The path of COVID-19

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SIDNEY — Chinese researchers publishing in the British medical journal, The Lancet, argued the first case of COVID-19 was contracted on Dec. 1, 2019, — three months later, it reached Ohio.

On March 9, three people in Cuyahoga County tested positive for the SARS-CoV-2 virus, a novel, zoonotic strain of the coronavirus COVID-19 disease that frequently causes fever, dry coughing, shortness of breath and fatigue. As of March 12, a fourth person located in Stark County tested positive and an additional 24 suspected Ohio cases are awaiting test results. A fifth person with a postive diagnosis has been found in Trumbull County.

It can also be fatal, especially among the elderly, those with lung or heart diseases, and diabetics. An additional 20-plus suspected Ohio cases are awaiting test results.

According to the World Health Organization (WHO), that on Wednesday classified COVID-19 as a pandemic, the exact cause of the outbreak cannot be determined. But it speculates “patient zero” (also known as the “index case”) likely ate an infected bat or pangolin from a wild animal market located in Wuhan, China, which is when they believe a virus made the leap from an animal to the first human.

As the infected animal was likely in good health before it was eaten, it would have possessed unique antibodies to the SARS-CoV-2 virus that might have been used to easily synthesize a vaccine. Given the severity and lack of any vaccine or therapy, China outlawed the sale and consumption of wild animals and shut down these food markets. Since neither the exact patient nor the exact animal have been determined, researchers need to search for a vaccine the hard way—one of these ways is to repurpose drugs already approved by the Food and Drug Administration and evaluated their safety and effectiveness through numerous clinical trials, a process that could take months until a suitable one is discovered.

The need to speed vaccine and therapy development prompted the Bill & Melinda Gates Foundation, Wellcome, and Mastercard to announce Tuesday they will dedicate $125 million to this cause. Current drug candidates in the clinical trial pipeline include, among others, Remdesivir, Lopinavir, and ritonavir. This is in addition to the $8.3 billion in emergency aid earmarked on March 6th for COVID-19 that is to be split between the CDC, USAID, NIH, FDA, SBA, and Medicare Telehealth.

Universities, with their large sporting events and tens of thousands of students in close living quarters and large lecture halls, pose a difficult challenge. While the CDC did provide guidance at the federal level directed towards institutions of higher education, such as dealing with study abroad students, it did not address the major decision-making actions actually occurring now, like when to hold virtual classes instead of in-person ones, when to cancel sporting events and other group gatherings, when to tell students not to return to campus, and how to handle university-sponsored international and domestic travel at the undergraduate, graduate, faculty and staff levels.

Neither did state agencies, like the Ohio Department of Health (ODH), issue formal guidance to their K-12 and college level education leaders on several important issues. For example, while the ODH made some suggestions about large gatherings by pointing to a publication by the CDC, practical applications were unclear, such as how many people constitute a “large” gathering or whether non-essential gatherings should be cancelled or postponed. Additionally, educational institutions are likely concerned with legal and financial repercussions they may incur and were left wondering about the best way to protect both their students and their vested interests as an institution.

What has happened is institutions have been struggling to arrive at a rapid transition over the past few days from in-person to virtual classes, clearing dormitories, and reducing all but essential travel. Trying to make sense of the various COVID-19 policies being adopted by universities nationwide is no easy task. Daniel Stanford, director of Faculty Development and Technology Innovation in DePaul University’s Center for Teaching and Learning, is one of the individuals who is tackling the problem with a grass roots effort. His spreadsheet, which was established in large part from contributions from the POD Network listserv, could be helpful to create national best practices for the rapid transition of courses to a fully online environment.

“There are so many people at schools across the country sharing resources and helping each other figure this out. I feel lucky to work with amazing colleagues who are working long hours to ensure teachers can keep teaching and students can keep learning,” said Stanford.

The Ohio State University was one of several universities in the state and the nation unprepared to risk the well-being of their faculty, staff, and students upon their return from spring break. In addition to switching to having all six of their campuses (Columbus, Lima, Marion, Mansfield, Newark and ATI Wooster) switch to virtual classes, OSU prohibited new events. Other college campuses are also recommending postponing or canceling planned extracurricular activities where more than 100 people would be gathered.

A bit less surprising were the on-campus class cancellations closest to the confirmed cases in Cuyahoga County including Case Western Reserve University and John Carroll University. Both Kent State University and the University of Akron cancelled classes until March 16 and March 30, respectively, when they will begin remote instruction. Youngstown State University is extending spring break until March 22 while it transitions to online instruction and is suspending all university-sponsored domestic and international travel. Ashland University will end in-person classroom instruction on March 16 and will begin online instruction on March 18; they recommended non-international residential students return home until notified. Baldwin Wallace University and Ursuline College are extended spring break and are preparing for remote learning. Oberlin College will end face-to-face classes on March 18 and will decide about remote instruction by March 25. Suspension of Walsh University’s classes has already taken effect with online instruction beginning March 13.

Otterbein University cancelled classes until resuming remotely on March 16. The University of Toledo cancelled classes March 16-17 and will begin remote instruction on March 18. Bowling Green State University will continue classes as scheduled until the end of the week and after returning from spring break will switch to virtual classes; it is also canceling all events with more than 100 people from March 14-April 17. Marietta College announced “all its courses will be moved to online-only starting on March 16 until further notice.”

The University of Michigan, located in an unaffected state, will continue classroom-based meetings but are asking students whose spring break destination was a high-risk country to self-quarantine for 14 days after they return. Indiana University has elected to teach classesonline for 14 days following return from Spring Break.

As of 11 a.m. on March 12, worldwide there have been more than 127,863 total cases, 4,718 deaths, and 68,310 total recovered cases, according to the Johns Hopkins Coronavirus Resource Center, which offers a coronavirus interactive world map which is being used by the World Health Organization and major media outlets around the globe. These figures represent both confirmed and suspected cases. As the focus of international attention about the disease, Johns Hopkins is migrating all in-person undergraduate classes to virtual instruction effective March 11 and all graduate classes except clinicals, practicums, and labs to virtual instruction as soon as possible. Students were urged not to return to campus housing after spring break and all university-sponsored domestic and international travel was cancelled for undergraduates and along with all non-essential international travel for graduate students, faculty and staff, and for them, domestic travel was discouraged. If in-person meets are held, Johns Hopkins recommend no more than 25 people attend.

Ohio’s state of emergency (March 9) is now among a flurry of 14 others, including Florida (March 1), Washington (March 2), California (March 4), Maryland (March 5), Kentucky (March 6), Utah (March 6), New York (March 7), Oregon (March 8), New Jersey (March 9), Rhode Island (March 9), Colorado (March 10), Massachusetts (March 10), Michigan (March 10), and North Carolina (March 10). An estimated 50 percent or more of the American population is expected to become infected, though many may not be symptomatic or experience only mild symptoms.

A 1-mile area around New Rochelle, New York, Tuesday also became the first city with a section classified as a “containment area,” where K-12 schools and places of religious worship were closed and the National Guard was called in to help distribute food and disinfect.

Ohio under state of emergency

By Shannon Bohle

For the Sidney Daily News

How to protect yourself

Tips to help protect yourself and your family against the spread of the disease were provided in an earlier Sidney Daily News article. The CDC provides additional advice on protecting workplaces, schools, commercial locations, and the home. Here are a few key takeaways:

• Be conscientious about what you touch: avoid shaking hands or touching your face, wash hands frequently, disinfect common surfaces touched by hands, and avoid handling currency.

• Substitute videoconferencing in place of in-person meetings and postpone large meetings, like conferences.

• Be aware of concerns associated with business or school travel: for example, know the risks of any area you intend to visit, and disinfect surfaces before touching them when using public transit, if possible.

• Ensure employees handling food are carefully screened.

• Improve ventilation by keeping air/heat on or by opening a window.

• Stay home if you or a family member are sick.

The writer is a regular contributor to the Sidney Daily News.

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