Open Learn Coronavirus Course Report

Name: Ghaajanan Ramanan

Course access:
https://www.open.edu/openlearncreate/course/view.php?id=5319#tabs-1

Links to the A Level course: Topic 6 Learning objectives:

 Know the structure of bacteria and viruses.
 Identify the major routes pathogens may take when entering the body and describe
the role of barriers in protecting the body from infection, including skin, stomach
acid, and gut and skin flora.
 Explain how individuals may develop immunity (natural, artificial, active, passive).

This is my report that I have produced during the time of completing the online course.
The course is split into 4 sections and I will produce a report that covers each one using the
lesson time each week to work through the sections at my own pace.

What to include in my report for each section?

 Have a heading for each sub-section and record the glossary of terms for each one.
 Next, read through the whole sub-section once including watching a video all the
way through once, if there is one. Get a feeling for what the sub-section is telling you
about.
Then write a summary of the most important points from each sub-section. The
amount of work for each sub-section will vary; you may be describing trends from
graphs, or you may be recording summary notes of the main points from a video
stopping and rewinding it as you wish.
 Under a heading of: ‘Interesting/new ideas, write about what you have learnt from
reading at least one of the selection of ‘Further reading’ links at the bottom of each
sub-section.
 The result of the Section quiz, plus any feedback notes on what you need to review.

Lastly, submit the completed section of the report you have made for the week, including
any quiz mark, on Show my homework the end of Sunday for your teacher to see how you
are doing.
 Section 4

My Notes:
Understanding the numbers:
In the UK, in the early stages of the pandemic, only hospitalised patients were tested. So
anyone with mild disease who stayed at home would not be counted. In many countries
there are very few tests, and very few places that can do tests. If you don’t do any tests you
don’t have any confirmed cases. If you do mass testing, including many people with no
symptoms, you will detect a higher proportion of the infections in your population. You may
also get some false positive results. This increase in testing will mean you increase your
case numbers and move up the league. Even in countries where deaths are counted,
COVID-19 deaths are missed. In China the number of deaths in Wuhan was revised
upwards after a review of likely causes of death of those not tested. There is also variation
in which deaths a country reports. Until late April, the daily figures reported in the UK were
only for hospital deaths , and didn’t include the large numbers of deaths in care homes.

It is clear that we cannot take all the numbers at face value. But within a country, if the
testing and reporting remain constant, trends can be interpreted. And we can make
estimates about what proportion of cases and infections are missed. In countries with good
death reporting, deaths from COVID-19 are the most reliable indicator. But the average time
from infection to death may be more than 3 weeks. So deaths tell us about infections that
happened several weeks before.

Case Fatality Rate: The number of deaths from a disease as a proportion of the total number of
disease cases.

Excess Deaths: The difference between observed deaths, and expected deaths over a
particular time period.

Pneumonia: A lung infection, which can be caused by bacteria, viruses, or fungi.

Herd Immunity:
Immunity is the reduction of susceptible population.

Herd immunity: the protection given to a population against an outbreak of a specific disease
when a high percentage of the population have gained immunity against it.

Immunity: when a person is not likely to get a disease because they have already been
infected, or from a vaccine they are said to be ‘immune’.

R0: average number of secondary cases per case (number of successful transmissions per
case) in a totally susceptible population.

Vaccine: Substances containing disabled parts of a particular pathogen, usually given via
injection. Vaccines stimulate the body to produce antibodies to provide immunity against that
pathogen.

Net production number: Rt (t is changeable)

Better Understanding the Spread of COVID-19?:

Epidemiology: study of health and disease in populations; look at distribution, prevention and
control of disease; key role in public health emergencies; conduct studies to understand
transmission and who is more likely to be infected or develop severe symptoms; evaluate
interventions also.

Medical statistics: working alongside epidemiologists; applying and interpreting health data.

Mathematical modelling: using data to predict what might happen in future; combine
surveillance and clinical data along with anything known about other diseases.

Case definition: allows epidemiologists to use surveillance to identify and track cases; earlier
based on symptoms and risk factors; later changed after knowing more about symptoms and
PCR testing

Surveillance and measures of infectiousness: collecting date to identify who is infected,

where infections are transmitted, number of secondary cases; collected through testing,
population surveys, hospital records; data is analysed geographically and amongst other
people.

Predicting the spread: mathematical models; info on what is known about biological
transmission, how long someone is infected for, how quickly the virus spreads, who is
infected, patterns of contact; models vary on age.

What is a vaccine?

Primary immune response: Frequently exposed to pathogens; often get sick when exposed
to a pathogen for the first time; immune system fights back and we recover.

Secondary immune response: Could get exposed to the same pathogen again later; but the
immune system is ready for it and we don’t get sick.

Vaccination: expose the immune system to dead, inactive forms of the pathogen to give the
same immunity but without the illness.

Pathogen: microbe causing illness; such as SARS-Cov-2, smallpox, polio, etc.

Antigen: part of the pathogen that is recognisable to our immune system; in SARS-CoV-2
the spike proteins stick out from the surface.

Antibodies: proteins produced by immune cells that bind to antigen.

What progress has been made with a COVID Vaccine?

Pre-clinical development: researchers determine exactly what the vaccine consists of; test
dosage, safety and efficacy in animals.

Clinical development: testing on healthy volunteers to make sure it is safe and effective.
Phase 1: 10 to 100 people; phase 2: 100 to 1000 people; phase 3: 1000 to 10,000 people.
Randomised control trials in phases 2 and 3. Phase 4: vaccine used in the real world.

160 vaccine candidates as of May 2020

Antibody: Protein produced by our immune cells that bind s to an antigen.

Clinical development: Development phase involving human volunteers.

Inactivated v accine: Consists of killed versions of the target pathogen. These versions are
detected by our immune cells but cannot cause illness.

Non-replicating viral vector: A harmless virus that has been modified to display antigens from
a different pathogen. For example, several vaccine candidates use adenoviruses (a type of
common cold virus) as delivery systems to display SARS-CoV-2 proteins to our immune cells.
The vector viruses are able to infect cells but cannot replicate or cause sustained infection.

Pre-clinical development: Development phase occurring in laboratories before a vaccine is

tested in humans, often involving animal testing .

Exiting Lockdown:

Before we can think about exiting lockdown, the net reproduction number, R, must be less
than 1 (i.e. the number of new infections must be falling). But in the UK, even with the effort
everyone has put in to social distancing and staying home, R is estimated at between 0.7
and 1. This doesn't leave much room for manoeuvre. If we let go too quickly, cases may rise
again quickly leading straight into another lockdown. It's likely that physical distancing rules
(staying more than 2m away from other people) will continue for some time. But what other
behavioural strategies might apply? One idea that's been suggested is the use of social
'bubbles'. This is also called social contact clustering. In this, two households would be able
to socialise exclusively with one another - limiting any infection risk from the outside by their
exclusivity. This may be an opportunity to see others, but only if people stick to their bubble,
and don't try and cheat and add in more friends than they should.
Until successful treatments and vaccines are developed, it may be necessary for high risk
groups to continue living under the rules of the lockdown while lower risk group start to ease
out of some of the restrictions. This is tough to comply with, but may ultimately be the best
thing for their health. Once an effective vaccine for SARS-CoV-2 is developed, tested and
available and large scale, we may be able to resume something closer to 'normal life'.
However, as discussed in step 4.5, this may not be for 12-18 months.

Contact tracing: the process of identifying people who may have had contact with an
infected individual (“contacts”), testing them for infection, treating the infected and tracing
their contacts in turn. The public health aim being to reduce the number of new infections in
a population.