Learning From the COVID-19 Pandemic : Implications for Science, Health, and Healthcare

Cover Half Title Title Page Copyright Page Table of Contents Preface Editor Biographies List of Contributors 1 Impact of Covid-19 On Science, Education, Health Care, Environment, Economy, and Lifestyle 1.1 Introduction 1.2 Impact of Covid-19 On Science and Technology 1.3 Impact of Covid-19 On Healthcare Professionals and Services 1.3.1 Telemedicine/Telehealth 1.3.2 Psychological Impact On Healthcare Professionals 1.3.3 Social and Economic Impact On Healthcare Workers 1.4 Effect of Covid-19 On Education Sector 1.4.1 Positive Impact of Covid-19 On Education 1.5 The Impact of Covid-19 On Livelihoods and Lifestyles 1.6 Impact of Covid-19 On Environment and Economy 1.6.1 Environment 1.6.2 Economy 1.7 Technological Impact References 2 Lessons Learned From Covid-19: Health, Education, and Environment 2.1 Introduction 2.2 Coronaviruses 2.2.1 Severe Acute Respiratory Syndrome (SARS) 2.2.2 Middle East Respiratory Syndrome (MERS) 2.2.3 Coronavirus Disease (COVID-19) 2.3 Lessons Learned 2.3.1 Animals 2.3.2 Environment 2.3.3 Health 2.3.4 Science 2.3.5 Education 2.3.6 International Collaborations 2.4 Conclusions References 3 Science and Research During Pandemic: Covid-19 3.1 Introduction 3.2 Understanding the Virus and Its Variants 3.3 Diagnostic Measures 3.4 Therapeutics Used for Covid-19 3.5 Vaccine Development 3.6 Role of Research, ML, and AI in Combating the Pandemic 3.7 Other Challenges in Research During Covid-19 3.8 Conclusion References 4 Molecular Biology Lessons Learned From the Spiky Intruder SARS-CoV-2-19 4.1 Introduction 4.2 The Pandemic and Molecular Biology 4.3 SARS-CoV-2 Detection By the RT-PCR Method 4.4 The Test Method Performance Characterization 4.5 Validation of RT-PCR Methods for the Detection of SARS-CoV-2 4.6 Performance of the Test in Current Pandemic 4.6.1 Molecular Targets Selected 4.6.2 Limitations of SARS-CoV-2 Diagnostic Tests 4.6.3 Sampling Limitations 4.6.4 COVID-19 Viral Load in Sample Collection 4.6.5 Diagnostic Timing and Risk of False Negatives 4.6.6 Quality of Samples for Accurate Testing 4.7 Technical Limitations of the Diagnostic Tests 4.7.1 Methodological Limitations 4.7.2 Limitation of Reference Materials 4.7.3 Inter-Laboratory Comparisons 4.8 Conceptual Limitations of SARS-CoV-2 Diagnostic Tests 4.8.1 Lack of Knowledge About the Virus Genome 4.8.2 Genetic Diversity of SARS-CoV-2 4.9 Variants of SARS-CoV-2 4.10 Dominant Delta Variant Versus Upcoming Omicron Variant 4.11 Molecular Tests Impacted By SARS-CoV-2 4.12 What Should Test Kit Manufacturers and Testing Labs Do? 4.13 Rapid Screening of Variants With Test Kits 4.14 Surveillance of Variants 4.14.1 Genomic Surveillance of Variants 4.14.2 Wastewaters Screening of Variants 4.15 Impact of Globalization On Variants 4.16 Throughput of Detection Tests 4.17 Impact of Pandemic Bottlenecks On Testing Strategies 4.18 RNA-Based Vaccine Developments 4.19 Conclusion References 5 The Mystery Virus, SARS-CoV-2: And Its Dynamics 5.1 Introduction 5.2 Historical Development 5.3 Corona Virus Structure and Spread 5.3.1 Spike, Mutation, and Evolutionary Lineage 5.4 Mode of Entry of Virus 5.5 The Issue of Phylogeny and Strains in India 5.6 Development of Covaxin in India 5.7 Conclusions References 6 The Molecular Biology of SARS-CoV-2 and Its Evolving Variants 6.1 Introduction 6.2 General Morphology of SARS-CoV-2 6.3 Features and Distinction Between Coronaviruses 6.4 Variants of SARS-CoV-2 6.5 Viral Transmission and Replication of SARS-CoV-2 6.5.1 RdRp in Virus Evolution 6.6 Conclusion References 7 Covid-19 Pathology, Clinical Implications, and Prevention 7.1 Introduction 7.2 Clinico-Pathological Characteristics 7.2.1 Severity of Disease 7.2.2 Pathologenesis 7.3 Diagnosis 7.3.1 Viral Tests 7.3.2 Antibody Tests 7.3.3 Radiological Tests 7.4 Prevention 7.4.1 Vaccine for SARS-CoV-2 7.5 Conclusions Note References 8 COVID-19 and Comorbidities 8.1 Introduction 8.2 Diabetes Mellitus and COVID-19 8.3 Hypertension and COVID-19 8.4 Obesity and COVID-19 8.5 Cardiovascular Disease and COVID-19 8.6 Renal Diseases and COVID-19 8.7 Liver Disease and COVID-19 8.8 Lung Disease and COVID-19 8.9 Malignancy and COVID-19 8.10 Fractures and COVID-19 References 9 Immunology of COVID-19 9.1 Introduction 9.2 Types of Coronaviruses/The Coronavirus Family 9.3 Pathogenesis of SARS-CoV-2 9.4 Immune Response Against Coronavirus 9.4.1 Innate Immune Response in COVID-19 9.4.2 Cellular Immune Response/Adaptive Immunity in COVID-19 9.4.3 Humoral Immune Response in COVID-19 9.4.4 Cytokine Storm and Hyperinflammation 9.4.5 Immunogenetics 9.5 Conclusion References 10 Extrapulmonary Manifestations: After Effects of COVID-19 Post Recovery 10.1 Introduction 10.2 Extrapulmonary Manifestations of Coronavirus Infections 10.2.1 Renal Dysfunction 10.2.2 Gastrointestinal (GI) and Hepatic Manifestations 10.2.3 Cardiac Manifestation 10.2.4 Neurological Findings 10.2.4.1 Central Nervous System Manifestations 10.2.4.2 Peripheral Nervous System Manifestations 10.2.5 Hematological Manifestations 10.2.6 Skin Manifestations 10.2.7 Reproductive System Involvement 10.2.8 Ophthalmic Manifestations 10.2.9 Endocrinal Manifestations 10.2.10 Microbial Coinfections in COVID-19 10.2.11 COVID-19 and Unusual Manifestations 10.3 Conclusions References 11 Update On Covid-19 Treatment 11.1 Introduction 11.2 Virology and Potential Drug Targets 11.3 Therapeutic Approaches 11.4 Management of Covid-19 11.5 Mild-To-Moderate Disease 11.6 Severe Disease 11.7 Role of Convalescent Plasma 11.8 Role of Steroids for Covid-19 11.9 Antiviral Drugs 11.10 Kinase Inhibitors 11.11 Anti-SARS-CoV-2 Monoclonal Antibodies 11.12 Immunomodulators 11.13 Other Treatments 11.14 Treatment of Covid-19 in Special Populations 11.14.1 Pregnancy (33) 11.14.2 Children (34) References 12 A Virus SARS-CoV-2: Vaccination Strategies 12.1 Introduction 12.2 Immune Response to Covid-19 12.3 Strategies for Vaccine Against SARS-COV-2 12.3.1 DNA Vaccines 12.3.2 RNA Vaccines 12.3.3 Recombinant Vector Vaccines 12.3.4 Live Attenuated Vaccines 12.3.5 Inactivated Virus Vaccines 12.3.6 Subunit Vaccines 12.4 Plasma Therapy 12.5 Adverese Effects 12.6 Conclusion References 13 Preclinical Safety Assessment of Vaccines Developed Against COVID-19: Recent Updates 13.1 Introduction 13.2 Molecular Evolution 13.3 Preclinical Data 13.3.1 University of Oxford/Astrazeneca 13.3.2 Moderna 13.3.3 Sinovac 13.3.4 CanSino Biologics (Ad5-NCoV) 13.3.5 Sinopharm Vaccine 13.3.6 Inovio Pharmaceuticals Vaccine 13.3.7 Bharat Biotech 13.3.8 Zydus Cadila 13.4 Summary and Future Perspectives References 14 Mucormycosis in Covid-19 Patients 14.1 Introduction 14.2 Mucormycosis-Etiologic Agent 14.3 Epidemiology and Disease Manifestations 14.4 Classification of Mucormycosis Based On Anatomic Site of Infection 14.4.1 Rhino-Orbital-Cerebral Mucormycosis (ROCM) 14.4.2 Pulmonary Mucormycosis 14.4.3 Cutaneous Mucormycosis 14.4.4 Gastrointestinal Mucormycosis 14.4.5 Disseminated Mucormycosis 14.5 Diagnosis 14.5.1 Direct Microscopy 14.5.2 Histopathology 14.5.3 Culture and Identification 14.6 Treatment 14.7 Role of Medicinal Plants in Fungal Infections 14.8 Concluding Remarks References 15 Mucormycosis: An Emerging Opportunistic Infection in the Post-COVID Era 15.1 Introduction 15.2 Incidence 15.3 Etiological Mycology 15.4 Risk Factors and Underlying Diseases 15.5 Etiopathogenesis 15.6 Clinical Presentation 15.7 Rhino-Orbito-Cerebral Mucormycosis 15.8 Clinical Diagnosis 15.9 Treatment 15.9.1 Antifungals 15.9.1.1 Lipid and Liposomal Amphotericin B 15.9.1.2 Adjunctive Antifungal Agents 15.9.1.3 Combination Drug Therapy 15.9.2 Surgical Debridment 15.9.3 Adjuvant Treatment 15.9.4 Supportive Treatment 15.10 Prognosis and Follow-Up References 16 Role of DRDO in Covid-19 Containment 16.1 Introduction 16.2 SARS-CoV-2 and COVID-19 16.3 Role of DRDO In Containing the Spread Of COVID-19 16.4 Hand and Surface Sanitizer 16.5 Body Suits and Personal Protective Equipment (PPE) 16.5.1 Face Masks 16.5.2 N95 and N99 Masks 16.5.3 How to Wear and Remove N95 Or N99 Mask (Donning & Doffing) 16.5.4 Surgical Masks 16.5.5 Protective Face Shields 16.5.6 Quality of Face Masks 16.5.6.1 ASTM 2100 16.5.6.2 EN 14683 16.5.6.3 NIOSH 16.5.6.4 ISO 10993 16.5.7 Masks as Fashion During COVID-19 16.5.8 Disposal 16.5.9 Testing and Certification of Samples of PPE 16.6 UV-Based Sanitization Equipment 16.6.1 Ultra Swachh for Disinfection of PPE and Other Materials 16.6.2 Automated System for Decontamination of N95 Face Masks 16.6.3 UV Sanitization Box and Handheld UV Device 16.7 Other Sanitization Equipment and Systems 16.7.1 Germiklean-Dry Heat Sanitization System 16.7.2 Evaporating Fogger For Sanitization 16.7.3 Vehicle Sanitization Enclosure 16.7.4 Vehicle Sanitization System (Fog Based) 16.7.5 Shoe and Driveway Sanitizer 16.7.6 Mobile Area Sanitization System 16.7.7 Personnel Sanitization Enclosure (PSE) 16.7.8 Automatic Mist-Based Sanitizer Dispensing Unit 16.8 COVID-19 Sample Testing 16.9 Ventilators 16.10 Medical Oxygen Plant (MOP) 16.11 COVID Sample Collection Kiosk (COVSACK) 16.12 Mobile BSL3 Viral Research and Diagnostic Laboratory (VRDL) Lab 16.13 Different Types of Inflatable Shelters 16.13.1 Negative Pressure Inflatable Isolation Shelter for Ten Occupants 16.13.2 Anywhere Erectable Isolation Shelters 16.14 Metrics 16.15 Conclusion References 17 Food and Nutrition Security as Preventive and Therapeutic Health Care: Now and Beyond the Covid-19 Pandemic 17.1 SARS-CoV-2 17.2 Food as Sustainable Preventive Healthcare Therapy 17.2.1 Learning From the COVID-19 Pandemic 17.2.2 Food Supplements as Cure 17.3 Sustainable Development Goals 17.4 Challenges 17.4.1 Hunger 17.4.2 Hidden Hunger 17.4.3 Food Production 17.4.4 Demand and Supply Gap 17.4.5 Food Insecurity 17.4.6 Factors for Food Shortage 17.4.7 Wastage Due to Farm-To-Fork Losses 17.5 Impact of Food And Nutrition Insecurity 17.5.1 Learning From the Covid-19 Pandemic 17.6 Solutions: Food and Nutrition Scarcity to Security Bibliography 18 Potential Role of Natural Essential Oils in the Management of Respiratory Distress in Patients Infected With SARS-CoV-2: An Overview 18.1 Introduction 18.2 Deciphering Molecular Biology and Potential Strategies for Drug Therapy Against SARS-CoV-2 18.3 Approaches To Using Essential Oils in the Management of SARS-CoV-2 Infection 18.3.1 Antiviral Effects of Essential Oils in Managing SARS-CoV-2 Infection 18.3.2 Anti-Inflammatory and Immunomodulatory Effects of Essential Oils in Managing SARS-CoV-2 Infection 18.3.3 Antianxiety and Stress-Reducing Effects of Essential Oils in the Management of SARS-CoV-2 Infection 18.4 Insights for Using Essential Oils Therapy Against SARS-CoV-2 Infection 18.5 Discussion 18.6 Conclusions References 19 Traditional Herbal Medicines for Accelrating Research in and Biomedical Sciences in the Era of Covid-19 19.1 Introduction 19.2 Quantification and Assortment of Phytochemicals 19.3 Diabetes 19.4 Cancer 19.5 Covid-19 and Herbal Medicines 19.6 Conclusions References 20 Role of Physiotherapy in Covid-19 Pandemic 20.1 Introduction 20.2 Short-Wave Diathermy for Covidpneumonia 20.3 Role of Physiotherapy in Reducing Covid Hospital-Acquired Anxiety and Depression 20.3.1 Active Cycle of Breathing Technique (ACBT) 20.3.2 Proprioceptive Neuromuscular Facilitation of Respiration (PNF) 20.3.3 Light Exercises 20.4 Role of Physiotherapy in Mangement of Dyspnoea and Improving SPO2 Levels in Covid-19 Patients 20.4.1 Neurophysiological Facilitation (NPF) of Respiration 20.4.2 Acupressure 20.5 Exercises to Improve Immunity During Covid-19 Pandemic 20.6 Conclusion References 21 India’s Healthcare Scenario During 2020 21.1 Introduction 21.2 History of Pandemics 21.3 Challenges in the Healthcare Sector 21.4 Government Healthcare Schemes 21.5 Impact of Covid-19 Pandemic On Health Care System in India 21.6 Technological Innovations in Indian Healthcare Sector 21.6.1 Artificial Intelligence 21.6.2 Big Data 21.6.3 Digital Tools 21.7 Conclusion References 22 Healthcare in COVID-19 Era 22.1 Introduction 22.2 Aftermath: Biological Disaster 22.2.1 Changes in Primary Care 22.2.1.1 Behavioral Factors: Means as an Individual What I Can Do to Prevent Infection 22.2.1.2 Nutritional Factors 22.2.1.3 Social Factors 22.2.1.4 Mental Health Factors 22.2.1.5 Support Children and Elders in Family and Surroundings 22.2.1.6 Lockdown 22.2.2 Changes in Secondary Care 22.2.2.1 Specialty Care 22.2.2.2 Isolation 22.2.3 Changes in Tertiary Care 22.2.4 Physical and Mental Wellbeing of Healthcare Workers 22.3 Technology Upgrades in Health Care 22.3.1 Present State of Telemedicine in India 22.4 Challenges for Health Care References 23 Role of the World Health Organization in Combating the COVID-19 Pandemic 23.1 Introduction 23.2 About the World Health Organization 23.3 World Health Organization and Epidemiology 23.4 World Health Organization and the COVID-19 Pandemic 23.5 Globalization and Health 23.6 Pluralism in Global Health 23.7 Conclusion References 24 Environmental Safeguards in Running a Level-3 COVID-19 Facility: The SGPGIMS Way 24.1 Introduction 24.2 COVID-19 Preparedness at SGPGIMS 24.3 Key Thrust Areas 24.3.1 Bio-Medical Waste Management Protocol 24.3.2 Sanitization and Housekeeping Protocol 24.3.3 Dead Body Management Protocol 24.3.4 Healthcare Worker (HCW) Safety 24.3.5 COVID-19 Screening 24.3.6 Central Control Room 24.3.7 Continuity of Healthcare Delivery By Telemedicine Services 24.4 Conclusion References Index COVID-19 was first identified in Wuhan City in December 2019 and spread throughout Hubei Province and other parts of China. After causing significant morbidity and mortality in China, by February 2020, it had spread to numerous other countries, infecting millions of people and causing a large number of deaths across the world. The COVID-19 pandemic put a burden on almost all areas of the world including healthcare systems, education, industry, travel, etc. The pandemic revealed the vulnerability of the world’s healthcare systems and affected healthcare personnel significantly. The virus is able to attack not only the respiratory tract, but almost all the organs including the brain. Impacts on gut biota have also been noticed. The virus has caused both morbidity and mortality in humans without any geographical, cultural, or religious barriers. The emergence of new variants due to mutations in the virus has aggravated the problem. While the delta variant brought a second wave and killed a large number of people due to various factors such as lowering of saturated oxygen in blood and other physiological emergencies, the omicron variant proved to be less lethal. Though the pandemic has subsided, the emergence of the subvariants BA1 and BA2 and now their hybrids has started to increase the number of cases at exponential levels and has forced new lockdown measures in places such as China. As the conditions laid down to combat the pandemic have been relaxed, the virus may reach other countries and cause additional countries to resort to lockdown again. COVID-19 became the focus of the scientific community with the aim of developing new drugs, repurposing available drugs to be used against the virus, and developing a series of vaccines in a short time. The mild effect of omicron might have been due to the extensive vaccination programmes carried out in various countries. However, there is genuine fear that newly emerging variants may evade the immune system and cause damage to the body. This book highlights the impact of COVID-19 on science, industry, and healthcare systems. The chapters included in the volume come from dedicated experts belonging to basic sciences, biotechnology, pharmaceutical sciences, and other fields of sciences. These include discussions on how the virus evolves and attacks various organs in the body. A separate chapter explains the emergence of various strains of virus. The preparedness of hospitals and healthcare workers as well as different agencies such as DRDO to face the challenges posed by virus is also discussed. The way scientists and technologists developed new techniques to detect and control the virus have also been highlighted including a chapter on the development of vaccines to control the pandemic. This book is a key resource for students, teachers, medical personnel, administrators, and the public as a whole.