Science Now + Beyond

How is the COVID-19 pandemic going to end?

There are two ways a pandemic needs to die before we can declare it over. First, it needs to end medically: a period where the number of cases and deaths aren’t worrying anymore. But it also needs to end socially. Until we decide as a society that the pandemic isn’t a threat anymore and until we stop fearing it, COVID-19 will never truly come to an end. 

This is not the first time humanity is faced with a life-changing pandemic. Every century has had its own share of diseases and plagues, but the spread has never been so global. What can we learn from pandemics of the past to help us predict the way COVID-19 will make its way to the end?

Plague of Justinian: Herd Immunity

The Plague of Justinian arrived in Constantinople in 541 A.D. when Emperor Justinian ruled the Byzantine Empire. It spread like wildfire across Europe, Asia, North Africa, and Arabia. It’s estimated that half the world’s population at the time died as a result of the plague. At the time, there was no understanding of the plague and certainly no way to cure it. The remaining population is believed to have survived because of a newfound immunity.

But the picture painted by COVID-19 need not be so grim. If 70% or more of a population develops immunity, the spread of the disease can be combatted. 

However, attempts to build herd immunity without a vaccine haven’t gone well. In 2020, Sweden did not implement any strict lockdown rules in wake of the pandemic. Even though large social gatherings had been discouraged, other public places like bars or restaurants were open for business. Sweden had hoped to achieve herd immunity through coronavirus antibodies, but it did not go as planned. By November 2020, Sweden’s COVID-19 death toll per capita was 10 times more than its neighboring country, Norway. 

The road to herd immunity is long and deadly. Without putting the lives of an entire population at risk, herd immunity will never be successful without vaccines. 

Influenza: Endemic Flu

The H1N1 influenza pandemic, also known as the “Spanish flu,” took as many as 50 million lives from 1918 to 1919. Although its origins have nothing to do with Spain, the deadly flu picked up the name as the Spanish media–declared neutral in World War I–was one of the few countries allowed to report on it during media blackouts. World War I only made things worse. As soldiers moved across borders and oceans, they carried the deadly flu with them. 

Even though there have been three other viral pandemics in the 20th century, none have seen death as the 1918 pandemic did. The most important aspect of this pandemic is that the disease eventually turned into a less fatal seasonal flu, taking 290,000 to 650,000 lives every year worldwide.

In a similar way, some scientists believe the coronavirus will never really go away. It’s scary to imagine a world where we’re constantly at risk of contracting this disease. But this doesn’t mean it will be just as viral or lethal as is it today. Similar to influenza, we might see COVID-19 become a part of the seasonal flu that causes the common cold and similar respiratory infections every year.

Smallpox: Vaccines

For centuries, smallpox was an endemic that plagued Europe, Asia, and Arabia, killing three out of every ten people infected by it. But when explorers landed in the Americas, this disease, along with war, wreaked havoc in the lives of the indigenous people. Lack of natural immunity among the native population wiped out 90% of their population. 

Things took a turn in the eighteenth century when Edward Jenner created the first vaccine. Eventually in 1980, WHO declared smallpox completely eradicated. 

The COVID-19 vaccine has been effective so far. But while we may outsmart the virus with a good vaccine, the immunity it provides may not be permanent. Mutations of the coronavirus are rapidly developing and it affects immunity rates. Then there’s the entire nuisance of anti-vaxxers

We cannot predict what is certain about the future of this pandemic. Medically speaking, the pandemic will come to an end when we figure out everything about this infamous disease. In the meantime, social distancing may seem to be a new reality, but we’re already seeing how isolation impacts mental health. Furthermore, businesses and companies have been pushing for reopenings. Considering the current situation of the pandemic, we may stop fearing it before it is truly eradicated.

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Science Policy Now + Beyond Inequality

How the flu became another deadly cost of leaving Puerto Rico unaided after hurricane Maria

Flu season is finally over. No more sniffling friends, vaccinations or mountains of tissues. We can all breathe again, literally.

But the 2018 flu season was a terrifying one and brought up a lot of memories of the flu pandemic of 1918 where millions of people around the world died from influenza. The CDC reported 24 children dead in the first three weeks of January and then a total of 37 deaths by the end of flu season. While this may seem small in numbers compared to the actual medical epidemic of 1918, the tolls were still extremely large considering the fact that since that event society has managed to keep the influenza virus virtually contained.

What made this season even scarier and possibly aided in the death toll was the severe shortage of IVs.  Intravenous re-hydration (IV re-hydration) is a common and important treatment for flu patients and it’s been a large factor in preventing flu-related deaths in the past few decades. When your body contracts the flu virus you become extremely dehydrated and fluids are the key to boosting your immune system to fight the virus off. Our body is primarily made of water and that water is what keeps our immune system healthy and allows it to kill off harmful substances in our bodies.

This is why when you’re sick with pretty much anything, the first advice your doctor may give you is to drink a ton of fluids like water and drinks with restorative electrolytes, along with getting lots of rest.

Those who get extremely sick from the flu need something a little bit stronger than just orally consumable liquids. So they receive IV re-hydration to restore those fluids and crucial immune system boosting vitamins directly to their veins to avoid the detrimental effects of extreme dehydration, or rather, death. With such a large outbreak of influenza this year, hospitals were in huge demand of IV bags in order to treat people, but we ended up with a significant shortage according to USA today and the cause of this shortage was hurricane Maria.

Baxter pharmaceuticals are one of the largest companies that produce IVs for the United States and their main factories that supply these IVs are located in Puerto Rico. According to NPR Puerto Rico produces about 40 billion dollars worth of pharmaceuticals for the U.S. which is more than any other state or U.S. territory.

However, Puerto Rico has been without power and supplies for months after the devastation of hurricane Maria and is in severe need of aid. That aid from the U.S was lacking, to say the least, and without resources, the power to run the factories, and workers who were now homeless and hungry, shipments of IVs were extremely hard to come by.

Puerto Rico is still fighting for aid and just recently Trump has decided to cease aid supplies to the island. Even though FEMA has provided almost $50 million worth of aid to go to power line reconstruction and unemployment assistance, Puerto Rico still faces a ton of devastation. This is extremely problematic when you consider the amount of money this island provides to the U.S.

It seems that the blood of those that died flu season is on America’s hands.

We have let Puerto Rico suffer for decades while we continue to suck the island dry for all its resources and deny them rights and a say to what happens in America and on their own island. It seems our comeuppance has finally arrived and it has been deadly. Without continued help, Puerto Rico could still be in trouble come next flu season which could mean even more deaths both on the island and in the U.S.

This should not be our motivation for helping Puerto Rico because it is our responsibility to help them as an American territory, but it should catalyst that motivation and force us to ensure the success and upkeep of the island.

Trump may be ending aid, but there’s still a lot you can do to help. Continue to spread the word so that we don’t forget about this tragedy the way we forget about many others and donate to relief efforts that directly go to helping out. Together, we can help save thousands of lives because, at the end of the day, Puerto Rican citizens are our citizens and their livelihood and safety matters just as much as ours.

Science Now + Beyond

ASK A SCIENTIST: What are superbugs?

You may have heard the term “superbugs” in some media headlines. You’ve also probably been prescribed an antibiotic by a doctor before. Have you ever wondered why you haven’t been prescribed one for a cold?

Don’t be fooled: “superbugs” aren’t some kind of superhero insects. They’re the villainous faces behind a global health crisis causing 700,000 deaths per year. What are “superbugs”, and why sould we be worried about them?

The difference between bacteria and viruses

Bacteria are unicellular organisms that cause many of the diseases animals (including humans) can get through infection. The type of infection depends on how they enter our bodies. To name a few: Staphylococcus aureus bacteria often enter through skin and cause skin infections, Streptococcus pneumoniae can enter through our airways and cause pneumonia, Escherichia coli can enter through our urethras and cause UTIs, and Chlamydia trachomatis can enter through our reproductive tracts to cause an STI. Some of these bacteria have multiple sources of entry, causing various other diseases.

Viruses, meanwhile, are infectious agents that exist somewhere in the grey area between living and non-living. They don’t meet our current definition of “life”: they cannot replicate outside of a host cell. They have very different properties from the ones that make up the cells of bacteria. Rhinovirus is the most prevalent virus genus responsible for the common cold, while influenza virus causes flu, and norovirus causes food poisoning.

How do antibiotics work?

There are many classes of antibiotics, and their distinctions are based on where in the bacterial cell they are attacking or how they are attacking. One drug most familiar to us — penicillin — works by inhibiting an enzyme in bacteria that helps create the bacterial cell wall. This stops the bacteria from being formed. Another antibiotic, ciprofloxacin, kills an infection by interfering with bacterial DNA replication and transcription. The drug erythromycin does this through a third mechanism: by inhibiting bacterial protein synthesis.

Because viruses do not have those properties being targeted by antibiotics, those drugs will not effectively kill them. Some viruses have antiviral drugs that work against them, like acyclovir for herpes simplex virus, but others have no treatment whatsoever, like the common cold.

So, what are “superbugs”?

Just like us humans, bacteria undergo genetic mutations, which make each one of them a little bit unique within their species. Perhaps a mutation causes a bacterium in the bunch to produce an extra, powerful enzyme.

Now, let’s say this population of bacteria lives in a human’s body and is being treated with an antibiotic for five days. Each day the person takes the drug, they kill more and more bacteria, until (hopefully) it’s gone. But if any were left, what qualities might they have?

Remember “survival of the fittest”? The weaker bacteria are killed first, while the strongest survive. The survivors could be those organisms with the extra, powerful enzyme. These bacteria go on to replicate and pass their drug-resistant genetic material on to generations of billions of microorganisms, and the new norm for the population’s traits changes. Voilà, natural selection in action.

This really happened! Penicillin was the earliest antibiotic discovered by modern medicine. Decades after it was put into practice, scientists started to find an enzyme called penicillinase in the bacteria Staphylococcus aureus. This enzyme deactivated the drug penicillin. So, drug researchers developed clavulanic acid to specifically target that bacterial enzyme. It was added to penicillin-like drugs to be able to fight these stronger bacteria, and we still use Augmentin (amoxicillin + clavulanic acid) for ear infections.

An antibiotic can also kill off good bacteria which serve important purposes in our bodies. This promotes an environment ripe for resistant bacterial infections to reproduce unhindered.

Developing Drug-Resistant Infections

Penicillinase hasn’t been modern medicine’s only obstacle. Over the years, our response has been to develop new antibiotics that work in novel ways. But bacteria continue to find more ways to trick us. MRSA (Methcillin Resistant Staphylococcus Aureus) is a common, fatal threat in hospitals. The CDC recently reported that there was a fourfold increase last year in resistance towards one of the drugs used to treat gonorrhea. And multi-drug resistant Acinetobacter baumanii, already being treated with one of the strongest antibiotics on the market, has growing resistance to this last-resort drug.

Drug development is a grueling process that can’t keep up with superbug evolution. Soon, there may not be any big guns left.

What can be done about “superbugs”?

To tackle to the problem, we must correctly identify the causes.

Healthcare workers can help fight the problem of resistance by properly educating patients on antibiotic use, only prescribing antibiotics when needed, and prescribing the least powerful antibiotic effective for a treatment or immediately downgrading to a lower spectrum antibiotic when cultures come back. They should also practice proper hand hygiene, especially in hospitals where resistant bacteria spread rampantly.

All of us can help tackle resistance by only using antibiotics prescribed by our doctor, finishing the full prescription even when symptoms are gone, and not stockpiling or sharing antibiotics. For the virus-caused common cold, drink lots of fluids and seek symptom relief through over-the-counter drugs only. Prevention of infection in the first place is ideal, which means practicing hand hygiene as well as using barrier protection for STIs. Factory farms pump antibiotics into animals whether they’re sick or not, and when the livestock develop drug resistant infections they get passed down to us through unhygienic food handling. So, we should wash meat and produce, and try to buy organic when possible. And finally, stay informed: You can read the CDC’s report about the current biggest global infectious threats here.

Our individual antibiotic use doesn’t exist in a vacuum. But our collective action can help turn global health around for the better.

History Lost in History Historical Badasses

4 badass Native American women from history

Growing up, the only two Native American women I learned about were Sacagawea and Pocahontas. Of the 800 pages in my American history textbook, only about a paragraph or so was dedicated to them. Basically, I graduated high school with extremely limited knowledge of Native American women and their role in United States history.

Between the four of these women, countless armies were led, several battles won, and serious levels of badassery achieved.

1. Pine Leaf

pine leaf

Pine Leaf, also known as Woman Chief, is definitely someone we missed out on learning in U.S. History. Born in 1806 to the White Clay (Gros Ventre) Tribe, Pine Leaf was a woman with a fearsome reputation and courage in her veins.

As the story goes, Pine Leaf was kidnapped and raised by the White Clay tribe at the age of 10, and grew to be an independent, strong warrior as a result. She became so respected in battle that she eventually became a leading warrior chief of her tribe for 20 years, earning the title Bíawacheeitchish. 

2. Running Eagle

Brown Weasel Woman, better known as Running Eagle, also won her name on the battlefield. She was a highly respected, incredibly humble member of the Piegan Tribe around 1825. By the time she was 15, she had already proved her mad hunting skills during buffalo raids.

After her husband was killed by Crow warriors in battle, she turned to the Sun Spirit to help avenge his death. Her warrior prowess allowed her to lead countless raids west of the Rocky Mountains. Offended by the fact a woman was leading the raids against them, the Flathead tribe killed her. But not before she made a serious tough-girl name for herself.

3. Awashonks

Fierce warrior and skilled diplomat Awashonks became sachem, or chief, of the Sakonnet tribe in modern Rhode Island in 1674.

She and her tribe supported Chief Metacom when he broke a treaty with the New England colonialists after being humiliated by them for years. This conflict eventually led to what is popularly known as King Philip’s War.

The war ended in white victory, but not before Awashonks brokered peace between her tribe and the colonials again.

What I’m trying to say is: Awashonks was a badass.

4. Annie Dodge Wauneka

Annie Dodge Wanueka

Annie Dodge Wauneka, born 1910, is known as a powerhouse and advocate within the Navajo community for improved education and health. In 1963, she became the first Native American to win the Freedom Medal for her efforts.

Her passion for healthcare was also clear from a young age. In 1918, an influenza outbreak took the lives of many of her peers at her boarding school. Despite her young age, Annie is said to have gotten right into the thick of things and assisted staff in caring for the sick.

When she got older, she became involved with the needy Navajo community, who inspired her to give back. She was also a member of the Navajo Tribal Council for a total of 8 years.  Yes, Annie, yes.

Y’all, why weren’t these women in my textbooks?

Their passion, dedication, and fearlessness would have been a refreshing break from reading about the antics of white-powdered wiggies.

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