Principles of Epidemiology (MPH-502-DL2, MPH-502-DL2A)

Hippocrates (460-377 BC) the Father of Medicine and the First Epidemiologist used epidemiology principles to understand disease occurrence. During 2019-2020 Covid-19 caused global shutdowns renewing interest in epidemiology. The current Covid-19 pandemic utilized well-designed epidemiological tools to learn virus origin and whether it caused the disease? However, we never got past the origin to truly tackle this epidemic. Those who cannot remember the past are condemned to repeat it! (George Santayana-1905). In a 1948 speech Winston Churchill changed the quote slightly stating those who fail to learn from history are condemned to repeat it. According to how severe, widespread, and questionable treatment and origin were in this case did history repeat itself? We still do not know if this disease is found in humans or animals and in what locations? Treatment options were forced, coerced, and often displayed without the side effect history or feedback listing in the packaging panels. Combinations of virology labs, tools, and serology from patient samples, cohorts, and community surveys could have helped to reconstruct the events that led to the outbreaks. Utilizing genetic sequencing of how the virus was spread and possible links with animals were not adequately established. The current pandemic compares to the cholera outbreak in London because many believed it was a cloud of disease that hung close to earth and infected everyone much like covid. John Snow (1813-1858) identified the issue (water) and turned off the suspicious pump, thus controlling the spread of disease. Hence, the etiology of the disease as well as observation of the characteristics of those who became ill provided the conclusive evidence to the source of the contamination. We have yet to solidify the host of the Covid contagion nor treatment and as such the application, origin, and outcome are null. The Covid-19 pandemic has increased the awareness of Public Health. Public Health has become a household term. The pandemic has made amateur epidemiologists out of each of us so my opinion remains to be just that my “opinion.”

The 3 basic uses of epidemiology as they relate to the Covid-19 pandemic would have described the disease occurrence, identifying the causes of disease (agent), and to find factors that increase a person’s risk of disease (host) within the environment. These revelations would have resulted into a perfect scientific method of problem solving that could have helped to understand how people got sick and die, who gets sick and dies, and how to avoid getting sick. Epidemiology also describe the extent of disease in a population and the natural history, and what is the course and characteristics of the disease if left untreated. In this manner one can evaluate preventive measures and guide policy decisions. A well-understood disease has 4 basic elements 

  1. Homogeneous set of signs and symptoms
    2. Knowledge of the etiology
    3. Appreciation of the natural history
    4. Treatment derived from 2 and 3

References 

khanacademy. (2016, March 15). The scientific method. YouTube. Retrieved March 8, 2022, from https://www.youtube.com/watch?v=N6IAzlugWw0&t=1s

Rothman, K. J. (2012). Epidemiology: An introduction. Amazon. Retrieved March 8, 2022, from https://www.amazon.com/Introduction-Epidemiology-Distribution-Determinants-Disease/dp/1111540306

Macera, C. A., Shaffer, R., & Shaffer, P. M. (2012). Introduction to Epidemiology: Distribution and Determinants of Disease (Public Health Basics) (1st ed.). Cengage Learning

Scientific method is a commonsense way of looking at the world and defining our understanding of it. Observation, reason, and explanation of it – The observation would be an example of how to create the next step to ask a question as to why this observation occurs. A key part of the scientific method is creating a testable explanationwhich is a star pillar of the scientific method. The Covid-19 pandemic scientists asked the question where does Covid come from and what is the host, The backgrounders did the research, and constructed the hypothesis that it was found in bats  and the origin was unknown. Upon testing the hypothesis and data analysis the conclusion was drawn that this is false and that Covid was a man made weapon formed in Wuhan. The communication of the results and origin are greatly debated, butopen debate can foster communication among scientists, the scientific community, and the public alike.

Steps of the scientific method
1. Ask a Question
2. Do Background Research
3. Construct a Hypothesis
4. Test The Hypothesis
5. Analyze The Data and Draw a Conclusion
6. Communicate The Results

References

khanacademy. (2016, March 15). The scientific method. YouTube. Retrieved March 8, 2022, from https://www.youtube.com/watch?v=N6IAzlugWw0&t=1s (Links to an external site.)

Macera, C. A., Shaffer, R., & Shaffer, P. M. (2012). Introduction to Epidemiology: Distribution and Determinants of Disease (Public Health Basics) (1st ed.). Cengage Learning

The Black Death resulted in an increased disease frequency where 25 million deaths nearly one-third of the population was eliminated from the earth in just under five years. A recent study, published in The Lancet stated the number of lives lost to the (COVID-19) pandemic was close to 18 million, and that was just for 2021. The global excess deaths resulting for that same period totaled 18.2 million. These pandemics spread around the world while impacting wide-ranging daily activities. They likewise result in death, infection, businesses closing, social distancing, and stay at home orders. The coronavirus disease 2019 (COVID-19) pandemic developed much the same and many experts were puzzled to have been rejected and ridiculed for requesting to examine key aspects of the vaccine and disease origin. The challenges and developments were variable to significant degrees yet the progress of educating on the national and global level was shuddered. Only one agenda was tolerated involving origin, vaccination, and prevention protocols to be put in place. The emergence and spread of variants were never contained nor suppressed and variants are still of concern and the public responses to government and pharmaceutical interventions hesitant due to conflicting analogy and mistrust. 

The increased disease frequency of coronavirus disease-19 (COVID-19) in Europe is a result of lack of freedom to share medical knowledge and basic scientific awareness. SARS-CoV (2) has caused devastating health, economic, and social impact nationally, however its clinical spectrum can be asymptomatic in some and lead to respiratory failure and multi-organ failure or death in others. The human response for all is unknown, so a one size fit’s all injection is questionable. As a result hyperimmune responses can have moderate to severe responses and will develop if triggered by ritualistic shots and pills. If the immune system reacts to a wrong target it can amplify the damage(s) wrought by SARS-CoV (2). “European Union regulators warned that frequent Covid-19 booster shots could adversely affect the immune response and may not be feasible.” (Anghel, 2022) Blaming vaccinated and unvaccinated dehumanizes when we could never put humanity in a one size fit all box. Europe’s response has a lot to do with the weather, culture, and life stressors that impact this entire nation and weakens immune response seasonally and climatically. When the wealthy begin to flee, and our borders remain open for any and all new variants are inevitable, but we do not know if someone has a natural resistance, natural immunity, or otherwise. This is an enigma that the hands and wonders of time, season, and change faucet and it may involve taking some chances, but we should all be allowed to choose without threat and forced motives.

Frequency, also known as prevalence, measures the number of individuals within a specific population with a known or suspected disease. It questions the health outcomes of interest at a specified point in time. The point of prevalence is a measure of the frequency and prevalence of the disease during a specified period. Prevalence measures are used to describe the scope and distribution of health outcomes within a population.   

The measurement looks like this
 Prevalence = number of persons with the disease  
   Total number of persons

References 

Adam, D. (2022, March 10). Covid’s true death toll: Much higher than official records. Nature News. Retrieved March 14, 2022, from https://www.nature.com/articles/d41586-022-00708-0 (Links to an external site.)

Bloomberg. (n.d.). Bloomberg.com. Retrieved March 15, 2022, from https://www.bloomberg.com/news/articles/2022-01-11/repeat-booster-shots-risk-overloading-immune-system-ema-says

Mizokami, K. (2020, February 7). 25 million dead: How the black death nearly destroyed Europe. The National Interest. Retrieved March 14, 2022, from https://nationalinterest.org/blog/buzz/25-million-dead-how-black-death-nearly-destroyed-europe-91161

Rothman, K. J. (2012). Epidemiology: An introduction. Amazon. Retrieved March 8, 2022, from https://www.amazon.com/Introduction-Epidemiology-Distribution-Determinants-Disease/dp/1111540306 (Links to an external site.)

Stanton, C. (2022, March 14). ‘ample room for uncertainty’: As covid-19 cases rise again in Europe, could us see the same? USA Today. Retrieved March 14, 2022, from https://www.usatoday.com/story/news/nation/2022/03/13/covid-cases-rising-europe/7026697001/

The COVID pandemic incidence and prevalence is critical and the U.S. must establish a viable national program rapidly and deliver effective new research to a body of scientist and epidemiologist to study expediently. Vaccines need to be averted as levels of natural, neutral, and negative immunity is analyzed. The economic destruction, social upheaval, and insecurities are impacting the future generations and we must focus on studying the strong to better service the weak. COVID-19 has tragically killed more than one third of the earth’s population and the incidence of a new pandemic virus could be even more lethal and transmissible. COVID-19 prevalence has damaged economies, child development, and our future as a nation. The incidence and prevalence have fueled the optimism of many scientists to accelerate clinical trials. 

Disease frequency is different on the east and west coasts due to delaying effective control measures such as closing boarders and vaccine trial information being controlled and withheld from peer reviewers. The National Institutes of Health, Food and Drug Administration, and Centers for Disease Control/ Prevention, must partner with our leading scientists and health agencies and work together on one accord. When compulsively authoritarian leadership is in control exponential infection and death is likely. It’s not enough to mass manufacture new vaccines and place the primary focus on vaccination when herd immunity never required manufactured hands. A progressive nation is a wise nation, but only fools rush in and cripple while claiming to heal.

Interestingly, WHO has changed the definition of herd immunity three times last year. On June 9, 2020, the WHO website stated that, “Herd immunity is the indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection.” 

“This vaccine is leaky. Which means that a vaccinated person can still acquire the virus and spread the virus. It does not provide the sterilizing immunity (which means you can’t carry the virus) that most other vaccines offer. This is why many argue that calling it a vaccine is incorrect, as it does not provide immunity in the traditional sense of the word. However, becoming naturally infected and recovering from the virus does.” (Wetzler, 2021)

Media and news are retracting posted numbers involving the current Covid-19 pandemic. It is a puzzle that has missing pieces and even as such the disease frequency is different on the east and west coasts depending on what they determine to dictate. The numbers always are to complete an agenda and rarely speak for the people. The narrative as such is that the vaccinated states are faring the best, contrary to the voice of the citizens who use underground medias to avoid being shadow banned. The new mRNA COVID-19 vaccines have been a phenomenal accomplishment, game-changer, safe and highly efficacious in preventing severe disease is posted everywhere although developed in a matter of months, not years. I impart upon the government to not underestimate the wisdom of the generations at hand. Forcing information into the ears of a wise man draws suspicion.

Here is my scientific methodology 

On January 12 –  British Prime Minister Boris Johnson is under pressure to resign after admitting he attended a garden party at his Downing Street residence, in breach of his government’s coronavirus lockdown rules.

On January 19 – The prime minister announces plans to end mandatory face coverings in public places and Covid passports both dropped.

* Nobody has mentioned the Prime Minister’s resignation since 

Reference

Macera, C. A., Shaffer, R., & Shaffer, P. M. (2012). Introduction to Epidemiology: Distribution and Determinants of Disease (Public Health Basics) (1st ed.). Cengage Learning

Wetzler, H. (2021, November 22). Opinion: Why aren’t we celebrating the naturally immune? ClarkCountyToday.com. Retrieved March 15, 2022, from https://www.clarkcountytoday.com/opinion/opinion-why-arent-we-celebrating-the-naturally-immune/

Case-control studies advantages are that they maintain the best design for studying rare diseases, can be performed in a short time period, less costly, easy access to historical data, allows the assessment of multiple independent variables. Case-control studies disadvantages are expense, and information bias. Randomized controlled trials are the new gold standard for reliable drug testing. “Nothing more clearly indicates the key role of an RCT in modern clinical research than the placement of this specific research method at the top of the list of levels of evidence in evidence-based medicine.” (Stanley, 2007) The advantage of RCT is the prevention of deliberate manipulation of data results. The participant nor the scientist can influence results as the participants are randomly assigned. With RCT the skewing of results and selection bias is eliminated as RCT removes the element of choice. This prevents the risk that researchers receiving direct or indirect funding from pharmaceutical companies are bias when looking to prove the efficacy and safety of new drugs. The disadvantages of RCT are the ability to assign higher risk participants with lower chance of success to the group receiving the treatment. 

References

Macera, C. A., Shaffer, R., & Shaffer, P. M. (2012). Introduction to Epidemiology: Distribution and Determinants of Disease (Public Health Basics) (1st ed.). Cengage Learning.

Statistical primer for cardiovascular research – unav.edu. (n.d.). Retrieved March 22, 2022, from https://www.unav.edu/documents/16089811/16216616/Stanley_design+RCT.pdf

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