Misplaced Pages

#395604

113-432: Iowa has been the most successful state in the competition, setting a record in 2023 with its fifth national championship. Although during their 2023 final round, they dropped 6 ballots of 12 to New Mexico’s Albuquerque Academy team resulting in the round’s judge ruling towards defense which is common because they have no burden of proof. Georgia has earned the title four times, while Washington State and Tennessee have each won

226-504: A PR move as anything else". By November 2021, the prospects for approval of such proposals (which by WTO tradition must be unanimous) looked increasingly remote; participants criticized the United States for not working to bridge the gap between supporters and opponents. Meanwhile, Tedros Adhanom Ghebreyesus has rejected the dichotomy between waiving patents and initiating technology transfers by including both measures as part of

339-625: A healthy diet are also recommended. Supportive care in severe cases includes treatment to relieve symptoms , fluid therapy , oxygen support and prone positioning , and medications or devices to support other affected vital organs. More severe cases may need treatment in hospital. In those with low oxygen levels, use of the glucocorticoid dexamethasone is recommended to reduce mortality. Noninvasive ventilation and, ultimately, admission to an intensive care unit for mechanical ventilation may be required to support breathing. Extracorporeal membrane oxygenation (ECMO) has been used to address

452-627: A variant of concern (VoC) or a variant of interest (VoI). Many of these variants have shared the more infectious D614G . As of May 2023, the WHO had downgraded all variants of concern to previously circulating as these were no longer detected in new infections. Sub-lineages of the Omicron variant (BA.1 – BA.5) were considered separate VoCs by the WHO until they were downgraded in March 2023 as no longer widely circulating. As of 24 September 2024 ,

565-400: A COVID-19 vaccine (unless noted otherwise). May include vaccination of non-citizens, which can push totals beyond 100% of the local population. Table is updated daily by a bot. Many countries have implemented phased distribution plans that prioritize those at highest risk of complications such as the elderly and those at high risk of exposure and transmission such as healthcare workers. In

678-432: A COVID-19 vaccine to reach the market, which may be too long to have any net impact on global public health. While discussing the idea of "open source" COVID-19 vaccine manufacturing, Bill Gates said: "There's not a single additional vaccine that would have come out of that .... no free IP would have improved anything related to this pandemic." His foundation has instead helped other countries reach licensing deals as in

791-520: A COVID‑19 vaccine for their own population. The Chinese government pledged in May 2020, that a successful Chinese vaccine would become a "global, public good", implying enough doses would be manufactured for both national and global distribution. Unlike mRNA vaccines, which have to be stored at subzero temperatures, inactivated vaccines from Sinovac and Sinopharm require ordinary refrigeration and may have more appeal in developing countries. In November 2021,

904-493: A comprehensive international study. Such deaths include deaths due to healthcare capacity constraints and priorities, as well as reluctance to seek care (to avoid possible infection). Further research may help distinguish the proportions directly caused by COVID-19 from those caused by indirect consequences of the pandemic. In May 2022, the WHO estimated the number of excess deaths by the end of 2021 to be 14.9 million compared to 5.4 million reported COVID-19 deaths, with

1017-592: A few hundred million doses. At the Group of Seven summit in June 2021, the United States promised to distribute 500   million vaccine doses internationally; this distribution began on 17 August. Preorders from rich countries were made during 2020 with 13 different vaccine manufacturers, whereas those for low-to-middle income countries were made primarily for the Oxford–AstraZeneca COVID-19 vaccine , which

1130-783: A global average of 64%. Logistics vaccination services assure necessary equipment, staff, and supply of licensed vaccines across international borders. Central logistics include vaccine handling and monitoring, cold chain management, and safety of distribution within the vaccination network. The purpose of the COVAX facility is to centralize and equitably administer logistics resources among participating countries, merging manufacturing, transport, and overall supply chain infrastructure. Included are logistics tools for vaccine forecasting and needs estimation, in-country vaccine management, potential for wastage, and stock management. Other logistics factors conducted internationally during distribution of

1243-595: A large number of people". During the COVID-19 pandemic, as with other pandemics, the meaning of this term has been challenged. The end of a pandemic or other epidemic only rarely involves the total disappearance of a disease, and historically, much less attention has been given to defining the ends of epidemics than their beginnings. The ends of particular epidemics have been defined in a variety of ways, differing according to academic field, and differently based on location and social group. An epidemic's end can be considered

SECTION 10

#1732775656396

1356-503: A list of four steps towards increasing vaccine production. He pointed out that the TRIPS agreement signed by all members of the WTO already allows for an emergency waiver of intellectual property rights in countries with free manufacturing capacities. Several observers have noted that the vaccine patent waiver debate involves an issue expected to outlast the COVID-19 pandemic: who will control

1469-451: A median range of 0.24% to 1.49%. IFRs rise as a function of age (from 0.002% at age 10 and 0.01% at age 25, to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85). These rates vary by a factor of ≈10,000 across the age groups. For comparison, the IFR for middle-aged adults is two orders of magnitude higher than the annualised risk of a fatal automobile accident and much higher than

1582-428: A more favorable position on the vaccination list, such as by bribery or making donations to hospitals. In response, state governments imposed large fines and other penalties for violation of federal vaccine distribution guidelines. A COVID-19 vaccine black market enabled some individuals to buy illegal early access to a vaccine. By mid-February 2021, China had arrested 80 people involved in vaccine contraband, and

1695-711: A precaution to avoid a rare blood clotting side effect associated with the AstraZeneca vaccine. Thailand began mixing-and-matching doses of the AstraZeneca and Sinovac vaccines in July 2021 amid concerns about the Sinovac vaccine's long-term protection. During 2020, as the COVID‑19 pandemic escalated globally and vaccine development intensified, the World Health Organization (WHO) COVAX facility adopted

1808-824: A random sample have consistently found that total infections considerably exceed the reported case counts. Many countries, early on, had official policies to not test those with only mild symptoms. The strongest risk factors for severe illness are obesity, complications of diabetes , anxiety disorders, and the total number of conditions. During the start of the COVID-19 pandemic it was not clear whether young people were less likely to be infected, or less likely to develop symptoms and be tested. A retrospective cohort study in China found that children and adults were just as likely to be infected. Among more thorough studies, preliminary results from 9 April 2020 found that in Gangelt ,

1921-517: A second dose of the same vaccine cannot be delivered in a reasonable timeframe. In Canada, authorities were investigating the effectiveness of a mixed series and ultimately recommended the use of a first shot consisting of the Oxford-AstraZeneca COVID-19 vaccine , followed by one of the mRNA vaccines. In June 2021, German authorities recommended using mRNA vaccines as a second shot after an AstraZeneca shot in younger people as

2034-421: A single dose of an mRNA vaccine to reach full two dose immunity. The use of the different vaccines in a two-shot regimen is not widespread; there is no data on the efficacy of mixed series for COVID-19 vaccines but such series are not expected to be unsafe or ineffective. The US Centers for Disease Control and Prevention (CDC) recommends the use of a mixed series only in exceptional circumstances, such as where

2147-461: A social phenomenon, not just a biological one. Time reported in March 2024 that expert opinions differ on whether or not COVID-19 is considered endemic or pandemic, and that the WHO continued to call the disease a pandemic on its website. During the initial outbreak in Wuhan , the virus and disease were commonly referred to as "coronavirus", "Wuhan coronavirus", "the coronavirus outbreak" and

2260-451: A test. Conversely, deaths of people who died from underlying conditions following a positive test may be included. Countries such as Belgium include deaths from suspected cases, including those without a test, thereby increasing counts. Official death counts have been claimed to underreport the actual death toll, because excess mortality (the number of deaths in a period compared to a long-term average) data show an increase in deaths that

2373-467: A vaccine at artificially low prices , then increase prices for profitability later if annual vaccinations are needed and as countries build stock for future needs. The WHO had set out the target to vaccinate 40% of the population of all countries by the end of 2021 and 70% by mid-2022, but many countries missed the 40% target at the end of 2021. Note about table in this section: Number and percentage of people who have received at least one dose of

SECTION 20

#1732775656396

2486-442: A vaccine holiday hub for the wealthy, who could pay a large sum of money to get inoculated before they became eligible for vaccination in their home countries. Some Canadians who maintained second homes in the United States were able to get vaccines earlier. As restrictions on vaccine eligibility were lowered in the United States, wealthier individuals from other countries with slower vaccination rates were reportedly travelling to

2599-518: Is associated with COVID-19 and is reported in as many as 88% of cases. The disease is mainly transmitted via the respiratory route when people inhale droplets and small airborne particles (that form an aerosol ) that infected people exhale as they breathe, talk, cough, sneeze, or sing. Infected people are more likely to transmit COVID-19 when they are physically close to other non-infected individuals. However, infection can occur over longer distances, particularly indoors. SARS‑CoV‑2 belongs to

2712-611: Is discouraged altogether by the World Health Organization (WHO), due to limited evidence of its efficacy. The severity of COVID-19 varies. It may take a mild course with few or no symptoms, resembling other common upper respiratory diseases such as the common cold . In 3–4% of cases (7.4% for those over age 65) symptoms are severe enough to cause hospitalisation. Mild cases typically recover within two weeks, while those with severe or critical diseases may take three to six weeks to recover. Among those who have died,

2825-544: Is estimated that least 215 million doses of COVID-19 vaccines purchased by EU countries have been discarded as per 2023, based on vaccine prices reported in the media. The first polio vaccine was never patented; some have argued that similar treatment of an effective COVID‑19 vaccine could enable fair distribution. Initially, negotiations at the World Trade Organization (WTO) on the issue of waiving patent rights were blocked for months by resistance by

2938-439: Is intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus that causes coronavirus disease 2019 ( COVID-19 ). Prior to the COVID-19 pandemic, an established body of knowledge existed about the structure and function of coronaviruses causing diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). This knowledge accelerated

3051-530: Is itself patentable. Although Moderna has stated that it will not seek enforcement of its patents during the pandemic, a patent waiver (voluntary or involuntary) would not force a vaccine manufacturer to disclose the complete knowledge (i.e., know-how ) for making a vaccine, which is not found in patents. The World Health Organization (WHO) has promoted the COVID-19 Technology Access Pool to facilitate disclosures, but participation

3164-854: Is lowest in cost and has no special refrigeration needs. The CEPI, the WHO, and charitable vaccine organizations, such as the Gates Foundation and GAVI, raised over US$ 20 billion during the first half of 2020, to fund vaccine development and preparedness for vaccinations, particularly for children in under-developed countries . CEPI, which was created to monitor fair distribution of infectious disease vaccines to low- and middle-income countries, has recommended considering manufacturing capacity, financing and purchasing, and releasing vaccine developers from liability. Despite opposition from some vaccine manufacturers, CEPI revised its February 2020 equitable access policy to apply specifically to its COVID‑19 vaccine funding: International groups, such as

3277-408: Is no such thing as generic vaccines". The manufacturer of each independently developed vaccine (including a purported copy of an existing vaccine) must run its own clinical trials to establish safety and efficacy. Independent copying of an existing first-generation vaccine is so hard that the resulting second-generation vaccine is often a significant improvement over the first-generation technology and

3390-490: Is not explained by COVID-19 deaths alone. Using such data, estimates of the true number of deaths from COVID-19 worldwide have included a range from 18.2 to 33.5 million (≈27.4 million) by 18 November 2023 by The Economist , as well as over 18.5 million by 1 April 2023 by the Institute for Health Metrics and Evaluation and ≈18.2 million (earlier) deaths between 1 January 2020, and 31 December 2021, by

3503-573: Is safe, unless everyone is safe." In contrast to the multibillion-dollar investment in vaccine technologies and early-stage clinical research, the post-licensing supply chain for a vaccine has not received the same planning, coordination, security or investment. A major concern is that resources for vaccine distribution in low- to middle-income countries , particularly for vaccinating children, are inadequate or non-existent, but could be improved with cost efficiencies if procurement and distribution were centralized regionally or nationally. In September,

National High School Mock Trial Championship - Misplaced Pages Continue

3616-571: Is that it sets a precedent which may discourage the private sector from future investments in vaccines and other lifesaving technologies, and in turn, future technologies not yet developed will never come to market when the public sector fails to pick up the slack. As one financial analyst explained: "It would be intensively counterproductive, in the extreme, because what it would say to the industry is: 'Don't work on anything that we really care about, because if you do, we're just going to take it away from you. ' " The "most depressing" worst-case outcome

3729-672: Is that pharmaceutical firms give up on saving lives and focus on inventing quality of life treatments which are more profitable and less likely to be expropriated; the most notorious examples of such treatments are Pfizer's Viagra and Allergan's Botox . The "threat of losing developers is real" in the vaccine sector, which had withered away to only a handful of companies by the turn of the 21st century and by 2021 had only recently begun to grow again. However, Peter Bach has argued that whether this risk might be worth it deserves to be frankly debated: "If this action allows for more access and more people to have their lives saved today in 2021 and

3842-452: Is the ratio of deaths to diagnoses. This metric can be misleading because of the delay between symptom onset and death and because testing focuses on symptomatic individuals. Based on Johns Hopkins University statistics, the global CFR was 1.02 percent (6,881,955 deaths for 676,609,955 cases) as of 10 March 2023. The number varies by region and has generally declined over time. Several variants have been named by WHO and labelled as

3955-406: Is the seventh known coronavirus to infect people, after 229E , NL63 , OC43 , HKU1 , MERS-CoV , and the original SARS-CoV . The standard method of testing for presence of SARS-CoV-2 is a nucleic acid test , which detects the presence of viral RNA fragments. As these tests detect RNA but not infectious virus, its "ability to determine duration of infectivity of patients is limited." The test

4068-614: Is typically done on respiratory samples obtained by a nasopharyngeal swab ; however, a nasal swab or sputum sample may also be used. The WHO has published several testing protocols for the disease. Preventive measures to reduce the chances of infection include getting vaccinated, staying at home or spending more time outdoors, avoiding crowded places, keeping distance from others, wearing a mask in public, ventilating indoor spaces, managing potential exposure durations, washing hands with soap and water often and for at least twenty seconds, practising good respiratory hygiene, and avoiding touching

4181-616: Is vitally important that inequities in access to COVID-19 vaccines are urgently addressed to ensure that vulnerable groups everywhere, including health workers and older persons, receive their first and second doses, alongside equitable access to treatment and diagnostics." Inequalities in vaccine distribution facilitate the emergence of new variants like SARS-CoV-2 Omicron variant . Concerns were raised that wealthy countries may receive their vaccines in 2020–21 while developing countries may be excluded from vaccinations until 2023–24. Data from April 2021 comports with this expectation since 25% of

4294-415: Is voluntary and none of the vaccine manufacturers have joined. Without access to the original vaccine manufacturer's know-how, reverse engineering the manufacturing process is difficult and expensive with no guarantee of success. Even if a third party succeeds, they must prove that fact to the satisfaction of regulatory authorities . For small molecule drugs, proving bioequivalence of a generic drug to

4407-514: The Huanan Seafood Wholesale Market there, but it is possible that human-to-human transmission began earlier. Molecular clock analysis suggests that the first cases were likely to have been between October and November 2019. The scientific consensus is that the virus is most likely of a zoonotic origin, from bats or another closely related mammal. While other explanations such as speculations that SARS-CoV-2

4520-407: The Institute for Health Metrics and Evaluation estimating the true number of cases as of early 2022 to be in the billions. One measure that public health officials and policymakers have used to monitor the pandemic and guide decision-making is the test positivity rate ("percent positive"). According to Johns Hopkins in 2020, one benchmark for a "too high" per cent positive is 5%, which was used by

4633-451: The World Health Organization (WHO) and Coalition for Epidemic Preparedness Innovations (CEPI), vaccine developers, governments, and industry evaluated the distribution of the eventual vaccine(s). Individual countries producing a vaccine may be persuaded to favor the highest bidder for manufacturing or provide first-class service to their own country. Experts emphasize that licensed vaccines should be available and affordable for people at

National High School Mock Trial Championship - Misplaced Pages Continue

4746-602: The basic reproduction number (R 0 ) for COVID-19 in January 2020 were between 1.4 and 2.5, but a subsequent analysis claimed that it may be about 5.7 (with a 95 per cent confidence interval of 3.8 to 8.9). In December 2021, the number of cases continued to climb due to several factors, including new COVID-19 variants. As of that 28   December, 282,790,822 individuals worldwide had been confirmed as infected. As of 14 April 2022 , over 500 million cases were confirmed globally. Most cases are unconfirmed, with

4859-474: The variants of interest as specified by the World Health Organization are BA.2.86 and JN.1, and the variants under monitoring are JN.1.7, KP.2, KP.3, KP.3.1.1, JN.1.18, LB.1, and XEC. Symptoms of COVID-19 are variable, ranging from mild symptoms to severe illness. Common symptoms include headache, loss of smell and taste , nasal congestion and runny nose , cough, muscle pain , sore throat , fever, diarrhoea , and breathing difficulties . People with

4972-429: The "Wuhan coronavirus outbreak", with the disease sometimes called "Wuhan pneumonia ". In January 2020, the WHO recommended 2019-nCoV and 2019-nCoV acute respiratory disease as interim names for the virus and disease per 2015 international guidelines against using geographical locations (e.g. Wuhan, China), animal species, or groups of people in disease and virus names in part to prevent social stigma . WHO finalised

5085-471: The 2009 Massachusetts state championship and desired to participate in the national championship in Atlanta, Georgia. Due to religious dietary restrictions and Shabbat observance the school asked for accommodation in order to participate without violating their religious beliefs. The school asked for two trials to be changed from Saturday to Thursday or Friday in order to avoid violating Shabbat. In response

5198-504: The COVAX partnership included 172 countries coordinating plans to optimize the supply chain for a COVID‑19 vaccine, and the United Nations Children's Fund joined with COVAX to prepare the financing and supply chain for vaccinations of children in 92 developing countries. As of 2023, more than 1.6 billion COVAX doses have been provided to poor nations, assisting in the vaccination of 52% of their population, compared to

5311-545: The Centre for Artistic Activism and Universities Allied for Essential Medicines , advocate for equitable access. Scientists have encouraged collaboration between the WHO, CEPI, corporations, and governments to ensure that vaccines are distributed in an evidence-based manner based on infection risk and to prioritize healthcare workers, vulnerable populations, and children. By mid-March 2021, 67 countries, mostly in Africa and

5424-562: The Chinese government pledged to donate in 2022 a further 600 million vaccine doses to Africa, and supply another 400 million through other routes including production by Chinese companies in Africa. In June 2020, the Serum Institute of India (SII) – a major manufacturer of global vaccines – reached a licensing agreement with AstraZeneca to make 1   billion doses of vaccine for low-and-middle income countries, of which half of

5537-540: The Colombian government intercepted a freezer with 70 doses of a Chinese-manufactured vaccine that a traveler brought with her into the airport without any accompanying paperwork. In the later half of February 2021, it was reported that wealthy and influential people from Canada and European countries flew to the United Arab Emirates to secure early access to the vaccine. The UAE promoted Dubai as

5650-745: The EU: Deploying a COVID‑19 vaccine may require worldwide transport and tracking of 10–19   billion vial doses, an effort readily becoming the largest supply chain challenge in history. As of September 2020, supply chain and logistics experts expressed concern that international and national networks for distributing a licensed vaccine were not ready for the volume and urgency, due mainly to deterioration of resources during 2020 pandemic lockdowns and downsizing that degraded supply capabilities. Globally, supplies critical to vaccine research and development are increasingly scarce due to international competition or national sequestration . Addressing

5763-597: The Middle East, had not yet reported any vaccinations. Countries that had begun vaccinations were generally prioritizing populations such as health workers or the elderly. It has also been suggested that elective surgery recipients should be prioritized since a patient recovering from surgery would be more vulnerable than average. Some expressed concern over the short shelf-life of the Moderna and Pfizer-BioNTech vaccines, which expire within hours after being removed from

SECTION 50

#1732775656396

5876-546: The National Board complaining against the lack of reasonable accommodation, asking the National Board not to punish children for their religious beliefs. The United States Congress condemned the National Board for failing to provide for these accommodations. On May 7, 2009, Fulton County Superior Court Chief Judge Doris Downs ruled that unless the competition would accommodate the Orthodox Jewish students, then

5989-831: The National High School Mock Trial Championship in Charlotte, North Carolina without being required to compete during the Jewish Sabbath. The American Mock Trial Invitational was created in 2006 by the New Jersey State Bar Foundation and the North Carolina Academy of Trial Lawyers as an alternative competition to address concerns of religious commitments by competing school teams. Maimonides School of Brookline, Massachusetts won

6102-470: The U.S. government had expressly agreed in its contracts with vaccine manufacturers to use doses only in the United States and its territories. The manufacturers requested this clause because most other countries do not have liability protections for vaccines as expansive as the Public Readiness and Emergency Preparedness Act . In late November 2021 the World Health Organization published, "it

6215-524: The UK and to the "highest bidder" – the United States, which made an advance payment of US$ 1.2 billion to secure 300   million vaccine doses for Americans, even before the AstraZeneca-Oxford vaccine or a Sanofi vaccine was proved safe or effective. Concerns exist about whether some countries producing vaccines may impose protectionist controls by export restrictions that would stockpile

6328-600: The US, Switzerland, Norway, and the EU. Initially one observer considered the US position unlikely to change, but as of April 2021 the US administration was discussing the issue and then reversed course and announced its support for a patent waiver for COVID-19 vaccines on 5 May 2021. 400 non-profit organizations and 115 members of the European Commission have signed a letter urging the United States and Europe to side with

6441-569: The United Kingdom prioritized elder care facility residents and carers, followed by healthcare workers and those over 80 years of age. Subsequent phases are based largely on age, declining from 75 years in 5-year increments. Some countries used accelerated dose 1 plans with extended dose 2 intervals after the first dose in order to extend vaccination to as many people as possible until vaccine availability improved. Data suggests that people who have recovered from COVID-19 may only require

6554-519: The United States to be vaccinated. The U.S. state of Alaska announced in April 2021 that it would intentionally offer free vaccinations to tourists at major Alaskan airports starting 1 June 2021. In an effort to guard against vaccine tourism, Greece restricted its eligibility to those with a social security number. However, this had the effect of excluding part of the elderly or immigrant population as well as some Greek citizens who worked abroad before

6667-858: The United States, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) voted in December 2020, that the first doses of the vaccine should be prioritized for healthcare workers and residents and staff of nursing homes. ACIP recommended that the second phase of distribution (Phase 1b) include persons aged ≥75 years and non-healthcare frontline essential workers such as those employed in grocery stores , restaurants , military , law enforcement , fire departments , retail , sanitation , schools , public transportation , self-storage , hotels , warehousing , and news media . However, states control

6780-640: The WHO in the past. As of 10 March 2023, more than 6.88   million deaths had been attributed to COVID-19. The first confirmed death was in Wuhan on 9 January 2020. These numbers vary by region and over time, influenced by testing volume, healthcare system quality, treatment options, government response, time since the initial outbreak, and population characteristics, such as age, sex, and overall health. Multiple measures are used to quantify mortality. Official death counts typically include people who died after testing positive. Such counts exclude deaths without

6893-419: The WHO, US, European Union, and Australia. On 12 November 2022, the WHO released its Global Vaccine Market Report. The report indicated that "inequitable distribution is not unique to COVID-19 vaccines"; countries that are not economically strong struggle to obtain vaccines. On 14 November 2022, the first inhalable vaccine was introduced, developed by Chinese biopharmaceutical company CanSino Biologics , in

SECTION 60

#1732775656396

7006-490: The WTO members in the global south. Some question if patent waiver proposals formulated for small molecule drugs can be applied to complex biologics like vaccines. One vaccine production expert argued that "there is an unrecognized gap in understanding ... nearly all of the people who are providing views on the value of removing patent protections have zero experience in vaccine development and manufacturing." Indeed, most of

7119-721: The advocacy in favor of patent waivers has come from the public health community (which has drawn inspiration from the history of raucous HIV/AIDS activism in the 1980s and 1990s), while most members of the vaccinology community (i.e., actual experts on development and production of vaccines) have effectively refused to lend their credibility to such proposals by either remaining silent or refusing to take any position. Small molecule drugs are easy to copy and can be quickly brought to market by generic drug manufacturers who are not required to run their own full-scale clinical trials because they can piggyback on regulatory approvals obtained by original drug manufacturers. In contrast, "there

7232-399: The affected companies. Any price tag in the billions would therefore look small in comparison. In early stages of the pandemic, it was not known if it would be possible to create a safe, reliable and affordable vaccine for this virus, and it was not known exactly how much the vaccine development could cost. Even with several vaccines on the market, the antigenicity changes in new variants of

7345-448: The broad family of viruses known as coronaviruses . It is a positive-sense single-stranded RNA (+ssRNA) virus, with a single linear RNA segment. Coronaviruses infect humans, other mammals, including livestock and companion animals, and avian species. Human coronaviruses are capable of causing illnesses ranging from the common cold to more severe diseases such as Middle East respiratory syndrome (MERS, fatality rate ≈34%). SARS-CoV-2

7458-465: The broader technology of RNA therapeutics . Howard Dean has accused Narendra Modi of trying to gain access to such technology by promoting the "disingenuous" claim that patent waivers will accelerate vaccine production. Josh Rogin has pointed out that control of mRNA technology has " national security implications " for the United States, and that its development was initially funded by U.S. taxpayers through DARPA for that reason. Central to

7571-408: The case of the Oxford-AstraZeneca COVID-19 vaccine , 97% of this came from taxpayer money. As of November 2020, companies subsidized under the United States' Operation Warp Speed program have set initial pricing at US$ 19.50 to US$ 25 per dose, in line with the influenza vaccine . In December 2020, a Belgian politician briefly published the confidential prices agreed between vaccine producers and

7684-530: The case of the Oxford/AstraZeneca vaccine being produced by India's Serum Institute. Another concern, raised by Pfizer CEO Albert Bourla , is that allowing unauthorized third-party vaccine production would severely disrupt vaccine developers' efforts to ramp up vaccine production when original developers and third-party producers all end up competing for the same scarce raw materials. This is why some conclude that voluntary technology transfers are

7797-648: The centre of a major infection cluster in Germany, 15 per cent of a population sample tested positive for antibodies . Screening for COVID-19 in pregnant women in New York City , and blood donors in the Netherlands, found rates of positive antibody tests that indicated more infections than reported. Seroprevalence -based estimates are conservative as some studies show that persons with mild symptoms do not have detectable antibodies. Initial estimates of

7910-760: The city of Shanghai, China. For the first two years of the pandemic, no specific and effective treatment or cure was available. In 2021, the European Medicines Agency's (EMA) Committee for Medicinal Products for Human Use (CHMP) approved the oral antiviral protease inhibitor , Paxlovid (nirmatrelvir plus the HIV antiviral ritonavir ), to treat adult patients. FDA later gave it an EUA. Most cases of COVID-19 are mild. In these, supportive care includes medication such as paracetamol or NSAIDs to relieve symptoms (fever, body aches, cough), adequate intake of oral fluids and rest. Good personal hygiene and

8023-513: The consequence is down the road we may not have some new gene therapy for 100 kids, then that's the trade-off worth discussing". Favored distribution of vaccines within one or a few select countries, called "vaccine sovereignty", is a criticism of some of the vaccine development partnerships, such as for the AstraZeneca-University of Oxford vaccine candidate, concerning whether there may be prioritized distribution first within

8136-456: The courthouse would not be allowed to be used for the competition. COVID-19 pandemic The COVID-19 pandemic (also known as the coronavirus pandemic and COVID pandemic ), caused by severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ), began with an outbreak of COVID-19 in Wuhan , China, in December 2019. It spread to other areas of Asia, and then worldwide in early 2020. The World Health Organization (WHO) declared

8249-484: The cumulative number of infected individuals (including asymptomatic and undiagnosed infections and excluding vaccinated infected individuals). It is expressed in percentage points. Other studies refer to this metric as the infection fatality risk . In November 2020, a review article in Nature reported estimates of population-weighted IFRs for various countries, excluding deaths in elderly care facilities, and found

8362-508: The debate is whether profits from strong intellectual property rights are necessary to ensure that someone will conduct the applied research which turns promising laboratory experiments into marketable drugs and vaccines. Such research is dauntingly expensive (on average, $ 3   billion per successful drug) and nearly always fails (only 12 percent of drugs which enter clinical trials ultimately obtain FDA approval), and "governments have neither

8475-441: The development of various vaccine platforms during early 2020. The initial focus of SARS-CoV-2 vaccines was on preventing symptomatic and severe illness. The COVID-19 vaccines are widely credited for their role in reducing the severity and death caused by COVID-19. As of March 2023, more than 5.5 billion people had received one or more doses (11.8 billion in total) in over 197 countries. The Oxford-AstraZeneca vaccine

8588-489: The doses would go to India. Similar preferential homeland distribution may exist if a vaccine is manufactured in Australia. In the United States, the vaccine distribution line, while varying by state, has placed healthcare workers and senior citizens high on the list for COVID-19 vaccination, while less essential workers are secondary recipients. Due to the long process of distribution, some individuals tried to secure

8701-552: The expense of citizens in poorer nations who wait for vaccines to either become available or are donated. The WHO Regional Office of Africa highlighted vaccine discard in African countries, after Nigeria destroyed about 1 million donated doses of AstraZeneca vaccine after being donated with only a few weeks till expiration. Other countries such as Malawi, and South Sudan have either destroyed expired or close to expiring vaccines or paused donated shipments due to expiration concerns. It

8814-513: The eyes, nose, or mouth with unwashed hands. Those diagnosed with COVID-19 or who believe they may be infected are advised by healthcare authorities to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask before entering the healthcare provider's office and when in any room or vehicle with another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal household items. A COVID-19 vaccine

8927-418: The final plans for prioritization, distribution, and logistics of vaccinating everyone as supply becomes available. The European Union began phased vaccine rollout on 27 December 2020. Each member state is managing distribution with a common focus on prioritizing healthcare workers, people at high risk of exposure, the elderly, and those with serious health conditions. The COVID‑19 vaccination programme in

9040-416: The first half of 2021. Yet, by mid-December, some 16 countries representing only 14% of the world's population had preordered more than 10   billion vaccine doses or about 51% of the available world supply. Specifically, Canada, Australia, and Japan – having only 1% of the world's COVID‑19 cases – had collectively reserved some 1   billion vaccine doses, while the COVAX facility had reserved only

9153-459: The freezer; they argued that, once the vaccine is unfrozen, it is better to apply these doses to anyone who can be found rather than discard the doses. As of March 2021, the United States had ordered twice the necessary doses to cover its own population, but it remained unclear when it might share surplus doses with other countries. In April 2021, Vanity Fair reported that it would be difficult to share surplus doses with other countries because

9266-419: The frontlines of healthcare and in most need. In April 2020, it was reported that the UK agreed to work with 20 other countries and global organizations, including France, Germany, and Italy, to find a vaccine and share the results, and that UK citizens would not get preferential access to any new COVID‑19 vaccines developed by taxpayer-funded UK universities. Several companies planned to initially manufacture

9379-474: The general public beginning in December 2020, made available through government and international programs such as COVAX , aiming to provide vaccine equity . Treatments include novel antiviral drugs and symptom control. Common mitigation measures during the public health emergency included travel restrictions , lockdowns , business restrictions and closures, workplace hazard controls , mask mandates , quarantines, testing systems, and contact tracing of

9492-511: The global population having received at least one dose. While 4.19   million vaccines were then being administered daily, only 22.3 percent of people in low-income countries had received at least a first vaccine by September 2022, according to official reports from national health agencies, which are collated by Our World in Data . During a pandemic on the rapid timeline and scale of COVID-19 cases in 2020, international organizations like

9605-665: The infected. The pandemic caused severe social and economic disruption around the world, including the largest global recession since the Great Depression . Widespread supply shortages , including food shortages , were caused by supply chain disruptions and panic buying . Reduced human activity led to an unprecedented temporary decrease in pollution . Educational institutions and public areas were partially or fully closed in many jurisdictions, and many events were cancelled or postponed during 2020 and 2021. Telework became much more common for white-collar workers as

9718-439: The issue of respiratory failure. Existing drugs such as hydroxychloroquine , lopinavir/ritonavir , and ivermectin are not recommended by US or European health authorities, as there is no good evidence they have any useful effect. The antiviral remdesivir is available in the US, Canada, Australia, and several other countries, with varying restrictions; however, it is not recommended for use with mechanical ventilation, and

9831-576: The majority of the unreported 9.5 million deaths believed to be direct deaths due the virus, rather than indirect deaths. Some deaths were because people with other conditions could not access medical services . A December 2022 WHO study estimated excess deaths from the pandemic during 2020 and 2021, again concluding ≈14.8 million excess early deaths occurred, reaffirming and detailing their prior calculations from May as well as updating them, addressing criticisms. These numbers do not include measures like years of potential life lost and may make

9944-465: The money nor the risk tolerance to take over the role of businesses in developing pharmacy-ready medicines". Moderna co-founder Robert S. Langer has argued that early private investors deserve "a lot of credit" for its successful COVID-19 vaccine since they "put the money in way before" the U.S. federal government got involved, and thereby laid the foundation for the company's success many years later. The risk of waiving patents for COVID-19 vaccines

10057-525: The motto "No one is safe unless everyone is safe" to emphasize the need for equitable vaccination . The facility set a goal of supplying COVID‑19 vaccines to nearly 100 low-to-middle income countries that could not afford them. COVAX sought to fundraise US$ 6.8 billion to purchase and deliver vaccines to participating countries in proportion to their populations. On 18 December 2020, the facility announced agreements with vaccine manufacturers to supply 1.3   billion doses for 92 low-middle income countries in

10170-568: The national championship three times. California, New Jersey, South Carolina, Indiana, New Mexico, and Arizona have all won twice. Past winners and runners-up of the competition include the following schools: *The 2021 and 2022 NHSMTC were held virtually over Zoom because of the COVID-19 pandemic . The Torah Academy of Bergen County from Teaneck, New Jersey had won its state's 2005 competition, but faced difficulties in its ultimately successful effort to gain accommodations to participate in

10283-495: The official names COVID-19 and SARS-CoV-2 on 11 February 2020. Tedros Adhanom Ghebreyesus explained: CO   for corona , VI   for virus , D   for disease and 19 for when the outbreak was first identified (31 December 2019). WHO additionally uses "the COVID-19 virus" and "the virus responsible for COVID-19" in public communications. WHO named variants of concern and variants of interest using Greek letters . The initial practice of naming them according to where

10396-406: The original drug costs only about US$ 1 to $ 2   million; but for biologics, proving biosimilarity of a third-party product to the original product requires clinical trials, with costs ranging from US$ 100 to $ 250   million. One financial analyst specializing in pharmaceuticals estimated that it would take a minimum of two years after patent waiver for the first independent reproductions of

10509-534: The outbreak a public health emergency of international concern (PHEIC) on 30 January 2020, and assessed the outbreak as having become a pandemic on 11 March. COVID-19 symptoms range from asymptomatic to deadly, but most commonly include fever, sore throat , nocturnal cough , and fatigue. Transmission of the virus is often through airborne particles . Mutations have produced many strains (variants) with varying degrees of infectivity and virulence . COVID-19 vaccines were developed rapidly and deployed to

10622-407: The pandemic 2021's leading cause of death . The time between symptom onset and death ranges from   6 to 41 days, typically about 14 days. Mortality rates increase as a function of age. People at the greatest mortality risk are the elderly and those with underlying conditions. The infection fatality ratio (IFR) is the cumulative number of deaths attributed to the disease divided by

10735-495: The pandemic evolved. Misinformation circulated through social media and mass media , and political tensions intensified . The pandemic raised issues of racial and geographic discrimination , health equity , and the balance between public health imperatives and individual rights . The WHO ended the PHEIC for COVID-19 on 5 May 2023. The disease has continued to circulate, but as of 2024, experts were uncertain as to whether it

10848-469: The pandemic. In the European Union, several travel agencies offered "vaccine vacations". The Maldives also offered vaccines as part of holiday travel packages. An effective vaccine for COVID‑19 could save trillions of dollars in global economic impact, according to economists Arnab Acharya and Sanjay Reddy who advocate suspending patent protections for vaccines temporarily and compensating

10961-581: The population in high income countries have been vaccinated compared to only 0.2% in low income countries. The head of the World Health Organization said on 4 August 2021 that rich countries had administered about 100 doses per 100 people while poor countries had administered only about 1.5 doses for every 100 people, and therefore, in his estimation, it was important to prioritize vaccination in poor countries before offering booster vaccines in rich countries. The WHO Director General Tedros Adhanom Ghedreyesus raised concerns about rich countries hoarding vaccines at

11074-415: The population's age structure and the age-specific pattern of infections. There have also been reviews that have compared the fatality rate of this pandemic with prior pandemics, such as MERS-CoV. For comparison the infection mortality rate of seasonal flu in the United States is 0.1%, which is 13 times lower than COVID-19. Another metric in assessing death rate is the case fatality ratio (CFR), which

11187-462: The risk of dying from seasonal influenza . In December 2020, a systematic review and meta-analysis estimated that population-weighted IFR was 0.5% to 1% in some countries (France, Netherlands, New Zealand, and Portugal), 1% to 2% in other countries (Australia, England, Lithuania, and Spain), and about 2.5% in Italy. This study reported that most of the differences reflected corresponding differences in

11300-496: The same infection may have different symptoms, and their symptoms may change over time. Three common clusters of symptoms have been identified: one respiratory symptom cluster with cough, sputum , shortness of breath, and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhoea. In people without prior ear, nose, and throat disorders, loss of taste combined with loss of smell

11413-532: The school obtained attorney Nathan Lewin to represent the school. Lewin filed a complaint with the US Department of Justice alleging religious discrimination and a violation of civil rights . Attorney Elizabeth Price resigned from the Georgia State Bar in protest over the National Board refusing to grant the requests for accommodation. The Anti-Defamation League sent a letter of protest to

11526-589: The spread of the virus within the community, and mitigation strategies (commonly known as " flattening the curve ") that attempt to lessen the effects of the virus on society, but which still tolerate some level of transmission within the community. These initial strategies can be pursued sequentially or simultaneously during the acquired immunity phase through natural and vaccine-induced immunity . Deployment of COVID-19 vaccines As of 12 August 2024 , 13.53   billion COVID-19 vaccine doses have been administered worldwide, with 70.6 percent of

11639-437: The superior option for producing more doses —since the transferor's active assistance can help the transferee bypass time-consuming clinical trials by taking advantage of existing approvals for the transferor's vaccine —and others describe patent waiver proposals as "more symbolic than practical". Derek Lowe has characterized the U.S. government's May 2021 announcement of support for patent waiver proposals as "almost as much of

11752-411: The time from symptom onset to death has ranged from two to eight weeks. Prolonged prothrombin time and elevated C-reactive protein levels on admission to the hospital are associated with severe course of COVID-19 and with a transfer to intensive care units (ICU). Between 5% and 50% of COVID-19 patients experience long COVID , a condition characterised by long-term consequences persisting after

11865-694: The typical convalescence period of the disease. The most commonly reported clinical presentations are fatigue and memory problems, as well as malaise , headaches, shortness of breath , loss of smell, muscle weakness , low fever and cognitive dysfunction . Many countries attempted to slow or stop the spread of COVID-19 by recommending, mandating or prohibiting behaviour changes, while others relied primarily on providing information. Measures ranged from public advisories to stringent lockdowns. Outbreak control strategies are divided into elimination and mitigation. Experts differentiate between elimination strategies (known as " zero-COVID ") that aim to completely stop

11978-429: The vaccine first, but given how many competing interests there are, this is unlikely to happen". From Phase I clinical trials, 84–90% of vaccine candidates fail to make it to final approval during development, and from Phase III, 25.7% fail  – the investment by a manufacturer in a vaccine candidate may exceed US$ 1 billion and end with millions of useless doses given advanced manufacturing agreements. In

12091-543: The variants were identified (e.g. Delta began as the " Indian variant") is no longer common. A more systematic naming scheme reflects the variant's PANGO lineage (e.g., Omicron 's lineage is B.1.1.529) and is used for other variants. SARS-CoV-2 is a virus closely related to bat coronaviruses , pangolin coronaviruses, and SARS-CoV . The first known outbreak (the 2019–2020 COVID-19 outbreak in mainland China ) started in Wuhan , Hubei, China, in December 2019. Many early cases were linked to people who had visited

12204-429: The virus mean that the billions of dollars could still be invested without success. Before an effective vaccine was developed, it was clear that billions of doses would need to be manufactured and distributed worldwide. In April 2020, the Gates Foundation estimated that manufacturing and distribution could cost as much as US$ 25 billion . Gates also admitted "Ideally, there would be global agreement about who should get

12317-512: The way along the supply chain." As an example highlighting the immensity of the challenge, the International Air Transport Association stated that 8,000 Boeing 747 cargo planes, equipped for precision vaccine cold storage, would be needed to transport one dose for the entire population in the more than 200 countries experiencing the COVID‑19 pandemic. GAVI states that "with a fast-moving pandemic, no one

12430-467: The worldwide challenge faced by coordinating numerous organizations – the COVAX partnership, global pharmaceutical companies, contract vaccine manufacturers, inter- and intranational transport, vaccine storage facilities, and health organizations in individual countries – Seth Berkley , chief executive of GAVI, stated: "Delivering billions of doses of vaccine to the entire world efficiently will involve hugely complex logistical and programmatic obstacles all

12543-443: Was accidentally released from a laboratory have been proposed, as of 2021 these were not supported by evidence. Official "case" counts refer to the number of people who have been tested for COVID-19 and whose test has been confirmed positive according to official protocols whether or not they experienced symptomatic disease. Due to the effect of sampling bias , studies which obtain a more accurate number by extrapolating from

12656-457: Was still a pandemic. Pandemics and their ends are not well-defined, and whether or not one has ended differs according to the definition used. As of 24 November 2024, COVID-19 has caused 7,075,455 confirmed deaths. The COVID-19 pandemic ranks as the fifth- deadliest pandemic or epidemic in history . In epidemiology , a pandemic is defined as "an epidemic occurring over a very wide area, crossing international boundaries, and usually affecting

12769-445: Was the most widely used. According to a June 2022 study, COVID-19 vaccines prevented an additional 14.4 million to 19.8 million deaths in 185 countries and territories from 8 December 2020 to 8 December 2021. On 8 November 2022, the first recombinant protein-based COVID-19 vaccine (Novavax's booster Nuvaxovid ) was authorised for use in adults in the United Kingdom. It has subsequently received endorsement/authorisation from

#395604