Preventing Pandemics & Preparing Health Care

COVID-19, Lung Insufficiencies, Fractal Geometry & Hyperactivity of the Inflammatory System

Outline

• Evolution of Pandemics
• 3 P´s for Pandemics
• Understanding the pandemic disease
• Some Health Care Challenges
• Conclusion

Desirable Physician Attributes

• Medical Knowledge [ACGME/ABMS] about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care
  
• Employ Evidenced-based Practice [IOM] Integrate best research with clinical expertise and patient values for optimum care, and participate in learning and research activities to the extent feasible
• Systems-Based Practice [ACGME/ABMS] as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value

Accreditation & Designation

Release date: This activity was released 8/15/2020.

Termination date: The content of this activity remains eligible for CME Credit until 8/14/2023, unless reviewed or amended prior to this date.

Neurovations Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Neurovations Education designates this other activity (blended learning) for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosures of Financial Relationships

Neither the speaker, peer reviewers nor any other person with control of, or responsibility for, the development, management, presentation or evaluation of the CME activity has, or has had within the past 12 months, any relevant financial relationships to disclose. This includes any relationships of an involved person's spouse/partner.

Additional Reading

• Lindahl, S. G. (2020). Using the prone position could help to combat the development of fast hypoxia in some patients with COVID‐19. Acta Paediatrica.
• de Groot, R. J., Baker, S. C., Baric, R. S., Brown, C. S., Drosten, C., Enjuanes, L., ... & Perlman, S. (2013). Commentary: Middle east respiratory syndrome coronavirus (mers-cov): announcement of the coronavirus study group. Journal of Virology, 87(14), 7790-7792.
• Woo, P. C., Lau, S. K., Lam, C. S., Lau, C. C., Tsang, A. K., Lau, J. H., ... & Zheng, B. J. (2012). Discovery of seven novel Mammalian and avian coronaviruses in the genus deltacoronavirus supports bat coronaviruses as the gene source of alphacoronavirus and betacoronavirus and avian coronaviruses as the gene source of gammacoronavirus and deltacoronavirus. Journal of Virology, 86(7), 3995-4008.
• Forni, D., Cagliani, R., Clerici, M., & Sironi, M. (2017). Molecular evolution of human coronavirus genomes. Trends in Microbiology, 25(1), 35-48.
• Ye, Z. W., Yuan, S., Yuen, K. S., Fung, S. Y., Chan, C. P., & Jin, D. Y. (2020). Zoonotic origins of human coronaviruses. International Journal of Biological Sciences, 16(10), 1686.
• Gussow, A. B., Auslander, N., Faure, G., Wolf, Y. I., Zhang, F., & Koonin, E. V. (2020). Genomic determinants of pathogenicity in SARS-CoV-2 and other human coronaviruses. Proceedings of the National Academy of Sciences.
• Wei, J., Alfajaro, M., Hanna, R., DeWeirdt, P., Strine, M., Lu-Culligan, W., ... & Mankowski, M. (2020). Genome-wide CRISPR screen reveals host genes that regulate SARS-CoV-2 infection. Biorxiv.
• Tracey, K. J. (2015). Approaching the next revolution? Evolutionary integration of neural and immune pathogen sensing and response. Cold Spring Harbor Perspectives in Biology, 7(2), a016360.
• Nicoli, F., Solis-Soto, M. T., Paudel, D., Marconi, P., Gavioli, R., Appay, V., & Caputo, A. (2020). Age-related decline of de novo T cell responsiveness as a cause of COVID-19 severity. GeroScience, 1-5.
• Grifoni, A., Weiskopf, D., Ramirez, S. I., Mateus, J., Dan, J. M., Moderbacher, C. R., ... & Marrama, D. (2020). Targets of T cell responses to SARS-CoV-2 coronavirus in humans with COVID-19 disease and unexposed individuals. Cell.
• Tracey, K. J. (2002). The inflammatory reflex. Nature, 420(6917), 853-859.
• Andersson, U., Yang, H., & Harris, H. (2018). Extracellular HMGB1 as a therapeutic target in inflammatory diseases. Expert opinion on therapeutic targets, 22(3), 263-277.
• Tracey, K. J. (2007). Physiology and immunology of the cholinergic antiinflammatory pathway. The Journal of Clinical Investigation, 117(2), 289-296.
• Douglas, W. W., Rehder, K., Beynen, F. M., Sessler, A. D., & Marsh, H. M. (1977). Improved oxygenation in patients with acute respiratory failure: the prone position. American Review of Respiratory Disease, 115(4), 559-566.
• Beck, K. C., & Rehder, K. (1986). Differences in regional vascular conductances in isolated dog lungs. Journal of Applied Physiology, 61(2), 530-538.