Visualizing How COVID-19 Antiviral Pills and Vaccines Work
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COVID-19

Visualizing How COVID-19 Antiviral Pills and Vaccines Work at the Cellular Level

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Current Strategies to Tackle COVID-19

Since the pandemic started in 2020, a number of therapies have been developed to combat COVID-19.

The leading options for preventing infection include social distancing, mask-wearing, and vaccination. They are still recommended during the upsurge of the coronavirus’s latest mutation, the Omicron variant.

But in December 2021, The United States Food and Drug Administration (USDA) granted Emergency Use Authorization to two experimental pills for the treatment of new COVID-19 cases.

These medications, one made by Pfizer and the other by Merck & Co., hope to contribute to the fight against the coronavirus and its variants. Alongside vaccinations, they may help to curb extreme cases of COVID-19 by reducing the need for hospitalization.

Despite tackling the same disease, vaccines and pills work differently:

VaccinesPills
Taken by injectionTaken by mouth
Used for prevention Used for treatment only
Create an enhanced immune system by stimulating antibody productionDisrupt the assembly of new viral particles

How a Vaccine Helps Prevent COVID-19

The main purpose of a vaccine is to prewarn the body of a potential COVID-19 infection by creating antibodies that target and destroy the coronavirus.

In order to do this, the immune system needs an antigen.

It’s difficult to do this risk-free since all antigens exist directly on a virus. Luckily, vaccines safely expose antigens to our immune systems without the dangerous parts of the virus.

In the case of COVID-19, the coronavirus’s antigen is the spike protein that covers its outer surface. Vaccines inject antigen-building instructions* and use our own cellular machinery to build the coronavirus antigen from scratch.

When exposed to the spike protein, the immune system begins to assemble antigen-specific antibodies. These antibodies wait for the opportunity to attack the real spike protein when a coronavirus enters the body. Since antibodies decrease over time, booster immunizations help to maintain a strong line of defense.

*While different vaccine technologies exist, they all do a similar thing: introduce an antigen and build a stronger immune system.

How COVID Antiviral Pills Work

Antiviral pills, unlike vaccines, are not a preventative strategy. Instead, they treat an infected individual experiencing symptoms from the virus.

Two drugs are now entering the market. Merck & Co.’s Lagevrio®, composed of one molecule, and Pfizer’s Paxlovid®, composed of two.

These medications disrupt specific processes in the viral assembly line to choke the virus’s ability to replicate.

The Mechanism of Molnupiravir

RNA-dependent RNA Polymerase (RdRp) is a cellular component that works similar to a photocopying machine for the virus’s genetic instructions. An infected host cell is forced to produce RdRp, which starts generating more copies of the virus’s RNA.

Molnupiravir, developed by Merck & Co., is a polymerase inhibitor. It inserts itself into the viral instructions that RdRp is copying, jumbling the contents. The RdRp then produces junk.

The Mechanism of Nirmatrelvir + Ritonavir

A replicating virus makes proteins necessary for its survival in a large, clumped mass called a polyprotein. A cellular component called a protease cuts a virus’s polyprotein into smaller, workable pieces.

Pfizer’s antiviral medication is a protease inhibitor made of two pills:

  1. The first pill, nirmatrelvir, stops protease from cutting viral products into smaller pieces.
  2. The second pill, ritonavir, protects nirmatrelvir from destruction by the body and allows it to keep working.

With a faulty polymerase or a large, unusable polyprotein, antiviral medications make it difficult for the coronavirus to replicate. If treated early enough, they can lessen the virus’s impact on the body.

The Future of COVID Antiviral Pills and Medications

Antiviral medications seem to have a bright future ahead of them.

COVID-19 antivirals are based on early research done on coronaviruses from the 2002-04 SARS-CoV and the 2012 MERS-CoV outbreaks. Current breakthroughs in this technology may pave the way for better pharmaceuticals in the future.

One half of Pfizer’s medication, ritonavir, currently treats many other viruses including HIV/AIDS.

Gilead Science is currently developing oral derivatives of remdesivir, another polymerase inhibitor currently only offered to inpatients in the United States.

More coronavirus antivirals are currently in the pipeline, offering a glimpse of control on the looming presence of COVID-19.

Author’s Note: The medical information in this article is an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Please talk to your doctor before undergoing any treatment for COVID-19. If you become sick and believe you may have symptoms of COVID-19, please follow the CDC guidelines.

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Business

Pandemic Recovery: Have North American Downtowns Bounced Back?

All North American downtowns are facing a sluggish recovery, but some are still seeing more than 80% less foot traffic than pre-pandemic times

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Pandemic Recovery: Have Downtowns Bounced Back?

As we continue on our journey towards recovery from the impacts of the pandemic, North American offices that sat empty for months have started to welcome back in-person workers.

This small step towards normalcy has sparked questions around the future of office life—will office culture eventually bounce back to pre-pandemic levels, or is remote work here to stay?

It’s impossible to predict the future, but one way to gauge the current state of office life is by looking at foot traffic across city centers in North America. This graphic measures just that, using data from Avison Young.

Change in Downtown Office Traffic

According to the data, which measures foot traffic in major office buildings in 23 different metropolitan hubs across North America, remains drastically below pre-pandemic levels.

Across all major cities included in the index, average weekday visitor volume has fallen by 73.7% since the early months of 2020. Here’s a look at each individual city’s change in foot traffic, from March 2, 2020 to Oct 11, 2021:

CityCountryChange in Foot Traffic
Austin🇺🇸-51.70%
Calgary🇨🇦-54.50%
Boston🇺🇸-54.90%
New York🇺🇸-60.50%
San Francisco🇺🇸-60.80%
Edmonton🇨🇦-62.20%
Houston🇺🇸-67.90%
Chicago🇺🇸-68.10%
Vancouver🇨🇦-68.20%
Los Angeles🇺🇸-68.60%
Philadelphia🇺🇸-69.00%
Washington, DC🇺🇸-69.40%
San Francisco Peninsula🇺🇸-70.00%
Denver🇺🇸-73.50%
Nashville🇺🇸-75.60%
East Bay/Oakland🇺🇸-76.10%
Atlanta🇺🇸-77.50%
Dallas🇺🇸-79.80%
Montreal🇨🇦-80.30%
Toronto🇨🇦-81.20%
Miami🇺🇸-82.20%
Silicon Valley🇺🇸-82.60%
Ottawa🇨🇦-87.70%

The Canadian city of Calgary is a somewhat unique case. On one hand, foot traffic has bounced back stronger than many other downtowns across North America. On the other hand, the city has one of the highest commercial vacancy rates in North America, and there are existential questions about what comes next for the city.

Interestingly, a number of cities with a high proportion of tech jobs, such as Austin, Boston, and San Francisco bounced back the strongest post-pandemic. Of course, there is one noteworthy exception to that rule.

A Tale of Two Cities

Silicon Valley has experienced one of the most significant drops in foot traffic, at -82.6%. Tech as an industry has seen one of the largest increases in remote work, as Bay Area workers look to escape high commuter traffic and high living expenses. A recent survey found that 53% of tech workers in the region said they are considering moving, with housing costs being the primary reason most respondents cited.

Meanwhile, in a very different part of North America, another city is experienced a sluggish rebound in foot traffic, but for very different reasons. Ottawa, Canada’s capital, is facing empty streets and struggling small businesses that rely on the droves of government workers that used to commute to downtown offices. Unlike Silicon Valley, where tech workers are taking advantage of flexible work options, many federal workers in Ottawa are still working from home without a clear plan on returning to the workplace.

It’s also worth noting that these two cities are home to a lot of single-occupant office buildings, which is a focus of this data set.

Some Businesses Remain Hopeful

Despite a slow return to office life, some employers are snapping up commercial office space in preparation for a potential mass return to the office.

Back in March 2021, Google announced it was planning to spend over $7 billion on U.S. office space and data centers. The tech giant held true to its promise—in September, Google purchased a Manhattan commercial building for $2.1 billion.

Other tech companies like Alphabet and Facebook have also been growing their office spaces throughout the pandemic. In August 2021, Amazon leased new office space in six major U.S. cities, and in September 2020, Facebook bought a 400,000 square foot complex in Bellevue, Washington.

Will More Employees Return or Stay Remote?

It’s important to note that we’re still in the midst of pandemic recovery, which means the jury’s still out on what our post-pandemic world will look like.

Will different cities and industries eventually recover in different ways, or are we approaching the realities of “new normal” foot traffic in North American city centers?

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Healthcare

How Does the COVID Delta Variant Compare?

How does the COVID-19 Delta variant compare with the original disease? Here are the key differences according to consolidated studies.

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How Does the COVID Delta Variant Compare Social

How Does the COVID Delta Variant Compare?

In late 2020, a variant of COVID-19 was detected in India that began to quickly spread.

Soon after it received the label “Delta,” it started to become the predominant strain of COVID-19 in countries of transmission. It spread faster than both the original disease and other variants, including “Alpha” that had taken hold in the UK.

Now the COVID-19 pandemic has essentially become the Delta pandemic, as the variant accounts for more than 90% of global cases.

But how does the COVID-19 Delta variant differ from the original disease? We consolidated studies as of September 2021 to highlight key differences between COVID-19 and the dominant variant. Sources include the CDC, Yale Medicine, and the University of California.

COVID-19 vs COVID-19 Delta Variant

At first glance, infections caused by the Delta variant are similar to the original COVID-19 disease. Symptoms reported from patients include cough, fever, headache, and a loss of smell.

But studies showed that the difference was in how quickly and severely patients got sick:

  • Spread rate: How quickly the infection spreads in a community (based on the R0 or basic reproductive number). The Delta variant spread 125% faster than the original disease, making it potentially as infectious as chickenpox.
  • Viral load: How much of a virus is detectable in an infected person’s blood, with higher loads correlating with more severe infections. Delta infections had a 1000x higher viral load.
  • Virus detectable: How long after exposure a virus is detectable in an infected person’s blood. Delta infections were found to be detectable four days after exposure, faster than the original disease (six days).
  • Infectious period: How long an infected person has the capability to pass on the virus to other people, from the first time they were exposed. Delta infections were contagious for longer than traditional COVID-19 infections, at 18 days compared to 13 days.
  • Risk of hospitalization: How much more or less likely is an infection going to require hospitalization for treatment? Infections caused by the Delta variant were twice as likely to cause hospitalization compared to the original disease.

One other important finding from studies was that the existing COVID-19 vaccines helped against Delta infections.

The CDC found that approved vaccines reduced the rate of infection by 5x and the rate of hospitalization by 29x in a breakthrough case. They also found that overall efficacy against infection can wane over time, however, and at-risk people might require a booster vaccine.

What About Other COVID-19 Variants?

Delta is just one of many COVID-19 variants tracked by health officials, but it’s the one we know the most about.

That’s because reliable statistics and information on diseases requires thousands of cases for comparisons. We know a lot about Delta (and the once-dominant UK strain Alpha) because of how widespread they became, but there haven’t been enough cases of other variants to reliably assess differences.

As of September 2021, WHO was tracking 20 COVID-19 variants around the world with different classifications based on potential severity:

  • 14 Variants under monitoring (VUM): Variants that are deemed to not pose a major global health risk, or no longer pose one.
  • 2 Variants of Interest (VOI): Variants that affect transmissibility, virulence, mutation, and other virus characteristics, and are spreading in clusters.
  • 4 Variants of Concern (VOC): Have similar characteristics to VOI but are further associated with a global risk.

Most of the current variants of interest and concern were first identified and labeled in late 2020, though 2021 variants are showing up as well.

LabelDesignationDocumented OriginEarliest Identified Date
AlphaVariant of ConcernUKSeptember 2020
BetaVariant of ConcernSouth AfricaMay 2020
GammaVariant of ConcernBrazilNovember 2020
DeltaVariant of ConcernIndiaOctober 2020
LambdaVariant of InterestPeruDecember 2020
MuVariant of InterestColombiaJanuary 2021

Should you be worried about all of these variants? For the most part, a lack of cases to provide clear information also reflects that they’re equivalent to or weaker than traditional COVID-19 infections.

But it’s important to note that our understanding of diseases and variants becomes more nuanced and accurate over time. As research continues over a longer timeline and over a wider database of cases, expect information on COVID-19 variants (and any disease) to become more concrete.

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