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Case Study 1
1. Is the emergence of the 2009 A (H1N1) virus an example of antigenic shift orantigenic drift? Explain the difference between shift and drift.
According to DeMarco and Healey-Walsh (2019), an antigenic shift is a sudden change in the molecular strain or structure of DNA or RNA in a microorganism, which results in a new strain of the microorgainism. By contrast, an antigenic drift refers to slow and progressive genetic changes that take place in DNA and RNA as organisms replicate in multiple hosts (DeMarco and Healey-Walsh, 2019). The novel influenza A (H1N1) was considered an antigenic shift because it occurred suddenly and those exposed had little to no immunity against it, causing quick onset of illness. Because it was a virus, it spread rapidly, thus causing a pandemic.
2. Why was the 2009 A (H1N1) influenza epidemic considered a pandemic?
An epidemic is an outbreak that occurs when there is an increased incidence of a disease beyond that which is normally found in the population, whereas a pandemic is an epidemic that occurs worldwide (DeMarco and Healey, 2019). The 2009 A H1N1 was first detected in the United States and spread quickly across the United States and the world. The virus contained a unique number of genes that had never been seen or detected before in people or animals, which meant that many people did not have any existing antibodies to fight it (CDC, 2019). This meant it had a greater devastating impact on individuals in regards to degree of sickness, hospitalizations, and morbidity. Because the virus moved quickly, was not detected previously among other influenza strains, and impacted a significant number of people in a short time, it was considered a pandemic.
Case Study 2
Name two reasons as to why the US failed to contain COVID-19?
There are a multitude of reasons that COVID-19 spread rapidly in the United States, and how much of it was avoidable vs unavoidable is up for debate depending on interpretation, execution, and of course, political view. That said, it is clear that ambiguous guidelines and mandated criteria could certainly account for one of the main reasons that infection spread. Depending on geographic location, political view, establishment (grocery store vs hospital, mom-and-pop store vs commercial chain), and individual preference, practices such as social distancing and mask wearing were open to interpretation. Protocol consistently changed through the summer and back into the fall of 2020 as people became antsy with following guidelines, and were then forced or scared back into following restricted protocol as COVID-19 cases again rose. It was and continues to be frustrating to have mixed messages at a federal and state level. The article references that, “almost 10 months into the pandemic, there has been no coherent national, federally led strategy to coordinate COVID-19 response activities across state and local jurisdictions” (Juliano et al., 2021). However, smaller countries were able to develop cohesive plans on a national and local level (Juliano et al., 2021). A second reason that COVID-19 spread so rapidly was the disconnected communication between all involved: the White House, the Food and Drug Administration, The US Department of Health and Human Services, and the Center for Disease Control and Prevention. The lack of agreement and communication between these powerhouses led to a huge erosion of the public’s confidence in federal decision making as well as commitment to a robust local, federal, and state partnership (Juliano et. al., 2021). Because the public grew suspicious and doubtful of the ability of these decision makers to guide the country with the appropriate recommendations and relay the truth, the public began to adjust the rules as they saw fit, thus further contributing to the divide.
2. Based on the lessons learned thus far, what can the U.S. do in the future when faced with a pandemic or national emergency related to infectious diseases?
Despite the tumultuous arguments as to why and how COVID-19 spread and the United States found itself in its current state, arguably many opportunities for improvement have surfaced. The chronic underfunding of health systems on multiple levels was exposed, thus creating an urgent need for revision (Juliano et al., 2021). It is well known that primary prevention is less expensive than secondary or tertiary prevention, so a push for education and wellness in communities would be an immediate need to promote a baseline understanding of infection control and health. Should the US be faced with a pandemic or emergency in the future, it would be in the country’s best interest to unite and present the public with a clear message that is cohesive and not open to interpretation. It is important that political views be set aside to produce a unified agreement and that media be monitored so that polarizing articles can be dismissed, as they only serve to sell papers and further attempt to divide the public and the country.
