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As Trump continues touting the anti-malaria drug hydroxychloroquine as a “miracle drug” for COVID-19 and asks what is the harm in trying it (which there are many, it can cause severe heart problems), we must again be reminded that there are people suffering from malaria and other autoimmune disorders that need this drug to survive. By Trump pushing this drug, people are rushing to buy it and taking away from those that actually need this drug to live. Malaria is still a major problem in many parts of Africa as well as South East Asia and the western Pacific. These people remain largely forgotten as the panic of COVID-19 spreads around the globe. However, they are no stranger to epidemics; they’ve been experiencing one their entire lives.

As mosquitoes become resistant to insecticides, it has become harder to eliminate malaria from the planet. The drugs being used to treat malaria are also failing as the organisms becomes drug resistant. Researchers have recently identified how the parasite manages to evade our immune system, which is always working to eliminate foreign antigens. It does this by releasing proteins into the host RBCs, which then stick to other RBCs and blood vessel walls. By sticking to the RBCs and blood vessel, it no longer circulates around the body, evading the spleen, which plays a huge role in detecting foreign antigens. It also continuously changes these proteins, so that by the time our body has made an antibody response to one, they stop working because the parasite has switched to another. The sticking together can also cause blood clots to form. If we target the mechanism of the protein and how it sticks, we can stop this from occurring and clear the infection before it is too late.

Another terrible consequence is cerebral malaria, which is when it crosses the blood brain barrier. 20% of those who get this are killed, with the 80% that survive developing long-term neurodevelopmental symptoms. Children in Africa are disproportionately affected by this, and Africa in general remains largely forgotten. Scientists have discovered a key protein, EphA2, which plays a main role in disrupting the blood brain barrier by loosening the junctions between cells. By blocking this protein, it would prevent cerebral malaria from occurring, saving thousands of lives and preventing many others from developing seizures. Let us not forget that hydroxychloroquine is still needed by many, and that COVID-19 is not what many other countries are afraid of the most.

Monoclonal antibodies are surely shaping up to be the future of helping to treat autoimmune disorders. These are man-made antibodies that are created by injecting human DNA into mice in order to create the desired antibody against an antigen. These monoclonal antibodies bind to one type of antigen and are made from cloned immune cells. By doing so, we can then control the antibody response that the body creates, and stop the body from attacking its own tissues. This can also help enhance the immune response of the body to cancerous tissue as well.

One drug currently approved by the FDA is adalimumab which is used to treat rheumatoid arthritis, an autoimmune condition where the body targets connective tissue. It is also used for psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, and plaque psoriasis. For the case of rheumatoid arthritis, it does this by inhibiting the progression of structural damage so that the body doesn’t continue destroying connective tissue. It also helps improve physical function in adults. This is done by blocking the inflammatory effects of TNF alpha, which usually promotes inflammation. It binds to TNF alpha to inhibit its effects so that the joints will not be destroyed.

However, there are a number of side effects of this drug. They include headache, rash, nausea, upset stomach, hypersensitivity reactions, and aplastic anemia. The site of injection may have swelling, redness, pain, and itching. It also has serious implications such as association with tuberculosis, sepsis, and fungal infections due to the blocking of TNF. Some studies have shown those using TNF developing cancer, and it can increase risk of reactivation of hepatitis B. In addition, it can worsen nervous diseases, and should never be used during an active infection. Since it suppresses the immune system, it can worsen other infections and make you more susceptible to illness. It is the acquired immune system being impacted as the TNF is no longer able to do its job in a normal infection. However, it can stop the joints from deteriorating, which is extremely painful, thus should be used but with caution in mind.

While the rest of the world is panicking about Covid-19, many other conflicts around the globe are quickly forgotten. In Congo, the fight against Ebola is still a major concern, perhaps more on the forefront of people’s minds compared to the coronavirus. I remember a few years back when everyone was freaking out about Ebola, and then it just suddenly disappeared. I guess when it’s a disease primarily affecting people in Africa, the rest of the world just doesn’t seem to care as much. We declared ourselves safe and quickly went back about our business, paying no mind to the suffering of people in the rest of the world.

The current outbreak in Congo began in 2018 and was almost over until Friday, April 10, when a new case was reported. They had almost made it two incubation periods until this setback occurred. This outbreak was particularly hard to deal with due to the amount of mistrust between people who live in Congo and their perception of foreign aid. Many simply don’t believe Ebola exists, and are wary of health care workers who try to take away their loved ones. There have been increases on attacks of healthcare workers and foreign aid workers, making this outbreak particularly difficult to control. The steps taken to mitigate this has been to have a transparent box to treat patients, so that their families can see and ensure their loved ones are doing well.

Another key instrument in curbing this outbreak has been the development of a vaccine. Over 256,000 people have been vaccinated, helping to stop those infected from spreading it those they come in contact with. As of currently there are still no FDA approved treatments for Ebola, though there are many drugs in trial. However, there has been a lack of US funding during this outbreak, making it difficult to gather resources to help curb the outbreak. Despite the fact that the rest of the world is so focused on coronavirus, we must not forget that there are other deadly diseases out there as well.

Everyone is wondering when life will return to normal. But we have to be aware that there is so little that we know about the way this virus operates, and normal might not be anywhere in sight. We also don’t know how long immunity against this virus lasts, or when the next outbreak will hit. We cannot let our guard down and think that everything will be okay, and be ill-prepared for the next pandemic. The only thing we can do right now is remain cautious, and try our best to help others through this pandemic.

Antibody tests are being developed by many companies to test for if someone has had Covid-19 so that perhaps the world can be reopened. Those who have been infected will likely not be reinfected, and so they would be safe to go back to work. Most of these tests are looking for the presence of IgM and IgG, which would indicate an immune response. IgM is the antibody produced first during infection, while IgG is produced later on. IgG is more specific and is better at destroying antigens. Thus, those producing IgG will most likely not be reinfected, while those producing IgM will because IgM does not produce memory cells. With these tests, we would be able to tell if someone has been infected and how long antibodies against Covid-19 remain after recovery.

However, there have been problems with antibody testing. Since the FDA has removed regulations requiring their permission in order to use, many companies are pushing out faulty tests and claiming that they work in order to make a profit. This makes it harder to accurately test for the presence of antibodies in blood. Even if the tests are indeed accurate, there is always the issue of false positives and false negatives. A false positive indicates the presence of antibodies when there is none and false negatives indicates no antibodies when in fact the person has been infected. This makes it harder to determine who has gotten Covid-19 and recovered, and there also exists many other types of coronavirus that might give a false positive. Thus, we need to be cautious in proceeding forward and not be too confident that anything is over.

As the coronavirus rages around the world, scientists are working to develop treatments for the virus. Our healthcare system is being overwhelmed, and unless we slow the spread it’ll soon fall apart completely. That is why it is so important to research treatments so that we do not overwhelm the healthcare system with too many patients. Also due to the fact that there is no treatment currently available, people are extremely fearful and has driven panic around the globe. This is why it is so important to have treatment available, so that people stop panicking and the world can calm down again.

One current treatment being used is plasma from recovered coronavirus patients. The plasma contains antibodies against the coronavirus, but will only last for a very short amount of time. This is a type of passive immunity, by transferring antibodies from a recovered patient to a sick one. However, since the patient does not produce their own antibodies, they can still get reinfected which could be a huge problem. I understand that we want to treat people as quickly as possible, but if there is no immunity to the coronavirus then we just prolong the problem even further.

Another treatment that is being looked at is the immunosuppressant tocilizumab which was used on a patient in China who had myeloma. This patient had atypical Covid-19 symptoms, with no cough or fever and had severe pneumonia. They gave him antiviral and corticosteroid therapies did not work. His levels of IL-6 were extremely high which was contributing to continued inflammation in his body, leading to possibly a cytokine storm. Thus, they gave him an immunosuppressant to decrease the IL-6 levels and 10 days later was discharged from the hospital. However, this was only one patient with pre-existing conditions, so who knows if this drug actually works to help get rid of coronavirus. Hopefully as time passes we can figure out a drug that works directly to combat Covid-19 so that our healthcare system does not entirely collapse.

The concept of T cell therapy is very foreign to me, and I had never heard of it before doing this blog post. It is a very good idea to use the body’s own defenses to battle cancer, but like all things is easier said than done. Re-engineering cells to be able to recognize cancer cells requires many years of research and trial, and has to be done so that the T cells do not harm the normal self cells. They have to have chimeric antigen receptors, which recognize tumor cells, and can then stay in the body for months after clearing cancer. However, there is much that is still unknown.

T cell therapy is currently being used to treat certain types of lymphoma and leukemia. Lymphoma is cancer of the lymphatic system and leukemia is cancer of the blood or bone marrow. Both are types of cancer that involve a large part of the body, and are hard to treat because these two systems circulate all over the body. Treating both of these is an incredibly expensive process, which can cost up to hundreds of thousands of dollars. T cell therapy is even more expensive, estimating up to $375,000 per treatment. This does not include hospital stays and other expenses, and doesn’t take into account other complications. I get that this is a very time consuming process and takes a lot of precise dedication to ensure that the correct receptor is attached to the T cell, but realistically how many people can afford treatment? And if it does not work for them, then it will cost so much more to receive additional treatments or alternative options. Cancer treatment drives families bankrupt and it really should not be this way, to have to choose between saving someone or saving your family.

An interesting thing about T cell therapy is the cells ability to only recognize cancers to be destroyed, and nothing else. For example, certain kinds of leukemia and lymphoma have CD19 antigens, which other cells and types of cancer do not have. This way, you can tailor the T cell to only destroy the cancerous cells and not harm the rest of the body, which is what chemotherapy does. Instead of wiping out the entire immune system, we can just instead destroy the cancer directly while having a milder impact on the rest of the body. However, as we know when T cells attack cytokines are also released, which an influx of them can lead to septic shock. There are also other side effects including neurotoxicity as well as killing of good B cells. Much is still unknown about this, and hopefully as more as learned about this, better cancer treatments will be developed.

I’ve always thought of tuberculosis as a terrifying thing of a past, something that no longer is super relevant today. Thus it was shocking to find out that it is the deadliest infectious disease in the world. It has surpassed AIDS as the cause of most deaths worldwide, yet it is largely unheard about in the USA. However, there are still millions of people a year who die from tuberculosis and around 10 million get infected with TB. There is the additional problem with the bacteria, Mycobacterium tuberculosis, becoming increasingly resistant to antibiotics, making it more difficult to treat.

There has been a lot of work on trying to develop a vaccine , however this newest one only has a 50% success rate. However low it is, scientists are still optimistic because it could save millions of lives. The current one used, BCG is not even in use in the USA because it does not protect adolescents or adults against attack of the lungs. However, this new vaccine known as M72 was only tested on adults who had latent TB and in Africa, which is not a representative population. This is only one country, one demographic of people, and one age group. Despite this, it is only composed of two shots one month apart which is much easier than taking antibiotics every day for a month. People would forget, which would allow antibiotic resistance to occur, leading to the problem of multi-drug resistant strains.

Treatment for tuberculosis can be up to 18 months, and thus the FDA has approved a new treatment that would reduce this time to 6 months. This consists of 3 different drugs taken orally, and two would target drug resistant strains which is becoming a more and more serious problem. Until recently, it had been very difficult to treat drug resistant strains and hopefully this will allow them to get treatment that is not as long lasting and does not cause pain. People with money would also be able to take off work to be hospitalized for over a year, and the drugs probably cost a lot of money too. Although tuberculosis is not talked about in the USA, it still very much a problem in poorer countries and there needs to be more effort put into treatment. It is not only rich people who deserve treatment and good healthcare.

My current mood as I sit in self quarantine in my home for 5 more days. I’m doing well as the world we know currently crashes in flames. We cancelled our spring break trip to Arizona because of coronavirus concerns, but my brother decided he wanted to travel anyways and went to DC to visit friends and also spent a ridiculous amount of money while at it. I only went to get my Tdap booster shot, and went back to UNC to grab some necessary things when it was announced that spring break was extended. Then they announced the closing of the dorms, so we had to go back again to get everything out. I’ve mostly spent the rest of the time sleeping and cleaning the house. No one does any organizing except me, and there is no better way to manage anxiety than to clean!

My parents made me open and disinfect a package from China because they are super paranoid despite me telling them multiple times that the coronavirus does not travel like that. Honestly I am kind of glad that I do not have to leave the house because I have terrible pollen allergies, and not having to be outside has made this allergy season a lot more bearable for me. Last year, I was constantly congested and miserable because I could not catch a break from the pollen. I was not able to concentrate in class or focus on doing homework because of how congested I was. There is also supposed to be new houses being built behind where I live, but I have currently seen no progress except trees being chopped down. I guess it’ll take 2 years for any actual progress to be made.

These days I’ve been getting ahead on my homework and catching up on T.V. shows that I haven’t had the time to watch. Everyone in my house is now working from home, and it is weird to always have everyone around. I’m used to being in the house by myself during break, and so waking up to my parents around to make me food is weird but great. The best part of being at home is just being able to eat whatever you want. My mom is naturally a hoarder and so we’ve always been prepared for any situation. We currently have 20 bottles of detergent because she had coupons to use many years ago. My parents are not letting me leave the house which is fine by me since I cannot be around pollen anyways. They do all the grocery shopping and I just disinfect around the house. I hope that everyone else is doing well, and we all get through this safely.

When the coronavirus first started wreaking havoc in January, I never thought that it would end up becoming a worldwide problem. I had been convinced that it would remain mostly in China, and with proper care and isolation we would not face an outbreak in the USA. But here we are now, with cases developing all around the world and America is no exception. My family just cancelled our spring break trip due to fears of airline travel. The rest of my family is in China, and my grandparents are bored out of their minds from isolation.

With North Carolina having two confirmed cases, it just seems that it will be a matter of time before every single state is affected by the coronavirus. The USA government does not have the power the Chinese government does in shutting down the entire country, or closing off entire cities. There would be a riot here if they tried that, and there is no possible way to really enforce it anyways. NYC declared a state of emergency as cases reached 89 and DC just declared its first case, both are places that me and my brother need to go to soon. Italy has locked down much of its north and schools have shut down. I just hope that the situation quells itself soon or the horrors will continue.

Then there is the problem of healthcare, and people not being able to afford hospitalization or medication. Especially for the urban poor, they are an extremely vulnerable population because of a long distrust with the medical system. They also are not updated on the latest news because many lack cell phones and reliable service. And it is difficult for them to avoid crowds as many are homeless. If this population is hit, they will suffer the hardest. Every healthcare crisis has always hit those who are poor the most, and this will not change unless we somehow fix the system. I can only hope that the virus spares these people, but they unlike humans don’t discriminate.

Sexually transmitted diseases are some of the most stigmatized in our society, and a large reason why is that one has to admit to being sexually active. This is largely looked down upon, especially for women who decide to be sexually active. Women are also more likely to be misdiagnosed and ignored for their symptoms compared to men. It is no wonder that so many cases go unreported and STDs are on the rise. As methods for prevention against pregnancy gain more popularity, people begin to disregard the risks of STDs.

The number of STDs have hit a record high in the USA and numbers continue to rise despite public health officials efforts. Particularly gonorrhea and syphilis have reached numbers not seen since 1991 in 2018. The reason why is unclear, as there is better testing and public knowledge and yet numbers continue rising unheeded. I think that part of the reason is that people are afraid to get tested for these because there is such a social stigma against STDs, and one faces the risk of judgement from their loved ones. Another might be the high cost of healthcare, especially because many who fear repercussions from family cannot afford treatment on their own.

Another factor is the double standards in society against women. Women who are sexually active are viewed as lesser and more of the blame is placed on them. They are also more susceptible to STDs due to the anatomy of the vagina. Women also have a tendency to be misdiagnosed in healthcare, and STDs are no exception to this. The symptoms of STDs in women are a lot more nonspecific and can be due to many reasons, not just an STD. I think the only reason to solve this problem is to have better training for women to be able to tell when something is off and to de-stigmatize STDs, so that they will actively seek out help. Another is to make better tests so that it does not take as long to diagnose women when they need help.