1. Genome of corona viruses
2. Comparative analysis of emergence and spreading
3. Entry Mechanism
4. COVID-19 Case Study
5. Face mask Case Study
6. Pharmacologic Treatments for Coronavirus Disease
7. BCG vaccine
1. Genome of corona viruses
2. Comparative analysis of emergence and spreading
3. Entry Mechanism
4. COVID-19 Case Study
5. Face mask Case Study
6. Pharmacologic Treatments for Coronavirus Disease
7. BCG vaccine
COVID-19 is a global infectious disease pandemic with high morbidity and mortality for at risk individuals. This slide is intended for the medical students, medical doctors and those in training for masters of medicine (MMED).
Covid-19 is an infectious disease caused by SARS-CoV-2. mechsnism, pathogenesis and causes, transmission,symptoms and therapeutic strategies
Published by karuna raghuwanshi,M.pharma II semester (pharmaceutics),Pharmacy department.
SARS Corona-virus 2: Genome Sequencing And Its ApplicationSarbajitRay2
This presentation encompasses the details of genomic sequencing of SARS CoV-2 and the applications of genomic sequencing.
Prepared By:
Adyasha Nayak
Sarbajit Ray
Sugata Lahiri
Badri Prasad Sarangi
The 2019–20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[4] The outbreak was first identified in Wuhan, Hubei, China, in December 2019, and was recognized as a pandemic by the World Health Organization (WHO) on 11 March 2020.[5] As of 25 March, more than 422,000 cases of COVID-19 have been reported in more than 190 countries and territories, resulting in more than 18,900 deaths and more than 109,000 recoveries.
TheNeuroSurgeons sponsored the presentation to the Zimbabwe Association of Neurological Surgeons.
we are learning more about the neurological manifestations of the novel coronavirus as we are frantically looking for solution to this formidable pandemic.
The global Corona virus pandemic has brought in a lot of issues, concerns and challenges to humanity and the ecosystem. There is a medical emergency to take up strict measures to slow or stop the spread of this virulent pathogen SARS-CoV-2, the virus that causes COVID-19 which is a new variant indicating its origin to the Wuhan city of China. People across nations have been experiencing all the economic and psychological consequences due to this outbreak, and the whole world has joined hands in eradicating this deadly disease. A lot of awareness schemes are being undertaken by many countries and organizations, to not only control the infection but also to revive normalcy. This article provides valuable information about the cause, symptoms, diagnosis, treatment protocols, counseling support systems, innovation strategies, etc., all to ensure that we overcome this crisis and spring back to our healthy routines.
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
COVID-19 is a global infectious disease pandemic with high morbidity and mortality for at risk individuals. This slide is intended for the medical students, medical doctors and those in training for masters of medicine (MMED).
Covid-19 is an infectious disease caused by SARS-CoV-2. mechsnism, pathogenesis and causes, transmission,symptoms and therapeutic strategies
Published by karuna raghuwanshi,M.pharma II semester (pharmaceutics),Pharmacy department.
SARS Corona-virus 2: Genome Sequencing And Its ApplicationSarbajitRay2
This presentation encompasses the details of genomic sequencing of SARS CoV-2 and the applications of genomic sequencing.
Prepared By:
Adyasha Nayak
Sarbajit Ray
Sugata Lahiri
Badri Prasad Sarangi
The 2019–20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[4] The outbreak was first identified in Wuhan, Hubei, China, in December 2019, and was recognized as a pandemic by the World Health Organization (WHO) on 11 March 2020.[5] As of 25 March, more than 422,000 cases of COVID-19 have been reported in more than 190 countries and territories, resulting in more than 18,900 deaths and more than 109,000 recoveries.
TheNeuroSurgeons sponsored the presentation to the Zimbabwe Association of Neurological Surgeons.
we are learning more about the neurological manifestations of the novel coronavirus as we are frantically looking for solution to this formidable pandemic.
The global Corona virus pandemic has brought in a lot of issues, concerns and challenges to humanity and the ecosystem. There is a medical emergency to take up strict measures to slow or stop the spread of this virulent pathogen SARS-CoV-2, the virus that causes COVID-19 which is a new variant indicating its origin to the Wuhan city of China. People across nations have been experiencing all the economic and psychological consequences due to this outbreak, and the whole world has joined hands in eradicating this deadly disease. A lot of awareness schemes are being undertaken by many countries and organizations, to not only control the infection but also to revive normalcy. This article provides valuable information about the cause, symptoms, diagnosis, treatment protocols, counseling support systems, innovation strategies, etc., all to ensure that we overcome this crisis and spring back to our healthy routines.
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
Introduction:
RNA interference (RNAi) or Post-Transcriptional Gene Silencing (PTGS) is an important biological process for modulating eukaryotic gene expression.
It is highly conserved process of posttranscriptional gene silencing by which double stranded RNA (dsRNA) causes sequence-specific degradation of mRNA sequences.
dsRNA-induced gene silencing (RNAi) is reported in a wide range of eukaryotes ranging from worms, insects, mammals and plants.
This process mediates resistance to both endogenous parasitic and exogenous pathogenic nucleic acids, and regulates the expression of protein-coding genes.
What are small ncRNAs?
micro RNA (miRNA)
short interfering RNA (siRNA)
Properties of small non-coding RNA:
Involved in silencing mRNA transcripts.
Called “small” because they are usually only about 21-24 nucleotides long.
Synthesized by first cutting up longer precursor sequences (like the 61nt one that Lee discovered).
Silence an mRNA by base pairing with some sequence on the mRNA.
Discovery of siRNA?
The first small RNA:
In 1993 Rosalind Lee (Victor Ambros lab) was studying a non- coding gene in C. elegans, lin-4, that was involved in silencing of another gene, lin-14, at the appropriate time in the
development of the worm C. elegans.
Two small transcripts of lin-4 (22nt and 61nt) were found to be complementary to a sequence in the 3' UTR of lin-14.
Because lin-4 encoded no protein, she deduced that it must be these transcripts that are causing the silencing by RNA-RNA interactions.
Types of RNAi ( non coding RNA)
MiRNA
Length (23-25 nt)
Trans acting
Binds with target MRNA in mismatch
Translation inhibition
Si RNA
Length 21 nt.
Cis acting
Bind with target Mrna in perfect complementary sequence
Piwi-RNA
Length ; 25 to 36 nt.
Expressed in Germ Cells
Regulates trnasposomes activity
MECHANISM OF RNAI:
First the double-stranded RNA teams up with a protein complex named Dicer, which cuts the long RNA into short pieces.
Then another protein complex called RISC (RNA-induced silencing complex) discards one of the two RNA strands.
The RISC-docked, single-stranded RNA then pairs with the homologous mRNA and destroys it.
THE RISC COMPLEX:
RISC is large(>500kD) RNA multi- protein Binding complex which triggers MRNA degradation in response to MRNA
Unwinding of double stranded Si RNA by ATP independent Helicase
Active component of RISC is Ago proteins( ENDONUCLEASE) which cleave target MRNA.
DICER: endonuclease (RNase Family III)
Argonaute: Central Component of the RNA-Induced Silencing Complex (RISC)
One strand of the dsRNA produced by Dicer is retained in the RISC complex in association with Argonaute
ARGONAUTE PROTEIN :
1.PAZ(PIWI/Argonaute/ Zwille)- Recognition of target MRNA
2.PIWI (p-element induced wimpy Testis)- breaks Phosphodiester bond of mRNA.)RNAse H activity.
MiRNA:
The Double-stranded RNAs are naturally produced in eukaryotic cells during development, and they have a key role in regulating gene expression .
Earliest Galaxies in the JADES Origins Field: Luminosity Function and Cosmic ...Sérgio Sacani
We characterize the earliest galaxy population in the JADES Origins Field (JOF), the deepest
imaging field observed with JWST. We make use of the ancillary Hubble optical images (5 filters
spanning 0.4−0.9µm) and novel JWST images with 14 filters spanning 0.8−5µm, including 7 mediumband filters, and reaching total exposure times of up to 46 hours per filter. We combine all our data
at > 2.3µm to construct an ultradeep image, reaching as deep as ≈ 31.4 AB mag in the stack and
30.3-31.0 AB mag (5σ, r = 0.1” circular aperture) in individual filters. We measure photometric
redshifts and use robust selection criteria to identify a sample of eight galaxy candidates at redshifts
z = 11.5 − 15. These objects show compact half-light radii of R1/2 ∼ 50 − 200pc, stellar masses of
M⋆ ∼ 107−108M⊙, and star-formation rates of SFR ∼ 0.1−1 M⊙ yr−1
. Our search finds no candidates
at 15 < z < 20, placing upper limits at these redshifts. We develop a forward modeling approach to
infer the properties of the evolving luminosity function without binning in redshift or luminosity that
marginalizes over the photometric redshift uncertainty of our candidate galaxies and incorporates the
impact of non-detections. We find a z = 12 luminosity function in good agreement with prior results,
and that the luminosity function normalization and UV luminosity density decline by a factor of ∼ 2.5
from z = 12 to z = 14. We discuss the possible implications of our results in the context of theoretical
models for evolution of the dark matter halo mass function.
Deep Behavioral Phenotyping in Systems Neuroscience for Functional Atlasing a...Ana Luísa Pinho
Functional Magnetic Resonance Imaging (fMRI) provides means to characterize brain activations in response to behavior. However, cognitive neuroscience has been limited to group-level effects referring to the performance of specific tasks. To obtain the functional profile of elementary cognitive mechanisms, the combination of brain responses to many tasks is required. Yet, to date, both structural atlases and parcellation-based activations do not fully account for cognitive function and still present several limitations. Further, they do not adapt overall to individual characteristics. In this talk, I will give an account of deep-behavioral phenotyping strategies, namely data-driven methods in large task-fMRI datasets, to optimize functional brain-data collection and improve inference of effects-of-interest related to mental processes. Key to this approach is the employment of fast multi-functional paradigms rich on features that can be well parametrized and, consequently, facilitate the creation of psycho-physiological constructs to be modelled with imaging data. Particular emphasis will be given to music stimuli when studying high-order cognitive mechanisms, due to their ecological nature and quality to enable complex behavior compounded by discrete entities. I will also discuss how deep-behavioral phenotyping and individualized models applied to neuroimaging data can better account for the subject-specific organization of domain-general cognitive systems in the human brain. Finally, the accumulation of functional brain signatures brings the possibility to clarify relationships among tasks and create a univocal link between brain systems and mental functions through: (1) the development of ontologies proposing an organization of cognitive processes; and (2) brain-network taxonomies describing functional specialization. To this end, tools to improve commensurability in cognitive science are necessary, such as public repositories, ontology-based platforms and automated meta-analysis tools. I will thus discuss some brain-atlasing resources currently under development, and their applicability in cognitive as well as clinical neuroscience.
Richard's entangled aventures in wonderlandRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
This pdf is about the Schizophrenia.
For more details visit on YouTube; @SELF-EXPLANATORY;
https://www.youtube.com/channel/UCAiarMZDNhe1A3Rnpr_WkzA/videos
Thanks...!
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
2. ANDHRA UNIVERSITY
SEMINAR -2022
M.TECH BIOTECHNOLOGY
• CONTENTS
INTRODUCTION
SIGNS AND SYMPTOMS
CAUSE
PATHOPHYSIOLOGY
DIAGNOSIS & PREVENTION
TREATMENT
MORTALITY RATIO SUBMITTED TO
CONCULSION K.JAYA RAJU SIR
PROFESSOR
4. INTRODUCTION
Coronavirus disease 2019 (COVID-19).
•Initial outbreak in Wuhan.
•Incubation period 2-14 days .
• Covid-19 acronym by Tedros Adhanom
•Genesis of corona virus
5. SIGNS AND SYMPTOMS
• Headache
• loss of smell (anosmia)
• Taste (ageusia),
•Nasal congestion and runny nose,
• Cough,
• Muscle pain,
• Sore throat,
•Fever,
• Diarrhea,
• Breathing difficulties
•Mild pneumonia
•Black fungus
•White fungus
•Fatigue
7. Virology
• The structural proteins of SARS-CoV-2 include :
• membrane glycoprotein (M),
• envelope protein (E),
• nucleocapsid protein (N), and the
• spike protein (S).
8. SARS-CoV-2 variants
• As of December 2021, there are five dominant variants of SARS-CoV-2 spreading among global
populations:
• The Alpha variant (B.1.1.7, formerly called the UK variant), first found in London and Kent,
• The Beta variant (B.1.351, formerly called the South Africa variant),
• The Gamma variant (P.1, formerly called the Brazil variant),
• The Delta variant (B.1.617.2, formerly called the India variant),
• The Omicron variant (B.1.1.529), which had spread to 57 countries as of 7 December.
9. PATHOPHYSIOLOGY
❑The SARS-CoV-2 virus can infect a wide range of cells and systems of the body.
❑ COVID‑19 is most known for affecting the upper respiratory tract (sinuses, nose, and throat) and the lower respiratory tract (windpipe
and lungs).
❑The lungs are the organs most affected by COVID‑19 because the virus accesses host cells via the receptor for the enzyme
angiotensin-converting enzyme 2 (ACE2), which is most abundant on the surface of type II alveolar cells of the lungs.
❑ The virus uses a special surface glycoprotein called a "spike" to connect to the ACE2 receptor and enter the host cell.
10.
11. VIRAL AND HOST FACTORS
Virus proteins
• Multiple viral and host factors affect the pathogenesis of the virus.
• The S-protein, includes two subunits: S1 and S2.
• S1 determines the virus-host range and cellular tropism via the receptor-binding domain.
• S2 mediates the membrane fusion of the virus to its potential cell host via the H1 and HR2, which are heptad
repeat regions.
• Studies have shown that S1 domain induced IgG and IgA antibody levels at a much higher capacity. It is the focus
spike proteins expression that are involved in many effective COVID‑19 vaccines.
• The M protein is the viral protein responsible for the transmembrane transport of nutrients. It is the cause of the
bud release and the formation of the viral envelope.
• The N and E protein are accessory proteins that interfere with the host's immune response.
12.
13. Host factors :
• Human angiotensin converting enzyme 2 (hACE2) is the host factor that SARS-COV2 virus targets causing
COVID‑19.
• The effect of the virus on ACE2 cell surfaces leads to leukocytic infiltration, increased blood vessel permeability,
alveolar wall permeability, as well as decreased secretion of lung surfactants. These effects cause the majority of
the respiratory symptoms. However, the aggravation of local inflammation causes a cytokine storm eventually
leading to a systemic inflammatory response syndrome
• Among healthy adults not exposed to SARS-CoV-2, about 35% have CD4+
T cells that recognize the
SARS-CoV-2 S protein (particularly the S2 subunit) and about 50% react to other proteins of the virus,
suggesting cross-reactivity from previous common colds caused by other coronaviruses.
14. Diagnosis & prevention
COVID‑19 can provisionally be diagnosed on the basis of symptoms and confirmed using :
Reverse transcription polymerase chain reaction (RT-PCR)
a sample of nose or throat swab is taken of the person to analyze the genetic fragments of the virus.
Chest CT scans
Chest computed tomography (CT) scan is an important method for the diagnosis of COVID-19 pneumonia
15. Nucleic acid testing
• The NAAT procedure works by first
amplifying – or making many copies
of – the virus's genetic material, if any
is present in a person's specimen.
Amplifying those nucleic acids
enables NAATs to detect very small
amounts of SARS-CoV-2 RNA in a
specimen, making these tests highly
sensitive for diagnosing COVID-19.
18. Treatment
There is no specific, effective treatment or cure for coronavirus disease 2019 (COVID‑19), the disease caused by the SARS-CoV-2 virus.
Vaccination
Fluid therapy
Oxygen support
Medications (NSAID,antidepressents,antivirals,)
Plasma Theraphy
21. WHAT IS VACCINE ?
• A preparation that is used to stimulate the body's immune response against diseases.
22. TYPES OF VACCINES
• COVI SHIELD - AstraZeneca's
• COVAXIN, - BHART BIOTECH
• Corbevax- Texas Children's Hospital Center for Vaccine Development
• Spikevax- Modern Biotech SPAIN
• Sputnik V, - Gamaleya Research Institute of Epidemiology and Microbiology in Russia.
25. DIFEERENCE BETWEEN COVAXIN &
COVISHIELD
• The Covishield vaccine is given in two doses, 84 days or 1214 weeks apart.
• Doctors give Covaxin in two doses, but 30 days apart.
• Both vaccines can be stored at temperatures between 2 and 8 degrees Celsius. Makes
storage in the refrigerator easy and is ideal for the Indian climate
27. MORTALITY RATIO: (Death ratio)
Case Fatality rate :
The case fatality rate (CFR) = The number of Deaths
The number of diagnosed cases within a given time interval.
Based on Johns Hopkins University statistics, the global death-to-case ratio is 1.50% as of 1 February 2022. The number varies by region .
CFR 2022 India Global
Total
population
138 Crores 775.28 crores
Covid cases 4.15 crores
(3.007%)
37.8 crores
(4.87%)
Covid death
cases
4.96 lakh
(1.19%)
56.7 Lakhs
(1.5%)
28. CONCLUSION
This new virus outbreak has challenged the economic, medical
and public health infrastructure of China and to some extent, of other countries
especially, its neighbours. Time alone will tell how the virus will impact our lives here
in India. More so, future outbreaks of viruses and pathogens of zoonotic origin are
likely to continue. Therefore, apart from curbing this outbreak, efforts should be made
to devise comprehensive measures to prevent future outbreaks of zoonotic origin.
The Corona virus disaease is continues to spread across the world following a
trajectory that is difficult to predict the health humanitarian and socio economic
policies adopted by countries will determine the speed and strength of the recovery.