The Manual on Viruses

Warning

Warning

Warning

Warning

Protect yourself and the others:

Use a Mask and Gloves

Please Follow the Instructions to avoid the spread:

If you don´t follow them serious consequences are going to follow.

Designed by

Verena Metz Zumarán

The Manual on Viruses

First publication: 22. July, 2020

THE MANUAL ON VIRUSES

DESIGNED BY VERENA METZ ZUMARÁN

Nature is really complex and I don’t blame

anyone for not understanding it from the beginning.

I include myself in those people. It

takes a lot of time to understand what viruses

are, where they come from and their effect on

human lives. Humans in the past, faced a lot of

times, situations without any basic knowledge,

and correct behavior. Not being informed is a

huge mistake. This book provides a basic understanding

of viruses, its impact on our lives,

and in our society. This book has a look at past

and present events and also to a possible future.

We are going to be able to recognize the

strong interconnection between nature, science,

politics, and society, an interconnection

that is impossible to avoid.

Dedicated to my big motivation,

sister and amazing virologist Camila

Content

VIRUSES

How viruses are build

Viral infection

Evolution of a virus

Chain of infection / Transmission

Antiviral Drugs

VIRUSES IN THE MODERN WORLD

Epidemic

Pandemic

Endemic

Outbreak

EBOLA: THE KILLIG WORM

Transmission

Tracing a Host

Cases and outbreaks of EVD

2014-2016 Biggest Ebola outbreak

6

HIV: A SLOW DEATH

Where HIV comes from

The AIDS EPIDEMIC ARISES

The Fight Against HIV / Social activism

How HIV can become drug-resistant

INFLUENZA: THE CRISIS FROM LAST CENTURY

What is the Flu?

The “Flu” season and pandemics

The “Spanish Flu”

The Flu takes a heavy toll on society

The Mask resistance

CORONAVIRUSES: A VIRUS IN MODERN TIMES

SARS-CoV

MERS

COVID-19

What we didn´t see coming

7

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

“Bad news wrapped in protein”










Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

Viruses

A virus, can you see it?

Viruses are so much smaller than bacteria, that are impossible to see either in

person or with a normal light microscope. The diameter of virions is approximately

15 nm (nanometers) to 440 nm, in other words, millions of viruses would

fit on the tip of a needle. Viruses were not visible until the invention of the electron

microscope.


// 11

My interpretation for Viruses:

totally independent of

their host for their existance.

Extracting and killing them

without compation.

12 // WHAT WE NEED TO KNOW

How Viruses are build

Without a host cell, viruses cannot carry out their life-sustaining functions or

reproduce. They cannot synthesize proteins, because they lack ribosomes

and must use the ribosomes of their host cells to translate viral messenger

RNA into viral proteins. Viruses cannot generate or store energy in the form

of adenosine triphosphate (ATP), but have to derive their energy, and all

other metabolic functions, from the host cell. They also parasitize the cell

for basic building materials, such as amino acids, nucleotides, and lipids

(fats). Although viruses have been speculated as being a form of protolife,

their inability to survive without living organisms makes it highly unlikely that

they preceded cellular life during the Earth's early evolution. Some scientists

speculate that viruses started as rogue segments of genetic code that

adapted to a parasitic existence.

The structure of Viruses are really simple. All viruses contain either DNA

or RNA (but not both), and a protein coat, which encases the nucleic acid.

Some viruses are also enclosed by an envelope of fat and protein molecules.

(a) NAKED NUCLEOCAPSID

(EX.: BACTERIOPHAGE)

DNA

PROTEIN COAT

(CAPSIS)

(b) ENVELOPED VIRUS

(EX.: INFLUENZA, COVID -1 9)

NUCLEID ACID

(GENETICAL

MATERIA)

RNA

MEMBRANE ENVELOPE

(LIPID ENVELOPE)

Viruses are totaly dependent of their host, and without

them they have no possibility to exist. They use

their host cells components, such as the Ribosom,

as slaves to multiply themselfs, causing the death

of the cells and spreading to other cells to continue

with the same prosses.


// 13

What is a Viral Infection?

In everyday life, we tend to think of a

viral infection as the nasty collection

of symptoms we get when catch a

virus, such as the flu or the chicken

pox. But what’s actually happening

in your body when you have a virus?

At the microscopic scale, a viral infection

means that many viruses are

using your cells to make more copies

of themselves. The viral lifecycle

is the set of steps in which a virus

recognizes and enters a host cell,

“reprograms” the host by providing

instructions in the form of viral DNA

or RNA, and uses the host’s resources

to make more virus particles (the

output of the viral “program”). At the

end the cell dies and the many new

viruses spread to other cells to realize

the same lifecycle.

For a typical virus, the lifecycle can

be divided into five broad steps:

(1) ATTACHMENT:

The virus recognizes and

binds to a host cell via a

receptor molecule on the

cell surface.

(2) ENTRY:

The virus or its genetic

material enters the cell.

(3) GENOME REPLI-

CATION AND GENE

EXPRESSION:

The viral genome is copied

and its genes are expressed

to make viral proteins.

(4) ASSEMBLY. New viral

particles are assembled

from the genome copies

and viral proteins.

(5) RELEASE:

Completed viral particles

exit the cell and can infect

other cells.

(5)

(1)

(4)

(2)

(3)


Evolution of a Virus

DNA: genetic materia

RNA: is the messenger

between DNA and the

Ribosom.

Ribosom: build the proteins

and reads the mRNA

(=messenger RNA)

Have you ever wondered why a different strain of flu virus comes

around every year? Or how HIV, the virus that causes AIDS, can become

drug-resistant? The short answer to these questions is that viruses

evolve. That is, the "gene pool" of a virus population can change

over time and sometimes faster than their hosts, such as humans.

Genetic variation means there are some genetic (heritable) differences in a

population. In viruses, variation comes from two main sources:

1. Recombination:

Happens when two viruses have infected the same cell at the same time, so

that the floating parts (segments carrying one or a few genes) of two different

viruses can recombine and create a new mixed virus.

Ex. Influenza ("flu") viruses are masters of reassortment. When two influenza

viruses infect the same cell at the same time, some of the new viruses made

inside of the cell may have a mix of segments. Pigs in particular are wellknown

"mixing vessels" for influenza viruses. Pig Cells can be recognized,

and thus infected, by both human and bird influenza viruses. If a cell in the

pig is infected with two types of virus at the same time, it may release new

viruses that contain a mixture of genetic material from the human and bird

viruses.

This kind of swap is common for influenza viruses in nature. For example,

remember the H1N1 influenza strain ("swine flu") that caused a pandemic

in 2009? H1N1 had RNA segment from human and bird viruses, as well as

pig viruses from both North America and Asia. This combo reflects a series

of reassortments that occurred step by step over many years to produce

this H1N1 strain.

Human immunodeficiency

virus (HIV): is

the virus that causes acquired

immune deficiency

syndrome (AIDS). HIV is

an RNA virus with a high

mutation rate and evolves

rapidly, leading to the

emergence of drug-resistant

strains.

2. Random mutation:

Is a permanent change in the genetic material (DNA or RNA) of a virus. A

mutation can happen if there is a mistake during copying of the DNA or RNA

of the virus. RNA viruses have a hight mutation rate (more than DNa viruses).

Why is this the case? The key difference lies in the copying machinery.

Most DNA viruses copy their genetic material using enzymes from the host

cell, called DNA polymerases, which “proofread" (catch and fix mistakes as

they go). RNA viruses instead use enzymes called RNA polymerases, which

don't proofread and thus make many more mistakes.


// 15

CHAIN OF INFECTION:

From person to Person:

You to me

Me to him

Him to them


Zoonosis:

A bat to a mouse

A mouse to a snake

A snake to a human

Infectious diseases result from the interaction of agent, host, and environment.

More specifically, transmission occurs when the agent leaves its reservoir or

host through a portal of exit, is conveyed by some mode of transmission, and

enters through an appropriate portal of entry to infect a susceptible host. This

sequence is sometimes called the chain of infection.


// 17

Reservoirs

The reservoir of an infectious agent is the habitat in which

the agent normally lives, grows, and multiplies. Reservoirs

include humans, animals, and the environment. The reservoir

may or may not be the source from which an agent is transferred

to a host.

Human reservoirs:

Many common infectious diseases have human reservoirs.

Diseases that are transmitted from person to person

without intermediaries include the sexually transmitted

diseases, measles, mumps, streptococcal infection,

and many respiratory pathogens. For example, because

humans were the only reservoir for the smallpox virus,

naturally occurring smallpox was eradicated after the last

human case was identified and isolated.

(1) Asymptomatic or passive

or healthy carriers are

those who never experience

symptoms despite being

infected.

(2) Incubatory carriers are

those who can transmit the

agent during the incubation

period before clinical illness

begins.

(3) Convalescent carriers

are those who have recovered

from their illness but

remain capable of transmitting

to others.

(4) Chronic carriers are

those who continue to harbor

a pathogen for months

or even years after their

initial infection.

Human reservoirs may or may not show the effects of

illness. A carrier is a person with inapparent infection

who is capable of transmitting the pathogen to others.

Carriers commonly transmit disease because they do not

realize they are infected, and consequently take no special

precautions to prevent transmission. Symptomatic

persons who are aware of their illness, on the other hand,

may be less likely to transmit infection because they are

either too sick to be out and about, take precautions to

reduce transmission, or receive treatment that limits the

disease.

Many newly recognized

infectious diseases in

humans, including HIV/

AIDS, Ebola infection and

SARS, are thought to have

emerged from animal hosts,

although those hosts have

not yet been identified.

Animal reservoirs:

Humans are also subject to diseases that have animal

reservoirs. Many of these diseases are transmitted from

animal to animal, with humans as incidental hosts. The

term zoonosis refers to an infectious disease that is transmissible

under natural conditions from vertebrate animals

to humans. Many newly recognized infectious diseases

in humans, including HIV/AIDS, Ebola infection and

SARS, are thought to have emerged from animal hosts,

although those hosts have not yet been identified.

(More to Zoonosis on the next page...)


Modes of transmission

An infectious agent may be transmitted from its natural

reservoir to a susceptible host in different ways.

Here is one classification:

DIRECT: In direct transmission, an infectious agent is

transferred from a reservoir to a susceptible host by direct

contact or droplet spread.

Direct contact: occurs through skin-to-skin contact, kissing,

and sexual intercourse, such as through contact with

open wounds, mucous membranes, or abraded skin contacting

an infec ted animal or its tissues or fluids (e.g.,

blood, saliva, urine). Inoculation of pathogens can occur

from bites or scratches.

Droplet spread: Droplet spread refers to spray with relatively

large, short-range aerosols produced by sneezing,

coughing, or even talking. Droplets containing pathogens

travel through the air and are inhaled by another animal

or human.

INDIRECT: refers to the transfer of an infectious agent

from a reservoir to a host by suspended air particles,

inanimate objects (vehicles), or animate intermediaries.

Airborne: occurs when infectious agents are carried by

dust or droplet nuclei suspended in air. Airborne dust

includes material that has settled on surfaces and become

resuspended by air currents as well as infectious

particles blown from the soil by the wind.

Vehicles: that may indirectly transmit an infectious agent

include food, water, biologic products (blood), and fomites

(inanimate objects such as handkerchiefs, bedding,

or surgical scalpels).

Vectors: such as mosquitoes, fleas, and ticks Transfer

of a pathogen from an infected animal to another animal

or a human by an insect (e.g., flea, tick, mosquito).


// 19

ZOONOSIS

Humans coexist in a complex, interdependent relationship with the

companion, production, and wild animals we depend on for our food,

livelihoods, and well-being, as well as with the environments we live

and work in together. The interface between humans, animals, and the

environments we share can also be a source of diseases impacting

public health and the social and economic well-being of the world population.

Such diseases, transmissible from animals to humans through

direct contact or though food, water, and the environment, are commonly

referred to as “zoonoses.” Animals thus play an essential role in maintaining

zoonotic infections in nature. Zoonoses may be bacterial, viral,

or parasitic, or may involve unconventional agents. As well as being a

public health problem, many of the major zoonotic diseases prevent

the efficient production of food of animal origin and create obstacles to

international trade in animal products. An example how this diseases

are transmitted from animals to humans, is BRUSHMEAT or in WET

MARKETS.



// 21

WET MARKETS

A wet market (also called a public market) is a marketplace selling fresh

meat, fish, produce, and other perishable goods.

If sanitation standards are not maintained, wet markets can spread disease.

Those that carry live animals and wildlife are at especially high risk

of transmitting zoonoses. Because of the openness, newly introduced

animals may come in direct contact with sales clerks, butchers, and

customers or to other animals which they would never interact with in

the wild. This may allow for some animals to act as intermediate hosts,

helping a disease spread to humans.

Due to unhygienic sanitation standards and the connection to the spread

of zoonoses and pandemics, critics have grouped wet markets that hold

live animals together with factory farming as major health hazards in

China and across the world.


Animal markets in Wuhan by Amnat Alamy

China may be the source of the coronavirus outbreak


// 23

JUST A SMALL PRICK IN

THE ASS AND IT’S OVER


Antiviral Drugs

In biology, a pathogen in

the oldest and broadest

sense, is anything that can

produce disease. A pathogen

may also be referred to

as an infectious agent, or

simply a germ.

Antiviral drugs are a class of medication used for treating viral infections.

Most antivirals target specific viruses, while a broad-spectrum antiviral is effective

against a wide range of viruses. Unlike most antibiotics, antiviral drugs

do not destroy their target pathogen; instead they inhibit their development.

There have been really effective anti viral drugs, as for example agains HIV,

that can be now be far less contagious and deadly. But save antiviral drugs

are really hard to develope.

How does vaccination works?

Vaccines prevent diseases that can be dangerous, or even deadly.

Vaccines greatly reduce the risk of infection by working with the

body’s natural defenses to safely develop immunity to disease. This

fact sheet explains how the body fights infection and how vaccines

work to protect people by producing immunity.

To understand how vaccines work, it helps to first look at how the body

fights illness. When germs, such as bacteria or viruses, invade the body, they

attack and multiply. This invasion, called an infection, is what causes illness.

The immune system uses several tools to fight infection. Blood contains red

blood cells, for carrying oxygen to tissues and organs, and white or immune

cells, for fighting infection.

The first time the body encounters a germ, it can take several days to make

and use all the germ-fighting tools needed to get over the infection. After

the infection, the immune system remembers what it learned about how to

protect the body against that disease. The body keeps a few T-lymphocytes,

called memory cells, that go into action quickly if the body encounters the

same germ again. When the familiar antigens are detected, B-lymphocytes

produce antibodies to attack them.

Vaccines help develop immunity by imitating an infection. This type of infection,

however, almost never causes illness, but it does cause the immune

system to produce T-lymphocytes and Once the imitation infection goes

away, the body is left with a supply of “memory” T-lymphocytes, as well as

B-lymphocytes that will remember how to fight that disease in the future.

However, it typically takes a few weeks for the body to produce T-lymphocytes

and B-lymphocytes after vaccination. Therefore, it is possible that a

person infected with a disease just before or just after vaccination could

develop symptoms and get a disease, because the vaccine has not had

enough time to provide protection.


// 25

A quick but important

reminder: Antibiotics don’t

work against Viral Infections


Immunity is the best way to

defeat a Virus


// 27

Viruses in the Modern World










Knowing the basics

of viruses:

1

HIV and Ebola as an example of

Epidemics

2

Influenza Virus and Coronavirus:

the Pandemics that attaced the

modern society

AN EPIDEMIC is a disease that affects a large number

of people within a community, population, or region.

A PANDEMIC is an epidemic of disease that has

spread across a large region, for instance multiple

continents or worldwide, affecting a substantial number

of people.

For example, when COVID-19 was limited to Wuhan, China,

it was an epidemic. The geographical spread turned it into a

pandemic.

AN ENDEMIC is something that belongs to a particular

people or country. Is when that infection is constantly

maintained at a baseline level in a geographic

area without external inputs.

For example, chickenpox is endemic in the UK, but malaria

is not. Every year, there are a few cases of malaria reported

in the UK, but these do not lead to sustained transmission in

the population due to the lack of a suitable vector (mosquitoes

of the genus Anopheles).

AN OUTBREAK is a greater-than-anticipated increase

in the number of endemic cases. It can also be a single

case in a new area. If it’s not quickly controlled,

an outbreak can become an epidemic.

Last summer’s dengue fever outbreak in Hawaii is as an example.

Dengue fever is endemic to certain regions of Africa,

Central and South America, and the Caribbean. Mosquitoes

in these areas carry dengue fever and transmit it from person

to person. But in 2019 there was an outbreak of dengue fever

in Hawaii, where the disease is not endemic. It’s believed

an infected person visited the Big Island and was bitten by

mosquitoes there. The insects then transferred the disease to

other individuals they bit, which created an outbreak.

30 //

VIRUSES IN THE MODERN WORLD


// 31

Ebolavirus - em photo


bolavirus - em photo



Ebola: The killing Worm

EVD:

Ebola virus diseas

Viral outbreak:

With a viral outbreak, there

is a greater number of

people who contract the

virus all at one time in one

location

Ebola virus disease (EVD) is a deadly disease with occasional

outbreaks that occur primarily on the African coWntinent.

EVD most commonly affects people and nonhuman

primates (such as monkeys, gorillas, and chimpanzees).

The average EVD case fatality rate is around 50%. Case fatality

rates have varied from 25% to 90% in past outbreaks.

Ebola virus was first discovered in 1976 near the Ebola River

in what is now the Democratic Republic of Congo. Since then,

the virus has been infecting people from time to time, leading to

outbreaks in several African countries. Scientists do not know

where Ebola virus comes from. However, based on the nature of

similar viruses, they believe the virus is animal-borne, with bats or

nonhuman primates with bats or nonhuman primates (chimpanzees,

apes, monkeys, etc.) being the most likely source. Infected

animals carrying the virus can transmit it to other animals, like

apes, monkeys, duikers and humans.


// 35

Transmission

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The virus spreads to people initially through direct contact

with the blood, body fluids and tissues of animals.

Ebola virus then spreads to other people through direct

contact with body fluids of a person who is sick with

or has died from EVD. This can occur when a person

touches these infected body fluids (or objects that are

contaminated with them), and the virus gets in through

broken skin or mucous membranes in the eyes, nose, or

mouth. People can get the virus through sexual contact

with someone who is sick with EVD, and also after recovery

from EVD. The virus can persist in certain body

fluids, like semen, after recovery from the illness.

Causes:

transmission can occur in

any context in which there is

contact with or consumption

of non-human animals,

animal products, or animal

derivatives. This can occur

in a companionistic (pets),

economic (farming, trade,

butchering, etc.), predatory

(hunting, butchering or

consuming wild game) or

research context.

Zoonosis:

infectios disease caused by

a pathogen (an infectious

agent, including bacteria,

viruses, parasites, prions,

etc) that has jumped from

nonhuman animal (usually

vertebrates) to humans

Body Fluids:

Blood, Saliva, Semen, Vaginal

fluids, Muchus, Urine.

They are the transmitions

paths from viruses from one

human to others

36 // EPIDEMIC / EBOLA: THE KILLING WORM

Tracing a host

Following the discovery of the virus, scientists studied

thousands of animals, insects, and plants in search of its

source. Gorillas, chimpanzees, and other mammals may

be implicated when the first cases of an EVD outbreak in

people occur. However, they – like people – are “deadend”

host. Like other viruses of its kind, it is possible

that the reservoir host animal of Ebola virus does not

experience acute illness despite the virus being present

in its organs, tissues, and blood. Thus, the virus is likely

maintained in the environment by spreading from host to

host or through intermediate hosts or vectors.

African fruit bats are likely involved in the spread of Ebola

virus and may even be the source animal (reservoir host).

Scientists continue to search for conclusive evidence of

the bat’s role in transmission of Ebola. The most recent

Ebola virus to be detected, Bombali virus, was identified

in samples from bats collected in Sierra Leone.

“Dead end” host:

Means that the organism

dies following the infection

and does not survive and

spread the virus to other

animals.

African Fruits bats collected

in Sierra Leoana

(Evola host)


// 37

Cases and outbreaks of EVD

The first outbreak occurred in the Democratic Republic of Congo (formerly

Zaire) in a village near the Ebola River, which gave the virus its name. The

second outbreak occurred in what is now South Sudan, approximately 500

miles (850 km) away.

Initially, public health officials assumed these outbreaks were a single event

associated with an infected person who traveled between the two locations.

However, scientists later discovered that the two outbreaks were caused by

two genetically distinct viruses: Zaire ebolavirus and Sudan ebolavirus. After

this discovery, scientists concluded that the virus came from two different

sources and spread independently to people in each of the affected areas.

Viral and epidemiologic data suggest that Ebola virus existed long before

these recorded outbreaks occurred. Factors like population growth, encroachment

into forested areas, and direct interaction with wildlife (such as

bushmeat consumption) may have contributed to the spread of the Ebola

virus.

Zaire ebolavirus, Bundibugyo ebolavirus, and Sudan ebolavirus are the three

species of Ebola virus responsible for the larger outbreaks in Africa. Zaire

ebolavirus is the most fatal Ebola virus. It was associated with the 2014-

2016 outbreak in West Africa, the largest Ebola outbreak to date with more

than 28,600 cases, as well as the current ongoing outbreak in Democratic

Republic of Congo (DRC).

Viral Hemorrhagic Fevers

(VHFs):

Are a group of illnesses

caused by four families of

viruses. These include the

Ebola and Marburg, Lassa

fever, and yellow fever

viruses. VHFs have common

features: they affect many

organs, they damage the

blood vessels, and they

affect the body’s ability to

regulate itself. Some VHFs

cause mild disease, but

some, like Ebola or Marburg,

cause severe disease

and death. Vaccinations

exist for only a few types of

viral hemorrhagic fevers.

Bushmeat:

Is meat from wildlife species

(bats, monkeys, rats,

snakes, etc.) that are hunted

for human consumption

in tropical forests. Bushmeat

is an important food

resource (also economicaly)

for poor people, particularly

in rural areas.

It provides increased

opportunity for transmission

of several zoonotic

viruses from animal hosts to

humans, such as Ebolavirus,

HIV, and various species

of coronavirus including

SARS-CoV-2.


2014-2016 Biggest ebola outbreak

The initial case, or index patient, was reported in December 2013. An

18-month-old boy from a small village in Guinea is believed to have been

infected by bats. After five additional cases of fatal diarrhea occurred in that

area, an official medical alert was issued on January 24, 2014, to the district

health officials. The Ebola virus soon spread to Guinea’s capital city of Conakry,

and on March 13, 2014, the Ministry of Health in Guinea issued an

alert for an unidentified illness. Shortly after, the Pasteur Institute in France

confirmed the illness as EVD caused by Zaire ebolavirus. On March 23,

2014, with 49 confirmed cases and 29 deaths, the WHO officially declared

an outbreak of EVD.

Weak surveillance systems and poor public health infrastructure contributed

to the difficulty surrounding the containment of this outbreak and it quickly

spread to Guinea’s bordering countries, Liberia and Sierra Leone. By July

2014, the outbreak spread to the capitals of all three countries. This was

the first time EVD extended out from more isolated, rural areas and into

densely populated urban centers, providing an unprecedented opportunity

for transmission.

On August 8, 2014, WHO declared the deteriorating situation in West

Africa a Public Health Emergency of International Concern (PHEIC), which

is designated only for events with a risk of potential international spread or

that require a coordinated international response. Over the duration of the

epidemic, EVD spread to seven more countries: Italy, Mali, Nigeria, Senegal,

Spain, the United Kingdom, and the United States. Later secondary infection,

mainly in a healthcare setting, occurred in Italy, Mali, Nigeria, and the

United States.

The scope of this outbreak, both in terms of cases and geography, can be

attributed to the unprecedented circulation of EVD into crowded urban areas,

increased mobilization across borders, and conflicts between key infection

control practices and prevailing cultural and traditional practices in West

Africa. Engaging local leaders in prevention programs and messaging, along

with careful policy implementation at the national and global level, helped to

eventually contain the spread of the virus and put an end to this outbreak.

Liberia was first declared Ebola-free in May 2015. Additional cases were

found and treated, and the country was again declared Ebola-free in September

2015. More cases were discovered in November 2015. On January

14, 2016, Liberia again announced it was Ebola-free; however, cases were

detected in March and April of 2016, and Liberia made its final declaration

on June 1, 2016.

REPORTED N° OF CASES:

28610

REPORTED N° OF

DEATHS: 11308

% OF FATAL CASES: 39%

COUNTRIES: Guinea,

Liberia, sierra Leone (West

African Epidemic)

As of February 28, 2016,

there were 28,639 suspected,

probable, and confirmed

cases of Ebola and 11,316

deaths from Ebola during

the 2014 epidemic in West

Africa. In comparison, there

were 2,427 reported cases

and 1,597 deaths in all

other known cases and outbreaks

of Ebola combined.


// 39

First outbreak: 1976

Species: Sudan Ebolavirus, Zaire

Ebolovirus

Countries: Democratic Republic of

Congo, Sudan, United Kindom

Reported N° of Cases: 603

Reported N° of Deaths: 280

Origins: workers of a cotton hopital

Transmition: Associated with the

act of nursing patient, use of contaminated

needles and and syringes

at the hospital and clinics in the area

and close personal contact.

Year: 1977

Species: Zaire Ebolovirus


Reported N° of Deaths and % of

fatal cases: 1 (100%)

Countries: Democratic Republic of

Congo (formely Zaire)

Year: 1979

Species: Sudan Ebolavirus




Coutries: Sudan

Origins: Introduced into four families

from a locasl hospital.

Transmition: Hospital disssemination

and intrafamilial spread.

Year: 1989-1992

Species: Resto ebolavirus (does not

cause illnes in people)

Coutries: Philippines, Italie, United

States of America

Origin and transmition: introduced

into quarantine facilities by monkeys

importation

Year: 1995


Coutries: Democratic Republic of

Congo (formely Zaire)



fatal cases: charcoal maker in the

forested areas near the city.

Transmition: spread through families

and hospitals

Mesures: Use of mask, gloces and

gowns for healthcare personnel.

Year: 2000

Species: Sudan Ebolovirus

Coutries: Uganda




MESURES: Community action

and local government support was

critical in controlling this outbreak.

Providing from correct and timely

messaging to limit spreading.

Year: 2001


Coutries: Republic of the Congo

and Gabon




Origins Associated with hunting

and contact with wildlife in the

sorrounding area.

Year: 2003-2005


Coutries: Republic of the Congo



fatal cases:39 (83%)

Year: 2007

Species: Zaire Ebolavirus, Bundiugyo

(Uganda)

Coutries: Democratic Republic of

Congo (formely Zaire), Uganda




Origins: Introduced into four families

from a locasl hospital.

Transmition: Hospital disssemination

and intrafamilial spread.

Year: 2008

Species: Resto Ebolavirus )does

not cause illnes in people


Reported N° of Deaths: 0

Coutries: Philippnes

Origins: fist known occurrence of

Ebola - Reston virus in pigs

Year: 2008

Species: Zaire Ebolavirus




Coutries: Democatrc republic of

Congo (formaly Zaire)

Year: 2014





Countries: Democratic republic of

Congo (formerly Zaire)

Origin: Not relaed to the large outbreak

in West Africa

Biggest Outbreak 2014-2016





Coutries: Guinea, Liberia, sierra

Leone (West African Epidemic)

Origins: cases of EVD in the forested

rural region of southeastern

Guinea

Problems: Fragil public health

infrastructure, poor infection control

pesures and strained health care

system

August 2014: WHO declared the

situation a Public Health Emergency

of International Concern (PHEIC)

Until now the spread of Ebola

Virus has not stopped. Every

year some cases around the

worls have been registrated.

Health Organizations have been

intervening, to prevent an outbreak

as the one from 2014-2016

in Western Africa.


Zairian nurse prepered to enter in a ebola

isolation ward.

By Ethleen Lloyd, USCDCP / PIXNIO

Medial ecacuation from a suspected Ebolavirus

infected patient.

By Joel G. Breman and Dr. Lyle Conrad,

USCDCP / PIXNIO

Man infected by coronavirus is being isoleted

to avoid the spread.

By Dr. Lyle Conrad, USCDCP / PIXNIO

Zairian Burses, wearing protective clothes

for their own protection. They change the

bedding for ebola isolated patient.


Sanitary procedures practiced in Kikwit ZAire

Clinic countries (1995) and avoid ebola

outbreak.


Scientists took samples from animals collection

in Kikwit, Zaire.


Ebola has been far more deadly in places like

Congo than in wealthier nations.

By Pascale Zinten / Agence France-Presse

Scientis and doctores making research.

By WHO/S. Hawkey

Passport for humanitarian workers to enter

restricted areas of the Ebola crisis in Sierra

Leone.

by Julia Broska

Health workers dressed in protective gear

beginning their shift at an Ebola treatment

center in Beni, Democratic Republic of

Congo.

By Jerome Delay/Associated Press

A health worker carries a child suspected of

having Ebola into the MSF treatment centre in

Paynesville, Liberia.

By John Moore/Getty Images

Temporary screens tents erected at the

ground in the general hospital of Kikwit.



// 41


TREATMENT BUT NO VACCINATION

ON WORK BUT ON A GOOD WAY.

There is currently NO

antiviral drug (vaccionation)

to treat EVD in people.

When used early,

basic interventions can

significantly improve the

chances of survival.

Drugs that are being

developed to treat EVD work

by stopping the virus from

making copies of itself.

There has been the rVSV-ZEBOV vaccine that was

sudied in trial involving 11 841 people. Among the

5837 people who recieved the vaccine, no Ebola

cases were recorde 10 days or more after vaccination.

In comparison, there were 23 cases 10 days or

more after vaccination amonge those who did not

recieved the vaccine.


// 43

HIV: A slow death

HIV: human immunodeficiency

virus

AIDS: Acquired immunodeficiency

syndorm

CD4 cells (T cells):

help the immune system

fight off infections.

ART: Antiretroviral Therapy

HIV is the virus that can lead to AIDS if not treated. Unlike

some other viruses, the human body can’t get rid of HIV completely,

even with treatment. So once you get HIV, you have it

for life.

HIV attacks the body’s immune system, specifically the CD4

cells (T cells), which help the immune system fight off infections.

Untreated, HIV reduces the number of CD4 cells (T cells)

in the body, making the person more likely to get other infections

or infection-related cancers. Over time, HIV can destroy

so many of these cells that the body can’t fight off infections

and disease. These opportunistic infections or cancers take

advantage of a very weak immune system and signal that the

person has AIDS, the last stage of HIV infection.

No effective cure currently exists, but with proper medical care,

HIV can be controlled. The medicine used to treat HIV is called

ART. If people with HIV take ART as prescribed, their viral load

(amount of HIV in their blood) can become undetectable. If it

stays undetectable, they can live long, healthy lives and have

effectively no risk of transmitting HIV to an HIV-negative partner

through sex. Before the introduction of ART in the mid-1990s,

people with HIV could progress to AIDS in just a few years. Today,

someone diagnosed with HIV and treated before the disease

is far advanced can live nearly as long as someone who

does not have HIV.


// 47

In the 1980s and early 1990s, the outbreak of HIV and AIDS swept across

the United States and rest of the world, though the disease originated

decades earlier. Today, more than 70 million people have been infected

with HIV and about 35 million have died from AIDS since the start of the

pandemic, according to the World Health Organization (WHO).

Where Did AIDS Come From?

Scientists have traced the origin of HIV back to chimpanzees and simian

immunodeficiency virus (SIV), an HIV-like virus that attacks the immune

system of monkeys and apes.

In 1999, researchers identified a strain of chimpanzee SIV called SIVcpz,

which was nearly identical to HIV. Chimps, the scientist later discovered, hunt

and eat two smaller species of monkeys—red-capped mangabeys and greater

spot-nosed monkeys—that carry and infect the chimps with two strains of

SIV. These two strains likely combined to form SIVcpz, which can spread

between chimpanzees and humans.

SIVcpz likely jumped to humans when hunters in Africa ate infected chimps,

or the chimps’ infected blood got into the cuts or wounds of hunters. Researchers

believe the first transmission of SIV to HIV in humans that then

led to the global pandemic occurred in 1920 in Kinshasa, the capital and

largest city in the Democratic Republic of Congo.

The virus spread may have spread from Kinshasa along infrastructure routes

(roads, railways, and rivers) via migrants and the sex trade.

In the 1960s, HIV spread from Africa to Haiti and the Caribbean when Haitian

professionals in the colonial Democratic Republic of Congo returned home.

The virus then moved from the Caribbean to New York City around 1970

and then to San Francisco later in the decade.

International travel from the United States helped the virus spread across

the rest of the globe.

48 // GLOBAL EPIDEMIE / HIV: A SLOW DEATH

The AIDS Epidemic Arises

CDC: Centers for Disease

Control and Prevention

GRID: Gay-related immune

deficency

Though HIV arrived in the United States around 1970, it

didn’t come to the public’s attention until the early 1980s.

In 1981, the CDC published a report about five previously

healthy homosexual men becoming infected with

Pneumocystis pneumonia, which is caused by the normally

harmless fungus Pneumocystis jirovecii. This type

of pneumonia, the CDC noted, almost never affects people

with uncompromised immune systems.

The following year, The New York Times published an

alarming article about the new immune system disorder,

which, by that time, had affected 335 people, killing 136

of them. Because the disease appeared to affect mostly

homosexual men, officials initially called GRID.

Though the CDC discovered all major routes of the disease’s

transmission—as well as that female partners of

AIDS-positive men could be infected—in 1983, the public

considered AIDS a gay disease. It was even called the

“gay plague” for many years after.

In September of 1982, the CDC used the term AIDS

to describe the disease for the first time. By the end of

the year, AIDS cases were also reported in a number of

European countries.

CDC laboratorian, Carol Reed, conducts AIDS research

in 1973. Since the beginning of the AIDS epidemic, the

CDC has been at the forefront of HIV investigation and lab

research.

Smith Collection


// 49

Social activism against the spread of HIV/AIDS and in support of effective

treatment has taken place in multiple nations across the world over the past

several decades. In terms of the complex history of HIV/AIDS in human beings,

widespread criticism by regular individuals against public health organizations

(including, often, government-managed medical bureaucracies) have escalated

into protest movements due to slow treatment responses and outright discrimination

against patients (such as gay man), socio-economic inequality to healthcare,

plus the proliferation of misconceptions about HIV/AIDS.


The fight against HIV/AIDs (1980s)

Starting in the early 1980s, AIDS activist

groups and organizations began to emerge

and advocate for people infected with HIV in

the United States. Though it was an important

aspect of the movement, activism went

beyond the pursuit of funding for AIDS research.

Groups acted to educate and raise

awareness of the disease and its effects on

different populations, even those thought to

be at low-risk of contracting HIV. This was

done through publications and "alternative

media" created by those living with or close

to the disease.

In contrast to this "alternative media" created

by activist groups, mass media reports

on AIDS were not as prevalent, most likely

due to the stigma surrounding the topic. The

general public was therefore not exposed to

information regarding the disease. In addition,

the federal government and laws in place essentially

prevented individuals afflicted with

AIDS from getting sufficient information about

the disease. Risk reduction education was

not easily accessible, so activist groups took

action in releasing information to the public

through these publications.

Activist groups worked to prevent spread of

HIV by distributing information about safe sex.

They also existed to support people living with

HIV/AIDS, offering therapy, support groups,

and hospice care.

Both men and women, heterosexual and queer

populations were active in establishing and

maintaining these parts of the movement. Because

AIDS was initially thought only to impact

gay men, most narratives of activism focus on

their contributions to the movement. However,

women also played a significant role in raising

awareness, rallying for change, and caring for

those impacted by the disease. Lesbians helped

organize and spread information about transmission

between women, as well as supporting

gay men in their work. Narratives of activism

also tend to focus on organizing done in coastal

cities, but AIDS activism was present and

widespread across both urban and more rural

areas of the United States. Organizers sought

to address needs specific to their communities,

whether that was working to establish needle

exchange programs, fighting against housing

or employment discrimination, or issues faced

primarily by people identified as members of

specific groups (such as sex workers, mothers

and children, or incarcerated people).

Initially when the AIDS epidemic surfaced in

the United States, a large proportion of patients

were LGBT community members, leading to

stigmatization of the disease. Because of this,

the AIDS activist groups took initiative in testing

and experimenting with new possible medications

for treating HIV, after researchers outside

of the community refused. This research originally

done by early activist groups contributed

to treatments still being used today.


// 51

The AIDS Memorial Quilt, listing the names

of those lost, on display in the nation's

capital. Today it constitutes the largest piece

of community folk art in the world.

Washington, D.C.. April, 1988.

Los Angeles Public Library

The idea for the NAMES Project Memorial Quilt was conceived on

November 27, 1985 by AIDS activist Cleve Jones during the annual

candlelight march, in remembrance of the 1978 assassinations of San

Francisco Supervisor Harvey Milk and Mayor George Moscone. For

the march, Jones had people write the names of loved ones that were

lost to AIDS-related causes on signs, and then they taped the signs to

the old San Francisco Federal Building.

By National Institutes of Health

The NAMES Project, emerged as a

way of memorializing those who had

passed, refusing to let them be forgotten

by the historical narrative.


The GMHC (formerly Gay Men’s Health Crisis), founded

in January 1982, is a New York City–based non-profit,

volunteer-supported and community-based AIDS service

organization whose mission statement is “end the AIDS

epidemic and uplift the lives of all affected”.

Such as them other organization like he Lesbian AIDS Project,

and SisterLove were created to address the needs of

certain populations living with HIV/AIDS and raise money

for research.

A crowd of 2,000 gathers for a candlelight vigil to those who have

been lost to the AIDS epidemic.

Organized by the Gay Men’s Health Crisis (GMHC)

Los Angeles, California. May 30, 1987.



// 53

One of the most prominent HIV/AIDS

activist groups, ACT UP (AIDS Coalition

to Unleash Power), got its

start in 1987 at the Lesbian, Gay,

Bisexual & Transgender Community

Center in New York State. It was

an international, grassroots political

group working to end the AIDS pandemic.

The group worked to improve

the lives of people with AIDS through

direct action, medical research, treatment

and advocacy, and working to

change legislation and public policies.

Larry Kramer talked as part of

a rotating series of speakers, and

his well-attended speech focused

on action to fight AIDS while condemning

the Gay Men's Health Crisis

(GMHC) group. Though a founder

of GMHC, Kramer resigned due to

his perceiving of the organization

as politically impotent. During the

1980s and 1990s as well as onward,

ACT UP focused on strident public

demonstration aimed at shocking

mainstream public opinion.

Inspired by posters made by the Art Workers Coalition and the Guerrilla Girls, the group (ACT

UP) decided to create their own poster to be wheatpasted around New York City. Rejecting

any photographic image as necessarily exclusionary, the group decided to use more abstract

language in an attempt to reach multiple audiences. They created the Silence=Death poster

using the title phrase and a pink triangle, known from its association with the persecution of

homosexuals in Nazi Germany in the 1930s and 1940s.


Gay ACT UP members carrying huge banner that reads THE

AIDS CRISIS IS NOT OVER as they walk down the street during

a march in July 1990.

Michael Abramson The LIFE Images Collection

Police officers drag away activists of the ACT UP coalition who'd been protesting

outside of City Hall.

New York, New York. March 28, 1989.

New York Public Library


// 55

Protestors march against the arrival of Pope

John Paul II, whose conservative doctrine on

issues such as abortion, sex, and homosexuality

in October 1995.

van Agostini/Liaison

Marchers parade through Manhattan carrying a

banner which reads 'A.I.D.S.: We need research,

not hysteria!' in June 1983.

by Barbara Alper

People hold up signs representing the numbers

of AIDS victims in a demonstration to support

AIDS Victims in Central Park, New York on

August 8, 1983.

by Allan Tannenbaum


A man marches in a candlelight vigil for those lost

to the AIDS epidemic.

Los Angeles, California. May 30, 1987.


Activists take the first steps in a walkathon to raise

funds for AIDS research.

Los Angeles, California. July 29, 1985.



// 57

Transmission

You can get or transmit HIV only through specific

activities.

Only certain body fluids—blood, semen (cum), pre-seminal

fluid (pre-cum), rectal fluids, vaginal fluids, and

breast milk—from a person who has HIV can transmit

HIV. These fluids must come in contact with a mucous

membrane or damaged tissue or be directly injected

into the bloodstream (from a needle or syringe) for

transmission to occur. Mucous membranes are found

inside the rectum, vagina, penis, and mouth.

HIV is spread mainly by:

1. Having anal or vaginal sex with someone who has

HIV without using a condom or taking medicines to

prevent or treat HIV.

2. Sharing needles or syringes, rinse water, or other

equipment (works).

Less commonly:

1. From mother to child during pregnancy, birth, or

breastfeeding.

In extremely rare cases:

1. Oral sex.

2. Receiving blood transfusions, blood products, or

organ/tissue transplants that are contaminated with

HIV.

3. Eating food that has been pre-chewed by a person

with HIV.

4. Being bitten by a person with HIV.

5. Contact between broken skin, wounds, or mucous

membranes and HIV-infected blood or blood-contaminated

body fluids.

6. Deep, open-mouth kissing if both partners have sores

or bleeding gums and blood from the HIV-positive

partner gets into the bloodstream of the HIV-negative

partner.

(2) Used to prepare drugs

for injection with someone

who has HIV.

(1) Although the risk can

be high if a mother is living

with HIV and not taking

medicine.

(1) It is theoretically possible

if an HIV-positive man

ejaculates in his partner’s

mouth during oral sex.

(3) The contamination

occurs when infected blood

from a caregiver’s mouth

mixes with food while

chewing.


HIV does not survive long outside the human

body (such as on surfaces), and it cannot reproduce

outside a human host.

IT IS NOT SPREAD BY

• Mosquitoes, ticks, or other insects.

• Saliva, tears, or sweat that is not mixed with the

blood of an HIV-positive person.

• Hugging, shaking hands, sharing toilets, sharing

dishes, or closed-mouth or “social” kissing with

someone who is HIV-positive.

• Other sexual activities that don’t involve the exchange

of body fluids (for example, touching).

These posters, collected by the Wellcome Trust, reveal the various messages displayed around

the world, amid widespread fear, ignorance, and misinformation about the epidemic.

Wellcome Library, London


// 59

Fernando Aiuti was an Italian immunologist and politician.

His face is associated with a photo that traveled around the

world in the early 1990s, when the AIDS issue was particularly

acute, in the wake of the number of victims that the virus

continued to reap in the world.

In 1991, during a congress in Cagliari where the causes

of AIDS infection were discussed, Dr. Aiuti kissed Rosaria

Iardino, one of his 25-year-old HIV-positive patients, on the

mouth. A strong gesture, through which the immunologist

wanted to demonstrate that the virus could not be transmitted

orally.


SAVE SEX, SAVE LOVE

CONDOMS : PROTECT

YOURSELF AND THE

OTHERS

KISSING IST NOT

PROHIBITED!


// 61

How can HIV become

Drug-resistant?

HIV is an RNA virus with a high mutation rate

and evolves rapidly, leading to the emergence of

drug-resistant strains.

HIV’s high mutation rate

Because RNA viruses like HIV have a high mutation rate,

there will be lots of genetic variation in the population of

HIV viruses in a patient’s body. Many of the mutations

will be harmful, and the mutant viruses will simply “die”

(fail to reproduce). However, some mutations help viruses

reproduce under specific conditions. For instance, a

mutation may provide resistance to a drug.

Evolution of drug resistance

Certain drugs can block the replication of HIV by inhibiting

key viral enzymes. Taking one of these drugs will at

first reduce a patient’s viral levels. After awhile, however,

the HIV viruses typically “bounce back” and return to

high levels, even though the drug is still present. In other

words, a drug-resistant form of the virus emerges.

To see why this took place, let’s use the

example of a specific type of antiviral drug,

a reverse transcriptase inhibitor. Reverse

transcriptase inhibitors, like the nevirapine

molecule shown in the diagram below, bind

to a viral enzyme called reverse transcriptase

(the red-and-brown structure). The

drug keeps the enzyme from doing its job of

copying the RNA genome of HIV into DNA.

If this enzyme is inactive, an HIV virus can’t

permanently infect a cell.

Most HIV viruses are stopped by nevirapine.

However, a very small fraction of the

viruses in the HIV population will (by random

chance) have a mutation in the gene for reverse

transcriptase that makes them resistant

to the drug. For instance, they might have a

genetic change that alters the drug’s binding

site on the enzyme, so that the drug is no

longer able to latch on and inhibit enzyme

activity.

The viruses with this resistance mutation will

reproduce despite the presence of the drug

and, over generations, can re-establish the

viral levels present before the drug was administered.

Not only that, but the entire virus

population will now be resistant to the drug!


Image modified from “Exploring the structure,” by David S.

Goodsell, RCSB PDB Molecule of the Month, CC BY 4.0.


// 63


Years losing her son David to AIDS, Kay Kirby tends to his friend

Peta, suffering from the same illness as her son, Ohio. 1992.

by Therese Frare

HAART drug resistance

If HIV can evolve its way around a drug, how can the virus be stopped? What

seems to work best is a combination approach, with three or more drugs taken

at the same time. This approach to treatment is called highly active antiretroviral

therapy, or HAART for short. The drugs given in a HAART "cocktail" typically target

different parts of the HIV lifecycle.

The HAART approach works because it's relatively unlikely that any one HIV virus

in a population will happen to have three mutations that give resistance to all three

drugs at the same time. Although multi-drug-resistant forms of the virus do eventually

evolve, multi-drug combinations considerably slow the evolution of resistance.


// 65

In 1987, the first antiretroviral medication for HIV,

azidothymidine (AZT), became available.

Numerous other medications for HIV are now available, and

are typically used together in what’s known as antiretroviral

therapy (ART) or highly active antiretroviral treatment (HAART).

The regimes work by preventing the virus from multiplying,

giving the immune system a chance to recover and fight off

infections and HIV-related cancers. The therapy also helps

reduce the risk of HIV transmission, including between an

infected mother and her unborn child.

The World Health

Organization (WHO), in

1988, declared December

1st to be World AIDS Day.

3D computer-generated

rendering of a

whole influenza (flu) virus

in semi-transparent

blue with a clear background.

A transparent

area in the center of

the image allows the

viewer to see inside of

the influenza virus to

see its ribonucleoproteins

(RNPs).

Influenza: the crisis from the last century

When we look back, we never remember, that it is not the first

time that the world has experienced a pandemic like the one we

are experiencing now because of the COVID-19. A century ago

a pandemic emerged, The spanish flu, caused by the H1N1

virus. Such as now it caused big health, social and economical

problems around the world. Adding that it happened at the end

of World War I where countries were coming out of one crisis

and going into another.

Seasonal illness: an

infection that spreads

throughout the world)

Pandemic: an infection

that spreads throughout the

world)

The flu, or influenza, is a highly contagious viral infection that

mainly affects the respiratory system. It’s usually a seasonal

illness, with yearly outbreaks killing hundreds of thousands of

people around the world. Though rare, completely new versions

of the virus may infect people and spread quickly, resulting in

pandemics with death tolls in the millions. Symptoms of the flu

include sudden onset fever, coughing, sneezing, a runny nose,

and severe malaise, though it can also include vomiting, diarrhea

and nausea. Influenza has plagued humankind for centuries

and, given its highly variable nature, may continue to do so

for centuries to come.


// 71

What Is the Flu?

Influenza is a viral respiratory infection that causes symptoms similar to, but

more severe than, the common cold. Flu symptoms can include sudden onset

fever, cough, runny or stuffy nose and severe malaise (feeling unwell). The

flu can cause serious complications, including pneumonia, bronchitis and

sinus and ear infections.

Influenza viruses, which are part of the Orthomyxoviridae family of viruses,

cause the flu. There are four types of influenza viruses: A, B, C and D. Human

influenza A and B viruses cause seasonal epidemics of disease (known as

the flu season) almost every winter in the United States. Influenza A viruses

are the only influenza viruses known to cause flu pandemics, i.e., global

epidemics of flu disease. A pandemic can occur when a new and very different

influenza A virus emerges that both infects people and has the ability

to spread efficiently between people. Influenza type C infections generally

cause mild illness and are not thought to cause human flu epidemics. Influenza

D viruses primarily affect cattle and are not known to infect or cause

illness in people.

Influenza A virus, which also infects including birds, swine, horses, and other

animals, is further divided into subtypes based on two antigens (proteins)

on the virus’s surface: hemagglutinin (H), of which there 18 subtypes, and

neuraminidase (N), of which there 11 subtypes.

The specific virus is recognized by these antigens. For example, H1N1 refers

to influenza A virus with hemagglutinin subtype 1 and neuraminidase

subtype 1, and H3N2 refers to influenza A virus with hemagglutinin subtype

3 and neuraminidase subtype 2. Influenza B viruses circulate widely only

among humans.

72 // PANDEMIC / INFLUENZA: THE CRISIS OF THE LAST CENTURY

The “flu season”

Lasts typically from late fall to spring. Each year, flu epidemics

cause 3 to 5 million cases of severe illness and

about 290,000 to 650,000 deaths around the globe,

according to the World Health Organization (WHO).

How Flu Pandemics Arise

Influenza is a constantly evolving virus. It quickly goes

through mutations that slightly alter the properties of its

H and N antigens.

Due to these changes, acquiring immunity (either by getting

sick or vaccinated with a flu shot) to an influenza subtype

such as H1N1 one year will not necessarily mean a

person is immune to a slightly different virus circulating

in subsequent years.

But since the strain produced by this “antigenic drift” is

still similar to older strains, the immune systems of some

people will still recognize and properly respond to the

virus.

In other cases, however, the virus can undergo major

changes to the antigens such that most people don’t

have an immunity to the new virus, resulting in pandemics

rather than epidemics.

This “antigenic shift” can occur if an influenza A subtype

in an animal jumps directly into humans.

It can also occur if an intermediate host such as a pig—

which is susceptible to avian, human, and swine influenza—becomes

simultaneously infected by influenza viruses

from two different species and the viruses exchange

genetic information to acquire completely new antigens,

a process called genetic reassortment.


// 73

Flu Pandemics

An influenza pandemic is a global outbreak of a new influenza A virus

that is very different from current and recently circulating human seasonal

influenza A viruses. Pandemics happen when new (novel) influenza

A viruses emerge which are able to infect people easily and spread

from person to person in an efficient and sustained way. Because the

virus is new to humans, very few people will have immunity against the

pandemic virus, and a vaccine might not be widely available. The new

virus will make a lot of people sick. How sick people get will depend on

the characteristics of the virus, whether or not people have any immunity

to that virus, and the health and age of the person being infected.

1580: earliest pandemic

outbreak from influenza

Spread: began in Asia

during th summer and

spread to Africa, Europo

and subsequently

reached the Americas.

Deaths: Unknown

(Deaths in Rome alone:

8000)

1072

Spread: began in Russia

and spread throghout

Europe within 6

months and all the world

within three years.

Fact: King Louis XV was

reportedly infected and

stated that the disease

spread like a foolish little

girl, or follette in French.

1781

Spread: began in china,

spread to Russia and

encompasse Europe

and North America.

Facts: the infection

struck 30,000 people

each day in St. Petersburg

and affected twothirds

of the population

in Rome.

1830–1833

Spread: began in China,

and then spread by

ships to the Philippines,

India and Indonesia, and

finally across Russia and

into Europe.

1831–1832

Spread: beganin North

America

Facts: the pandemic

may have affected 20

to 25 percent of the

world’s population.

1889: The first “modern”

flu pandemic, The “Russian

Flu”

Spread: Began in

Russia It reached the

American continent just

70 days after it began

Facts: affected approx.

40 percent of the

world’s population.

1918: The Spanish flu

pandemic , the “mother

of all pandemics.”

Facts: was the deadliest

in history, affecting

one-third of the world’s

population and killing up

to 50 million people.

1957: The Asian flu

(caused by H2N2),

Deaths: 1.1 million

people worldwide. T

Facts: hese flu strains

arose from a genetic

reassortment between

a human and an avian

virus.

1968: Hong Kong flu

(H3N2),

Deaths: 1 million people

worldwide.

Facts: These flu strains

arose from a genetic

reassortment between

a human and an avian

virus.

2009: a new influenza

A H1N1 (The “swine flu”

because it comes from

pigs)

Facts: virus emerged in

North America. Primarily

affected children and

young adults who had

no immunity to the new

virus.

Deaths: 203,000 people

worldwide.



// 75

The Spanish flu,

the “Mother of all Flu pandemics”

The Spanish flu pandemic of 1918, after the world war 1 and the deadliest

in history, infected an estimated 500 million people worldwide—

about one-third of the planet’s population—and killed an estimated 20

million to 50 million victims. The 1918 flu was first observed in Europe,

the United States and parts of Asia before swiftly spreading around the

world. At the time, there were no effective drugs or vaccines to treat this

killer flu strain. Citizens were ordered to wear masks, schools, theaters

and businesses were shuttered and bodies piled up in makeshift

morgues before the virus ended its deadly global march.

It’s unknown exactly where the particular strain of influenza that caused the

pandemic came from; however, the 1918 flu was first observed in Europe,

America and areas of Asia before spreading to almost every other part of the

planet within a matter of months. One unusual aspect of the 1918 flu was

that it struck down many previously healthy, young people—a group normally

resistant to this type of infectious illness—including a number of World War

I servicemen. The first known case was reported at Camp Funston in Fort

Riley, Kansas, on March 11, 1918.

In fact, more U.S. soldiers died from the 1918 flu than were killed in battle

during the war. Forty percent of the U.S. Navy was hit with the flu, while

36 percent of the Army became ill, and troops moving around the world in

crowded ships and trains helped to spread the killer virus.

Is often estimated at 20 million to 50 million victims worldwide, other estimates

run as high as 100 million victims—around 3 percent of the world’s

population. The exact numbers are impossible to know due to a lack of

medical record-keeping in many places.

When the 1918 flu hit, doctors and scientists were unsure what caused it

or how to treat it. Unlike today, there were no effective vaccines or antivirals,

drugs that treat the flu. Complicating matters was the fact that World War

I had left parts of America with a shortage of physicians and other health

workers. And of the available medical personnel in the U.S., many came

down with the flu themselves.

Virus Killed the Young, Old and In-Between


Hospitals in some areas were so overloaded with flu

patients that schools, private homes and other buildings

had to be converted into makeshift hospitals, some of

which were staffed by medical students.

Influenza victims crowd into an emergency hospital near

Fort Riley, Kansas in 1918.

National Museum of Health

Influenza victims crowd into an emergency hospital near

Fort Riley, Kansas in 1918.

National Museum of Health


// 77

Officials in some communities imposed quarantines,

ordered citizens to wear masks and shut down public

places, including schools, churches and theaters. People

were advised to avoid shaking hands and to stay indoors,

libraries put a halt on lending books and regulations were

passed banning spitting.

Policemen stand in a street in Seattle, Washington, wearing protective masks made

by the Seattle Chapter of the Red Cross, during the influenza epidemic in 1918.

National Archives

The U.S. Army 39th regiment wear masks to prevent influenza in Seattle in December

of 1918. The soldiers are on their way to France.

Everett Historical

An open-air barber shop. Public events were encouraged to be held

outdoors to hinder the spread of the disease during the influenza epidemic.

Photographed at the University of California, Berkeley, in 1919.

National Archives

Physics class, University of Montana, Missoula, 1919. During the influenza

epidemic, classes were held outdoors.

National Archives

The congregation prays on the steps of the Cathedral of Saint Mary of the Assumption,

where they gathered to attend mass and pray during the influenza epidemic, in

San Francisco, California.

Bettmann / Bettmann Archive



// 79

The Flu takes a heavy Toll

on Society

The flu took a heavy human toll, wiping out entire families

and leaving countless widows and orphans in its wake.

Funeral parlors were overwhelmed and bodies piled up.

Many people had to dig graves for their own family members.

The flu was also detrimental to the economy. In the United

States, businesses were forced to shut down because

so many employees were sick. Basic services such as

mail delivery and garbage collection were hindered due

to flu-stricken workers.

In some places there weren’t enough farm workers to

harvest crops. Even state and local health departments

closed for business, hampering efforts to chronicle the

spread of the 1918 flu and provide the public with answers

about it.

By the summer of 1919, the flu pandemic came to an

end, as those that were infected either died or developed

immunity.

Almost 90 years later, in 2008, researchers announced

they’d discovered what made the 1918 flu so deadly:

A group of three genes enabled the virus to weaken a

victim’s bronchial tubes and lungs and clear the way for

bacterial pneumonia.


A typist wears her influenza mask in October of 1918. Worried

by the hold that disease had taken in New York City,

practically all workers covered their faces in gauze masks as

a protection against disease.

National Archives

Red Cross Motor Corps members on duty during the influenza

epidemic in the United States, in St. Louis, Missouri, in

October of 1918.

National Archives

A girl stands next to her sister, who is lying in bed, in

November of 1918. The young girl became so worried

that she telephoned the Red Cross Home Service,

which came to help the woman fight the influenza virus.

Library of Congress via AP


// 81

The mask resistency

Local governments rolled out initiatives to try to stop

its spread. These varied by region, and included closing

schools and places of public amusement, enforcing

“no-spitting” ordinances, encouraging people to use handkerchiefs

or disposable tissues and requiring people to

wear masks in public.

Mask-wearing ordinances mainly popped up in the western

states, and it appears most people complied with them.

Their issue had less to do with the science behind them,

and more to do with personal comfort. The nation was

still fighting in World War I, and officials framed anti-flu

measures as a way to protect the troops from the deadly

outbreak.

Other early flu precautions involved gargling saltwater,

eating oranges and—at least for one set of parents—warning

people not to kiss their baby. These remain good

ideas, but even for those who already practice healthy flu

season habits, the CDC emphasizes that getting an annual

vaccination is one of the best ways to prevent the flu.


Japanese school girls wear protective masks to guard against the

influenza outbreak.

Bettmann / Bettmann Archive


// 83

A woman wears a sci-fi-looking flu nozzle attached to a

machine circa 1919. It´s not clear how it worked or if it had

health benefits.

by Topical Press Agency

In Sydney, Australia, nurses leave Blackfriars Depot in Chippenedale

during the flu epidemic in April of 1919.

NSW State Archives / Tara Majoor

Nurses in Boston hospitals are equipped with masks to fight

influenza in the spring of 1919.

National Archives


People in England wear different - looking

mask to prevent the flu circa 1932.

Imagno

In this hounting photo, a man in Australia poses

with a painting skull.and crossbones on his mask.

Sam Hood/State Library of New South

Wales

People in London wear masks to avoid catching

the flu circa 1932. This is a preventative mathod

people still use around the world today.

Fox Photos


// 85

It´s so colorfull: Transmission

electron micrograph

of SARS-CoV-2 virus

particles, isolated from a

patient. Image captured

and color-enhanced at the

NIAID Integrated Research

Facility (IRF) in Fort Detrick,

Maryland. Credit: NIAID

Coronaviruses: A virus in modern times

Coronaviruses are a large family of single-stranded–RNA viruses

causing mild to moderate upper-respiratory tract illnesses in

humans and animals, but the other known coronaviruses that

affect humans cause only the common cold. However, three

new coronaviruses have emerged from animal reservoirs over

the past two decades to cause serious and widespread illness

and death.

There are hundreds of coronaviruses, most of which circulate

among such animals as pigs, camels, bats and cats. Sometimes

those viruses jump to humans—called a spillover event—and

can cause disease. Four of the seven known coronaviruses

that sicken people cause only mild to moderate disease. Three

can cause more serious, even fatal, disease: SARS-CoV (2002

-2003), MERS (2013), SARS-CoV-2 (2019)


// 89

Although we may not believe it and most of us do not know it, before the Pandemic

we are living today, caused by COVID-19 (SARS-CoV-2), other viruses of the

same coronavirus family have already caused epidemics/pademics in past years.

Although they did not have the same impact, they left their mark and many people

have died because of them.

90 // PANDEMIC / CORONAVIRUS: A VIRUS IN MODERN TIMES

SARS coronavirus (SARS-CoV) emerged in November 2002 and caused

severe acute respiratory syndrome (SARS). The 2002/2003 Pandemic was

the first that appeared caused by SARS-CoV. Starting in southern China,

it spread to almost all continents within a few weeks and claimed 774 lives

within six months. The World Health Organization (WHO) distinguished between

countries where local chains of infection existed, i.e. where new infections

occurred, and those where the disease only occurred in travellers who

had become infected in the countries in the first category. Countries with

local chains of infection were the Republic of China, Hong Kong, Singapore,

Canada, Vietnam, Taiwan, the United States and the United Kingdom.

As the first pandemic of the 21st century, it aroused new fears among the

population and was widely covered by the media worldwide. It killed 45 people

outside Asia and is a warning example of the rapid spread of disease in the

interconnected, globalised world.

The "Super Spreader"

On February 21, Liu Jianlun, although sick for

a few days, travelled from Guangzhou to Hong

Kong for a wedding. There he moved into room

911 on the ninth floor of the Metropole Hotel,

where he infected twelve hotel guests within 24

hours. He died on 4 March in the Kwong Wah

Hospital. Among the newly infected were three

Singaporeans, two Canadians, the US businessman

Johnny Chen on his way to Singapore

and a 26-year-old local who visited a friend in

the hotel. The international guests, as hosts,

carried the virus beyond China's borders into

other countries, directly or indirectly infecting

about 350 people. The WHO has calculated

that more than 4000 SARS cases worldwide

can be attributed to Liu Jianlun at the Metropole

Hotel. For this reason, the building was given

the name "Superspreader", which was established

in the media, especially in the tabloid

press, for Liu Jianlun himself.

The Causes

The WHO sees the causes for the rapid spread

of the initial epidemic and later pandemic in

the very dense settlement of Guangzhou and

the surrounding Pearl River Delta (China). The

region is home to a large number of wild and

exotic animals, which is why it is very popular

with tourists, with its many speciality restaurants.

On animal farms, animal markets and in

restaurants the inhabitants live, work and eat

in close proximity to animals. The animals are

kept in cages, sold and slaughtered in front of

everyone. The counters where the raw meat

and slaughtered animals are sold are often only

a few meters away from the workers' eating

places. According to the WHO, these conditions

- overpopulated and unhygienic - are a

breeding ground for the spread of infection. It

is now assumed that SARS was transmitted by

the larval scooter.


// 91

Scientists have grown the virus from nasal swabs of two dromedaries in Saudi Arabia, genetically

sequenced it and found it was an "indistinguishable" match to MERS coronavirus found

in humans — an indication that the virus in the animals is capable of infecting humans


Middle East Respiratory Syndrome (MERS) is an illness caused by a

virus (more specifically, a coronavirus) called Middle East Respiratory Syndrome

Coronavirus (MERS-CoV). Most MERS patients developed severe

respiratory illness with symptoms of fever, cough and shortness of breath.

About 3 or 4 out of every 10 patients reported with MERS have died.

Health officials first reported the disease in Saudi Arabia in September 2012.

Through retrospective (backward-looking) investigations, they later identified

that the first known cases of MERS occurred in Jordan in April 2012. So

far, all cases of MERS have been linked through travel to, or residence in,

countries in and near the Arabian Peninsula. The largest known outbreak

of MERS outside the Arabian Peninsula occurred in the Republic of Korea

in 2015. The outbreak was associated with a traveler returning from the

Arabian Peninsula.

MERS-CoV has spread from ill people to others through close contact, such

as caring for or living with an infected person.

MERS can affect anyone. MERS patients have ranged in age from younger

than 1 to 99 years old.

CDC continues to closely monitor the MERS situation globally. We are

working with partners to better understand the risks of this virus, including

the source, how it spreads, and how to prevent infections. CDC recognizes

the potential for MERS-CoV to spread further and cause more cases globally

and in the U.S. We have provided information for travelers and are working

with health departments, hospitals, and other partners to prepare for this.


// 93

The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing

pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute

respiratory syndrome coronavirus 2 (SARS-CoV-2).

This illustration, created at

the Centers for Disease

Control and Prevention

(CDC), reveals ultrastructural

morphology exhibited

by coronaviruses. Note the

spikes that adorn the outer

surface of the virus, which

impart the look of a corona

surrounding the virion, when

viewed electron microscopically.

A novel coronavirus,

named Severe Acute

Respiratory Syndrome

coronavirus 2 (SARS-

CoV-2), was identified as

the cause of an outbreak of

respiratory illness first detected

in Wuhan, China in

2019. The illness caused by

this virus has been named

coronavirus disease 2019

(COVID-19).

This illustration of the virus

is one of the first and best

known around the world.

Being published in the

news, newspapers, memes,

internet, social media, etc.


December 2019: first identefied outbreak from COVID-19 in Wuhan, China.

11. March: Outbreak decleared a pandemic from the WHO

As of May 2020: more than more than 4.89 million cases of COVID-19 have

been reported in more than 188 countries and territories, resulting in more

than 323,000 deaths. More than 1.68 million people have recovered from

the virus. NO VACCINE HAS BEEN DEVELOPED UNTIL NOW.

Spread between people:

1. Spread mainly by: Close contact most often via Droplet spread (coughing,

sneezing, talking). droplets usually fall to the ground or onto surfaces

rather than travelling through air over long distances.

2. Less commonly: by touching a contaminated surface and then touching

their face.

It is most contagious during the first three days after the onset of symptoms,

although spread is possible before symptoms appear, and from people who

do not show symptoms.

Symptoms:

May appear 2-14 days after exposure to the virus. People with these symptoms

may have COVID-19:

- Cough

- Shortness of breath or difficulty breathing

- Fever

- Chills

- Muscle pain

- Sore throat

- New loss of taste or smell

- Less common: nausea, vomiting, or diarrhea

Emergency warning signs:

- Trouble breathing

- Persistent pain or pressure in the chest

- New confusion

- Inability to wake or stay awake

- Bluish lips or face

Preventive measures: hand washing, covering one’s mouth when coughing,

maintaining distance from other people, wearing a face mask in public

settings, and monitoring and self-isolation for people who suspect they are

infected. Authorities implemented travel restrictions, lockdowns, workplace

hazard controls, and facility closures. Many places have also worked to increase

testing capacity and trace contacts of infected persons.


// 95

Map of confirmed cases per capita as of 20 May 2020

Map of confirmed cases per capita as of 31 May 2020

10+ confirmed cases per 1,000

3–10 confirmed cases per 1,000

1–3 confirmed cases per 1,000

0.3–1 confirmed cases per 1,000

0.1–0.3 confirmed cases per 1,000

>0–0.1 confirmed cases per 1,000

No confirmed cases or no data


Map of confirmed deaths per capita as of 20 May 2020

Map of confirmed deaths per capita as of 31 May 2020

100+ confirmed deaths per million

10–100 confirmed deaths per million

1–10 confirmed deaths per million

0.1–1 confirmed deaths per million

>0–0.1 confirmed deaths per million

No confirmed deaths or no data


// 97














Close to the social and economic abyss

Close to the social and economic abyss

Close to the social and economic

we are only living the consequences of our actions










omic abyss



Close to the social and economic abyss Close to the social and economic

abyss Close to the social and econ











The pandemic has caused severe social and economic disruption across the

globe including the largest global recession since the Great Depression. It has

led to the postponement or cancellation of sporting, religious, political, and

cultural events, widespread supply shortages exacerbated by panic buying, and

decreased emissions of pollutants and greenhouse gases. Schools, universities,

and colleges are currently closed either on a nationwide or local basis in 185

countries. Misinformation about the virus has spread online and through multiple

news networks, and there have been incidents of xenophobia and discrimination

against Chinese people and against those perceived as being Chinese or as

being from areas with high infection rates.


// 99


DIRECTOR (e):

2 SECCIONES

CUERPO PERIODÍSTICO

NORMAS LEGALES

@DiarioElPeruano

diariooficialelperuano

Diario Oficial El Peruano

PRESIDENCIA

AÑO DE LA

UNIVERSALIZACIÓN

DE LA SALUD

FÉLIX ALBERTO

PAZ QUIROZ

FUNDADO EL 22 DE OCTUBRE DE 1825 POR EL LIBERTADOR SIMÓN BOLÍVAR

#YOMEQUEDOENCASA

COMO APOYO ANTE AISLAMIENTO SOCIAL, RESALTA PRESIDENTE

VIERNES 17

DE ABRIL DE 2020

PRECIO: S/ 2.00

AÑO: 194 / Nº 26609

Estado entregará bono

de S/ 760 a un millón

de familias rurales

Consejo de Ministros aprueba hoy el beneficio que se otorgará en una sola armada.

El presidente Martín Vizcarra y el jefe del Gabinete, Vicente Zeballos, ratificaron la confianza del Gobierno en que el país saldrá victorioso de la guerra contra coronavirus.

Autorizan

transferencia

de recursos

para segundo

depósito a

favor de independientes.

Policías

y militares

que fallezcan

por combatir

al coronavirus

recibirán

el ascenso

póstumo.

Ejecutivo

reconoce heroísmo

de los

que ofrendan

su vida por

proteger

de pandemia

a población.

Who would have thought that the next

world crisis would be a virus. We all

expected a nuclear war, an economic

crisis like the one in 2008, or a natural

disaster that would end everything.

This virus has exposed the weaknesses

of every state, every country and

every continent. Once again humans

have had to accept that they do not

own the world and that if they break

the rules of nature they will be threatened

with its end.

Ya se llevan a cabo 12,000 pruebas diarias para

detectar virus y hay 12,491 casos positivos.

Perú defiende función de la Organización

Mundial de la Salud en lucha contra el covid-19.

It was first mentioned in December of

the year 2019: A new Virus appeared

in Wuhan, China. In February 2020

all the media was reporting about

the same topic: “The New Coronavirus

(Covid-19)”, deathly for humans.

Italy takes as a first country, drastic

responses, seeing itself as the first

country threatened in Europe: A week

of closing of schools and colleges.

Not long after, everything is closed.

Italy, Spain and the rest of the world

take their measures. All countries

close their borders, to avoid continued

spread of the virus in order to

prevent their health systems fromcollapsing.

Quarantine is announced:

fifteen, twenty days, one month. But

people were still badly informed of

what was actually happening. Especially

considering that many do not

knew what a virus was or what that

little thing was, that kills our loved ones

and friends so rapidly. News and social

media caused panic and confusion.

Governments that didn’t know

how to react and handle.


// 101

A globalized World

An outbreak of such level as the one of the virus is nothing more than a result

ofglobalization. We humans have broken the rules of nature long time ago.

Our constant and desperate desire to have everything within reach, without

being conscious of the consequences. It is only necessary to take an animal

from its natural habitat with the only reason to satisfy our whims, so that a

virus has the opportunity to mutate in such a way that it inhabits humans,

being deathly for them.

Covid-19 has been able to expand due to the density with which people

inhabit this planet. Added to this, countries are interconnected as never

before, giving us the opportunity to move from one place to another with

impressive speed and at low cost, something that generations ago was not

imaginable. This is how the virus spread in China and travelled to Italy in a

couple of hours. With crowds it spreaded in a matter of days in a massive

and uncontrolled way around the world. This demonstrates that today a

local epidemic can lead to a global pandemic mucheasier than ever before

in history by having massive political, societal and economic consequences.


The Worlds Social and Economical breakdown

Covid-19 has caused severe damage, not only to health, but also to the

economy and society. The epidemic has forced more than a third of the

world’s population to undergo quarantine to prevent infections , the spread

of COVID-19 and thus to “Flatten the Curve”, which is a crucial to stop our

health systems from collapsing and limiting the number of deaths. In some

countries the measures taken have left brought damage than in others, due

to a weak or unstable health system, economy and government.

The lockdown has strongly affected the world’s economy, causing a severe

and ongoing global recession. IMF projecions suggest that the coronavirus

recession will be the most severe global economic downturn since the Great

Depression, and that it will be “far worse” than the Great Recession of 2009.

The recession has seen unusually high and rapid increases in unemployment

in many countries. It has left many people out on the streets and without an

income. The groups most vulnerable to the recession are those situated in

lower classes, who in many countries live from day to day and who cannot

afford to stop working. In addition, in most cases the promised support from

governments does not reach those who need it the most. This is how countries

in Latin America or Asia, with high levels of poverty and even extreme

poverty, are confronted with great difficulties and where, in many cases,

governments end up failing. According to a United Nations Economic Commission

for Latin America and the Caribbean estimate, the pandemic-induced

recession could leave 14-22 million more people to fall into extreme poverty .

The recession has caused damage in different sectors as tourism, energy,

consumer industry, arts, cultural heritage, cinema, almost in every sector. In

many cases, especially small ones, companies have been forced to close

their shops indefinitely.

The abandonment of society in this crisis has led to many protests demanding

the help of governments and municipalities. Others have no choice but to

look for ways to get by, being forced to return to their home towns or fight

to survive the day. Or in other countries such as the US, which by giving

absolute priority to its international situation and placement, has left its health

system and the needs of its population in neglect, causing millions of deaths

and unemployment that could have been avoided.


// 103

Crowded people fighting for their lives


In Peru, in the midst of the health emergency on the Covid-19, with

interprovincial transportation interrupted and after having exhausted their

meager savings, thousands are seeking to return to their regions. Many

are forced to return on foot, in the absence of public transportation and

government support.

Foto: GEC

Mass graves in Manaus-Brasil. While Rio de Janeiro or São Paulo have

imposed curfews and closed shops, right-wing populist President Jair

Bolsonaro recently called the lung disease Covid-19, which is caused by

the virus, a “mild flu”, although Brazil is now the third country in the world

to suffer from the virus.

Mass graves in Manaus by AFP or licensors

The civil war, which has lasted for more than five years, has plunged

Yemen, the country on the Arabian Peninsula, into the most serious humanitarian

crisis in the world. Four out of five people need some form of humanitarian

aid. This year alone, 110,000 people have fallen ill with cholera, plus

malaria and dengue fever. With the spread of the coronavirus, the situation

has worsened. The country lies in ruins and has no infrastructure to fight

another crisis like the coronavirus. by Khaled Abdullah / Reuters

In India, the second largest population in the world, thousands of migrants

and workers try to leave every day from New Delhi, as well as other large

cities, to the states from which they come in the face of the lack of work

due to the cessation of activity. The photo shows thousands of people

crowd into a bus station in Delhi, hoping to get out of the city.

by a. fadnavis / reuters

In Italy workers armed with signs and whistles 300 shopkeepers and hoteliers

protested on the steps of Trinità dei Monti against the Government

and the Municipality, to protect their activities and their employees. "Without

government aid we cannot reopen", their slogan. "On May 18th we will

remain closed - they announce - because with the measures studied so far

they will make us "die" slowly".

© Divisione La Repubblica GEDI Gruppo Editoriale S.p.A

Roughly 36 million people have now filed for jobless aid in the US in the

two months since the coronavirus first forced millions of businesses to

close their doors and shrink their workforces.

by Nam Y. Huh, The Associated Press , Niles, Ill., Wednesday, May

13, 2020


// 105

Every country in the world is facing the coronavirus crisis in a different

way. Countries with a weak government, an ineffective health

system and unstable policies are the most affected. Ulrich (German)

and Teresa (Peruvian), are a couple living in Tarapoto- Peru, where

the spread of the virus and deaths are currently increasing exponentially,

while Europe is already returning to normal, this despite

the fact that the infections have started relatively at the same time.

They tell us about the situation in Peru and Latin America and the

problems that the goverment is facing.

Looking at and comparing the situation in Europe and Latin America,

what do you think are the differences in the way people and

government are handling it?

The ways in which the governments of Latin America respond are very

different. For example, the national government of Brazil has long ignored

the danger of the pandemic, while the government of Peru in the first phase

of the pandemic has opted for rather drastic measures (forty of the entire

population, curfew etc.). In both countries characterized by high inequalities

in their population, especially the poor cannot abide by the state’s measures.

The public health sector, too, has been very poor for decades and leaves

the poor unprotected.

Why does a pandemic like the one we are experiencing cause so

many problems in countries like Latin America?

The deficient public health sector and above all the high inequality in the

population’s access to health services. Similarly, most of the population

does not have the savings and income to overcome a long quarantine and

unemployment of economic activities that the Peruvian government has

imposed.

How is the situation in Peru? And what part of the population is

most affected?

On May 30, 155,671 cases of Covid-19 were confirmed in Peru, with

7,386 new cases compared to the previous day (https://covid19.minsa.

gob.pe/sala_situacional.asp) with the “epicenter” Lima (970 infected per

100,000 inhabitants). Peru was also ranked 12th in the world and second

after Brazil. The most affected population is the poor in the cones of Lima,

but equally in the provinces in the most economically vulnerable population,

the cases are increasing.

What measures has the Peruvian Government taken to avoid the

contagion? Have they been effective?

The most important measures are restrictions on the social and economic

activities of the population (quarantine and curfew) and the promotion of

protective measures, hygiene and social distancing. However, the implementation

of the economic recovery plan in recent weeks has exponentially

increased the number of infected people.


Do you think that the Peruvian government has acted in the best

possible way to deal with the problem?

The measures taken were adequate (forty, bonds for poor families, improvement

of the capacity of hospitals etc.) but they have not been able

to overcome the problems related to the neglect of the education and

health system for decades. Moreover, they have not had a differentiated

response to the different realities of the population in different social strata

and regions of the country.

And compared to other Latin American countries, one could say

that Peru is in a better position?

Currently, the pandemic in the country has gotten out of control and in

many cities, the health system has collapsed. Although the country has had

a good financial settlement, investments are not enough in the face of a

public health and education system that has been very neglected for years.

In addition, the neoliberal economic system with total lack of protection for

the worker as well as the very high level of informality in family economies

has caused the unemployment of many people who in the coming months

will no longer be able to recover, which will also limit economic recovery.

What support does the government promise to give its population,

especially those who do not have a stable monetary income, the

most vulnerable to an economic crisis? Is the government living

up to its promises? (If no) why do you think not?

Until the end of June, a bond of approximately US$ 200 to 5 million families

will be given to complement the previous bonds. The problem is that

the register of vulnerable families is not updated, therefore there are many

vulnerable families that do not benefit. The delivery is very slow and there

have also been cases of fraud by outsiders or corruption by the government

itself, since many vulnerable families do not have a bank account. Finally,

the government has not delivered the labtops to poor families who must

absolve the online education programs.

What are the government’s biggest weaknesses in the face of a

problem as big as this?

The biggest weaknesses of the government are the slowness of the logistic

processes, the lack of technological tools, corruption, insufficient control of

the management processes of the improvements of the health system and

the inability to respond to the increasing demand of hospital and intensive

care beds caused by the rapid spread of the virus in the country and a

differentiated response to the different realities of the non-homogeneous

population socially, economically and culturally. Finally, one weakness is

the inconsistency between economic recovery and the pandemic, which

has not yet reached its peak.

The population has been tolerant and understands the decisions

made by the government?

Because of low levels of education and lack of transparency of information,

some strata of the population do not understand the decisions that the

government has made.


// 107

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics

Absurd Politics


This crisis made once again clear, to us that politics are ridiculous.

Politics in many countries have failed again. It is not only

refered to third world governments, but also to major world

powers like the United States.

Each government has taken measures in its own country to

prevent the health system from collapsing, to minimize the rate

of infection and death, and to avoid high unemployment and

an economic crisis. Some countries had an harder time with

this crisis than others, and there are those countries that have

been victims of their politicians. Narcissists, neo-capitalists,

fascists, conservative, selfish people who are in power and

have corrupted their governments. Presidents making a lot of

promises with no results. Their goal is nothing more or less

than to “grow the economy” no matter what the price is. Not

even the death of thousands of people from a virus can stop

them. An economy that only benefits big business, ignoring

the needs of their citizens. Countries with a divided population,

living in inequality. A lot of people struggle surviving due

to the lack of resourses and very few benefit from the capitalist

and narcissistic politics imposed by the government.

There are some presidents who need to be mentioned . Presidents

who have made fools of themselves by the way they

handle the Coronavirus Crisis and who, up to now, seeing the

gravity of the situation, still stick to their opinion. Presidents

who from the beginning have totally denied the seriousness of

the coronavirus by downplaying it and leaving their population

in a state of neglect. And now the people have nothing left to

do but protest for their rights.


// 109

Still at the beginning of the Coronacrisis, while the virus was spreading widely

in Europe and many hospitals were overburdened, while infection rates in

Latin American countries, such as Brazil and Peru, were rising exponentially,

Jair Bolsonaro, the current president of Brazil, tried to play down

the situation.

“If I get infected with the virus, all I get is a ‘gripezinha’

(small flu) or a ‘resfriadinho’ (small cold),” the

president said,

while thousands of Brazilians protested in more than a dozen cities, requiring

to take the necessary measures to fight the virus. The protests against

President Bolsonaro became even stronger when he fired his health minister,

Mandetta, who advocated strict exit restrictions, while Bolzonaro found it

absolutely unnecessary. That proved that those who do not support Bolsonaro’s

opinion will be fired directly. This gesture denied the freedom of opinion

that is at the base of a democratic country in favor to a more dictatorship

goverment.

In the Rocinha favela in Rio, the lockdown with curfews worked because the

drug gang took matters into their own hands. “Anyone who leaves the house

will get a bullet in the head,” the gang threatened, as one resident described.

The threats worked. As well as in other cities around Brazil, they took their

own measures and opted for voluntary curfews, because they wouldn't be

able to keep up with high infection rates. Now Brazil is also facing collapse

- the city of Manaus is suffering in particular. Bolsonaro instead still sticks

to his opinion. Financial aid from the state is either not forthcoming or is

hardly ever forthcoming. Shops and shopping centers continue to open as

the country heads for the peak of the pandemic.


On the other side of the World Turkey’s coronavirus response looked to be

on the right track — until the country’s polarized politics got in the way. The

country’s approach has turned increasingly erratic as Erdogan, the president

of Turkey, tries to balance combatting the outbreak with reining in the popularity

of political rivals. Erdogan’s decisions have in many cases culminated in

chaos. The first lockdown, at the request of the opposition, was announced

two hours earlier. This led to crowds of people in markets and supermarkets

and making panic purchases while the stores were still open, even though

social distancing was highly recommended.

Erdogan said in one of his first speeches that the

pandemic could become an opportunity for Turkish

manufacturers as global companies seek to shift production

away from China. “If we can manage this oneor

two-week process well in our country and curb the

spread of the disease, we will have a good picture

before us,” Erdogan said.

From the beginning, the Turkish government has manipulated the statistics

of infections and deaths caused by the virus, to play down the situation and

leave Erdogan’s “popularity” intact, but that only contributed to the collapse

of the health system and the economy in the country and an unhappy population.

The Turkish government has also tried to clamp down on economic relief

efforts led by the opposition, investigating them for having started coronavirus

fundraising campaigns in March. Evren Balta, a professor of political science

at Istanbul’s Özyegin University, said that this lack of collaboration was a

product of Turkey’s fierce political polarization. “The government sees the

relief efforts as an opportunity for [opposition] mayors to become popular,

therefore it rejects any collaboration with them,” she said. To date, Erdogan

has not implemented the necessary measures to fight the coronavirus, as his

top priority is to maintain his popularity around the world. Turkey’s population

is facing high rates of unemployment and deaths. Turkey’s government is

one more repressing important information, public opinion and human rights.


// 111

No doubt Trump, the president of the United States, has

won the first place of absurdity, with his comments and

answers to the subject “Coronavirus”. You don’t have

to be a genius to confirm it, just listen to him or read

what he said in the past months. It´s even hard to make

everything fit in a page. At the end of January, the US

president still claimed to have everything "completely

under control", while the cases increased rapidly. A few

weeks later he even used war vocabulary and encouraged

researchers to use life-threatening methods. He ignored

at least 12 Coronavirus warnings in his daily intelligence

briefings.

A chronlogy of absurdity:


22 January (CNBC interview - the day before the first case

of corona in the USA was reported): “We have it totally under

control. It’s one person coming in from China. We have it under

control. It’s going to be just fine.”

30 January (in Michigan - On this day, the WHO declares

the spread of the virus to be a “health emergency of international

concern”): “We think we have it very well under control.

We have very little problem in this country at this moment

— five — and those people are all recuperating successfully.

But we’re working very closely with China and other countries,

and we think it’s going to have a very good ending for us …

that I can assure you.”

February 10: “You know in April, supposedly, it dies with

the hotter weather.” He told state governors: “You know, a

lot of people think that goes away in April with the heat -- as

the heat comes in. Typically, that will go away in April.” And

he said at a campaign rally: “Looks like by April, you know, in

theory, when it gets a little warmer, it miraculously goes away.

I hope that’s true.”

February 25: “ The coronavirus wich is very well under control

in our country. We have very few people with it. The people are

getting better, they’re all getting better. And I think that whole

situation will start working out. Lot of talent, a lot of brain power

is being put behind it. It´s a very good chance you‘re not gonna

die.” There were 53 confirmed cases and no deaths on the

day of Trump’s tweet; as of March 11, there were more than

1,000 cases and 31 deaths.

February 26: Trump baselessly predicts: “I think every aspect

of our society should be prepared. I don’t think it’s going to

come to that, especially with the fact that we’re going down,

not up. We’re going very substantially down, not up.” And he

said: “And again, when you have 15 people, and the 15 within

a couple of days is going to be down to close to zero, that’s a

pretty good job we’ve done.” Clearly, the number of US cases

and deaths was going up, not down. There were 60 total

cases in the US on the day Trump spoke here.

February 26: “This is a flu. This is like a flu,” Trump repeated.

“It’s a little like the regular flu that we have flu shots for. And

we’ll essentially have a flu shot for this in a fairly quick manner.”

March 6 (visiting Atlanta): “I like this stuff. I really get it. People

are surprised that I understand it. Every one of these doctors

said, ‘How do you know so much about this? ‘ Maybe I have

a natural ability. Maybe I should have done that instead of

running for president.”

March 11: “... very important for countries & businesses to

know that trade will in no way be affected by the 30-day restriction

on travel from Europe. The restriction stops people

not goods.”

March 15: “This is a very contagious virus. It’s incredible. But

it’s something that we have tremendous control over.”

March 17: “I’ve always known this is a — this is a real — this

is a pandemic. I’ve felt it was a pandemic long before it was

called a pandemic.”

March 28: “WE WILL WIN THIS WAR. When we achieve

this victory, we will emerge stronger and more united than ever

before!” (US surpasses 100,000 coronavirus cases)

March 29: “And so, if we can hold that down... so we have

between 100- and 200,000 — we all, together, have done a

very good job.”

April 1: Nobody has ever seen anything like this, where large

groups of people, all of a sudden, just by being in the presence

of somebody, have it. The flu has never been like that.” Almost

190,000 US infections were reported the day before.

April 3 (on the recommendation to wear fabric masks for

protection): ”It’s going to be, really, a voluntary thing ... I’m

choosing not to do it, but some people may want to do it, and

that’s okay...”

April 7:“The W.H.O. really blew it. For some reason, funded

largely by the United States, yet very China centric. We will be

giving that a good look. Fortunately I rejected their advice on

keeping our borders open to China early on. Why did they give

us such a faulty recommendation?” On 11 March 2020, the

WHO officially declared the Covid-19 outbreak a pandemic

April 23: An expert explained that bleach and disinfectants

can quickly kill the SARS CoV-2 pathogen on metallic

surfaces. Trump took this statement as the basis for

this statement regarding a treatment option for COVID-

19: “Right. And then I see the disinfectant, where it knocks

it out in a minute. One minute. And is there a way we can do

something like that, by injection inside or almost a cleaning.

Because you see it gets in the lungs and it does a tremendous

number on the lungs. So it would be interesting to check

that.”... “It wouldn’t be through injection. We’re talking about

through almost a cleaning, sterilization of an area. Maybe it

works, maybe it doesn’t work. But it certainly has a big effect

if it’s on a stationary object.”

April 23: Trump has another proposal to combat SARS-

CoV-2: “So, supposing we hit the body with a tremendous —

whether it’s ultraviolet or just very powerful light — and I think

you said that that hasn’t been checked, but you’re going to

test it. And then I said, supposing you brought the light inside

the body, which you can do either through the skin or in some

other way, and I think you said you’re going to test that too. It

sounds interesting.”


// 113

We could list a lot of cases of discrimination that happened

since the Virus spread started. You ask yourself

if we are really living in the twentieth century, in which

society should already be over with discriminating others.

During the Coronavirus crisis, these cases have been

getting worse. Since the outbreak originated in Wuhan-

China, people of Chinese or East Asian origin, as well as

from areas with high infection rates, such as Italy, have

been discriminated, leading to aggression against them,

division of the population, confrontations, protests, etc.

This was exacerbated by social media and comments

from authorities whose words have caused a very negative

impact on society.

The most evident examples of discrimination that have

been caused by the crisis of the coronavirus have been

seen in the United States.. Donald Trump (the current

President of the United States) as the most powerful

authority in the US has not collaborated in smoothing the

situation, instead, with his comments in different speeches,

he has sharpened the division of the population, between

neofascists/conservative and those who fight for

true democracy and equal rights.

This is how we can recognize that the way of speaking,

acting and misinforming increases discrimination in the

population.


Reporter: “Why do you keep calling

this ‘The chinese Virus’ ? There are reports

of dozens of incidents of bias agais

Chinese-Americans in this country. Your

own aide Secretary Azar says he does

not use this term. He says ethnicity is

does not cause the virus. Why do you

keep using it?”

US President Donald Trump has defended repeatedly

calling the coronavirus the “Chinese

virus” during a news conference, ignoring criticism

that it is racist. China experts argue that

labelling the virus this way will only increase tensions

between the two countries and encourage

xenophobia.

Asian-Americans have reported incidents of racial

slurs and physical abuse over the perception that

China caused COVID-19.

Trump: "It's not racist at all, it comes

from China, that's why."

Reporter: "And do you think, using

the term 'Chinese virus', that puts

Asian-Americans at risk, that people

might target them?"

Trump: "No, not at all. I think they probably

would agree with it 100 percent. It

comes from China."

I only talk bullshit,

just ignore me


The outbreak has been blamed for several instances of

supply shortages, stemming from globally increased usage

of equipment to fight outbreaks, panic buying, which in

several places led to shelves being cleared of grocery

essentials such as food, toilet paper, and bottled

water. A big issue was the demand for personal protection

equipment that rise a hundredfold, leading to

prices up to twenty times the normal price and also delays

in the supply of medical items of four to six months.

There was shortage in quipment such as medical masks,

gloves, face shields, gear, sanitising products and

medication, with the WHO warning that this will endanger

health workers. Also joined by potential shortage

of more advanced devices such as hospital beds, ICU

beds, oxygen therapy, ventilators and ECMO devices

and medical staff.


// 117

Toilet paper,

the new gold

The face mask, the last fashion trend

Disinfectants,

the new water


There are things that we will never forget.

Things, objects, that will always remind us

of this phase that each one of us had to live

and that are going to be put in relation to

the “Corona-Time”. Objects that one would

never have imagined would be the first to be

finished. Some objects that have never been

so important and necessary in our daily life.

Some objects that reflect the selfishness

within the human, thinking only of themself

and not of those around him. It has brought

out the animal inside us: the fastest, the

strongest, the richest survives. These objects

have reflected the injustice of capitalism; the

one with the most money survives.


// 119

Lets practice social distancing

There are always positive things that can be taken out of

every crisis. We have realized that what we thought was no

longer important in human life is still essential. One of the

biggest challenges that has been put to us, is social distancing

with the purpose of avoiding the spread of COVID-

19. No contact with friends, family, co-workers and human

relationships. Social distancing has been a hard and difficult

challenge to bear, which thanks to technological advances

has become much easier. No doubt after this crisis, the social

approach will be more appreciated than before, where

it was thought that technology and virtual life (social media)

had put an end to social contact. Now people are waiting

for the moment to go out and meet with others.


Nobody likes to be isolated,

everyone likes social contact


// 121

The importance of science

Camila is a virologist. She studied her bachelor’s and master’s in molecular

biology at the University in Heidelberg, with a focus on Infectious

Diseases. In the past years she has been working in the Molecular

Virology Department at the Heidelberg University Hospital.

Her research focuses on intestine viruses and immune response, but

since the corona times her laboratory started working on the novel

coronavirus. Apart from her professional background, she has been

living several years in South America. As such, she is able to not only

see the biological, but also the social impact of a new pandemic.

As a virologist, have you seen coming the SARS-Cov-20019 virus?

And did you thought it would spread that much and bring so many

consequences with it?

Yes. Indeed, in our Virology lectures in 2017 we were taught that the risk

of a zoonosis was coming strongly from coronaviruses. In general, scientists

are aware that virus spill over from animal to humans is occurring constantly,

and there is a high risk that these uprising human viruses lead to a pandemic.

Taking in account the environmental impact caused by human beings and

how interconnected the world is due to globalization, the probability of such a

pandemic occurring again in the next decades is very high.

Virologists knew that a new pandemic would have such a strong health impact

and spread as much or even more. However, we were never aware of the economic

impact which is probably as strong as the medical one.

Why do you think that the countries weren’t prepared for this crisis,

even though science was expecting the arrival of this virus?

This is a very good question, and something with which scientist are confronted

everyday not only on this topic. There is a strong miscommunication

between scientists and non-scientists. And sadly, I have to say the fault is

strongly on scientists. We often don’t put the effort in explaining our research

in a simple and understandable way as we stay in our comfort zone with people

that understand our concepts immediately. However, this miscommunication

is not only with non-scientist but also with politicians. And here I have to

say that politicians should be much more involved with science. However, they

don’t show much interest, not even in these very important topics. Furthermore,

few scientists are directly involved in politics. Taken together, the reason

why most countries were not prepared for this pandemic has many different

reasons and one important one is the missing communication.

Since research is super important especially in these cases, how

did the laboratories deal with the lockdown? What effect had it in

ongoing investigation?

As expected, there is a strong shift towards coronavirus investigation. At least

academic research is paid by public money. This means, that the money will

go to what seems to be the most important. Of course, coronavirus research is

essential at this point, however right now there is incredible amounts of money

being shifted from other fields in biology to virology. On a short term this has a

positive impact on virus research, but on a long term many labs working on our

topics including on basic research, which is not directly linked to medicine, will

need to close. These labs are as essential as virology labs as they investigate

the background in biology. Apart from this rather negative aspect, on a positive

side I see that research is being appreciated more in todays society.


Do you think that scientist could have intervened better in this situation

by informing the population?

Yes, they could have. As I mentioned before, often we don’t take the time to

explain in an easy way what we are doing. I also have to say that we are often

misinterpreted. For example, the whole vaccination topic is something we explain

a million times, but a group of people just don’t want to accept the huge advantage

vaccines are. Still, we have to take responsibility and I hope in the future this

communication improves.

Do you think that after the summer (2020) there could be a new outbreak?

I don’t want to conspire on anything, so everything I say here is merely my ideas

which right now are not based on scientific facts. Taking in account what I know

about the virus, I can imagine that this converts in a seasonal flu at least in northern

countries. However, in these past months people learned extremely much

about how to deal with a virus and I can imagine that outbreaks will have less

effect on public health. In regard to a big outbreak, of course this also could

happen, but I don’t want to go too far with my assumptions. Actually, everything

could happen, and this situation is so new that even epidemiologists have struggles

in seeing what is coming. Additionally, every country is completely different

so what could happen in one country most probably won’t happen in another one.

As a Scientist, do you think the measures that most governments have

taken were appropriated?

From a merely scientific point of view we are all in accordance that to ‘eliminate’

the virus the lock down would need to be much longer and restrictive. However,

we all know this is not feasible. As such, I think that most governments did the

best with their knowledge and resources. In this very new situation, I think most

politicians (excluding some obvious ones) handled the situation the best way

they could and probably there is no perfect way. I am happy not being in their

place.

I think it has been a big struggle for you scientist to be asked about

the vaccine, why is that?

When vaccines work, they are better than any medicine. However, it is impossible

to tell in advance if it will work in the first place. See HIV, it has been years

and years of research, but scientists were not able to develop a vaccine due to

the plasticity and different immune evading mechanisms of the virus. This means,

scientists don’t want to promise too much when it comes to development of a

vaccine within some months. Not only this, but with today’s security measures

the development of a vaccine takes around 10 years. Indeed, a vaccine for Ebola

has been already developed by 2015, however it is not freely on the marked

because they have to test people for several years to see the long-term effects. I

think that as soon as a coronavirus vaccine is developed, it will be on the marked

soon as politicians will help to develop fast-track security measures. I personally

hope that a vaccine can be developed and very fast, but it is difficult to say now.

How is it to step in in the laboratory marked in Corona times, as a new

professional?

We don’t notice many differences. Working in the lab comes with a lot of security

measures itself so we are used to it. The social distancing component is also ok

as we normally don’t work directly with other people all the time, and meetings

can be held online. We always have to use facemasks put you get used to it. I

didn’t feel so much impact professionally. We are very lucky in this sense as I

know that other professionals struggle much more.


// 123


To be continued...


// 125

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127

CREDITS

Free University of Bozen-Bolzano

Faculty of Design and Art

Bachelor in Design and Art – Major in Design

Course: Project Visual Communication

Course title: Order & Eccentricity

Summer Semester 2020

Design by:

Verena Metz Zumarán

Book Design | The manual on Viruses

Supervision:

Project leader: Prof. Antonino Benincasa

Graphic Design: Prof. a.c. Emilio Grazzi

Theories and languages of visual communication:

Prof. Emanuela De Cecco

Paper:

Inside pages –Munken Polar, 120 g/m2

Soft Cover – Munken Polar, 120 g/m2

Format:

185 x 254 mm

Fonts | Font Sizes & Leading:

Body Text

Berthold Akzidenz Grotesk BE

12/14,882 pt

Caption Text


7/9 pt

Title Text


29/31 pt

Subtitle Text


18/23 pt

Layout Grid:

6 Column Grid

Module proportion:

1.409 : 1

CPL | Character per line - Body Text:

65 characters including spaces

Binding:

Stitch binding

Printed:

Heidelberg, Germany, July 2020

First Edition:

2020

125 pages of knowledge 125 pages of knowledge

The Manual on Viruses

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