil at 749, and almost twice that of Argentina at 679.

Similarly, India at 88 compares well with Europe and the U.S., as does virtually all of Asia and Africa, but is doing much worse than its neighbors, with the second worst country in the region, Afghanistan, experiencing less than half the death rate of India.

The official Indian statement that up to 78,000 deaths 2 were averted by the lockdown has been criticized 3 for its assumptions. A more reasonable exercise is to estimate the excess deaths experienced by a country that breaks away from the pattern of its regional neighbors. So, for example, if India had experienced Afghanistan’s COVID-19 mortality rate, it would by now have had 54,112 deaths. And if it had the rate reported by Bangladesh, it would have had 49,950 deaths from COVID-19 today. In other words, more than half its current toll of some 122,099 COVID-19 deaths would have been avoided if it had experienced the same virus hit as its neighbors.

What might explain this outlier experience of COVID-19 CMRs and economic downslide in India and Peru? If the regional background conditions are broadly similar, one is left to ask if it is in fact the policy response that differed markedly and might account for these relatively poor outcomes.

Peru and India have performed poorly in terms of GDP growth rate in Q2 2020 among the countries displayed in Table 2, and given that both these countries are often treated as case studies of strong governance, this draws attention to the fact that there may be a dissonance between strong governance and good governance.

The turnaround for India has been especially surprising, given that until a few years ago it was among the three fastest growing economies in the world. The slowdown began in 2016, though the sharp downturn, sharper than virtually all other countries, occurred after the lockdown.

On the COVID-19 policy front, both India and Peru have become known for what the Oxford University’s COVID Policy Tracker 4 calls the “stringency” of the government’s response to the epidemic. At 8 pm on March 24, 2020, the Indian government announced, with four hours’ notice, a complete nationwide shutdown. Virtually all movement outside the perimeter of one’s home was officially sought to be brought to a standstill. Naturally, as described in several papers, such as that of Ray and Subramanian, 5 this meant that most economic life also came to a sudden standstill, which in turn meant that hundreds of millions of workers in the informal, as well as more marginally formal sectors, lost their livelihoods.

In addition, tens of millions of these workers, being migrant workers in places far-flung from their original homes, also lost their temporary homes and their savings with these lost livelihoods, so that the only safe space that beckoned them was their place of origin in small towns and villages often hundreds of miles away from their places of work.

After a few weeks of precarious living in their migrant destinations, they set off, on foot since trains and buses had been stopped, for these towns and villages, creating a “lockdown and scatter” that spread the virus from the city to the town and the town to the village. Indeed, “lockdown” is a bit of a misnomer for what happened in India, since over 20 million people did exactly the opposite of what one does in a lockdown. Thus India had a strange combination of lockdown some and scatter the rest, like in no other country. They spilled out and scattered in ways they would otherwise not do. It is not surprising that the infection, which was marginally present in rural areas (23 percent in April), now makes up some 54 percent of all cases in India. 6

In Peru too, the lockdown was sudden, nationwide, long drawn out and stringent. 7 Jobs were lost, financial aid was difficult to disburse, migrant workers were forced to return home, and the virus has now spread to all parts of the country with death rates from it surpassing almost every other part of the world.

As an aside, to think about ways of implementing lockdowns that are less stringent and geographically as well as functionally less total, an example from yet another continent is instructive. Ethiopia, with a COVID-19 death rate of 13 per million population seems to have bettered the already relatively low African rate of 31 in Table 1. 8

We hope that human beings will emerge from this crisis more aware of the problems of sustainability.

The way forward

We next move from the immediate crisis to the medium term. Where is the world headed and how should we deal with the new world? Arguably, that two sectors that will emerge larger and stronger in the post-pandemic world are: digital technology and outsourcing, and healthcare and pharmaceuticals.

The last 9 months of the pandemic have been a huge training ground for people in the use of digital technology—Zoom, WebEx, digital finance, and many others. This learning-by-doing exercise is likely to give a big boost to outsourcing, which has the potential to help countries like India, the Philippines, and South Africa.

Globalization may see a short-run retreat but, we believe, it will come back with a vengeance. Nations that build walls to keep out goods, people and talent will get out-competed by other nations in the product market. This realization will make most countries reverse their knee-jerk anti-globalization; and the ones that do not will cease to be important global players. Either way, globalization will be back on track and with a much greater amount of outsourcing.

To return, more critically this time, to our earlier aside on Ethiopia, its historical and contemporary record on tampering with internet connectivity 9 in an attempt to muzzle inter-ethnic tensions and political dissent will not serve it well in such a post-pandemic scenario. This is a useful reminder for all emerging market economies.

We hope that human beings will emerge from this crisis more aware of the problems of sustainability. This could divert some demand from luxury goods to better health, and what is best described as “creative consumption”: art, music, and culture. 10 The former will mean much larger healthcare and pharmaceutical sectors.

But to take advantage of these new opportunities, nations will need to navigate the current predicament so that they have a viable economy once the pandemic passes. Thus it is important to be able to control the pandemic while keeping the economy open. There is some emerging literature 11 on this, but much more is needed. This is a governance challenge of a kind rarely faced, because the pandemic has disrupted normal markets and there is need, at least in the short run, for governments to step in to fill the caveat.

Emerging economies will have to devise novel governance strategies for doing this double duty of tamping down on new infections without strident controls on economic behavior and without blindly imitating Europe and America.

Here is an example. One interesting opportunity amidst this chaos is to tap into the “resource” of those who have already had COVID-19 and are immune, even if only in the short-term—we still have no definitive evidence on the length of acquired immunity. These people can be offered a high salary to work in sectors that require physical interaction with others. This will help keep supply chains unbroken. Normally, the market would have on its own caused such a salary increase but in this case, the main benefit of marshaling this labor force is on the aggregate economy and GDP and therefore is a classic case of positive externality, which the free market does not adequately reward. It is more a challenge of governance. As with most economic policy, this will need careful research and design before being implemented. We have to be aware that a policy like this will come with its risk of bribery and corruption. There is also the moral hazard challenge of poor people choosing to get COVID-19 in order to qualify for these special jobs. Safeguards will be needed against these risks. But we believe that any government that succeeds in implementing an intelligently-designed intervention to draw on this huge, under-utilized resource can have a big, positive impact on the economy 12 .

This is just one idea. We must innovate in different ways to survive the crisis and then have the ability to navigate the new world that will emerge, hopefully in the not too distant future.

How to Write About Coronavirus in a College Essay

Students can share how they navigated life during the coronavirus pandemic in a full-length essay or an optional supplement.

Writing About COVID-19 in College Essays

Serious disabled woman concentrating on her work she sitting at her workplace and working on computer at office

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Experts say students should be honest and not limit themselves to merely their experiences with the pandemic.

The global impact of COVID-19, the disease caused by the novel coronavirus, means colleges and prospective students alike are in for an admissions cycle like no other. Both face unprecedented challenges and questions as they grapple with their respective futures amid the ongoing fallout of the pandemic.

Colleges must examine applicants without the aid of standardized test scores for many – a factor that prompted many schools to go test-optional for now . Even grades, a significant component of a college application, may be hard to interpret with some high schools adopting pass-fail classes last spring due to the pandemic. Major college admissions factors are suddenly skewed.

"I can't help but think other (admissions) factors are going to matter more," says Ethan Sawyer, founder of the College Essay Guy, a website that offers free and paid essay-writing resources.

College essays and letters of recommendation , Sawyer says, are likely to carry more weight than ever in this admissions cycle. And many essays will likely focus on how the pandemic shaped students' lives throughout an often tumultuous 2020.

But before writing a college essay focused on the coronavirus, students should explore whether it's the best topic for them.

Writing About COVID-19 for a College Application

Much of daily life has been colored by the coronavirus. Virtual learning is the norm at many colleges and high schools, many extracurriculars have vanished and social lives have stalled for students complying with measures to stop the spread of COVID-19.

"For some young people, the pandemic took away what they envisioned as their senior year," says Robert Alexander, dean of admissions, financial aid and enrollment management at the University of Rochester in New York. "Maybe that's a spot on a varsity athletic team or the lead role in the fall play. And it's OK for them to mourn what should have been and what they feel like they lost, but more important is how are they making the most of the opportunities they do have?"

That question, Alexander says, is what colleges want answered if students choose to address COVID-19 in their college essay.

But the question of whether a student should write about the coronavirus is tricky. The answer depends largely on the student.

"In general, I don't think students should write about COVID-19 in their main personal statement for their application," Robin Miller, master college admissions counselor at IvyWise, a college counseling company, wrote in an email.

"Certainly, there may be exceptions to this based on a student's individual experience, but since the personal essay is the main place in the application where the student can really allow their voice to be heard and share insight into who they are as an individual, there are likely many other topics they can choose to write about that are more distinctive and unique than COVID-19," Miller says.

Opinions among admissions experts vary on whether to write about the likely popular topic of the pandemic.

"If your essay communicates something positive, unique, and compelling about you in an interesting and eloquent way, go for it," Carolyn Pippen, principal college admissions counselor at IvyWise, wrote in an email. She adds that students shouldn't be dissuaded from writing about a topic merely because it's common, noting that "topics are bound to repeat, no matter how hard we try to avoid it."

Above all, she urges honesty.

"If your experience within the context of the pandemic has been truly unique, then write about that experience, and the standing out will take care of itself," Pippen says. "If your experience has been generally the same as most other students in your context, then trying to find a unique angle can easily cross the line into exploiting a tragedy, or at least appearing as though you have."

But focusing entirely on the pandemic can limit a student to a single story and narrow who they are in an application, Sawyer says. "There are so many wonderful possibilities for what you can say about yourself outside of your experience within the pandemic."

He notes that passions, strengths, career interests and personal identity are among the multitude of essay topic options available to applicants and encourages them to probe their values to help determine the topic that matters most to them – and write about it.

That doesn't mean the pandemic experience has to be ignored if applicants feel the need to write about it.

Writing About Coronavirus in Main and Supplemental Essays

Students can choose to write a full-length college essay on the coronavirus or summarize their experience in a shorter form.

To help students explain how the pandemic affected them, The Common App has added an optional section to address this topic. Applicants have 250 words to describe their pandemic experience and the personal and academic impact of COVID-19.

"That's not a trick question, and there's no right or wrong answer," Alexander says. Colleges want to know, he adds, how students navigated the pandemic, how they prioritized their time, what responsibilities they took on and what they learned along the way.

If students can distill all of the above information into 250 words, there's likely no need to write about it in a full-length college essay, experts say. And applicants whose lives were not heavily altered by the pandemic may even choose to skip the optional COVID-19 question.

"This space is best used to discuss hardship and/or significant challenges that the student and/or the student's family experienced as a result of COVID-19 and how they have responded to those difficulties," Miller notes. Using the section to acknowledge a lack of impact, she adds, "could be perceived as trite and lacking insight, despite the good intentions of the applicant."

To guard against this lack of awareness, Sawyer encourages students to tap someone they trust to review their writing , whether it's the 250-word Common App response or the full-length essay.

Experts tend to agree that the short-form approach to this as an essay topic works better, but there are exceptions. And if a student does have a coronavirus story that he or she feels must be told, Alexander encourages the writer to be authentic in the essay.

"My advice for an essay about COVID-19 is the same as my advice about an essay for any topic – and that is, don't write what you think we want to read or hear," Alexander says. "Write what really changed you and that story that now is yours and yours alone to tell."

Sawyer urges students to ask themselves, "What's the sentence that only I can write?" He also encourages students to remember that the pandemic is only a chapter of their lives and not the whole book.

Miller, who cautions against writing a full-length essay on the coronavirus, says that if students choose to do so they should have a conversation with their high school counselor about whether that's the right move. And if students choose to proceed with COVID-19 as a topic, she says they need to be clear, detailed and insightful about what they learned and how they adapted along the way.

"Approaching the essay in this manner will provide important balance while demonstrating personal growth and vulnerability," Miller says.

Pippen encourages students to remember that they are in an unprecedented time for college admissions.

"It is important to keep in mind with all of these (admission) factors that no colleges have ever had to consider them this way in the selection process, if at all," Pippen says. "They have had very little time to calibrate their evaluations of different application components within their offices, let alone across institutions. This means that colleges will all be handling the admissions process a little bit differently, and their approaches may even evolve over the course of the admissions cycle."

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Iran J Med Sci
v.45(4); 2020 Jul

A Narrative Review of COVID-19: The New Pandemic Disease

Kiana shirani, md.

1 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Erfan Sheikhbahaei, MD

2 Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Zahra Torkpour, MD

Mazyar ghadiri nejad, phd.

3 Industrial Engineering Department, Girne American University, Kyrenia, TRNC, Turkey

Bahareh Kamyab Moghadas, PhD

4 Department of Chemical Engineering, Shiraz Branch, Islamic Azad University, Shiraz, Iran

Matina Ghasemi, PhD

5 Faculty of Business and Economics, Business Department, Girne American University, Kyrenia, TRNC, Turkey

Hossein Akbari Aghdam, MD

6 Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Athena Ehsani, PhD

7 Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran

Saeed Saber-Samandari, PhD

8 New Technologies Research Center, Amirkabir University of Technology, Tehran, Iran

Amirsalar Khandan, PhD

9 Department of Electrical Engineering, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

10 0Technology Incubator Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

Nearly every 100 years, humans collectively face a pandemic crisis. After the Spanish flu, now the world is in the grip of coronavirus disease 2019 (COVID-19). First detected in 2019 in the Chinese city of Wuhan, COVID-19 causes severe acute respiratory distress syndrome. Despite the initial evidence indicating a zoonotic origin, the contagion is now known to primarily spread from person to person through respiratory droplets. The precautionary measures recommended by the scientific community to halt the fast transmission of the disease failed to prevent this contagious disease from becoming a pandemic for a whole host of reasons. After an incubation period of about two days to two weeks, a spectrum of clinical manifestations can be seen in individuals afflicted by COVID-19: from an asymptomatic condition that can spread the virus in the environment, to a mild/moderate disease with cold/flu-like symptoms, to deteriorated conditions that need hospitalization and intensive care unit management, and then a fatal respiratory distress syndrome that becomes refractory to oxygenation. Several diagnostic modalities have been advocated and evaluated; however, in some cases, diagnosis is made on the clinical picture in order not to lose time. A consensus on what constitutes special treatment for COVID-19 has yet to emerge. Alongside conservative and supportive care, some potential drugs have been recommended and a considerable number of investigations are ongoing in this regard

What’s Known

Substantial numbers of articles on COVID-19 have been published, yet there is controversy among clinicians and confusion among the general population in this regard. Furthermore, it is unreasonable to expect physicians to read all the available literature on this subject.

What’s New

This article reviews high-quality articles on COVID-19 and effectively summarizes them for healthcare providers and the general population.

Introduction

A pathogen from a human-animal virus family, the coronavirus (CoV), which was identified as the main cause of respiratory tract infections, evolved to a novel and wild kind in Wuhan, a city in Hubei Province of China, and spread throughout the world, such that it created a pandemic crisis according to the World Health Organization (WHO). CoV is a large family of viruses that were first discovered in 1960. These viruses cause such diseases as common colds in humans and animals. Sometimes they attack the respiratory system, and sometimes their signs appear in the gastrointestinal tract. There have been different types of human CoV including CoV-229E, CoV-OC43, CoV-NL63, and CoV-HKU1, with the latter two having been discovered in 2004 and 2005, respectively. These types of CoV regularly cause respiratory infections in children and adults. 1 There are also other types of these viruses that are associated with more severe symptoms. The new CoV, scientifically known as “SARS-CoV-2”, causes severe acute respiratory syndrome (SARS). 2 A newer type of the virus was discovered in September 2012 in a 60-year-old man in Saudi Arabia who died of the disease; the man had traveled to Dubai a few days earlier. The second case was a 49-year-old man in Qatar who also passed away. The discovery was first confirmed at the Health Protection Agency’s Laboratory in Colindale, London. The outbreak of this CoV is known as the Middle East Respiratory Syndrome (MERS), commonly referred to as “MERS-CoV”. The virus has infected 2260 people and has killed 912, most of them in the Middle East. 3 - 5 Finally, in December 2019, for the first time in Wuhan, in Hubei Province of China, a new type of CoV was identified that caused pneumonia in humans. 6 SARS-CoV-2 has affected 5404512 people and killed more than 343514 around the world according to the WHO situation report-127 (May 26, 2020). 3 , 7 - 10 The WHO has officially termed the disease “COVID-19”, which refers to corona, the virus, the disease, the year 2019, and its etiology (SARS-CoV-2). This type of CoV had never been seen in humans before. The initial estimates showed a mortality rate ranging from between 1% and 3% in most countries to 5% in the worst-hit areas ( Figure 1 ). 9 Some Chinese researchers succeeded in determining how SARS-CoV-2 affects human cells, which could help to develop techniques of viral detection and had antiviral therapy potential. Via a process termed “cryogenic electron microscopy (cryo-EM)”, these scientists discovered that CoV enters human cells utilizing a kind of cell membrane glycoprotein: angiotensin-converting enzyme 2 (ACE2). Then, the S protein is split into two sub-units: S1 and S2. S1 keeps a receptor-binding domain (RBD); accordingly, SARS-CoV-2 can bind to the peptidase domain of ACE2 directly. It appears that S2 subsequently plays a role in cellular fusion. Chinese researchers used the cryo-EM technique to provide ACE2 when it is linked to an amino acid transporter called “B0AT1”. They also discovered how to connect SARS-CoV-2 to ACE2-B0AT1, which is another complex structure. Given that none of these molecular structures was previously known, the researchers hoped that these studies would lead to the development of an antiviral or vaccine that would help to prevent CoV. Along the way, scientists found that ACE2 has to undergo a molecular process in which it binds to another molecule to be activated. The resulting molecule can bind two SARS-CoV-2 protein molecules simultaneously. The scientists also studied different SARS-CoV-2 RBD binding methods compared with other SARS-CoV-RBDs, which showed how subtle changes in the molecular binding sequence make the coronal structure of the virus stronger.

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Most cases with SARS-CoV-2 are asymptomatic or have mild clinical pictures such as influenza and colds. This group of patients should be detected and isolated in their homes to break the transmission chain of the disease and adhere to the precautionary recommendations in order not to infect other people. The screening process will help this group and suppress the outbreak in the community. Patients with the confirmed disease who are admitted to hospitals can contaminate this environment, which should be borne in mind by healthcare providers and policymakers.

Transmission

While the first mode of the transmission of COVID-19 to humans is still unknown, a seafood market where live animals were sold was identified as a potential source at the beginning of the outbreak in the epidemiologic investigations that found some infected patients who had visited or worked in that place. The other viruses in this family, namely MERS and SARS, were both confirmed to be zoonotic viruses. Afterward, the person-to-person spread was established as the main mode of transmission and the reason for the progression of the outbreak. 11 Similar to the influenza virus, SARS-CoV-2 spreads through the population via respiratory droplets. When an infected person coughs, sneezes, or talks, the respiratory secretions, which contain the virus, enter the environment as droplets. These droplets can reach the mucous membranes of individuals directly or indirectly when they touch an infected surface or any other source; the virus, thereafter, finds its ways to the eyes, nose, or mouth as the first incubation places. 11 - 15 It has been reported that droplets cannot travel more than two meters in the air, nor can they remain in the air owing to their high density. Nonetheless, given the other hitherto unknown modes of transmission, routine airborne transmission precautions should be considered in high-risk countries and during high-risk procedures such as manual ventilation with bags and masks, endotracheal intubation, open endotracheal suctioning, bronchoscopy, cardiopulmonary resuscitation, sputum induction, lung surgery, nebulizer therapy, noninvasive positive pressure ventilation (eg, bilevel positive airway pressure and continuous positive airway pressure ), and lung autopsy. In the early stages of the disease, the chances of the spread of the virus to other persons are high because the viral load in the body may be high despite the absence of any symptoms ( Figure 2 ). 11 - 13 The person-to-person transmission rates can be different depending on the location and the infection control intervention; still, according to the latest reports, the secondary COVID-19 infection rate ranges from 1% to 5%. 13 - 23 Although the RNA of the virus has been detected in blood and stool, fecal-oral and blood-borne transmissions are not regarded as significant modes of transmission yet. 19 - 26 There have been no reports of mother-to-fetus transmission in pregnant women. 27

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SARS-CoV-2 mode of transmission and clinical manifestations are illustrated in this figure. The potential source of this outbreak was identified to be from animals, similar to MERS and SARS, in epidemiologic studies; nonetheless, person-to-person transmission through droplets is currently the important mode. After reaching mucous membranes by direct or indirect close contact, the virus replicates in the cells and the immune system attacks the body due to its nature. Afterward, the clinical pictures appear, which are much more similar to influenza. However, different patients will have a spectrum of signs and symptoms.

Source Investigation

Recently, the appearance of SARS-CoV-2 in society shocked the healthcare system. 28 - 32 Veterinary corona virologists reported that COVID-19 was isolated from wildlife. Several studies have shown that bats are receptors of the CoV new version in 2019 with variants and changes in the environment featuring various biological characteristics. 33 - 36 The aforementioned mammals are a major source of CoV, which causes mild-to-severe respiratory illness and can even be deadly. In recent years, the virus has killed several thousands of people of all ages. 37 - 39 The mutated alternative of the virus can be transmitted to humans and cause acute respiratory distress. 40 , 41 One of the main causes of the spread of the virus is the exotic and unusual Chinese food in Wuhan: CoV is a direct result of the Chinese food cycle. The virus is found in the body of animals such as bats, 42 and snake or bat soup is a favorite Chinese food. Therefore, this sequence is replicated continuously. Almost everyone who was infected for the first time was directly in the local Wuhan market or had indirectly tried snake or bat soup in a Chinese restaurant. An investigation stated that the Malayan pangolin (Manis javanica) was a possible host for SARS-CoV-2 and recommended that it be removed from the wet market to prevent zoonotic transmissions in the future. 43 , 44

Pathogenesis

The important mechanisms of the severe pathogenesis of SARS-CoV-2 are not fully understood. Extensive lung injury in SARS-CoV-2 has been related to increased virus titers; monocyte, macrophage, and neutrophil infiltrations into the lungs; and elevated levels of pro-inflammatory cytokines and chemokines. Thus, the clinical exacerbation of SARS-CoV-2 infection may be in consequence of a combination of direct virus-induced cytopathic and immunopathological effects due to excessive cytokinesis. Changes in the cytokine/chemokine profile during SARS infection showed increased levels of circulating cytokines such as tumor necrosis factor-α (TNF-α), C–X–C motif chemokine 10 (CXCL10), interleukin (IL)-6, and IL-8 levels, in conjunction with elevated levels of serum pro-inflammatory cytokines such as IL-1, IL-6, IL-12, interferon-gamma (IFN-γ), and transforming growth factor-β (TGF-β). Nevertheless, constant stimulation by the virus creates a cytokine storm that has been related to acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndromes (MODS) in patients with COVID-19, which may ultimately lead to diminished immunity by lowering the number of CD4+ and CD8+ T cells and natural killer cells (crucial in antiviral immunity) and decreasing cytokine production and functional ability (exhaustion). It has been shown that IL-10, an inhibitory cytokine, is a major player and a potential target for therapeutic aims. 45 - 51 Severe cases of COVID-19 have respiratory distress and failure, which has been linked to the altered metabolism of heme by SARS-CoV-2. Some virus proteins can dissociate iron from porphyrins by attacking the 1-β chain of hemoglobin, which decreases the oxygen-transferring ability of hemoglobin. Research has also indicated that chloroquine and favipiravir might inhibit this process. 52

Clinical Manifestations

SARS-CoV-2, which attacks the respiratory system, has a spectrum of manifestations; nonetheless, it has three main primary symptoms after an incubation period of about two days to two weeks: fever and its associated symptoms such as malaise/fatigue/weakness; cough, which is nonproductive in most of the cases but can be productive indeed; and shortness of breath (dyspnea) due to low blood oxygenation. Although these symptoms appear in the body of the affected person over two to 14 days, patients may refer to the clinic with gastrointestinal symptoms (nausea/vomiting-diarrhea) or decreased sense of smell and/or taste. More devastatingly, however, patients may refer to the emergency room with such coagulopathies as pulmonary thromboembolism, cerebral venous thrombosis, and other related manifestations. The WHO has stated that dry throat and dry cough are other symptoms detected in the early stages of the infection. 53 , 54 The estimations of the severity of the disease are as follows: mild (no or mild pneumonia) in 81%, severe (eg, with dyspnea, hypoxia, or >50% lung involvement on imaging within 24 to 48 hours) in 14%, and critical (eg, with respiratory failure, shock, or multiorgan dysfunction) in 5%. In the early stages, the overall mortality rate was 2.3% and no deaths were observed in non-severe patients. Patients with advanced age or underlying medical comorbidities have more mortality and morbidity. 55 Although adults of middle age and older are most commonly affected by SARS-CoV-2, individuals at any age can be infected. A few studies have reported symptomatic infection in children; still, when it occurs, it has mild symptoms. The vast majority of cases have the infection with no signs and symptoms or mild clinical pictures; they are called “the asymptomatic group”. These patients do not seek medical care and if they come into close contact with others, they can spread the virus. Therefore, quarantine in their home is the best option for the population to break the transmission of the virus. It should be considered that some of these asymptomatic patients have clinical signs such as chest computed tomography scan (CT-Scan) infiltrations. Similar to bacterial pneumonia, lower respiratory signs and symptoms are the most frequent manifestations in serious cases of COVID-19, characterized by fever, cough, dyspnea, and bilateral infiltrates on chest imaging. In a study describing pneumonia in Wuhan, the most common clinical signs and symptoms at the onset of the illness were fever in 99% (although fever might not be a universal finding), fatigue in 70%, dry cough in 59%, anorexia in 40%, myalgia in 35%, dyspnea in 31%, and sputum production in 27%. Headache, sore throat, and rhinorrhea are less common, and gastrointestinal symptoms (eg, nausea and diarrhea) are relatively rare. 7 , 42 , 43 , 45 - 48 , 56 , 57 According to our clinical experience in Iran, anosmia, atypical chest pain, diarrhea, nausea/vomiting, and hemoptysis are other presenting symptoms in the clinic. It should be noted that COVID-19 has some unexplained potential complications such as secondary bacterial infections, myocarditis, central nervous system injury, cerebral edema, MODS, acute demyelinating encephalomyelitis (ADEM), kidney injury, liver injury, new-onset seizure, coagulopathy, and arrhythmias.

Laboratory data : Complete blood counts, which constitute a routine laboratory test, have shown different results in terms of the white blood cell count: from leukopenia and lymphopenia to leukocytosis, although lymphopenia appears to be the most common. Fatal cases have exhibited severe lymphopenia accompanied by an increased level of D-dimer. Liver function enzymes can be increased; however, it is not sufficient to diagnose a disease. The serum procalcitonin level is a marker of infection, especially in bacterial diseases. Patients with COVID-19 who require intensive care unit (ICU) management may have elevated procalcitonin. Increased urea and creatinine, creatinine-phosphokinase, lactate dehydrogenase, and C-reactive protein are other findings in some cases. 7 , 56 , 57

Imaging studies : Routine chest X-ray (CXR) is widely deemed the first-step management to evaluate any respiratory involvement. Although negative findings in CXR do not rule out the viral disease, patients without common findings do not have severe disease and can, consequently, be managed in the outpatient setting. 58 , 59 Another modality is chest CT-Scan. It can be ordered in suspected cases with typical symptoms at the first step, or it can be performed after the detection of any abnormalities in CXR. The most common demonstrations in CT-Scan images are ground-glass opacification, round opacities, and crazy paving with or without bilateral consolidative abnormalities (multilobar involvement) in contrast to most cases of bacterial pneumonia, which have locally limited involvement. Pleural thickening, pleural effusion, and lymphadenopathy are less common. 58 - 61 Tree-in-bud, peribronchial distribution, nodules, and cavity are not in favor of common COVID-19 findings. Although reverse transcriptase-polymerase chain reaction (RT-PCR) is used to confirm the diagnosis, it is a time-consuming procedure and has high false-negative/false-positive findings; hence, in the emergency clinical setting, CT-Scan findings can be a good approach to make the diagnosis. It is deserving of note, however, that false-positive/false-negative cases were reported by one study to be high and other differential diagnoses should be in mind in order not to miss any other cases such as acute pulmonary edema in patients with heart disease.

Suspected cases should be diagnosed as soon as possible to isolate and control the infection immediately. COVID-19 should be considered in any patient with fever and/or lower respiratory tract symptoms with any of the following risk factors in the previous 2 weeks: close contact with confirmed or suspected cases in any environment, especially at work in healthcare places without sufficient protective equipment or long-time standing in those places, and living in or traveling from well-known places where the disease is an epidemic. 61 - 66 Patients with severe lower respiratory tract disease without alternative etiologies and a clear history of exposure should be considered having COVID-19 unless confirmed otherwise. According to the Centers for Disease Control and Prevention (CDC), sending tests to check SARS-CoV-2 in suspected cases is based on physicians’ clinical judgment. Although there are some positive cases without clinical manifestations (ie, fever and/or symptoms of acute respiratory illness such as cough and dyspnea), infectious disease and control centers should take action in society to limit the exposure of such patients to other healthy individuals. The CDC prioritizes the use of the specific test for hospitalized patients, symptomatic patients who are at risk of fatal conditions (eg, age ≥65 y, chronic medical conditions, and immunocompromising conditions) and those who have exposure risks (recent travel, contact with patients with COVID-19, and healthcare workers). 61 - 66 Although treatment should be started after the confirmation of the disease, RT-PCR for highly suspected cases is a time-consuming test; accordingly, a considerable number of clinicians favor the use of a combination of clinical manifestations with imaging modalities (eg, CT-Scan findings) and their clinical judgment regarding the probability of the disease in order not to lose more time. 61 - 66

Treatment of COVID-19

There is no confirmed recommended treatment or vaccine for SARS-CoV-2; prevention is, therefore, better than treatment. Nevertheless, the high contagiousness of COVID-19, combined with the fact that some individuals fail to adhere to precautionary measures or they have significant risk factors, means that this infectious disease is inevitable in some people. Beside supportive treatments, many types of medications have been introduced. These medications come from previous experimental studies on SARS, MERS, influenza, or human immunodeficiency virus (HIV); hence, their efficacy needs further experimental and clinical approval. Patients with mild symptoms who do not have significant risk factors should be managed in their home like a self-made quarantine (in an isolated room); still, prompt hospital admission is required if patients exhibit signs of disease deterioration. 25 , 67 , 68 Isolation from other family members is an important prevention tip. Patients should wear face masks, eat healthy and warm foods similar to when struggling with influenza or colds, do the handwashing process, dispose of the contaminated materials cautiously, and disinfect suspicious surfaces with standard disinfectants. 69 Patients with severe symptoms or admission criteria should be hospitalized with other patients who have the same disease in an isolated department. When the disease is progressed, ICU care is mandatory. 25 , 67 , 68 SARS-CoV-2 attacks the respiratory system, diminishing the oxygenation process and forcing patients with low blood oxygen saturation to take extra oxygen from different modalities. Nasal cannulae, face masks with or without a reservoir, intubation in severe cases, and then extracorporeal membrane oxygenation in refractory hypoxia have been used; however, the safety and efficacy of these measures should be evaluated. As was mentioned above, impaired coagulation is one of the major complications of the disease; consequently, alongside all recommended supportive care and drugs, anticoagulants such as heparin should be administered prophylactically ( Table 1 ). Although it is said that all the clinical signs and symptoms of COVID-19 are induced by the immune system, as other research on influenza and MERS has revealed, glucocorticoids are not recommended in COVID-19 pneumonia unless other indications are present (eg, exacerbation of chronic obstructive pulmonary disease and refractory septic shock) due to the high risk of mortality and delayed viral clearance. Earlier in the national and international guidelines, nonsteroidal anti-inflammatory drugs such as naproxen were recommended on the strength of their antipyretic and anti-inflammatory components; however, the guideline has been revised recently and acetaminophen with or without codeine is currently the favored drug in patients with COVID-19. 25 , 67 , 68 According to the pathogenesis of the disease, whereby cytokine storm and immune-cell exhaustion can be seen in severe cases, selective antibodies against harmful interleukins such as IL-6 and IL-10 or other possible agents can be therapeutic for fatal complications. Tocilizumab, an IL-6 inhibitor, albeit with limited clinical efficacy, has been introduced in China’s National Health Commission treatment guideline for severe infection with profound pulmonary involvement (ie, white lung). 70 , 87

Summary of possible anti-COVID-19 drugs

mg, Milligrams; BD, Every 12 hours; RdRP, RNA-dependent RNA polymerase; TDS, Every 8 hours; IV, Intravenous; IL, Interleukin; μg, Micrograms

RNA synthesis inhibitors (eg, tenofovir disoproxil fumarate and 2’-deoxy-3’-thiacytidine [3TC]), neuraminidase inhibitors (NAIs), nucleoside analogs, lopinavir/ritonavir, atazanavir, remdesivir, favipiravir, INF-β, and Chinese traditional medicine (eg, Shufeng Jiedu and Lianhuaqingwen capsules) are the major candidates for COVID-19. 26 , 70 , 85 , 88 - 96 Antiviral drugs have been investigated for various diseases, but their efficacy in the treatment of COVID-19 is under investigation and several randomized clinical trials are ongoing to release a consensus result on the treatment of this infectious disease. Moderate-to-severe SARS-CoV-2 disease needs drug therapy. Favipiravir, a previously validated drug for influenza, is a drug that has shown promising results for COVID-19 in experimental and clinical studies, but it is under further evaluation. 70 , 79 , 80 Remdesivir, which was developed for Ebola, is an antiviral drug that is under evaluation for moderate-to-severe COVID-19 owing to its promising results in in vitro investigations. 70 , 73 - 75 , 81 Remdesivir was shown to have reduced the virus titer in infected mice with MERS-CoV and improved lung tissue damage with more efficiency compared with a group treated with lopinavir/ritonavir/INF-β. 67 , 70 Another investigation studied the potential efficacy of INF-β-1 in the early stages of COVID-19 as a potential antiviral drug. 86 Although there is some hope, an evidence-based consensus requires further clinical trials. 70 , 77 A combined protease inhibitor, lopinavir/ritonavir, is used for HIV infection and has shown interesting results for SARS and MERS in in vitro studies. 73 - 75 The clinical effectiveness of lopinavir/ritonavir for SARS-CoV-2 was also reported in a case report. 70 , 71 , 74 , 76 Atazanavir, another protease inhibitor, with or without ritonavir is another possible anti-COVID-19 treatment. 77 , 78 NAIs, including oseltamivir, zanamivir, and peramivir, are recommended as antiviral treatment in influenza. 68 Oral oseltamivir was tried for COVID-19 in China and was first recommended in the Iranian guideline for COVID-19 treatment; nevertheless, because of the absence of strong evidence indicating its efficacy for SARS-CoV-2, it was eliminated from the subsequent updates of the guideline. 85 RNA-dependent RNA polymerase inhibitors with anti-hepatitis C effects such as ribavirin have shown satisfactory results against SARS-CoV-2 RNA polymerase; however, they have limited clinical approval. 82 - 84 The well-known drugs for rheumatoid arthritis, systemic lupus erythematosus, and an antimalarial drug, chloroquine 71 and hydroxychloroquine 21 are other potential drugs for moderate-to-severe COVID-19 but with limited or no clinical appraisal. Hydroxychloroquine has exhibited better safety and fewer side effects than chloroquine, which makes it the preferred choice. 70 Furthermore, the immunomodulatory effects of hydroxychloroquine can be used to control the cytokine precipitation in the late phases of SARS-CoV-2 infections. There are numerous mechanisms for the antiviral activity of hydroxychloroquine. A weak base drug, hydroxychloroquine concentrates on such intracellular sections as endosomes and lysosomes, thereby halting viral replication in the phase of fusion and uncoating. Additionally, this immunosuppressive and antiparasitic drug is capable of altering the glycosylation of ACE2 and inhibiting both S-protein binding and phagocytosis. 72 A recent multicenter study showed that regarding the risks of cardiovascular adverse effects and mortality rates, hydroxychloroquine or chloroquine with or without a macrolide (eg, azithromycin) was not beneficial for hospitalized patients, although further research is needed to end such controversies. 97

Disease Duration

It is not easy to quarantine the patients who have fully recovered because there is evidence that they are highly infectious. 81 The recovery time for confirmed cases based on the National Health Commission reports of China’s government was estimated to range between 18 and 22 days. 73 As indicated by the WHO, the healing time seems to be around two weeks for moderate infections and 3 to 6 weeks for the severe/ serious disease. 75 Pan Feng and others studied 21 confirmed cases with COVID-19 pneumonia with about 82 CT-Scan images with a mean interval of four days. Lung abnormalities on chest CT showed the highest severity approximately 10 days after the initial onset of symptoms. All patients became clear after 11 to 26 days of hospitalization. From day zero to day 26, four stages of lung CT were defined as follows: Stage 1 (first 4 days): ground-glass opacities; Stage 2 (second 4 days): crazy-paving patterns; Stage 3 (days 9–13): maximum total CT scores in the consolidations; and Stage 4 (≥14 d): steady improvements in the consolidations with a reduction in the total CT score without any crazy-paving pattern. 74 Nevertheless, there are also rare cases reported from some studies that show the recurrence of COVID-19 after negative preliminary RT-PCR results. For example, Lan and othersstudied one hospitalized and three home-quarantined patients with COVID-19 and evaluated them with RT-PCR tests of the nucleic acid. All the patients with positive RT-PCR test results had CT imaging with ground-glass opacification or mixed ground-glass opacification and consolidation with mild-to-moderate disease. After antiviral treatments, all four patients had two consecutive negative RT-PCR test results within 12 to 32 days. Five to 13 days after hospital discharge or the discontinuation of the quarantine, RT-PCR tests were repeated, and all were positive. An additional RT-PCR test was performed using a kit from a different manufacturer, and the results were also positive. Their findings propose that a minimum percentage of recovered patients may still be infection carriers. 76

Supplements for COVID-19

Since the appearance of SARS-CoV-2 in Wuhan, China, there have been reports of the unreliable and unpredictable use of mysterious therapies. Some recommendations such as the use of certain herbs and extracts including oregano oil, mulberry leaf, garlic, and black sesame may be safe as long as people do not utilize their hands for instance. 98 According to data released by the CDC, vitamin C (VitC) supplements can decrease the risk of colds in people besides preventing CoV from spreading. The aforementioned organization states that frequent consumption of VitC supplements can also decrease the duration of the cold; however, if used only after the cold has risen, its consumption does not influence the disease course. VitC also plays an important role in the body. One of the main reasons for taking VitC is to strengthen the immune system because this vitamin plays a significant part in the immune system. Firstly, VitC can increase the production of white blood cells (lymphocytes and phagocytes) in the bone marrow, which can support and protect the body against infections. Secondly, VitC helps immune cells to function better while preserving white blood cells from damaging molecules such as free oxidative radicals and ions. Thirdly, VitC is an essential part of the skin’s immune system. This vitamin is actively transported to the skin surface, where it serves as an antioxidant and helps to strengthen the skin barrier by optimizing the collagen synthesis process. Patients with pneumonia have lower levels of VitC and have been revealed to have a longer recovery time. 69 , 99 In a randomized investigation, 200 mg/d of VitC was applied to older patients and resulted in improvements in the respiratory symptoms. Another investigation reported 80% fewer mortalities in a controlled group of VitC takers. 73 However, for effective immune system improvement, VitC should be consumed alongside adequate doses of several other supplements. Although VitC plays an important role in the body, often a balanced diet and the consumption of fresh fruits and vegetables can quickly fill the blanks. While taking high amounts of VitC is less risky because it is water-soluble and its waste is eliminated in the urine, it can induce diarrhea, nausea, and abdominal spasms at higher concentrations. Too much VitC may cause calcium-oxalate kidney stones. People with genetic hemochromatosis, an iron deficiency disorder, should consult a physician before taking any VitC supplements as high levels of VitC can lead to tissue damage. Some studies have evaluated the different doses of oral or intravenous VitC for patients admitted to the hospital for COVID-19. Although they used different regimens, all of them demonstrated satisfactory results regarding the resolution of the compilations of the disease, decreased mortality, and shortened lengths of stay in the ICU and/or the hospital. 100 , 101 Immunologists have also recommended 6 000 units of vitamin A (VitA) per day for two weeks, more than twice the recommended limit for VitA, which can create a poisoning environment over time. According to the guidance of the National Institutes of Health (NIH), middle-aged men and women should take 1 and 2 mg of VitA every day, respectively. The safe upper limit of this vitamin is 6000 mg or 5000 units, and overdose can have serious outcomes such as dizziness, nausea, headache, coma, and even death. Extreme consumption of VitA throughout pregnancy can lead to birth anomalies.

Similar to VitC, vitamin D (VitD) has antioxidant, anti-inflammatory, and immune-modulatory effects in our body such as reducing pro-inflammatory cytokines and inhibiting viral replication according to experimental studies. 83 The VitD state of our body is checked through 25 (OH) VitD in the serum. VitD deficiency is pandemic around the world due to multifactorial reasons. It has been shown that VitD deficient patients are prone to SARS-CoV-2 and, accordingly, treating VitD deficiency is not without benefits. Grant and others recommended 10 000 units per day for two weeks and then 5 000 units per day as the maintenance dose to keep the level between 40 and 100 ng/mL. 102 VitD toxicity causes gastrointestinal discomfort (dyspepsia), congestion, hypercalcemia, confusion, positional disorders, dysrhythmia, and kidney dysfunction.

James Robb, 103 a researcher who detected CoV for the first time as a consultant pathologist with the National Cancer Institute of America, suggested the influence of zinc consumption. Oral zinc supplements can be dissolved in the nback of the throat. Short-term therapy with oral zinc can decrease the duration of viral colds in adults. Zinc intake is also associated with the faster resolution of nasal congestion, nasal drainage, sore throats, and coughs. Researchers 104 , 105 have warned that the consumption of more than 1 mg of zinc a day can lead to zinc poisoning and have side effects such as lowered immune function. Children and old people with zinc insufficiency in developing nations are extremely vulnerable to pneumonia and other viral infections. It has also been determined that zinc has a major role in the production and activation of T-cell lymphocytes. 106 , 107

And finally, for high-risk people or those who work in high-risk places such as healthcare providers, hydroxychloroquine has been mentioned to be effective as a prophylactic regimen ( Table 2 ). Although different doses have been investigated so far, Pourdowlat and others recommended 200 mg daily before exposure, and for the post-exposure scenario, a loading dose of 600-800 mg followed by a maintenance dose of 200 mg daily. 74

Possible prophylactic regimens against SARS-CoV-2 infection

IU, International unit; mg, Milligrams; kg, Kilograms; ICU, Intensive care unit; g, Grams; IV, Intravenous; Vit, Vitamin; ng, Nanograms; mL, Milliliter

COVID-19 Kits and Deep Learning

COVID-19 has threatened public health, and its fast global spread has caught the scientific community by surprise. 108 Hence, developing a technique capable of swiftly and reliably detecting the virus in patients is vital to prevent the spreading of the virus. 109 , 110 One of the ways to diagnose this new virus is through RT-PCR, a test that has previously demonstrated its efficacy in detecting such CoV infections as MERS-CoV and SARS-CoV. Consequently, increasing the availability of RT-PCR kits is a worldwide concern. The timing of the RT-PCR test and the type of strain collected are of vital importance in the diagnosis of COVID-19. One of the characteristics of this new virus is that the serum is negative in the early stage, while respiratory specimens are positive. The level of the virus at the early stage of the illness is also high, even though the infected individual experiences mild symptoms. 111 For the management of the emerging situation of COVID-19 in Wuhan, various effective diagnostic kits were urgently made available to markets. While a few different diagnostics kits are used merely for research endeavors, only a single kit developed by the Beijing Genome Institute (BGI) called “Real-Time Fluorescent PCR” has been authenticated for clinical diagnostics. Fluorescent RT-PCR is reliable and able to offer fast results probably within a few hours (usually within two hours). Besides RT-PCR, China has successfully developed a metagenomic-sequencing kit based on combinatorial probe-anchor synthesis that can identify virus-related bacteria, allowing observation and evaluation during the transmission of the virus. Furthermore, the metagenomic-sequencing kit based on combinatorial probe-anchor synthesis is far faster than the abovementioned fluorescent RT-PCR kit. Apart from China, a Singapore-based laboratory, Veredus, developed a virus detection kit (Vere-CoV) in late January. It is a portable Lab-On-Chip used to detect MERS-CoV, SARS-CoV, and SARS-CoV-2, in a single examination. This kit works based on the VereChip™ technology, the lines of code (LOC) program incorporating two different influential molecular biological functions (microarray and PCR) precisely. Several studies have focused on SARS-CoV diagnostic testing. These papers have presented investigative approaches to the identification of the virus using molecular testing (ie, RT-PCR). Researchers probed into the use of a nested PCR technique that contains a pre-amplification step or integrating the N gene as an extra subtle molecular marker to improve on the sensitivity. 112 - 115 CT-Scan is very useful for diagnosing, evaluating, and screening infections caused by COVID-19. One recommendation for scanning the disease is to take a scan every three to five days. According to researchers, most CT-Scan images from patients with COVID-19 are bilateral or peripheral ground-glass opacification, with or without stabilization. Nowadays, because of a paucity of computerized quantification tools, only qualitative reports and sometimes inaccurate analyses of contaminated areas are drawn upon in radiology reports. A categorization system based on the deep learning approach was proposed by a study to automatically measure infected parts and their volumetric ratios in the lung. The functionality of this system was evaluated by making some comparisons between the infected portions and the manually-delineated ones on the CT-Scan images of 300 patients with COVID-19. To increase the manual drawing of training samples and the non-interference in the automated results, researchers adopted a human-based approach in collaboration with radiologists so as to segment the infected region. This approach shortens the time to about four minutes after 3-time updating. The mean Dice similarity coefficient illustrated that the automatically detected infected parts were 91.6% similar to the manually detected ones, and the average of the percentage estimated error was 0.3% for the whole lung. 116 , 117

Prevention Considerations

In the healthcare setting, any individual with the manifestations of COVID-19 (eg, fever, cough, and dyspnea) should wear a face mask, have a separate waiting area, and keep the distance of at least two meters. Symptomatic patients should be asked about recent travel or close contact with a patient in the preceding two weeks to find other possible infected patients. The CDC and WHO have announced special precautions for healthcare providers in the hospital and during different procedures. Wearing tight-fitting face masks with special filters and impermeable face shields is necessary for all of them. 11 , 18 , 65 , 66 , 76 , 118 - 124 Other people should pay attention to the CDC and WHO preventive strategies, which recommend that individuals not touch their eyes, mouth, and nose before washing or disinfecting their hands; wash their hands regularly according to the standard protocol; use effective disinfection solutions (ie, containing at least 60% ethylic alcohol) for contaminated surfaces; cover their mouth when coughing and sneezing; avoid waiting or walking in crowded areas, and observe isolation protocols in their home. Postponing elective work and decreasing non-urgent visits and traveling to areas in the grip of COVID-19 may be useful to lessen the risk of exposure. If suspected individuals with mild symptoms are managed in outpatient settings, an isolated room with minimal exposure to others should be designed. Patients and their caregivers should wear tight-fitting face masks. 11 , 18 , 65 , 66 , 76 , 118 - 124 Substantial numbers of individuals with COVID-19 are asymptomatic with potential exposure; accordingly, a screening tool should be employed to evaluate these cases. In addition to passport checks, corona checks have been incorporated into the protocols in airports and other crowded places. The use of a remote thermometer to measure body temperature leads to an increase in the number of false-negative cases. It is, thus, essential that everyone pay sufficient heed to the WHO and CDC recommendations in their daily life. Traveling is not prohibited, but it should be restricted and passengers from any country should be monitored. 11 , 18 , 65 , 66 , 76 , 118 - 124

SARS-CoV-2 is the new highly contagious CoV, which was first reported in China. While it had a zoonotic origin in the beginning, it subsequently spread throughout the world by human contact. COVID-19 has a spectrum of manifestations, which is not lethal most of the time. To diagnose this condition, physicians can avail themselves of laboratory and imaging findings besides signs and symptoms. RT-PCR is the gold standard, but it lacks sufficient sensitivity and specificity. Although there are some potential drugs for COVID-19 and some vitamins or minerals for prophylaxis, the best preventive strategies are quarantine (staying at home) and the use of personal protective equipment and disinfectants.

Acknowledgement

The authors express their gratitude toward the Supporting Organizations for Foreign Iranian Students, Islamic Azad University Isfahan (Khorasgan) Branch, and Isfahan University of Medical Sciences.

Conflict of Interest: None declared.

Students’ Essays on Infectious Disease Prevention, COVID-19 Published Nationwide

As part of the BIO 173: Global Change and Infectious Disease course, Professor Fred Cohan assigns students to write an essay persuading others to prevent future and mitigate present infectious diseases. If students submit their essay to a news outlet—and it’s published—Cohan awards them with extra credit.

As a result of this assignment, more than 25 students have had their work published in newspapers across the United States. Many of these essays cite and applaud the University’s Keep Wes Safe campaign and its COVID-19 testing protocols.

Cohan, professor of biology and Huffington Foundation Professor in the College of the Environment (COE), began teaching the Global Change and Infectious Disease course in 2009, when the COE was established. “I wanted very much to contribute a course to what I saw as a real game-changer in Wesleyan’s interest in the environment. The course is about all the ways that human demands on the environment have brought us infectious diseases, over past millennia and in the present, and why our environmental disturbances will continue to bring us infections into the future.”

Over the years, Cohan learned that he can sustainably teach about 170 students every year without running out of interested students. This fall, he had 207. Although he didn’t change the overall structure of his course to accommodate COVID-19 topics, he did add material on the current pandemic to various sections of the course.

“I wouldn’t say that the population of the class increased tremendously as a result of COVID-19, but I think the enthusiasm of the students for the material has increased substantially,” he said.

To accommodate online learning, Cohan shaved off 15 minutes from his normal 80-minute lectures to allow for discussion sections, led by Cohan and teaching assistants. “While the lectures mostly dealt with biology, the discussions focused on how changes in behavior and policy can solve the infectious disease problems brought by human disturbance of the environment,” he said.

Based on student responses to an introspective exam question, Cohan learned that many students enjoyed a new hope that we could each contribute to fighting infectious disease. “They discovered that the solution to infectious disease is not entirely a waiting game for the right technologies to come along,” he said. “Many enjoyed learning about fighting infectious disease from a moral and social perspective. And especially, the students enjoyed learning about the ‘socialism of the microbe,’ how preventing and curing others’ infections will prevent others’ infections from becoming our own. The students enjoyed seeing how this idea can drive both domestic and international health policies.”

A sampling of the published student essays are below:

Alexander Giummo ’22 and Mike Dunderdale’s ’23 op-ed titled “ A National Testing Proposal: Let’s Fight Back Against COVID-19 ” was published in the Journal Inquirer in Manchester, Conn.

They wrote: “With an expansive and increased testing plan for U.S. citizens, those who are COVID-positive could limit the number of contacts they have, and this would also help to enable more effective contact tracing. Testing could also allow for the return of some ‘normal’ events, such as small social gatherings, sports, and in-person class and work schedules.

“We propose a national testing strategy in line with the one that has kept Wesleyan students safe this year. The plan would require a strong push by the federal government to fund the initiative, but it is vital to successful containment of the virus.

“Twice a week, all people living in the U.S. should report to a local testing site staffed with professionals where the anterior nasal swab Polymerase Chain Reaction (PCR) test, used by Wesleyan and supported by the Broad Institute, would be implemented.”

Kalyani Mohan ’22 and Kalli Jackson ’22 penned an essay titled “ Where Public Health Meets Politics: COVID-19 in the United States ,” which was published in Wesleyan’s Arcadia Political Review .

They wrote: “While the U.S. would certainly benefit from a strengthened pandemic response team and structural changes to public health systems, that alone isn’t enough, as American society is immensely stratified, socially and culturally. The politicization of the COVID-19 pandemic shows that individualism, libertarianism and capitalism are deeply ingrained in American culture, to the extent that Americans often blind to the fact community welfare can be equivalent to personal welfare. Pandemics are multifaceted, and preventing them requires not just a cultural shift but an emotional one amongst the American people, one guided by empathy—towards other people, different communities and the planet. Politics should be a tool, not a weapon against its people.”

Sydnee Goyer ’21 and Marcel Thompson’s ’22 essay “ This Flu Season Will Be Decisive in the Fight Against COVID-19 ” also was published in Arcadia Political Review .

“With winter approaching all around the Northern Hemisphere, people are preparing for what has already been named a “twindemic,” meaning the joint threat of the coronavirus and the seasonal flu,” they wrote. “While it is known that seasonal vaccinations reduce the risk of getting the flu by up to 60% and also reduce the severity of the illness after the contamination, additional research has been conducted in order to know whether or not flu shots could reduce the risk of people getting COVID-19. In addition to the flu shot, it is essential that people remain vigilant in maintaining proper social distancing, washing your hands thoroughly, and continuing to wear masks in public spaces.”

An op-ed titled “ The Pandemic Has Shown Us How Workplace Culture Needs to Change ,” written by Adam Hickey ’22 and George Fuss ’21, was published in Park City, Utah’s The Park Record .

They wrote: “One review of academic surveys (most of which were conducted in the United States) conducted in 2019 found that between 35% and 97% of respondents in those surveys reported having attended work while they were ill, often because of workplace culture or policy which generated pressure to do so. Choosing to ignore sickness and return to the workplace while one is ill puts colleagues at risk, regardless of the perceived severity of your own illness; COVID-19 is an overbearing reminder that a disease that may cause mild, even cold-like symptoms for some can still carry fatal consequences for others.

“A mandatory paid sick leave policy for every worker, ideally across the globe, would allow essential workers to return to work when necessary while still providing enough wiggle room for economically impoverished employees to take time off without going broke if they believe they’ve contracted an illness so as not to infect the rest of their workplace and the public at large.”

Women’s cross country team members and classmates Jane Hollander ’23 and Sara Greene ’23 wrote a sports-themed essay titled “ This Season, High School Winter Sports Aren’t Worth the Risk ,” which was published in Tap into Scotch Plains/Fanwood , based in Scotch Plains, N.J. Their essay focused on the risks high school sports pose on student-athletes, their families, and the greater community.

“We don’t propose cutting off sports entirely— rather, we need to be realistic about the levels at which athletes should be participating. There are ways to make practices safer,” they wrote. “At [Wesleyan], we began the season in ‘cohorts,’ so the amount of people exposed to one another would be smaller. For non-contact sports, social distancing can be easily implemented, and for others, teams can focus on drills, strength and conditioning workouts, and skill-building exercises. Racing sports such as swim and track can compete virtually, comparing times with other schools, and team sports can focus their competition on intra-team scrimmages. These changes can allow for the continuation of a sense of normalcy and team camaraderie without the exposure to students from different geographic areas in confined, indoor spaces.”

Brook Guiffre ’23 and Maddie Clarke’s ’22 op-ed titled “ On the Pandemic ” was published in Hometown Weekly, based in Medfield, Mass.

“The first case of COVID-19 in the United States was recorded on January 20th, 2020. For the next month and a half, the U.S. continued operating normally, while many other countries began their lockdown,” they wrote. “One month later, on February 29th, 2020, the federal government approved a national testing program, but it was too little too late. The U.S. was already in pandemic mode, and completely unprepared. Frontline workers lacked access to N-95 masks, infected patients struggled to get tested, and national leaders informed the public that COVID-19 was nothing more than the common flu. Ultimately, this unpreparedness led to thousands of avoidable deaths and long-term changes to daily life. With the risk of novel infectious diseases emerging in the future being high, it is imperative that the U.S. learn from its failure and better prepare for future pandemics now. By strengthening our public health response and re-establishing government organizations specialized in disease control, we have the ability to prevent more years spent masked and six feet apart.”

In addition, their other essay, “ On Mass Extinction ,” was also published by Hometown Weekly .

“The sixth mass extinction—which scientists have coined as the Holocene Extinction—is upon us. According to the United Nations, around one million plant and animal species are currently in danger of extinction, and many more within the next decade. While other extinctions have occurred in Earth’s history, none have occurred at such a rapid rate,” they wrote. “For the sake of both biodiversity and infectious diseases, it is in our best interest to stop pushing this Holocene Extinction further.”

An essay titled “ Learning from Our Mistakes: How to Protect Ourselves and Our Communities from Diseases ,” written by Nicole Veru ’21 and Zoe Darmon ’21, was published in My Hometown Bronxville, based in Bronxville, N.Y.

“We can protect ourselves and others from future infectious diseases by ensuring that we are vaccinated,” they wrote. “Vaccines have high levels of success if enough people get them. Due to vaccines, society is no longer ravaged by childhood diseases such as mumps, rubella, measles, and smallpox. We have been able to eradicate diseases through vaccines; smallpox, one of the world’s most consequential diseases, was eradicated from the world in the 1970s.

“In 2000, the U.S. was nearly free of measles, yet, due to hesitations by anti-vaxxers, there continues to be cases. From 2000–2015 there were over 18 measles outbreaks in the U.S. This is because unless a disease is completely eradicated, there will be a new generation susceptible.

“Although vaccines are not 100% effective at preventing infection, if we continue to get vaccinated, we protect ourselves and those around us. If enough people are vaccinated, societies can develop herd immunity. The amount of people vaccinated to obtain herd immunity depends on the disease, but if this fraction is obtained, the spread of disease is contained. Through herd immunity, we protect those who may not be able to get vaccinated, such as people who are immunocompromised and the tiny portion of people for whom the vaccine is not effective.”

Dhruvi Rana ’22 and Bryce Gillis ’22 co-authored an op-ed titled “ We Must Educate Those Who Remain Skeptical of the Dangers of COVID-19 ,” which was published in Rhode Island Central .

“As Rhode Island enters the winter season, temperatures are beginning to drop and many studies have demonstrated that colder weather and lower humidity are correlated with higher transmissibility of SARS-CoV-2, the virus that causes COVID-19,” they wrote. “By simply talking or breathing, we release respiratory droplets and aerosols (tiny fluid particles which could carry the coronavirus pathogen), which can remain in the air for minutes to hours.

“In order to establish herd immunity in the US, we must educate those who remain skeptical of the dangers of COVID-19. Whether community-driven or state-funded, educational campaigns are needed to ensure that everyone fully comprehends how severe COVID-19 is and the significance of airborne transmission. While we await a vaccine, it is necessary now more than ever that we social distance, avoid crowds, and wear masks, given that colder temperatures will likely yield increased transmission of the virus.”

Danielle Rinaldi ’21 and Verónica Matos Socorro ’21 published their op-ed titled “ Community Forum: How Mask-Wearing Demands a Cultural Reset ” in the Ewing Observer , based in Lawrence, N.J.

“In their own attempt to change personal behavior during the pandemic, Wesleyan University has mandated mask-wearing in almost every facet of campus life,” they wrote. “As members of our community, we must recognize that mask-wearing is something we are all responsible and accountable for, not only because it is a form of protection for us, but just as important for others as well. However, it seems as though both Covid fatigue and complacency are dominating the mindsets of Americans, leading to even more unwillingness to mask up. Ultimately, it is inevitable that this pandemic will not be the last in our lifespan due to global warming creating irreversible losses in biodiversity. As a result, it is imperative that we adopt the norm of mask-wearing now and undergo a culture shift of the abandonment of an individualistic mindset, and instead, create a society that prioritizes taking care of others for the benefit of all.”

Shayna Dollinger ’22 and Hayley Lipson ’21 wrote an essay titled “ My Pandemic Year in College Has Brought Pride and Purpose. ” Dollinger submitted the piece, rewritten in first person, to Jewish News of Northern California . Read more about Dollinger’s publication in this News @ Wesleyan article .

“I lay in the dead grass, a 6-by-6-foot square all to myself. I cheer for my best friend, who is on the stage constructed at the bottom of Foss hill, dancing with her Bollywood dance group. Masks cover their ordinarily smiling faces as their bodies move in sync. Looking around at friends and classmates, each in their own 6-by-6 world, I feel an overwhelming sense of normalcy.

“One of the ways in which Wesleyan has prevented outbreaks on campus is by holding safe, socially distanced events that students want to attend. By giving us places to be and things to do on the weekends, we are discouraged from breaking rules and causing outbreaks at ‘super-spreader’ events.”

An op-ed written by Luna Mac-Williams ’22 and Daëlle Coriolan ’24 titled “ Collectivist Practices to Combat COVID-19 ” was published in the Wesleyan Argus .

“We are embroiled in a global pandemic that disproportionately affects poor communities of color, and in the midst of a higher cultural consciousness of systemic inequities,” they wrote. “A cultural shift to center collectivist thought and action not only would prove helpful in disease prevention, but also belongs in conversation with the Black Lives Matter movement. Collectivist models of thinking effectively target the needs of vulnerable populations including the sick, the disenfranchised, the systematically marginalized. Collectivist systems provide care, decentering the capitalist, individualist system, and focusing on how communities can work to be self-sufficient and uplift our own neighbors.”

An essay written by Maria Noto ’21 , titled “ U.S. Individualism Has Deadly Consequences ,” is published in the Oneonta Daily Star , based in Oneonta, N.Y.

She wrote, “When analyzing the cultures of certain East Asian countries, several differences stand out. For instance, when people are sick and during the cold and flu season, many East Asian cultures, including South Korea, use mask-wearing. What is considered a threat to freedom by some Americans is a preventive action and community obligation in this example. This, along with many other cultural differences, is insightful in understanding their ability to contain the virus.

“These differences are deeply seeded in the values of a culture. However, there is hope for the U.S. and other individualistic cultures in recognizing and adopting these community-centered approaches. Our mindset needs to be revolutionized with the help of federal and local assistance: mandating masks, passing another stimulus package, contact tracing, etc… However, these measures will be unsuccessful unless everyone participates for the good of a community.”

A published op-ed by Madison Szabo ’23 , Caitlyn Ferrante ’23 ran in the Two Rivers Times . The piece is titled “ Anxiety and Aspiration: Analyzing the Politicization of the Pandemic .”

John Lee ’21 and Taylor Goodman-Leong ’21 have published their op-ed titled “ Reassessing the media’s approach to COVID-19 ” in Weekly Monday Cafe 24 (Page 2).

An essay by Eleanor Raab ’21 and Elizabeth Nefferdorf ’22 titled “ Preventing the Next Epidemic ” was published in The Almanac .

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CORRESPONDENCE
18 February 2020

Coronavirus: global solutions to prevent a pandemic

Charlotte H. Watts ,
Patrick Vallance &
Christopher J. M. Whitty 2

You can also search for this author in PubMed Google Scholar

Government Department of Health and Social Care, London, UK.

You have full access to this article via your institution.

Investment in research must be fast-tracked if we are to tackle the new coronavirus disease, COVID-19. We need greater insight into the transmission, progression and epidemiology of this respiratory illness. We need to know the risk factors for infection, the role of asymptomatic or mild infection and the nature of ‘super-spreaders’. We must determine disease seasonality and the viability of the virus in hot, humid environments, and improve estimates of death rates by age.

Research relevant to countries with weaker surveillance, lab facilities and health systems should be prioritized. In those regions, vaccine supply routes should not rely on refrigeration, and diagnostics should be available at the point of care. The World Health Organization is mapping such research and development priorities.

Social-science issues are important, too. These include how to communicate to the public what the options are for managing and preventing the disease, and how to tackle misconceptions and fear and avoid stigmatization. Community engagement and responsibility must be encouraged.

Nature 578 , 363 (2020)

doi: https://doi.org/10.1038/d41586-020-00457-y

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Trials that infected people with common colds can inform today’s COVID-19 challenge trials

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ORIGINAL RESEARCH article

Face masks during the covid-19 pandemic: a simple protection tool with many meanings.

$\nLucia Martinelli$

1 MUSE – Science Museum, Trento, Italy
2 Faculty of Croatian Studies, University of Zagreb, Zagreb, Croatia
3 Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
4 Institute for the Study of Science, Technology and Innovation, The University of Edinburgh, Edinburgh, United Kingdom
5 Business Information Systems, Cork University Business School, University College Cork, Cork, Ireland
6 Communication and Society Research Centre, University of Minho, Braga, Portugal
7 University Hospital Medical Center “Bežanijska kosa”, and University of Belgrade Faculty of Medicine, Belgrade, Serbia
8 Department of Health Economics, Faculty of Medicine, University of Szeged, Szeged, Hungary
9 Department of Political Science, Centre for the Study of Contemporary Solidarity (CeSCoS), University of Vienna, Vienna, Austria
10 Department of Global Health & Social Medicine, King's College London, London, United Kingdom

Wearing face masks is recommended as part of personal protective equipment and as a public health measure to prevent the spread of coronavirus disease 2019 (COVID-19) pandemic. Their use, however, is deeply connected to social and cultural practices and has acquired a variety of personal and social meanings. This article aims to identify the diversity of sociocultural, ethical, and political meanings attributed to face masks, how they might impact public health policies, and how they should be considered in health communication. In May 2020, we involved 29 experts of an interdisciplinary research network on health and society to provide their testimonies on the use of face masks in 20 European and 2 Asian countries (China and South Korea). They reflected on regulations in the corresponding jurisdictions as well as the personal and social aspects of face mask wearing. We analyzed those testimonies thematically, employing the method of qualitative descriptive analysis. The analysis framed the four dimensions of the societal and personal practices of wearing (or not wearing) face masks: individual perceptions of infection risk, personal interpretations of responsibility and solidarity, cultural traditions and religious imprinting, and the need of expressing self-identity. Our study points to the importance for an in-depth understanding of the cultural and sociopolitical considerations around the personal and social meaning of mask wearing in different contexts as a necessary prerequisite for the assessment of the effectiveness of face masks as a public health measure. Improving the personal and collective understanding of citizens' behaviors and attitudes appears essential for designing more effective health communications about COVID-19 pandemic or other global crises in the future.

To wear a face mask or not to wear a face mask?

Nowadays, this question has been analogous

to the famous line from Shakespeare's Hamlet:

“To be or not to be, that is the question.”

This is a bit allegorical ,

but certainly not far from the current circumstances

where a deadly virus is spreading amongst us ... Vanja Kopilaš, Croatia.

Introduction

The coronavirus disease 2019 (COVID-19) pandemic is currently perceived as one of the greatest global threats, not only to public health and well-being, but also to global economic and social stability. While the first two decades of the third millennium were characterized by crisis—most notably the economic downturn of 2008 and the looming climate change—the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus originating from China has given rise to most drastic societal and political responses. These included measures as severe as states forbidding citizens from leaving their homes and effectively shutting down all social and economic activities ( 1 ). In Europe, Italy was the first country to officially detect the presence of COVID-19 in its territory, and it swiftly adopted measures to contain its spread ( 2 – 4 ). Within a few weeks, the epidemic progressively spread across Europe. Because of the novel situation and the contradictory opinions of experts, including representatives of the scientific community and World Health Organization (WHO), the level of threat caused by the disease appeared unclear ( 5 ). The assessment of the perceived risks of the disease varied in the public discourse—some considered it just as “a stronger influenza”; others drew parallels with the very deadly Spanish Flu outbreak in the 1918–1920, and many were simply not sure what to believe. Nevertheless, most felt the novel and unpleasant feeling of being vulnerable to the invisible threat of the infection (i.e., to be the ones in danger) or to be contagious themselves (i.e., to be the danger).

A variety of public health and hygiene measures have been initiated; the most visually noticeable perhaps is the wearing of face masks. The medical research on the use of face masks as personal protective equipment (PPE) against SARS-CoV-2 transmission was interpreted very cautiously, and the initial guidance from health officials was conflicting ( 6 ). The WHO advice was conceived to avoid unnecessary paternalism and at the same time be comprehensive in discussing different medical aspects of mask use. However, it was updated several times, shifting from initial statements that face masks are not to be worn by healthy individuals toward gradual adoption of face masks as useful in slowing community transmission. In particular, “…WHO has updated its guidance to advise that to prevent COVID-19 transmission effectively in areas of community transmission, governments should encourage the general public to wear masks in specific situations and settings as part of a comprehensive approach to suppress SARS-CoV-2 transmission” ( 7 ). Gradually, face mask use has been recognized as a suitable measure within the scientific community ( 8 – 12 ), if nothing else due to the application of the “precautionary principle” in the face of an acute crisis ( 13 , 14 ). This has since been backed up by empirical observations ( 15 , 16 ).

Different, mandatory or voluntary, practices, and contradictory indications about the utility of face mask wearing were introduced across affected countries. Generally speaking, face masks have been adopted as one of the measures to reduce the COVID-19 spread across Europe, despite the fact that wearing masks in Europe is not common or familiar, and it is often associated with Asian countries ( 17 ). The social conventions and personal meanings of face mask use have received relatively little attention. Its use is deeply connected to social and cultural practices, as well as political, ethical, and health-related concerns, personal, and social meanings ( 18 , 19 ).

In this study, our aim was to address three aspects of face mask wearing—public policies, individual behaviors and attitudes, and the collective experiences of the affected communities. In order to develop insights into the wider meanings of face mask wearing beyond (just) preventing the spread of infection, we tapped into the expertise of a scholarly interdisciplinary network, the Navigating Knowledge Landscapes—NKL ( http://knowledge-landscapes.hiim.hr/ ), predominantly consisting of Europe-based scholars. The network is dedicated to furthering research on topics related to medicine, health, and society and comprises academics working across the disciplinary spectrum. We invited NKL members in May 2020 to provide their observations on the topic, also based on their professional experience. They were asked to describe the face mask usage in their countries and provide their subjective standpoints and/or those from their social environment. Subsequently, these testimonies within the specific time window (May 2020) containing narratives on face masks from the contributing experts were thematically analyzed using the method of qualitative descriptive analysis ( 20 , 21 ).

Materials and Methods

The invitation to write their views about face mask wearing was sent by e-mail to 97 experts, all members of the interdisciplinary research network Navigating Knowledge Landscapes (NKL; http://knowledge-landscapes.hiim.hr/ ). The invitation was sent on May 11, 2020, and the responses were collected until May 26, 2020 (over 16 days' period). The experts were asked to contribute a single-page narrative structured in four parts, framed as follows:

• Part 1: What are the rules adopted in your country about face mask wearing? What would be the overall approach for use of the face masks in your community (government instructions, availability, the citizen compliance)?

• Part 2: What is your individual/personal attitude and practice in relation to face masks? If applicable, start with good practice and end with what you consider to be mistakes.

• Part 3: How do you judge the behavior of people you encounter? Face masks (or no face masks) and interpersonal interactions. Again, start with positive and end with negative.

• Part 4 (optional): free to say whatever you think is important to the practices of your community in relation to face masks.

Twenty-nine scholars responded (30% of those invited), providing 27 contributions (two contributions were coauthored). They were from 22 countries, 20 from Europe (Albania, Austria, Bosnia and Herzegovina, Croatia, Czechia, Estonia, Hungary, Italy, Ireland, Norway, Poland, Portugal, Romania, Serbia, Slovenia, Spain, Sweden, Turkey, Ukraine, and United Kingdom) and two from Asia (China and South Korea). The contributors belonged to the following academic disciplines: biology (2), economics (1), engineering (2), information systems (1), law (1), medicine (6), philosophy (5), psychology (1), and sociology (10).

The contributors as experts are all highly educated (Ph.D., holders or Ph.D., students), and most of them are employed in academic institutions and perform research activities in their respective disciplines. The authors of this study were among the contributors.

The testimonials were based on the aforementioned open-ended questions and narrative in style. “Face mask” was used as the umbrella term for all types of face coverings, from the custom-made cotton scarves to disposable surgical masks and medical-grade N95 respirators. This was done to preserve the authenticity of these narratives without going into detail about the medical or microbiological features of the different types of face coverings. In the same way, grammatical or vocabulary use of non-native English speakers was kept as it was. The contributions received were collected and published as a citable open-source dataset at Mendeley Data repository ( 22 ).

The contributions were thematically analyzed by employing a qualitative descriptive approach ( 23 ). We chose this method because it aimed to provide “rich descriptions about a phenomenon, which little may be known about” [( 23 ), p. 3] and was particularly useful for exploratory research such as our study. It is characterized by staying close to the empirical data, instead of seeking to provide a more conceptual interpretation of the phenomenon in question. Moreover, open-ended questions address different aspects of the same topic and allow formulating answers that could let respondents to frame face mask wearing according to their own personal views ( 24 ).

Concerning the thematic analysis, we divided testimonials in three categories. The first category captured the situation in the respondent's country; the subcategories we were interested in were the regulatory framework and the supply situation in each respective country. The second category captured experts' own use of masks. Here we focused in particular on whether and in which situations they reported to wear (or not wear) masks, what kind of face covering they used, and the meaning they ascribed to masks (e.g., mask wearing as a symbol of social cohesion). Third, we categorized the participants' accounts regarding the practices and attitudes of mask wearing they observed in others. We created an MS Excel file in which we collected the respondents' statements on these different categories. In a subsequent step, we analyzed the data for patterns and recurring topics. We looked for country-specific differences and similarities in regulations and practices. Moreover, we also paid close attention to how the experts made sense of their experiences with mask wearing and how the issues addressed were expressed (e.g., experts referring to folk stories, metaphors, or past incidents). When presenting our research results, we focused on the topics we identified as prevalent through our inductive analysis, and we contextualized it based on the published research.

The narratives analyzed in this study were given with the full consent of the people who wrote them and were made available for public access as an open-source repository for the research purpose ( 22 ). All the authors provided their consent that the narratives are published in the repository under their full name and affiliation and that they can be used for research purposes. The authors were cited here under their full names, recognizing their authorship of the narratives and their contribution to the dataset collection. The study received ethical approvals from the Ethical Committees of the University of Edinburgh, Scotland, UK and the University of Zagreb, Faculty of Croatian Studies, Croatia.

Face Mask Wearing From Medical to Public Settings

The use of a face mask—of various specifications according to the required degree of protection/function—is part of the PPE required in several professional activities, most noticeable in healthcare. One of the participants in this study, who works in healthcare, described her own experience in terms of the caring features of the face masks from medical to communal setting.

“ As an obstetrician–gynecologist, I am used with the mask, I feel it a part of my professional life, and I am trying to convince people that there is no way of considering the mask as an enemy but as a protection-like and umbrella against the rain, like a coat against the cold—and as a sign of civilization to protect our colleges and people around.” [Iuliana Ceausu, Romania]

The contextual transfer of face mask use from healthcare settings to public spaces is precisely the aspect of making the “outside world” closely resemble scientific apparatus. This includes measuring its success as a feature of the social power derived from the accuracy of the scientific prediction. For instance, Latour ( 25 ) specifically examines the public nature of Pasteur's demonstration of the efficacy of the process of animal vaccination by making a “prophecy” that vaccinated cattle on a pilot farm will survive, while other infected animals will perish. In the same way, the (anecdotally) apparent success of the use of face masks reinforces the belief in their utility and efficacy:

“ The people working in the shops would use the masks too… I see familiar faces of the employees all the times of lockdown, although they spend all time in the shop with many different customers, obviously they did not get sick. This was for me a major reassuring fact that the danger is not so high as it could be seen from the media.” [Srećko Gajović, Croatia]

It is worth remembering here the significant number of deaths of inadequately protected healthcare workers during the COVID-19 epidemic in various countries, mainly due to the lack of the appropriate PPE supplies ( 26 ).

The Politics of a Face Mask

Following initial confusion around the utility of face masks for slowing down the spread of COVID-19 pandemic, there is increasing scientific evidence to support citizens' wearing of face coverings, albeit the public health advice and legislation vary from country to country. A recent study in Germany indicated that a mandatory approach to face mask wearing achieved better compliance than voluntary one, and it was perceived as an effective, fair, and socially responsible measure ( 27 ).

In our study, accordingly, the reported country policies differed across rather a wide spectrum of approaches—ranging from legally mandated instructions to cover one's face in all public spaces reinforced by financial penalties (i.e., payable fines), to recommendations only, official indifference, or advice against this practice ( Table 1 ). We were interested how these policies related to the concurrent COVID-19 situation expressed as total number and increase of cases per million people in these countries during the period when experts made their contributions. We observed an obvious trend showing that the countries with more strict rules had better epidemiological situation than those not mandating the face mask usage ( Table 1 ).

Table 1 . Perception of the official policies on face mask usage in May 2020.

In some countries, face mask–related policies did not need to be prescribed as this was part of existing established habits; in the same way, no fines are necessary to get people to wash their hands. In particular, since the SARS epidemic in 2003, in many Asian countries, masks are customary wear used to protect against seasonal flu and the common cold. In China and South Korea, they are also employed to protect citizens from pollutants ( 17 , 29 ).

“ In South Korea, it is common to wear a mask to keep the cold from getting worse in the winter and to prevent the spread of cold to others. Also, as the yellow dust from China and fine dust became much severe, it was common for many people, especially children, to wear masks even before the corona crisis. For this reason, many families even had a lot of masks in their homes before the corona crisis. Personally, I'm familiar with wearing a mask, and I'd like to wear it in order not to harm other people, as I may be a potential patient.” [Jiwon Shim, South Korea]

In contrast, in the West, the use of face masks is rare in social settings. Hence, because of the public visibility of face mask usage, face masks became an ideological symbol in some countries, with divergent political mindsets governing their adaption or rejection ( 17 ). Political dividing lines were particularly apparent in the United States, where the President refused to wear a mask until the last days of July 2020, when the floundering poll numbers and the increasing numbers of COVID-19 cases prompted the need to recommend this health protection device ( 30 ). Thus, in the United States and elsewhere, face masks were used by citizens to express their opinions in public.

“ At the beginning of the pandemic, the use of masks had political connotations: since the government advised against their use, their wearing was even considered a form of political opinion.” [Iñigo de Miguel Beriain, Spain]

The public statement made by wearing (or not wearing) the face mask did not only address the political standpoints but have also been used to communicate various societally relevant statements, i.e., stating ethnical, religious, or cultural affiliations ( 31 ). For instance, many countries that before COVID-19 banned face coverings in public spaces are now mandating it, supporting the idea that the past bans were motivated on the basis of religious/cultural beliefs ( 17 ).

“ Ethical and moral dilemmas have already risen, especially in countries where Muslim minorities live. If you ban a burka covering the face due to security reasons, how would you deal with massive usage of face masks?” [Gentian Vyshka, Albania]

“ The decision to wear a face mask is not an easy one. Traditionally, face coverings are an indicator of political persuasion and religious belief. I perceive that the widespread covering of one's face in public is a significant cultural and social shift in Ireland.” [Ciara Heavin, Ireland]

“To Wear a Face Mask, or Not to Wear a Face Mask, That Is the Question…”

The collected narratives indicated that the contributors had a clear standpoint on their own face mask usage and developed arguments to support their decisions to wear or not to wear face masks.

“ As soon as I leave the house and find myself in the supermarket or in public places, I wear a mask. However, I do not wear a mask when I take a walk in the forest. I started wearing it even before it became mandatory. I think it is important to wear masks, especially to avoid endangering others, e.g., elderly people. I find it unspeakable when people who wear masks are ridiculed by those who do not wear masks. At least that's what happened to me in the beginning, before the mask duty… Many thought that the people wearing masks would want to protect themselves in particular. Very few thought that people wearing masks wanted to protect their social environment.” [Melike Sahinol, Turkey]

“ My personal view is that as long as the spread of the virus is under control (as it currently is), there is no need to make the masks obligatory. I personally have not worn a mask (have not purchased any either) with the exception of when I visited healthcare institution (provided by them). I must also say, though, that none of my family members are considered a vulnerable population. If my grandmother would live with us, I might think differently.” [Kadri Simm, Estonia]

What was exemplified in many narratives is that individual usage is not meant predominantly for an individual's self-protection, but the decision was based on people's relationship to others. The citizens' question “should I protect myself” evolved into “can I protect the others?”

“ I wear disposable masks, understanding they protect others from me, more than me from others. I wear them to demonstrate responsible behavior and attitude to benefit of society.” [Predrag Pale, Croatia]

The experiences of interaction with others in relation to face mask wearing were mentioned frequently, indicating the importance of the social context of individual behavior.

“ I experienced cases when my request to keep distance or to take on a mask properly was treated offensively or as a sign of mistrust…” [Christina Nasadyuk, Ukraine]

“ I put it on when I go to the grocery store because at the early stage of the pandemic, I was warned by the lady working at the counter that I am putting her life ‘in danger by not wearing a mask.' Obviously, I did not want to take chances with her life again, so I purchased one of those cloth masks.” [Vanja Kopilaš, Croatia]

However, many testimonies pointed out that masks have not been used properly. The health risks of incorrectly wearing a face mask represent an important argument against the use of face masks as a public health measure ( 32 ).

“ …25% wore masks improperly, on their necks, or covering only their mouths, but not noses. …They do not know how to put the mask on, and when they remove their masks, they touch the outside of the mask, which is inappropriate and wrong.” [Izet Mašić, Bosnia and Herzegovina]

“ Also, one can observe many cases of half-compliance or sham compliance. For instance, people do wear masks, but slide them down onto their chins or take them off completely while talking to someone on the street or speaking on the phone. And this is all a performance, keeping their masks somewhere within reach in case of the sudden emergence of police officers, who are indeed issuing fines for not wearing a mask.” [Aleksandra Głos, Poland]

This is even more complicated in situations when face masks were scarce (the stocks gradually improved through time in all examined locales).

“ During the early stages of disease progression, mask wearing was not a common practice, mainly due to the complete absence and highly inflated prices in stores.” [Rostyslav Bilyy, Ukraine]

“ I do not use face mask. In the early stage of the COVID-19 epidemic in Norway, my understanding was that available masks should be reserved for people in the health and caring sector.” [Anna Lydia Svalastog, Norway]

“ I think the biggest concern is that the mask has been in short supply for a long time, and that its trade has not been subject to official pricing, so prices have been uncontrolled… The mask was in short supply when emergency was announced, but it is now available in many places and can be obtained at the checkout of almost every grocery store if someone started shopping without it.” [Norbert Buzas, Hungary]

The shortage of masks ignited a burst of creativity in producing homemade masks, with a proliferation of tutorials for their production on the Internet and social media.

“ Nowhere was possible to come to the face masks. Typical situation: the government did announce decree, but it did not provide the means for its implementation. We as ordinary citizens need to improvise with needlework of masks at home as well. Taking in regard that immediately rapacious war profiteers did appear by selling masks the needlework of masks at home was even not the worst solution.” [Franc Mali, Slovenia]

“ Although during the first weeks there was lack of masks and respirators, it was great how many people proved their creativity. It concerned not only the textile reusable masks, but also design and development of respirators with higher level of protection. They were mostly printed on 3D printers. Later on, some of the approved types were taken by larger producers, and mass production started.” [Lenka Lhotska, Czechia]

Mask Wearing at the Interface of Personal and Social Responsibility

Besides being shaped by public discourse and social norms, risk perception also has a strong personal element. Some people seem like they do not care; others are quite relaxed, and some are more cautious. As for COVID-19, conflicting perspectives and emotions and even the psychological entrapment syndrome known as “cabin fever” (i.e., referencing long winter isolation in a small cabin) have been reported ( 33 ). Here, restricted microenvironments and quarantine are felt as secure places. The additional challenges were noticeable during the shift from the lockdown phase and the beginning of the so-called “phase 2” or “reopening” when people were allowed to leave their home again.

“ ‘Convivere,' i.e., ‘live together with' the virus is the expression used by experts and media, to describe the phase 2, but this narrative could result quite distressing: how glad would someone be when living with a submicroscopic entity, that is such dangerous?” [Lucia Martinelli, Italy]

During this second phase, going back to living with “the others” demands new social behavior/etiquette combined with increased safety measures. The face masks start to be part of the new everyday rituals of saying hello, having a coffee together, and protecting each other. The role of peers in shaping the behavior of others is significant. People not committed to wearing mask can feel peers' pressure to comply. Moreover, “a collapse between the status of being at risk and being a risk ” was noted ( 34 – 36 ).

“ The face mask, I realize, signals both positions, at the same time as it doesn't provide a definite answer: are you the risk object or the object at risk? Saying this, my individual attitude toward face masks cannot be pried apart from the social acceptance and use of the same. As long as the nonuse of face masks constitutes the norm, I will most likely interpret the usage as deviant and worrying. On the other hand, if the vast majority of the Swedish population would wear face masks, I would most likely start wearing a face mask as well. Here, the mass effect kicks in.” [Jennie Olofsson, Sweden]

“ The massive use of the masks among Albanian citizens… has become a normal well-adopted ritual of surviving, implemented as of a social significance for ‘not letting the virus in.' This social cohesion on the intrapersonal view as ‘to scare the virus” and ‘fear of an enemy' comes close to a group approach of ‘control and stability.' This ritual of social cohesion vis-à-vis the ‘fear of death' or ‘fear of the unknowing' is a similar to a psychological regression, when the individual survival depended largely from the herd.” [Gentian Vyshka, Albania]

“ For me, unlike other measures to contain the spread of the virus, the wearing of masks is predominantly a symbol of social cohesion and complying with the rules and not so much a measure to effectively protect myself and others from infection. The few times I saw someone without a mask entering a supermarket or the metro, my first thoughts were about social deviance and the arrogance of ignoring a commonly agreed-upon practice, and not about the risk of infection.” [Mirjam Pot & Barbara Prainsack, Austria]

Individual and collective responsibility and trust in the institutions and in the official assessment of risks and recommendations as to the adopted measures are crucial to build up a degree of epistemic agreement ( 37 ). However, this is perhaps more challenging in a contested environment of “recommendation trust” ( 38 ), which likely depends on communicating certainty ( 39 ), of which very little has been seen during COVID-19 pandemic. Hence, the acceptance of official advice varied among countries, cultures, and political contexts, with some degree of contradiction.

“ In general, there seems to be a relatively wide acceptance of government recommendations, but a very patchy uptake. Though the Scottish Government advice is trusted more than that from the UK Government, significant generational and cultural differences can be seen as to its implementation… in a multicultural society such as Scotland, there are some subtle differences between people from different cultural backgrounds and traditions who are either more accustomed to follow stricter government instructions, or from cultures where face mask wearing is more commonplace.” [Matjaž Vidmar, Scotland, UK]

“ Finally, as an anecdote, I would mention the recent case of expelling an opposition MP from the Assembly because he did not have a mask on his face, although the Prime Minister who warned the MP did not have a mask either.” [Zoran Todorović, Serbia]

The pandemic also seems to have reminded many people about the responsibility of humanity toward the preservation of all the living organisms and, as recognized by the Centers for Disease Control and Prevention ( 40 ), that our health is closely connected to the health of whole environment.

“ We should see ourselves as the most important participants and the biggest beneficiaries of public health, so we should take expert advice—wear mask. In other word, under this special situation, we need to work with medical experts, government to co-build a safe, harmonious and orderly living world with ‘One Health' concept, rather to resist or despise it.” [Bie Ying Long, China]

The Face Mask: A New Barrier Affecting Social Relations?

If we assume that in the near future we will be used to living with the pandemic, or even a series of pandemics, we are currently developing new norms for social interaction. Being with other people and enjoying their company are essential for our mental and physical well-being. How do these interactions include face mask usage? What will socializing look like in the era of physical distancing (i.e., “keeping a safe space between yourself and other people who are not from your household”) ( 41 )? These issues are being recognized as particularly challenging.

“ We must reinforce the message that face masks do not remove (or even reduce) the need for social distancing as well as excellent hand and respiratory hygiene. We need to avoid a situation where face masks become a weapon that could negatively impact our fight against this invisible enemy.” [Ciara Heavin, Ireland]

“ I believe the benefits of face masks may be overestimated and lead us into a false sense of security in which we take unwarranted risks—such as touching more objects and neglecting handwashing or going outside when suffering from a cough or cold. Therefore, my preference would be to give greater attention to other steps such as providing screens and visors for workers in public facing roles and reinforcing protective mechanisms around social distancing.” [Helena Webb & Sue Ziebland, England, UK]

“ Since the use of a mask started to become widespread, people seem to feel safer and unfortunately are more at risk, for example, not maintaining physical distance, making appointments with extended family and friends, etc.” [Helena Machado, Portugal]

Not all evidence is in support of above assessments that face masks bring about a (false) sense of security. In a recent study conducted in the Italian Venice metropolitan area, wearing a mask has proven to be a visual factor strengthening physical distancing as a public health measure ( 3 ). Between February 24 and April 29, 2020, distances have been measured by an operator wearing an exclusive sensor-based “social distancing belt.” They were interchangeably “unmasked,” “masked,” “do it yourself (DIY)-masked,” “goggles masked,” and “goggles DIY-masked.” Results show that people tended to stay closer to an unmasked person, while mask wearing tended to increase the physical distance. This paradox is explained by considering humans' intrinsic social nature that favors social vs. antisocial behaviors ( 3 ). Wearing a mask thus can turn unconscious social behavior into conscious antisocial behavior.

“ I believe that due to the extraordinarity of wearing face coverings in public spaces in Scotland, these do not encourage an undue feeling of ‘safety' by their use, rather the reverse. Hence, with full awareness that the evidence for being protected by this measure is not there, rather, I hope that by wearing a face covering, I may remind (or even deter) others from breaking social distancing rules.” [Matjaž Vidmar, Scotland, UK]

Marchiori's study ( 3 ) also suggests that distance increases with face mask wearing, thus supporting the importance of visual stimuli as a signal of danger. This fact recalled in the mind of our colleague, Bie Ying Long, the ancient Chinese tale of “The Blind Man Who Lights a Lantern While He Walks in the Night,” which proposes a “wise” interpretation of action as interplay of altruism and self-interest ( 42 ). When people asked a blind man for the reason why was he carrying a large lantern when he traveled at night, he replied that while day and night were not different to him, carrying a lantern while walking in the night was for the sake of everyone. For him, the lantern provided protection from other people, allowing them to avoid bumping into him. For others, carrying a lantern shone a light on them and let them walk more securely.

“ In the present, we should learn the kind of survival wisdom of the blind man in the story. To wear a mask proactively does not mean ‘I'm infected with the virus,' rather to protect my own health. At the same time, it is a reminder to others that we are still in a time of crisis; we need to pay highly attention to our health and life safety very seriously.” [Bie Ying Long, China]

However, face mask use may have adverse systemic effects, as well:

“ The use of a mask is seen as an act of responsibility and altruism. However, I notice that people with masks tend to avoid personal interaction and to decrease the time they talk to each other. They avoid looking at others.” [Helena Machado, Portugal]

“ The syntagm social distancing is problematic because it symbolically transforms the rule of physical distance into the subversion or deconstruing of social ties. Face masks are strongly related to this implicated meaning. The human estrangement as a part of the ‘COVID-19 regime' is the reason I have been more annoyed by some people strongly emphasizing the need for masks and physical distance than by those exhibiting the lack of interest for the personal protection against the infection.” [Renata Šribar, Slovenia]

In this framework, institutional health communication plays a crucial role in motivating citizens to wear face masks and use them properly (i.e., how to handle it and how to cover one's mouth and nose), as well as to respect physical distancing and hygiene procedures. Here, the choices of narratives by public health system officials play a crucial role. Accordingly, the expression “social distance” tends to be avoided nowadays. “Physical distancing” has been adopted by the WHO, which they define as keeping a distance and avoiding spending time in crowded places or in groups ( 43 ). More distressing expressions such as “avoiding all unnecessary contacts” and “unnecessary contacts with the others” are used in some official advices ( 44 ). These messages may appear authoritarian, by intruding in the personal space of what is “unnecessary” and about who are “the others” when considering social contacts and human relations.

Conversely, an interesting example for motivating the correct use of face masks is the communication campaign “Per tornare tutti insieme a sorridere” [To get back to smiling together] by the Italian Health Ministry ( 45 ). This message designed to stimulate feelings of mutual protection and solidarity among relatives, as well as among strangers. Motivation is crucial because, as we have demonstrated, a face mask can be perceived as both a physical and psychological barrier, particularly in countries where covering one's face is not a common habit.

Wearing a face mask, in fact, makes it hard to recognize if someone is smiling at you and to acknowledge non-verbal communication and emotions shared with facial expressions. This limitation has been noticed in the interactions with older, fragile, and cognitively impaired persons/patients, communication with whom strongly relies on body language ( 46 ). Not only in these contexts, but also in relation to day-to-day activities, especially with strangers, new communication skills are necessary, such as direct eye contact ( 47 ) and body gestures. Moreover, to communicate with those with hearing loss, special transparent masks have been proposed ( 48 ). As the fear of infection makes us more distrustful of strangers and even of friends and family members, to achieve the social interaction we were used to before the pandemic, a new demonstration of care and affection should be conceived.

“ When I walk and nobody is around me, I do not have my mask on the mouth and nose; however, when I'm approaching people, I pose it in the proper way and smile (with my eyes): I consider this a sort of ‘greetings and courtesy nod,' a way to say ‘I care for your health, do not be afraid by me, we will help each other.' I consider it as a message of solidarity.” [Lucia Martinelli, Italy]

Although a “simple” face mask may not be considered in or of itself a sophisticated technological artifact, its systemic use in healthcare settings, its past adopted use in certain social contexts, and the current significant expansion of its application to public health measures (as evidenced through the testimonies and literature outlined above), it can be understood as a facet of a substantial technoscientific project. Importantly, face mask use in the case of COVID-19 has an obvious medical/healthcare connotation, even though face masks are used in many professions to protect the workers against inhaling dust or harmful substances. In fact, many mask types worn during the pandemic come from non-medical supplies (the standard “filtering face-piece” or FFP1 and FFP2 models). However, it is the medical-grade masks that serve as a reference point for all other (varieties of) face coverings.

Face mask wearing can be conceived within the practice of extending the medical science into the “outside world,” by making the behaviors and rituals of the society/culture more alike the scientific (laboratory) practices ( 25 ). The ideological repertoires used in doing so, however, depend critically on cultural differences among societies being thus transformed, and understanding them can help contextualize the political and social dimensions of implementing this public health measure. Such understanding can also serve as a resource for the introduction of other measures, as well as the uptake of face mask wearing in environments where it has not yet been adopted. In short, face masks are being recognized as boundary objects mediating between different individual and collective ideologies ( 31 ) and are as such artifacts with distinct politics ( 49 ).

The aim of this exploratory study was to understand face mask wearing in terms of public policies, individual behaviors and attitudes, and the collective experiences of the affected communities. The main results of our study highlight that the societal and personal practices of wearing (or not wearing) face masks are influenced by ( 1 ) individual perceptions of infection risk, ( 2 ) personal interpretations of responsibility and solidarity, ( 3 ) cultural traditions and religious imprinting, and ( 4 ) the need of expressing self-identity.

First, even for individuals who might not be concerned for their personal health and safety, the wearing of a face mask often indicates a level of care and respect toward others. The decision about wearing a face mask is mediated by standpoints on utility of face masks based on scientific knowledge and/or in the absence of scientific consensus also on political beliefs ( 17 ).

Second, the behaviors of others were described in the collected testimonies in terms of societal responsibilities and rituals of social interaction, highlighting the role of peers in shaping the individual behavior. The narratives shine a light on the perceived balance between protecting oneself and social responsibility, reasserting the notion “If the people wearing masks are protecting you, isn't it right that you should protect them in return?” ( 17 ). However, this leads to inherent contradictions in the behavioral change required. The interchangeability of being at risk and being a risk is particularly striking ( 34 – 36 ), making face mask wearing both an act of self-interest as well as altruism ( 42 ). In a similar vein, what could be perceived previously as anti-sociable behavior may now be beneficial for societal well-being (protection against the pandemic) and, in fact, preferred ( 3 ).

Third, our analysis highlighted that many countries, specifically those in Europe, that previously banned face coverings in public spaces are now mandating them. Face mask wearing has enjoyed varying levels of acceptance across different cultural, governmental, and religious environments; however, even in our study, we could show that the strict rules correspond to the better epidemiological situation ( 50 ). Moreover, the voluntary policy and insufficient compliance can be perceived as less fair allowing individuals to compromise epidemiological measures, while a mandatory policy appears as an effective, fair, and socially responsible ( 27 ). Although the mask can become a symbol of the fight against the virus or of neglect, it remains controversial who and when should have the control on the use of the symbol ( 51 ).

Fourth, the use of face masks preventing the spread of the virus is complemented or even upgraded by the use of face mask as a visual communication tool during times of lockdown and isolation providing a new way to communicate during a pandemic. This covers both political statements in relation to states' public health measures, as well as personal expression of raising awareness, collective solidarity, or just as a part of new pandemic-related esthetic.

We hope that this research will help develop new frameworks to guide a more holistic approach to understanding and enabling behavioral change among citizens, as well as enabling new models for non-verbal communication, noting specific challenges such as disability ( 46 , 48 ). Recent articles highlight the need to develop new ways to communicate while wearing face masks through body language, particularly in terms of using eye contact to communicate emotion ( 52 , 53 ). Also, there is an opportunity to develop new ethical frameworks to guide collective and individual decision making around face coverings. For health policy makers, our study highlights that public messaging plays a crucial role in institutional health communication and that in-depth knowledge of various cultures and ethics concerning health habits are relevant to informing and developing reliable information resources and policies for citizens during a global health pandemic.

However, this study was not without limitations. We acknowledge that our sample is yet representative of a group of intellectuals with a higher level of education, and therefore, the data cannot be generalized to the whole society. The methods we applied for data collection and analysis, however, fit the aim of our research: to explore the broad range of personal and social meanings of mask wearing in different countries. Furthermore, our sample combines the professional and personal observations by health and other experts providing a unique interdisciplinary perspective on face masks. Although we asked standard questions, we let people answer them in freestyle. We did not ask our authors to alter, explain, or correct their narratives in any way.

As shown by the narratives, during the COVID-19 crisis, inconsistent information may influence citizens' level of perceived risk, thus resulting in excessive fear or denial of the reality of the pandemic ( 54 ). The credibility and the source of the information may be crucial to promoting citizen compliance and best practice of face mask wearing. Here, the need to better communicate the complexities of (un)certainty ( 39 ) may be a useful lesson for public health officials and experts building “recommendation trust” in their advice ( 38 ).

From a purely medical perspective, the effectiveness of measures to contain the spread of the virus is independent of the geographic area where these measures are implemented. From a social scientific perspective, however, individual and public health is always embedded, in particular social, cultural, and political contexts. Because of these influencing factors, health measures and devices are imbued with particular meanings that differ across countries. The specific meaning of a device, such as a mask, acquires also shapes how people deal with it and how they integrate it (or not) into their everyday routines and practices ( 55 ). Ultimately, this implies that studying the personal and social meaning of mask wearing in different contexts is also necessary for the assessment of the effectiveness of face masks as a public health measure.

In conclusion, our study points out the need of an in-depth understanding of the various social, cultural, religious, and ethical considerations on health habits and attitudes in a time of pandemics. Additional knowledge about the variety of personal and collective understanding of face mask wearing is essential for designing more effective health communication during and beyond the COVID-19 pandemic.

Data Availability Statement

The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found below: http://dx.doi.org/10.17632/9s6fm7vdbc.1 ( 22 ).

Ethics Statement

The studies involving human participants were reviewed and approved by Ethical Committees of the University of Edinburgh, Scotland, UK and the University of Zagreb, Faculty of Croatian Studies, Croatia. The patients/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

Author Contributions

LM, VK, SG, CH, HM, NB, MP, and BP: designed the study. LM, VK, and SG: performed data acquisition, organization and analysis and wrote the first version of the manuscript. VK, MV, CH, HM, ZT, NB, MP, and BP: contributed to the interpretation of the results and critically revised manuscript. All authors approved the submission to the journal.

SG and VK acknowledge EU European Regional Development Fund, Operational Programme Competitiveness and Cohesion, grant agreement No.KK.01.1.1.01.0007, CoRE—Neuro, and awarded to University of Zagreb School of Medicine for financial support.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We are grateful to the University of Zagreb, Faculty of Croatian Studies for covering Ph.D. tuition fees for VK. We thank Navigating Knowledge Landscapes Network for providing the framework for the study.

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Keywords: COVID-19, face mask, physical distancing, health communication, personal protecting equipment

Citation: Martinelli L, Kopilaš V, Vidmar M, Heavin C, Machado H, Todorović Z, Buzas N, Pot M, Prainsack B and Gajović S (2021) Face Masks During the COVID-19 Pandemic: A Simple Protection Tool With Many Meanings. Front. Public Health 8:606635. doi: 10.3389/fpubh.2020.606635

Received: 15 September 2020; Accepted: 27 November 2020; Published: 13 January 2021.

Reviewed by:

Copyright © 2021 Martinelli, Kopilaš, Vidmar, Heavin, Machado, Todorović, Buzas, Pot, Prainsack and Gajović. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Srećko Gajović, srecko.gajovic@hiim.hr

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Persuasive Essay Guide

Persuasive Essay About Covid19

How to Write a Persuasive Essay About Covid19 | Examples & Tips

11 min read

Steps to Write a Persuasive Essay About Covid-19

Here are the steps to help you write a persuasive essay on this topic, along with an example essay:

Step 1: Choose a Specific Thesis Statement

Your thesis statement should clearly state your position on a specific aspect of COVID-19. It should be debatable and clear. For example:

Step 2: Research and Gather Information

Collect reliable and up-to-date information from reputable sources to support your thesis statement. This may include statistics, expert opinions, and scientific studies. For instance:

COVID-19 vaccination effectiveness data
Information on vaccine mandates in different countries
Expert statements from health organizations like the WHO or CDC

Step 3: Outline Your Essay

Create a clear and organized outline to structure your essay. A persuasive essay typically follows this structure:

Introduction
Background Information
Body Paragraphs (with supporting evidence)
Counterarguments (addressing opposing views)

Step 4: Write the Introduction

In the introduction, grab your reader's attention and present your thesis statement. For example:

Step 5: Provide Background Information

Offer context and background information to help your readers understand the issue better. For instance:

Step 6: Develop Body Paragraphs

Each body paragraph should present a single point or piece of evidence that supports your thesis statement. Use clear topic sentences, evidence, and analysis. Here's an example:

Step 7: Address Counterarguments

Acknowledge opposing viewpoints and refute them with strong counterarguments. This demonstrates that you've considered different perspectives. For example:

Step 8: Write the Conclusion

Summarize your main points and restate your thesis statement in the conclusion. End with a strong call to action or thought-provoking statement. For instance:

Step 9: Revise and Proofread

Edit your essay for clarity, coherence, grammar, and spelling errors. Ensure that your argument flows logically.

Step 10: Cite Your Sources

Include proper citations and a bibliography page to give credit to your sources.

Remember to adjust your approach and arguments based on your target audience and the specific angle you want to take in your persuasive essay about COVID-19.

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Examples of Persuasive Essay About Covid19

When writing a persuasive essay about the Covid-19 pandemic, it’s important to consider how you want to present your argument. To help you get started, here are some example essays for you to read:

Check out some more PDF examples below:

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

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Examples of Persuasive Essay About Covid-19 Vaccine

Covid19 vaccines are one of the ways to prevent the spread of Covid-19, but they have been a source of controversy. Different sides argue about the benefits or dangers of the new vaccines. Whatever your point of view is, writing a persuasive essay about it is a good way of organizing your thoughts and persuading others.

A persuasive essay about the Covid-19 vaccine could consider the benefits of getting vaccinated as well as the potential side effects.

Below are some examples of persuasive essays on getting vaccinated for Covid-19.

Covid19 Vaccine Persuasive Essay

Persuasive Essay on Covid Vaccines

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Examples of Persuasive Essay About Covid-19 Integration

Covid19 has drastically changed the way people interact in schools, markets, and workplaces. In short, it has affected all aspects of life. However, people have started to learn to live with Covid19.

Writing a persuasive essay about it shouldn't be stressful. Read the sample essay below to get idea for your own essay about Covid19 integration.

Persuasive Essay About Working From Home During Covid19

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Examples of Argumentative Essay About Covid 19

Covid-19 has been an ever-evolving issue, with new developments and discoveries being made on a daily basis.

Writing an argumentative essay about such an issue is both interesting and challenging. It allows you to evaluate different aspects of the pandemic, as well as consider potential solutions.

Here are some examples of argumentative essays on Covid19.

Argumentative Essay About Covid19 Sample

Argumentative Essay About Covid19 With Introduction Body and Conclusion

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Examples of Persuasive Speeches About Covid-19

Do you need to prepare a speech about Covid19 and need examples? We have them for you!

Persuasive speeches about Covid-19 can provide the audience with valuable insights on how to best handle the pandemic. They can be used to advocate for specific changes in policies or simply raise awareness about the virus.

Check out some examples of persuasive speeches on Covid-19:

Persuasive Speech About Covid-19 Example

Persuasive Speech About Vaccine For Covid-19

You can also read persuasive essay examples on other topics to master your persuasive techniques!

Tips to Write a Persuasive Essay About Covid-19

Writing a persuasive essay about COVID-19 requires a thoughtful approach to present your arguments effectively.

Here are some tips to help you craft a compelling persuasive essay on this topic:

Choose a Specific Angle

Start by narrowing down your focus. COVID-19 is a broad topic, so selecting a specific aspect or issue related to it will make your essay more persuasive and manageable. For example, you could focus on vaccination, public health measures, the economic impact, or misinformation.

Provide Credible Sources

Support your arguments with credible sources such as scientific studies, government reports, and reputable news outlets. Reliable sources enhance the credibility of your essay.

Use Persuasive Language

Employ persuasive techniques, such as ethos (establishing credibility), pathos (appealing to emotions), and logos (using logic and evidence). Use vivid examples and anecdotes to make your points relatable.

Organize Your Essay

Structure your essay involves creating a persuasive essay outline and establishing a logical flow from one point to the next. Each paragraph should focus on a single point, and transitions between paragraphs should be smooth and logical.

Emphasize Benefits

Highlight the benefits of your proposed actions or viewpoints. Explain how your suggestions can improve public health, safety, or well-being. Make it clear why your audience should support your position.

Use Visuals -H3

Incorporate graphs, charts, and statistics when applicable. Visual aids can reinforce your arguments and make complex data more accessible to your readers.

Call to Action

End your essay with a strong call to action. Encourage your readers to take a specific step or consider your viewpoint. Make it clear what you want them to do or think after reading your essay.

Revise and Edit

Proofread your essay for grammar, spelling, and clarity. Make sure your arguments are well-structured and that your writing flows smoothly.

Seek Feedback

Have someone else read your essay to get feedback. They may offer valuable insights and help you identify areas where your persuasive techniques can be improved.

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Common Topics for a Persuasive Essay on COVID-19

Here are some persuasive essay topics on COVID-19:

The Importance of Vaccination Mandates for COVID-19 Control
Balancing Public Health and Personal Freedom During a Pandemic
The Economic Impact of Lockdowns vs. Public Health Benefits
The Role of Misinformation in Fueling Vaccine Hesitancy
Remote Learning vs. In-Person Education: What's Best for Students?
The Ethics of Vaccine Distribution: Prioritizing Vulnerable Populations
The Mental Health Crisis Amidst the COVID-19 Pandemic
The Long-Term Effects of COVID-19 on Healthcare Systems
Global Cooperation vs. Vaccine Nationalism in Fighting the Pandemic
The Future of Telemedicine: Expanding Healthcare Access Post-COVID-19

In search of more inspiring topics for your next persuasive essay? Our persuasive essay topics blog has plenty of ideas!

To sum it up,

You have read good sample essays and got some helpful tips. You now have the tools you needed to write a persuasive essay about Covid-19. So don't let the doubts stop you, start writing!

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Frequently Asked Questions

Are there any ethical considerations when writing a persuasive essay about covid-19.

Yes, there are ethical considerations when writing a persuasive essay about COVID-19. It's essential to ensure the information is accurate, not contribute to misinformation, and be sensitive to the pandemic's impact on individuals and communities. Additionally, respecting diverse viewpoints and emphasizing public health benefits can promote ethical communication.

What impact does COVID-19 have on society?

The impact of COVID-19 on society is far-reaching. It has led to job and economic losses, an increase in stress and mental health disorders, and changes in education systems. It has also had a negative effect on social interactions, as people have been asked to limit their contact with others.

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I Thought We’d Learned Nothing From the Pandemic. I Wasn’t Seeing the Full Picture

M y first home had a back door that opened to a concrete patio with a giant crack down the middle. When my sister and I played, I made sure to stay on the same side of the divide as her, just in case. The 1988 film The Land Before Time was one of the first movies I ever saw, and the image of the earth splintering into pieces planted its roots in my brain. I believed that, even in my own backyard, I could easily become the tiny Triceratops separated from her family, on the other side of the chasm, as everything crumbled into chaos.

Some 30 years later, I marvel at the eerie, unexpected ways that cartoonish nightmare came to life – not just for me and my family, but for all of us. The landscape was already covered in fissures well before COVID-19 made its way across the planet, but the pandemic applied pressure, and the cracks broke wide open, separating us from each other physically and ideologically. Under the weight of the crisis, we scattered and landed on such different patches of earth we could barely see each other’s faces, even when we squinted. We disagreed viciously with each other, about how to respond, but also about what was true.

Recently, someone asked me if we’ve learned anything from the pandemic, and my first thought was a flat no. Nothing. There was a time when I thought it would be the very thing to draw us together and catapult us – as a capital “S” Society – into a kinder future. It’s surreal to remember those early days when people rallied together, sewing masks for health care workers during critical shortages and gathering on balconies in cities from Dallas to New York City to clap and sing songs like “Yellow Submarine.” It felt like a giant lightning bolt shot across the sky, and for one breath, we all saw something that had been hidden in the dark – the inherent vulnerability in being human or maybe our inescapable connectedness .

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Read More: The Family Time the Pandemic Stole

But it turns out, it was just a flash. The goodwill vanished as quickly as it appeared. A couple of years later, people feel lied to, abandoned, and all on their own. I’ve felt my own curiosity shrinking, my willingness to reach out waning , my ability to keep my hands open dwindling. I look out across the landscape and see selfishness and rage, burnt earth and so many dead bodies. Game over. We lost. And if we’ve already lost, why try?

Still, the question kept nagging me. I wondered, am I seeing the full picture? What happens when we focus not on the collective society but at one face, one story at a time? I’m not asking for a bow to minimize the suffering – a pretty flourish to put on top and make the whole thing “worth it.” Yuck. That’s not what we need. But I wondered about deep, quiet growth. The kind we feel in our bodies, relationships, homes, places of work, neighborhoods.

Like a walkie-talkie message sent to my allies on the ground, I posted a call on my Instagram. What do you see? What do you hear? What feels possible? Is there life out here? Sprouting up among the rubble? I heard human voices calling back – reports of life, personal and specific. I heard one story at a time – stories of grief and distrust, fury and disappointment. Also gratitude. Discovery. Determination.

Among the most prevalent were the stories of self-revelation. Almost as if machines were given the chance to live as humans, people described blossoming into fuller selves. They listened to their bodies’ cues, recognized their desires and comforts, tuned into their gut instincts, and honored the intuition they hadn’t realized belonged to them. Alex, a writer and fellow disabled parent, found the freedom to explore a fuller version of herself in the privacy the pandemic provided. “The way I dress, the way I love, and the way I carry myself have both shrunk and expanded,” she shared. “I don’t love myself very well with an audience.” Without the daily ritual of trying to pass as “normal” in public, Tamar, a queer mom in the Netherlands, realized she’s autistic. “I think the pandemic helped me to recognize the mask,” she wrote. “Not that unmasking is easy now. But at least I know it’s there.” In a time of widespread suffering that none of us could solve on our own, many tended to our internal wounds and misalignments, large and small, and found clarity.

Read More: A Tool for Staying Grounded in This Era of Constant Uncertainty

I wonder if this flourishing of self-awareness is at least partially responsible for the life alterations people pursued. The pandemic broke open our personal notions of work and pushed us to reevaluate things like time and money. Lucy, a disabled writer in the U.K., made the hard decision to leave her job as a journalist covering Westminster to write freelance about her beloved disability community. “This work feels important in a way nothing else has ever felt,” she wrote. “I don’t think I’d have realized this was what I should be doing without the pandemic.” And she wasn’t alone – many people changed jobs , moved, learned new skills and hobbies, became politically engaged.

Perhaps more than any other shifts, people described a significant reassessment of their relationships. They set boundaries, said no, had challenging conversations. They also reconnected, fell in love, and learned to trust. Jeanne, a quilter in Indiana, got to know relatives she wouldn’t have connected with if lockdowns hadn’t prompted weekly family Zooms. “We are all over the map as regards to our belief systems,” she emphasized, “but it is possible to love people you don’t see eye to eye with on every issue.” Anna, an anti-violence advocate in Maine, learned she could trust her new marriage: “Life was not a honeymoon. But we still chose to turn to each other with kindness and curiosity.” So many bonds forged and broken, strengthened and strained.

Instead of relying on default relationships or institutional structures, widespread recalibrations allowed for going off script and fortifying smaller communities. Mara from Idyllwild, Calif., described the tangible plan for care enacted in her town. “We started a mutual-aid group at the beginning of the pandemic,” she wrote, “and it grew so quickly before we knew it we were feeding 400 of the 4000 residents.” She didn’t pretend the conditions were ideal. In fact, she expressed immense frustration with our collective response to the pandemic. Even so, the local group rallied and continues to offer assistance to their community with help from donations and volunteers (many of whom were originally on the receiving end of support). “I’ve learned that people thrive when they feel their connection to others,” she wrote. Clare, a teacher from the U.K., voiced similar conviction as she described a giant scarf she’s woven out of ribbons, each representing a single person. The scarf is “a collection of stories, moments and wisdom we are sharing with each other,” she wrote. It now stretches well over 1,000 feet.

A few hours into reading the comments, I lay back on my bed, phone held against my chest. The room was quiet, but my internal world was lighting up with firefly flickers. What felt different? Surely part of it was receiving personal accounts of deep-rooted growth. And also, there was something to the mere act of asking and listening. Maybe it connected me to humans before battle cries. Maybe it was the chance to be in conversation with others who were also trying to understand – what is happening to us? Underneath it all, an undeniable thread remained; I saw people peering into the mess and narrating their findings onto the shared frequency. Every comment was like a flare into the sky. I’m here! And if the sky is full of flares, we aren’t alone.

I recognized my own pandemic discoveries – some minor, others massive. Like washing off thick eyeliner and mascara every night is more effort than it’s worth; I can transform the mundane into the magical with a bedsheet, a movie projector, and twinkle lights; my paralyzed body can mother an infant in ways I’d never seen modeled for me. I remembered disappointing, bewildering conversations within my own family of origin and our imperfect attempts to remain close while also seeing things so differently. I realized that every time I get the weekly invite to my virtual “Find the Mumsies” call, with a tiny group of moms living hundreds of miles apart, I’m being welcomed into a pocket of unexpected community. Even though we’ve never been in one room all together, I’ve felt an uncommon kind of solace in their now-familiar faces.

Hope is a slippery thing. I desperately want to hold onto it, but everywhere I look there are real, weighty reasons to despair. The pandemic marks a stretch on the timeline that tangles with a teetering democracy, a deteriorating planet , the loss of human rights that once felt unshakable . When the world is falling apart Land Before Time style, it can feel trite, sniffing out the beauty – useless, firing off flares to anyone looking for signs of life. But, while I’m under no delusions that if we just keep trudging forward we’ll find our own oasis of waterfalls and grassy meadows glistening in the sunshine beneath a heavenly chorus, I wonder if trivializing small acts of beauty, connection, and hope actually cuts us off from resources essential to our survival. The group of abandoned dinosaurs were keeping each other alive and making each other laugh well before they made it to their fantasy ending.

Read More: How Ice Cream Became My Own Personal Act of Resistance

After the monarch butterfly went on the endangered-species list, my friend and fellow writer Hannah Soyer sent me wildflower seeds to plant in my yard. A simple act of big hope – that I will actually plant them, that they will grow, that a monarch butterfly will receive nourishment from whatever blossoms are able to push their way through the dirt. There are so many ways that could fail. But maybe the outcome wasn’t exactly the point. Maybe hope is the dogged insistence – the stubborn defiance – to continue cultivating moments of beauty regardless. There is value in the planting apart from the harvest.

I can’t point out a single collective lesson from the pandemic. It’s hard to see any great “we.” Still, I see the faces in my moms’ group, making pancakes for their kids and popping on between strings of meetings while we try to figure out how to raise these small people in this chaotic world. I think of my friends on Instagram tending to the selves they discovered when no one was watching and the scarf of ribbons stretching the length of more than three football fields. I remember my family of three, holding hands on the way up the ramp to the library. These bits of growth and rings of support might not be loud or right on the surface, but that’s not the same thing as nothing. If we only cared about the bottom-line defeats or sweeping successes of the big picture, we’d never plant flowers at all.

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COMMENTS

How to stop the spread of COVID-19
COVID-19 tests can help prevent the spread to others. You can use COVID-19 self-tests at home and get quick results whether or not you have symptoms. Wash your hands many times a day with soap and running water for at least 20 seconds. In general, this is a good practice to help prevent the spread of germs.
Staying Safe from COVID-19
Staying Safe from COVID-19. The coronavirus that causes COVID-19 spreads primarily from person to person through respiratory droplets. This can happen when someone with the virus coughs, sneezes, sings or talks when close to others. By closely following a few safety measures, you can help protect yourself and others from getting sick.
How to Protect Yourself and Your Family from Coronavirus Disease 2019
Prepare and protect yourself from COVID-19. Here are some more steps everyone can take to help stop the spread of COVID-19: Take safety precautions according to the level of COVID-19 in your community. Find out your county's COVID-19 level here. Wash your hands often with soap and clean, running water for at least 20 seconds.
Coronavirus Prevention: How to Protect Yourself from COVID-19
Scientists are still learning about COVID-19, the disease caused by the coronavirus, but according to the CDC, this highly contagious virus appears to be most commonly spread during close (within 6 feet) person-to-person contact through respiratory droplets. "The means of transmission can be through respiratory droplets produced when a person coughs or sneezes, or by direct physical contact ...
Coronavirus disease (COVID-19)
Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Most people infected with the virus will experience mild to moderate respiratory illness and recover without requiring special treatment. However, some will become seriously ill and require medical attention. Older people and those with underlying medical ...
Advice for the public on COVID-19
Keep physical distance of at least 1 metre from others, even if they don't appear to be sick. Avoid crowds and close contact. Wear a properly fitted mask when physical distancing is not possible and in poorly ventilated settings. Clean your hands frequently with alcohol-based hand rub or soap and water.
informative essay about preventing covid-19
Informative essay about preventing covid-19 - 25627973. answered Informative essay about preventing covid-19
How to protect yourself and others from COVID-19
COVID-19 tests can help prevent the spread to others. You can use COVID-19 self-tests at home and get quick results whether or not you have symptoms. Wash your hands many times a day with soap and running water for at least 20 seconds. In general, this is a good practice to help prevent the spread of germs.
Frontiers
COVID-19: Emergence, Spread, Possible Treatments, and Global Burden. The Coronavirus (CoV) is a large family of viruses known to cause illnesses ranging from the common cold to acute respiratory tract infection. The severity of the infection may be visible as pneumonia, acute respiratory syndrome, and even death.
Frontiers
The misinformation topics varied between the severity and spread of COVID-19, treatment and prevention, conspiracy theories, and miscellaneous unverifiable claims. Their results from 296 adult participants (Mage = 36.23; 117 women) suggest two different profiles. One indicating that those reporting more liberal positions and lower social ...
What you need to know about COVID-19 vaccines
العربية. 25 October 2022. Vaccines save millions of lives each year. The development of safe and effective COVID-19 vaccines are a crucial step in helping us get back to doing more of the things we enjoy with the people we love. We've gathered the latest expert information to answer some of the most common questions about COVID-19 ...
An Introduction to COVID-19
A novel coronavirus (CoV) named '2019-nCoV' or '2019 novel coronavirus' or 'COVID-19' by the World Health Organization (WHO) is in charge of the current outbreak of pneumonia that began at the beginning of December 2019 near in Wuhan City, Hubei Province, China [1-4]. COVID-19 is a pathogenic virus. From the phylogenetic analysis ...
The complexity of managing COVID-19: How important is good ...
At first glance, from the end of October 2020, Peru, with 1039 COVID-19 deaths per million population looks bad by any standard and much worse than India with 88. Peru's CMR is currently among ...
Getting the COVID-19 Vaccine
For some COVID-19 vaccines, two doses are required . It's important to get the second dose if the vaccine requires two doses. For vaccines that require two doses, the first dose presents antigens - proteins that stimulate the production of antibodies - to the immune system for the first time. Scientists call this priming the immune response.
How to Write About Coronavirus in a College Essay
Students can choose to write a full-length college essay on the coronavirus or summarize their experience in a shorter form. To help students explain how the pandemic affected them, The Common App ...
A Narrative Review of COVID-19: The New Pandemic Disease
Nearly every 100 years, humans collectively face a pandemic crisis. After the Spanish flu, now the world is in the grip of coronavirus disease 2019 (COVID-19). First detected in 2019 in the Chinese city of Wuhan, COVID-19 causes severe acute respiratory distress syndrome. Despite the initial evidence indicating a zoonotic origin, the contagion ...
Students' Essays on Infectious Disease Prevention, COVID-19 Published
Kalyani Mohan '22 and Kalli Jackson '22 penned an essay titled " Where Public Health Meets Politics: COVID-19 in the United States ," which was published in Wesleyan's Arcadia Political Review. They wrote: "While the U.S. would certainly benefit from a strengthened pandemic response team and structural changes to public health ...
Coronavirus: global solutions to prevent a pandemic
Coronavirus: global solutions to prevent a pandemic. By. Charlotte H. Watts, Patrick Vallance &. Christopher J. M. Whitty. Investment in research must be fast-tracked if we are to tackle the new ...
Frontiers
10 Department of Global Health & Social Medicine, King's College London, London, United Kingdom. Wearing face masks is recommended as part of personal protective equipment and as a public health measure to prevent the spread of coronavirus disease 2019 (COVID-19) pandemic. Their use, however, is deeply connected to social and cultural practices ...
Persuasive Essay About Covid19
Step 5: Provide Background Information. Offer context and background information to help your readers understand the issue better. For instance: Background Information: COVID-19, caused by the novel coronavirus SARS-CoV-2, emerged in late 2019 and quickly spread worldwide, leading to millions of infections and deaths.
informative essay about covid-19 pandemic
rodaranches. report flag outlined. Answer: COVID-19 is a pandemic. Thousands of people are being affected and millions of people are being infected. We can't go outside and play, school is closed and we can't visit family and friends. The novel coronavirus has caused many loved ones to be mourned and missed.
More Questions and Answers About COVID-19 Vaccines
Josh Sharfstein answers a list of important questions about COVID-19 vaccines. Q&A. Most COVID vaccine information is focused on how effective they are at preventing serious disease, hospitalization, and death. How is it possible that the vaccine is more effective at preventing serious illness and death than it is preventing a mild infection?
What We Learned About Ourselves During the COVID-19 Pandemic
The landscape was already covered in fissures well before COVID-19 made its way across the planet, but the pandemic applied pressure, and the cracks broke wide open, separating us from each other ...

Masks Strongly Recommended but Not Required in Maryland, Starting Immediately

Staying Safe from COVID-19

Get vaccinated for COVID-19 and get a booster as soon as you’re eligible

Be aware of infection rates in your area

Practice physical distancing

Wear a mask

Practice hand hygiene

Take precautions if you are living with or caring for someone who is sick

If you feel sick, follow these guidelines:

Coronavirus (COVID-19)

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How to Protect Yourself and Your Family from Coronavirus Disease 2019 (COVID-19)

What can I do to prevent coronavirus disease 2019 (COVID-19)?

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Prevent COVID-19: How to Protect Yourself from the Coronavirus

Know how it spreads

Practice social distancing

Wash your hands

Wear a mask

Restrict your travel

Watch for symptoms

How NewYork-Presbyterian is prepared

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How to protect yourself and others from COVID-19

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Review Date 2/22/2023

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The complexity of managing COVID-19: How important is good governance?

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A Narrative Review of COVID-19: The New Pandemic Disease

Erfan Sheikhbahaei, MD

Zahra Torkpour, MD

Bahareh Kamyab Moghadas, PhD

Matina Ghasemi, PhD

Hossein Akbari Aghdam, MD

Athena Ehsani, PhD

Saeed Saber-Samandari, PhD

Amirsalar Khandan, PhD

Introduction

Transmission

Source Investigation

Pathogenesis

Clinical Manifestations

Treatment of COVID-19

Disease Duration

Supplements for COVID-19

COVID-19 Kits and Deep Learning

Prevention Considerations

Acknowledgement

Students’ Essays on Infectious Disease Prevention, COVID-19 Published Nationwide

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