According to the statistics, 359 death cases reported in China. Apart from China, 299, 37, 33 cases of deaths in Hong Kong, Taiwan, Singapore reported, respectively, due to the SARS outbreak^24,25. Around 9 years later SARS revisited. In November 2012, an Egyptian virologist Dr. A. M. Zaki referred a specimen from the first confirmed case to virologist at the Erasmus Medicinal Center (EMC) in Rotterdam, The Netherlands. Later, the additional laboratory-proven situation was detected in London which was confirmed by UK Health Protection Agency (HPA) and called London1_Novel CoV 2012^26,27. An article issued in the New England Journal of Medicine by Dr. Zaki and co-authors added further account on virus details and a scientific name called Human Coronavirus-Erasmus Medicinal Center (HCoV-EMC), which was then frequently used in the scientific literature^28-30. In May 2013, the COVID-19 analyzing committee of the International Taxonomy of Viruses implemented the authorized term, the MERS-CoV³¹. About one year later (in 2013), an observation published in The New England Journal of Medicine reported the possibility of camel to human communication of the virus. The man after tending camel died of the viral infection. The fact was validated when the DNA samples of the man the sickening animal were initiate to be identical³². Global investigation of potential epidemics and preparedness has improved since and because of the SARS epidemic the few points of this helped today’s crisis of COVID-19. After the 4^th meeting, the IHREC decided that the conditions for a Public Health Emergency of International Apprehension had not at existing been met, this was the pointing out fact which was neglected³³.

Beginning of the Chain of Infection-Transmission in China:

As per the earlier report of WHO, the China was conversant of pneumonia of indefinite cause noticed in Wuhan City of Hubei Province (China). Later, about 44 victims with pneumonia of mysterious etiology have been described to WHO by the national establishments in China up to 3 January 2020. Amongst the 44 cases testified, 11 were in critical stage, while the enduring 33 patients were in stable condition. Bestowing to media reports, the anxious market in Wuhan was shut on 1 January 2020 for conservational sanitation and disinfection, by which the infection was anticipated to spread³⁴. The recognition of the symptoms reported among the patients alike to several respiratory diseases such as common cold, flu and pneumonia which are most predominant in the winter season, might be the point of general overlooking. Responsible national authorities reported necessary action for all patients’ isolation and symptomatic treatment in Wuhan medical institutions. Generally, the clinical signs and symptoms mainly fever and coughing was noted while some of them have difficulty in breathing. The chest radiographs showed invasive lesions of both lungs³⁵.

In the intermittent time (1 December 2019 to 31 January 2020), the National IHR Focal Point of Saudi Arabia testified 19 cases of MERS-CoV infection, counting 8 deaths. The cases were reported from the different regions of the jurisdiction³⁶. An interlinked report on 9 and 13 January 2020 from the National IHR view of the United Arab Emirates (UAE) disclosed an additional two laboratory-confirmed cases of MERS-CoV³⁷. As discussed earlier, it is undeniable fact that the traveling of the infected persons and their contact with the other peoples sparked a chain reaction of infection. It was evidenced that a case-patient (male), traveled to Wuhan (China), lately, he developed a fever but didn’t visit the Huanan Seafood Market. He asserted that he was in close primary contact with a person with pneumonia. Further, the possibility of the contacted person might be infectious with COVID-19. Soon after, he traveled to Japan and diagnosed negative for influenza at the local clinic on the 6^th of January. The progressive symptoms of cough, sore throat and fever tend to visit the hospital and were found to have abnormal chest x-ray with lesions on 10 January. Due to intermittent and non-recoverable symptoms, the case was then notified to local public health authorities and accused as “Unidentified Serious Infectious Illness”. The patient reported 2019-nCoV RNA test positives on 15 January 2020³⁸.

A 35-year-old female (Chinese national) was residing in Wuhan, Hubei jurisdiction in China. The patient had developed symptoms like temperature, chilly, and muscle pain, for the sake of illness she visited a hospital in Wuhan and was primarily analyzed with a common cold. Considering the recurrent illness, the case-patient was shifted to another hospital there he was tested positive for coronavirus (RTPCR) assay and afterward confirmed positive for novel coronavirus at the Korea Centers for Disease Control and Prevention (KCDC), on 20 January 2020. According to the WHO report, this was the fourth internationally transferred case of 2019-nCoV from Wuhan City, China by travelers³⁹. Subsequently, National IHR Focal Point for Qatar reported one laboratory confirmed case affection of MERS-CoV to WHO. The relevant authority was concerned about 106 close contacts with the case-patient up to 5 March. Earlier reports indicate 949 infected cases including 3 deaths⁴⁰. A typical transmission of COVID-19 from animal to human and community transmission illustrated in Figure 2.

Figure 2. Transmission stages of covid-19

ABOUT SARS COV-2

Origin of COVID-19

The taxonomic classification includes SARS-CoV-2 as a rinsing of severe acute respiratory syndrome-related coronavirus (SARSr-CoV). Presently, more than six different CoV strains are identified to infect humans, that includes; HCoV- 229E (229E), HCoV-OC43 (OC43), severe acute respiratory syndrome coronavirus (SARS-CoV), HCoV-NL63 (NL63), HCoV-HKU1 (HKU1), and MERS-CoV⁴¹. It was alleged that it may have zoonotic origins which is quite similar to bat originated coronaviruses, known to have occurred from a bat-borne virus³. In addition, an intermediate animal reservoir (pangolin) thought to be involved in its transmission to humans. Most of the infections associating with human coronaviruses are mild with common cold-like symptoms. The seven coronaviruses known to transmit humans are in the alpha and beta genera these include MERS-CoV and SARS-CoV, both are beta-coronaviruses⁴². Though the first recognized infections from the SARS-CoV-2 strain were revealed in Wuhan (China), the initial source of viral transference to humans remained unclear to the date⁴³. It is also unclear whether the strain became pathogenic prior or later the contagion event. Because, many of the initial persons (workers) appeared infected from Huanan Seafood Market all the resources, media and literature focused that will be the origin place of the virus. Rebutting the fact, some research indicates that visitors had introduced the virus to the market by virtue of which market then facilitated the rapid expansion of the infections^44,45.

Virology of COVID-19

SARS-CoV is a part of 36 coronaviruses family Coronaviridae within Nidovirales. These are formally known for causing respiratory system or intestinal contagions in humans as well as animals. Lately, SARS-CoV-2 known by the interim name novel coronavirus (2019-nCoV), is a positive-sense single-stranded RNA virus ²^,³. A pragmatic-sense single-stranded RNA virus (ssRNA) is a virus that adopts pragmatic-sense single-stranded RNA as its genome. The pragmatic-sense viral RNA genome can assist as messenger RNA which can be relocated into protein in the host cell by host ribosomes. Pragmatic-sense ssRNA viruses owned to category IV in the Baltimore categorization^46,47.

Microscopically, coronaviruses are miniscule in size (about 65 – 125 nm diameter) and contain an ssRNA as a nucleic material (size ranging from 26 to 32 kbs in length, Figure 3). The subgroups of coronaviruses family include alpha (α), beta (β), gamma (γ) and delta (δ) coronavirus². Phylogenetically, Genomic analysis showed that SARS-CoV- 2 are related to SARS-like bat viruses; hence the conclusion can be drawn that bats could be the feasible prime reservoir. The International Committee on Taxonomy of Viruses (ICTV) announced that the variances between recently known 2019-nCoV and the virus strain from the 2003 SARS outbreak were insufficient to make them separate viral species with the procured data. Consequently, it was identified that 2019-nCoV as a strain of grave acute respiratory syndrome-linked coronavirus^48,49.

Human Coronavirus 229E (alpha coronavirus) Strain 229E was come across during 1966 and was thereafter exhibit to be structurally similar to IBV and MHV. Human Coronavirus OC43 (beta coronavirus, lineage A) Strain OC43 was come across, during 1967, from the nasopharyngeal secretion of a patient with the common cold. Lately, Similar to 229E, OC43 was structurally similar from IBV and MHV with similar symptoms⁴¹.

Viral Life Cycle:

After getting an infection, the patient doesn’t show any immediate symptoms. The declination time of SARS is 2 to 14 days; it may vary according to the immunity of the person whereas some cases with longer incubation periods had been reported^3,41. In brief, after receptor obligation, the conformational changes in the S protein enables viral fusion with the host cell membrane by the endosomal pathway, subsequently, SARS-CoV-2 releases RNA into the host cell. The Genome RNA is replicase into viral replicase polyproteins (pp1a and 1ab), which are then split by viral proteinases. Then, viral proteins and genome RNA are subsequently compiled into capsid in the endoplasmic reticulum and Golgi apparatus then transported via vesicles and released from the cell². The trimers of S protein form the peplomers that discharge from the lipid envelope and crown-like projection which can be observed by an electron microscope. The fundamental receptor of the host cell-attached by S protein is ACE2, which is a metallo-protease shown in the major vascular endothelium.

A mouse model proved that ACE2 was showed a protective action against acute lung injury. The binding of the S protein to host cells arise in the down-regulation of ACE2, this procedure believed to promote the severity of lung damage in SARS ⁵⁰^,⁵¹. Although the coronavirus entry occurs through Lyso-/endosomal pathways⁵², recent evidence suggested that SARS-CoV go cells via pH- and receptor-dependent endocytosis. Treatment of cells either in addition to this SARS-CoV spike protein or spike-bearing false viruses causes the functional of ACE2, the functional receptor of SARS-CoV⁵³. However, endosomal acidification facilitates entry; the initiation of the S protein by protease can circumvent this inhibition and result in cell-to-cell fusion. The pH-sensitive endosomes protease cathepsin L involved in the entry pathway, whereas this pH-sensitive cathepsin L recognized as a potential target for some agents contributing to the elevation in endosomal pH, such as chloroquine^52,53.

Transmission and Host Susceptibility:

The reserve of SARS-CoV, SARS-CoV-like viruses in palm civets and a various species of dog accused the host of the prior source of humanoid infections. As a consequence of this, a huge amount of palm civets was selectively slaughtered in Guangdong (in January 2004) due to the fear of reemergence of SARS. The existence of the virus was demonstrated in many civets and various species of dogs, no more lab testing was done after 1000 samples³. A recent report showed that the MERS-CoV underwent recombination events between the different ancestries which believed to have occurred in camels in Saudi Arabia. Lineage 5, is linked with the MERS-CoV causing the breakout in South Korea in 2015 ⁴¹. The WHO deliberates bats the most prospective natural reservoir of SARS-CoV-2, however, differences between the bat coronavirus and SARS-CoV-2 suggest humans were infected via a transitional host ²^,⁵⁴.

Figure 4: The chain of Infection

According to current evidence, the COVID-19 virus is communicated between people through respiratory drip and communication routes (Figure 5). Droplet transmission arises when a person is in primary contact (within 1m) with case-patient (e.g. coughing or sneezing)⁵⁵. Droplet spread may also occur via vehicles in the immediate environment around the infected victims. Therefore, the transference of the COVID-19 virus can occur by through contact with infected victims and secondary contact with surfaces in the instantaneous environment or with things used on the infected person. Airborne transference is different from droplet transference as it refers to the occurrence of micro-organism within drip nuclei, which are usually considered to be particles, they can persist in the air for long periods of time and be conveyed to others over distances greater than 1m⁵⁶. Recent publications and WHO guidelines continue to indorse droplet and contact in domifications for those people caring for COVID-19 patients and have the risk of contact.

New Finding, Diagnostic Perspectives, and Treatments:

New Research Findings:

To date, reverse transcription-polymerase chain reaction (rRT-PCR) seems to the overall accepted test for the COVID-19 detection. although the methods have some pre-analytical hurdles like identification problems, insufficient procedures for collection, holding and loading of the swabs, presence of interfering substances, practical errors, and more vital is the specificity aspects. Moreover, it was observed that the patient receiving antiretroviral therapies produces complications in test results⁵⁷. A case study involving 94 patients confirmed with SARS-CoV-2 affection shown that the ant thrombin values in victims were lower than those in the control group (p < 0.001). In spite of this, the values of D-dimer, fibrinogen degradation products (FDP), and fibrinogen (FIB) in all cases were considerably elevated individuals in healthy controls. The blood clotting function in victims with the infected patient was markedly irrational differentiate with healthy controls, but on serving D-dimer and FDP values will be a ray of hope for the early identification case severity⁵⁸.

Recently, Henry B. and co-workers demonstrated an electronic survey (on PubMed (MEDLINE), China National Knowledge Infrastructure, and the Chinese Medical Journal Network) through March 5, 2020. The case reports or case series reporting clinical records in symptomatic or asymptomatic children and adolescents (0–≤19 years of age) with confirmed COVID-19. Except for adults, laboratory derangements were observed in children with confirmed COVID-19. The laboratory fluctuations testified in children with SARS is not constant with the early observations in cases of COVID-19. For further study, the lymphocyte count was monitored. IL-6 was investigated as a prognostic indicator in severe COVID-19⁵⁹. Early detection and intervention of COVID-19, in all types of the patient, is necessary. In the case of pregnant women, it may help to reduce possible obstetrical difficulties including, miscarriage, intrauterine growth restraint and preterm delivery. Although Pregnant women on the high-risk of infection, no evidence of vertical transmissions had been reported yet^60,61. Limited amounts of data were reported on the result of SARS-CoV-19 infection in pregnant women as well as susceptible to infection. Earlier reports described 18 pregnant women diagnosed with COVID-19 infection in the third stage shown alike symptoms to those in non-pregnant infected women. After the delivery (two pregnancy by cesarean), fetal distress and premature delivery were perceived in some cases. The test for SARS-CoV-2 was reported negative for all babies^62,63. Strategies, including neutralizing antibodies which will be disarm invading virus in developing stages, molecular docking⁶⁴, cytokine targeted therapies⁶⁵,

Diagnostic perspectives and Treatment:

Earliest effort for the diagnosis of COVID-19 was reported by Gerna and co-investigators. They demonstrated the immune-adherence hemagglutination (IAHA) method for coronavirus 229E antibody determination. The test involves the case-patient with acute infection showing 229E seroconversion during the winter-spring season⁶⁶. Previous studies of coronaviruses detection have revealed a variable incidence of infection and have not cleared the disease spectrum. Laboratory tests are played a vital role throughout many clinical complications and disease outbreak and it was made possible by inspection diagnosis, patient monitoring and epidemiologic surveillance⁶⁷ Till now, there is no lab tested drug or vaccine accessible to be getting cure from COVID-19. There is still the rumination of researches and there consequences regarding the clinical assessments. However, some of the broad-spectrum antiviral agents have been established as well as some symptomatic treatments resulted in clinical regaining². Considering as RNA virus alike human immunodeficiency virus (HIV), protease inhibitors lopinavir/ritonavir (LPV/r) currently recommended for the 2019-nCoV treatment according to latest guidelines ⁶⁸. Similarly, using molecular docking and homology modeling other anti-HIV drug nelfinavir, nucleotide analogue prodrug like Remdesivir reported for the inhibition of 2019-nCoV contamination in vitro^69,70.

As discussed earlier, the S protein of SARS-CoV uses the ACE-2 receptor for entry in the host cell; several attempts were made to explore the Chloroquine with differential aspects. It was evidenced that Chloroquine has a well-built antiviral effect on SARS-CoV infected cells. Fantini et al., keeping this mind, demonstrated the activity of CLQ and CLQ-OH using in-silico approaches to assess the strength of a broad these drug before their clinical appraisal⁷¹. Chloroquine interferes with virus-receptor requisite by ACE2 terminal glycosylation as well as in vitro study showed it can intensify the effects of other antiviral agents⁷². Recently, the Baricitinib (Janus kinase inhibitor) interrupts the receptor facilitating endocytosis resulting in virus passage into cells. Baricitinib was recognized for the reduction of lung infection and might be used for treatment for 2019-nCoV. The re-occurrence of infection is the new problems and the foremost challenge for the health experts. Recent studies showed that after treatment patient and testing negative, about 2 to 3 months later patient again showed positive towards test⁷³. A scholar from the USA developed detailed mapping of the spike-protein mutations which could prevent the COVID-19 binding about ten human antibodies⁷⁴.

Vaccine development and current status:

The global effort to produce a safe and effective COVID-19 vaccine is become fruitful. A handful of vaccines recently developed and authorized everywhere the globe from which few deployed for human use⁷⁵. It was reported that 7 Indian pharmaceutical companies and their worldwide partners developed vaccine for coronavirus. Worldwide, the WHO is tracking about 140 candidates vaccines, from which around 24 are in various phases of human clinical trials⁷⁶.

Preparedness, Risk Assessment, And Crisis Management:

Preparedness:

While no one can predict an emergency or crisis but we can prepare for the impact. Pandemics are unpredictable and can be frequent measures that can have severe impacts on human health and economic welfare globally. Extensive practical experience in dealing with outbreaks of COVID-19 at various levels demands the pandemic breakout preparedness and response exercises⁷⁷. The most economical approaches for enhancing pandemic preparedness, particularly in resource-constrained settings, like strengthening core public health infrastructure, including water and sanitation systems, increasing situational awareness, and fast extinguishing stimuli that could lead to epidemics. WHO highlighted some key principles that could be practiced for pandemic planning including; i) application of ethical principles to assist policymakers in balancing and protecting human rights, ii) integration of pandemic breakout preparedness and response to the national emergency frameworks, ii) addition of a “whole of society” approach which will promote health sector as well as other sectors such as businesses, families, communities and individuals, etc.

Recommended actions by WHO to be implemented by national authorities:

· Planning and coordination

· position nursing and assessment

· Falling the supper of disease

· Endurance of health care provision

· Communications

After any pandemic, there comes responsibilities and advocacy role which should be important to beat the pandemic (Figure 5).

Risk Assessment and Crisis Management:

Risk assessment is a systematic method of procurement relevant information and evaluating the probability and penalties of exposure to or release of workplace hazard (s) and determining the suitable risk control measures to decrease the risk to an acceptable level⁷⁸.

According to WHO, there are mainly three factors should be engaged into consideration while preparing and implementing risk assessment strategies^77,79.

Probability of further spread:

Mostly, human-to-human transmission, including transmission within families and healthcare surroundings, etc.

The probable influence on human health:

The virus can cause severe illness or maybe demise, although most cases appear to be moderate. Strategies to combat such a situation should be implemented

The efficiency of current preparedness and response measures:

At this stage, China, as well as countries in world, is dedicating considerable resources to public health control measures such as clinical management, quarantine of cities, isolation of case-patients, suspension of transport, local temporary curfew, etc. It will be significant to continual assessment of the effectiveness of measures and adaption of a new one.

In the stage of the pandemic, increase demand for timely and consistent information about 2019‑nCoV is anticipated, it is mandatory to prescribed technical risk communication and social media which will look after to track and respond to myths and rumors. Because of lack of knowledge (mostly in developing or LMICs), rumors are spread more profligate that of the virus.

Four pillars of pandemics:

Lessons from various past pandemic attacks teach us subtle and rigorous survivorship strategies. By knowing this, we can plan and assess the futuristic problems. A typical pandemic crisis always shows some common factors which are the fundamental of the circumstances which also come with key aspects which have enclosed its management elements. Instead, knowledge gaps in the relatives field also lags the mitigations and further management of pandemic get worst. All over, countries faced such problems. The common risk factors found in pandemics are illustrated in Figure6.

Risk:

Analyzing the pandemic risk factors is the most challenging task for any country, regardless of the recurrent or known reason. The probability of a pandemic is determined by the united effects of spark risk, where the chances of a pandemic are likely to arise and spread risk which considers how likely it will diffuse through human populations. Credible modeling and analytical tools are valued for assessing pandemic risk and assessing the probable load of pandemics.

Impacts:

The low- and middle-income countries (LMICs) suffer significant morbidity and mortality. Pandemics can cause sudden and widespread increases in unwholesomeness and death resulting in long term commercial harm through multiple channels. The individual behavioral change affects the societal as well as government sector performances like fear-induced hatred to workplaces and public gathering, rumors spreading, etc. in some cases rebellion can be anticipated.

Knowledge gaps:

Because the pandemic is geographic it comprises numerous, diverse types of trials and community health threats. Pandemic varies in emergency, incidence, and some other characteristics which directly or indirectly intervened by particular ideal awareness and response policy of the specific country. Because of the poor economic conditions, it would be anticipated that LMICs may suffer more such problems as compared to developed countries. Moreover, myths and beliefs also affect the social eradication of the disease.

Mitigation:

Pathogens with a pandemic potential need to deliberate resources and approaches mandatory for justification which can help to operative attentiveness and response. Strategic planning and a harmonized response would be implemented which would be looked after the situational awareness, public health messaging, reduction of transmission, and treatment and care of the patients. In addition, the implementation of palliative care of the treated person is the most important factor for social acceptance.

Figure 6. Four pillars of pandemics

Global Impacts Of Covid-19 Outbreak:

The world today is evidenced the evolution of inevitable situation raised of COVID-19, pinpointed to China. As on January 2020, WHO declared the outbreak of a novel COVID-19 as international emergency, subsequently the public health became an international concern. WHO stated that there is a high risk of COVID-19 scattering to other nations around the world, up to March 2020 it was happened Framing strategies for combating the disease, surrendered world to look back and review the historical perspectives and lesson learned from notable pandemics ⁸⁰. People around the world are living with the fear of pandemic concerning the expected raise of patient numbers. The COVID-19 made a lasting impact on economics as well as social and personal life of peoples. Contrary, contamination and conservatory gas discharges have collapsed across continents.

Health Sectors:

The most vital role now carried out by the health worker which includes doctors, nursing staff, cleaners and most importantly the research scholars from various streams. Gathering information about the beginning spread of the outbreak, its magnifying period can be used for the forecasting of infectiousness. Although, there is no confirm vaccine or effective antiviral drug is likely to be available soon on COVID-19, but the clinical investigation come up with the solution in any faces to save people’s lives. As China formerly run strict lockdown, following to this India taken same initiative, which is endangered Indian pharmaceutical industries⁸¹. The case decease rate, data from China, South Korea, Italy, and Iran suggested that the CFR showed directly proportional with age. Targeted social distancing for these groups could be the most effective way to reduce morbidity rate of infection. In this regard, framing an ideal De-isolation strategy for COVID-19 suspect cases is a ongoing challenge to the hospitals and concerned health sectors^82,83.

A ray of hope raised from the clinical and research personnel’s due to their concomitant research some of the available drug and therapy were implemented. Hence, sharing scientific information proved to an effective way to reduce public panic about COVID-19. The importance of real-time broadcasting of scientific evidences is until needed to combat to this period of uncertainty. It was undeniable fact academic and research journals are responsible for enabling the rapid dissemination of reliable information⁸⁴.

Government Sectors:

Any Governments will not be able to minimize both mortality rate without the support of citizens and empowered, competent health workers. Regardless of implementing strategies, all nations remained options to keep infection rate as low as possible became an ultimate priority. Hence, all governments decided to amend the lockdown. In spite of this, COVID-19 became spread much fast and developed into a epidemic by the invisible chains of transmission⁸⁵. A case report by Chinazzi M. et al., suggested that by 23 January 2020, the COVID-19 had readily spread to other cities within China. The travel bans selectively applied, of course in the travel quarantine around Wuhan and expected to be delayed epidemic spread. Their model indicated the Wuhan travel ban was firstly effective at minimizing international case importations only⁸⁶.

There are many complications in front of governments; the individuals respond to advice was the most inevitable one. Government communication strategies to keep the public notifying of how best to circumvent infection are necessary was the big task to manage further economic downturn. Experts suggested that the outbreak coronavirus (COVID-19) will depressingly affect global foreign direct investment (FDI) flows and it will create a downward burden on FDI will be -5% to -15%⁸⁷.

Social and Personal Mental Health:

The lack of national preparedness and international harmony will be a threat to global health. In the same way, it will be thought to arise economic chaos. The current pandemic of COVID-19, forecast the links of economic risk, xenophobic reactions amongst the nations. Mostly, the verbal attacks on people of Asian descent and descriptions like “The Chinese Virus” will be a threat for global harmony⁸⁰.

Because of a pandemic is not just a medical event it affects single person and society on many levels. Stigma and xenophobia are two features of the societal effect of pandemic infectious outbreaks. Fear and tension have also been joined to outbreaks. Panic and stress have also been linked to outbreaks. The individual behavior and response play a crucial role to control the growth of COVID-19. Self-motivated, rather than authority measures, early self-isolation, looking for medical advice unless symptoms are severe, and physical distancing are key concerns which should obeyed by the ideal citizens⁸⁸.

Pandemics reported to have psychological impact on peoples and it was obvious. A survey was conducted in China during the initial outbreak of COVID-19, suggested that 53.8% of subjects have psychological impact, 16.5% testified moderate to severe depressive symptoms; 28.8% stated moderate to severe anxiety symptoms and remaining shown stressed⁸⁹. To encounter these conditions, training for community health personnel can help for the management of patients’ psychological distress. Earlier, the media pointed out the animal protein marked would be the link of COVID-19 infection or the probable cause is eating animal meats, the peoples start to abandoned to eat eggs and other animal meat especially in India, following to this Indian government also distributed the rebuttal for the same⁹⁰.

CONCLUSION AND FUTURE PROSPECTIVE:

A formerly neglected, small infection in china raised global concern in a few weeks and compelled the WHO to declare an international emergency. The SARS-CoV2 spread a vivid fragrance of terror and insecurities regarding health and future prospects worldwide in peoples. The intricate nature of the virus raises predictive concerns in front of the scientific fraternity. The international communities especially need to focus strategies for the early and preparative management for protecting their peoples as well as healthcare workers. The developed nations too affected by the COVID-19 outbreaks, regardless of well-established resources, laboratories and competent staff. The early lesson needs to be learned from this deadly outbreak. However, the increase in cognizance of personal protection, hygiene, proper preparedness and response anticipated for lowering the risk of infection (by breaking human-to-human transmission chain) among peoples.

Lastly, a pandemic situational awareness is complex; harmonization across administrations, public, private sectors as well as other disciplines anticipated to break virus spread. Bridging the data gaps among society can improve pandemic preparedness planning and response through evidence-based decision making which will helpful for establishing supporting efforts for the further prevention and mitigation of pandemics.

Considering the brutal impact of COVID-19 on overall world, all nations need a critical assessments and workout for to best diagnosis and treatment. For precise and consistent result as well time availability of techniques substantial investment and control over economic sector is the prerequisites. Conventionally national laboratories are concisely use PCR based approaches, CRISPR (clustered regularly interspaced short palindromic repeats/CRISPR-associated) based technology has a new era of research and hopes. Now, nations efforts have been directed towards developing CRISPR based low cost, rapid detection strategy.⁹¹.

Consequently, escalating numbers of research article in different science literature added a common anxiety and race toward researchers perspectives⁹². In the war against novel corona virus, Sherlock Biosciences and Mammoth Biosciences have come up with innovative CRISPR platform for COVID-19 diagnosis and visual readout. Argentina and CASPR biotech, united states become new described a CRISPR/Cas12 based ultrasensitive, fast and cost effective portable SARSCoV-2 detection⁹³. The using saliva specimen for diagnosis of COVID-19 was stressed upon in report. Naturally providing molecules in saliva did not appear to exert any inhibitory influence in the CRISPR based paper strip assay. Summing up; to defend, adapt and survive, human race always come up with the solution with their inherent intelligence and the nanotechnology based new strategies are always paramount to human to keep adaptation and survivorship.

CONFLICT OF INTEREST:

None to declare.

ACKNOWLEDGMENT:

Authors are thankful to World Health Organization (WHO) and ICMR, India, for providing healthcare services and timely updates on COVID-19.

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Received on 21.10.2020 Modified on 17.12.2020

Int. J. Nur. Edu. and Research. 2021; 9(3):345-356.

DOI: 10.52711/2454-2660.2021.00080

Year	Pandemic	Geographic extent	Estimated morbidity and mortality rate	References
Early 1500s	Smallpox	America	<50 percent mortality of the county	12
1916	Polio	United States of America	<7000	13
1918	Spanish flu	Global	20 million–100 million deaths (111–555 deaths per 10,000 population)	14
1957	Asian flu	Global	0.7 million–1.5 million deaths (2.4–5.1 deaths per 10,000 population)	15
1968	Hong Kong flu	Global	1 million deaths (2.8 deaths per 10,000 population)	16
1981	HIV/AIDS	Global	More than 70 million infections, 36.7 million deaths	17
2003	SARS	4 continents, 37 Countries	8,098 possible cases, 744 deaths	18
2009	Swine flu	Global	151,700–575,500 deaths (0.2–0.8 per 10,000 population)	19
2012	MERS (coronavirus) epidemic	22 countries	1,879 symptomatic population, 659 deaths	20
2013	West African Ebola	10 countries	28,646 cases, 11,323 deaths (WHO 2016a)	21
2015	Zika virus	76 countries	2,656 reported cases of microcephaly or central nervous system malformation	22
2019	COVID-19	Global	<33,842,281 cases of COVID-19 reported worldwide, from which approximately 1,010,634 deaths and 25,677,951recovered	23