Shelby Evans

HSC 4500 Spring 2022

Professor Awadzi

Case Study Summation Paper

April 18, 2022

BACKGROUND

            On March 11, 2020, the Centers for Disease Control and Prevention (CDC) declared

COVID-19 a pandemic (CDC, 2022a). This declaration sparked the race to vaccine development

and dawned a world filled with unanswered questions. The first cases of COVID-19 developed

in December of 2019 in Wuhan China and began to enter other countries via air travel (CDC,

2022a). On January 31, 2020, Dr. Anthony Fauci Physician-scientist and immunologist, director

of the National Institute of Allergy and Infectious Diseases (NIAID), and the Chief Medical

Advisor to President Joe Biden gave an interview on the Today Show in which he discussed the

use of masks, the virulence of COVID-19, and the way in which the disease spread. At the time,

Dr. Fauci explained and feared that COVID-19 was being spread from person to person contact,

but condemned the use of masks (TODAY, 2020). Instead, personal hygiene, such as hand

washing, was encouraged as an infection-control and prevention measure (Merrill, 2021, P.

61). However, additional prevention measures followed quickly after.

            According to the Morbidity and Mortality Weekly Report (MMWR) issued by the CDC

on February 7, 2020 quarantine stations were issued at 18 major U.S. ports, enhanced health

screenings were put in place at the 3 major U.S. airports, and travel bans were enacted (Patel &

Jernigan, 2020). Upon further research, on April 3, 2020, the CDC began recommending all

individuals begin wearing face masks in public spaces, this was different than their prior

recommendation of saving such supplies for the medical professionals on the front lines (Aubrey

& Dwyer, 2020). COVID-19 is a communicable disease that spreads through the air or through

respiratory transmission; thus, it was hoped that with the implantation of masks and social

distancing the spread would slow (Merrill, 2021, P. 44).

            The Trump administration issued Operation Warp Speed on April 30, 2020, which aimed

to deliver 300 million doses of a COVID-19 vaccine by January 2021 by offering developers

additional funding (U.S. Department of Health and Human Resources, 2020). Although the

operation failed on its promised 300 million doses, on December 14, 2020, a critical care nurse

in New York City was the first of many to receive the Pfizer/BioNTech vaccine. With this new

vaccine, the hope of reaching herd immunity by the Fall of 2021 was high. However, herd

immunity can only be met when the number of protected or vaccinated individuals outnumbers

the level of susceptible individuals (Merrill, 2021, P. 57). With vaccine hesitancy and the fast

mutation of SARS-CoV-2, herd immunity was not met, and it is now unlikely to ever happen.

Instead, the focus is shifted to further enhancing prevention and treatment measures as outlined

by the Biden administration's National COVID-19 Preparedness Plan issued on March 2, 2022

(The White House, 2022).

DESCRIPTIVE EPIDEMIOLOGY

            Descriptive epidemiology provides insight into how diseases are distributed in regard to

person, place, and time (Merrill, 2021, P. 101). In regard to COVID-19, data was released on

April 7, 2020, showing that 68% of COVID-19-related deaths were occurring amongst Chicago’s

African American citizens (CDC, 2022a). This data was released a day after hundreds of civil

rights groups and doctors called for the release of race and ethnicity data pertaining to COVID-

19 cases by the government and CDC. Age was talked about greatly during the initial findings of

the pandemic, as researchers were trying to find the most susceptible populations. As of April 19,

2022, COVID-19-related deaths were highest amongst ages 85+ followed closely by the 75-84

age group (CDC, 2022b).

 

HEALTH AND POPULATION INDICATORS

            Health indicators are used to monitor the health status of COVID-19 amongst

communities. These indicators are typically produced in the form of data that can be compared

over time (Merrill, 2021, P. 132). The CDC recommends that two specific indicators be used to

measure COVID-19 community levels which are; new COVID-19 hospital admissions per

100,000 population and the percentage of staffed inpatient beds occupied by patients with

COVID-19. These measurements must be reported every seven days (CDC, 2022c).

THE STUDY OF COVID-19

            Many COVID-19 studies were cited in the Morbidity and Mortality Weekly Report

(MMWR) issued by the Centers for Disease Prevention (CDC). A particular report described a

cohort study design in which the researchers grouped people based on how many doses they

received, then by age and sex (Merrill, 2021, P. 162). The study pertained to the increased risk

for cardiac complications after being infected with COVID-19 and the mRNA vaccine. The

study’s findings indicated that the risk of complications was greater with infection than after

vaccination. The findings proved the importance of the continual recommendation of the vaccine

for eligible candidates as the protection benefits out way the risks (Block et al., 2022).

FIELD EPIDEMIOLOGY

            Since COVID-19 is a propagated source epidemic, once the individuals in Wuhan, China

were infected person to person transmission began (Merrill, 2021, P. 210). Although, the use of

field epidemiology was put to use once the cases were discovered to be of unknown origin, the
disease attack rate was too high as is common with airborne diseases (Merrill, 2021, P. 209).

Thus, the next steps lead field epidemiologists to determine the best control and prevention

measures to slow the spread (Merrill, 2021, P. 212).

CLINICAL EPIDEMIOLOGY

            Clinical epidemiology played a vital role in developing screening, tests, and treatment for

COVID-19. One challenge posed by COVID-19 testing was validity and reliability. As many

reportings of false positive or false negative test results were occurring amongst different brands

of COVID-19 tests (Merrill, 2021, P. 249). Because of these inconsistencies, many facilities such

as schools and places of work required a negative Polymerase chain reaction test (PCR) to return

after a case of COVID-19. The PCR test has been proven to have better sensitivity and overall

accuracy in detecting COVID-19 infection (Merrill, 2021, P. 250).   

THE ETHICAL PERSPECTIVE

            The COVID-19 pandemic raised many ethical concerns that had yet to be debated and

challenged in the 21st century. One ethical concern regarded the fair allocation of vaccine

distribution. According to an article published in the European Journal of Public Health, three

factors to consider were pertinent in fair vaccine allocation which was as follows: prioritizing the

disadvantage, benefitting people and limiting harm, and equal moral concern or non-

discrimination (Maeckelberghe, 2021). Further, ethical concerns were also raised about what

defines a vulnerable population, as such populations were supposed to be met with additional

support. However, some arguments were made if the term “vulnerable” referred to physical

characteristics such as age or if vulnerability constituted socioeconomic class. Maeckelberghe

argues that vulnerability is made up of layers and a blanket definition of the vulnerable should

not be applied.

CONCLUSION

            COVID-19 has further proven that epidemiology is the basic science of public health

(Merrill, 2021, P. 1). Without the many concepts, tests, and facts within epidemiology, the world

would not have made such remarkable progress in limiting the spread of COVID-19. As we

continue to live in a world with COVID-19 it is important that we all take heed to the

information given to us by epidemiologists and scientists around the world. It is with great hope

that through epidemiology the world will heal and there will be improved preparation for the

inevitable event of the next pandemic. 

 References

Aubrey, A. Dwyer, C. (2020, April 3). CDC Now Recommends Americans Consider Wearing

Cloth Face Coverings in Public. NPR. https://www.npr.org/sections/coronavirus-live-

updates/2020/04/03/826219824/president-trump-says-cdc-now-recommends-americans-

wear-cloth-masks-in-public

Block, J. P., Boehmer, T. K., Forrest, C. B., Carton, T. W., Lee, G. M., Gundlapalli, A. V.,

Ritchey, M. D., Puro, J., Paranjape, A., Oster, M. E., Nagavedu, K., Mayer, K. H., Ko, J.

Y., Kappelman, M. D., Harris, A. M., Ghildayal, N., Draper, C., Cowell, L. G., Chistakis,

D. A.,…Ajani, U. A. (2022, April 7). Cardiac complications after SARS-COV-2 infection

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U.S. Department of Health and Human Resources. (2020, April 30). Explaining Operation Warp

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