Prompt 12: Institutionalist versus anti-institutionalist views

     The CDC and WHO have largely impacted my COVID experience. These are major institutions that have affected the travel of individuals. We could not leave the country to visit family members in my family due to travel restrictions. Suppose individuals are vaccinated and agree to quarantine/practice safe COVID practices (like handwashing and mask-wearing). In that case, they should be able to travel. Placing strict travel bans has separated families from each other, international students from their institutions, and have majoring disrupted any other necessary travel. The CDC has also affected my college experience with social distancing and mask policies. To make these institutions more equitable for all communities, I would have them make individual recommendations for regions and not the whole world. For example, Mumbai should have different regulations than a town in Iowa. There should be better monitoring systems that can accurately update the regulations needed to keep people safe. 

 

    Lexington Public Health Department has also affected my COVID experience on a more local scale. This organization has affected how local businesses and organizations operate during COVID. For example, the men's shelter was shut down due to the number rising, but that left the people in need with a deficiency in resources. The public health department should expand resources given to groups affected by their actions (or at least some support).  

Prompt 11: Evolutionary and recent time scales

 Diseases can change and mutate through the years.  With COVID-19, the way we interact with the virus may change dramatically over decades.  We have already seen mutations of the SARS virus with the Delta and Omnicom variants. There may be more variants in the future. People must get vaccinated so that we can be better prepared to fight off future variants.

On the other hand, as time goes on, we also understand the virus. For example, the CDC thought COVID-19 may be contracted by a fomite transmission, but we now know that this is untrue. In the Middle Ages, the bubonic plague wiped out almost 1/3 of the world's population. Still, as time has progressed, the bubonic plague no longer haunts us. I think that COVID can follow this trend as technology and knowledge advance. We also will be able to study the disease and create new and better treatments as time goes on. 

Three factors that change SARS-Cov-2 are mask-wearing, vaccination rates, and government policies. When people wear masks and are vaccinated, they change the trajectory of the rates of COVID dramatically. When governments do not or cannot implement good practices to stop covid, it can dramatically increase the transmission rates of COVID. 

Prompt 10: Top-down and bottom up innovations

     COVAX is a joint effort by many groups (UNICEF, WHO, GAVI, CEPI, National Children's Fund, and a few more) that hope to evenly distribute the vaccines by population size to countries worldwide. The idea is that money is invested early on in the vaccine production and then distributed later. The bill and Melinda gates foundation, alongside the World Bank, have donated money to the cause. COVAX is struggling to provide the promised vaccines due to a shortage of supplies. India, a large producer of pharmaceuticals and vaccines, has turned inward to deal with its own COVID outbreaks and has not exported vaccines since March. Other countries have begun to seek different ways to get vaccines. Still, the trend is those larger countries that can afford to get vaccines are getting them while smaller countries suffer. Cuba and Tanzania opted out of the program. 

    A bottom-up approach specializes in health treatment to individual communities to better target disease. In the reading, bottom-up approaches helped identify channels of influence like friends and peers that made people more likely to receive a vaccine. Also, working closely with a community established trust among marginalized people groups. Open communication is also fostered when working from the bottom up, allowing for accurate patient and health provider information. Overall livelihoods of communities are also preserved or restored. Lastly, comprehensive health care initiatives are more impactful when working with a small community. 

Prompt 9: Eradication versus control

 Eradication should be the goal when it is financially and biologically feasible.  For example, smallpox could be eradicated because there was no other reservoir for the disease to live. If a virus had another reservoir, like commonly lived in bats, eradication would be impossible.  Humans would have to eliminate the bat population and not transmit the virus among themselves to eradicate the virus. In the case of smallpox, there was no other reservoir other than humans, so the main obstacle was ending human-to-human transmission. A vaccine was available, and the national community decided to dedicate its resources.  The smallpox vaccine initiative was also financially feasible.  

I think the control approach should be the first response for global health. Suppose health officials can support communities to alleviate most of the adverse side effects of the disease. In that case, I do not think eradication is needed. Take cancer as an example: cancer will most likely not be eradicated soon, but significant strides have been made in treating this disease. My younger brother was diagnosed with a stage two Wilm's tumor at 8 months old. He had a tumor the size of a cantaloupe surrounding his kidney, and if he had been born before the 1990s, his diagnosis would have been a death sentence. Instead, he went into surgery to remove the tumor and underwent 9 months of chemotherapy. The chemo made him sick, but chemo can have few side effects since then.  Suppose chemotherapy can continue to advance, possibly small pills with little to no major effects. In that case, a cancer diagnosis could be like strep throat. 

In COVID, I think a control approach to the pandemic is more realistic. We have already seen the SARs virus mutate into different variants. We are unsure how many reservoirs the virus would live in.  For now, masks should be worn in highly populated areas, and individuals should be vaccinated when they can be.  These approaches may seem like they are attempting eradication, but both methods are not 100% capable of stopping viral transmission. Eventually, eradication may be possible if a more effective vaccine is available and more individuals receive it. Still, for now, the control approach is most appropriate. 

Prompt 8: Wealth, class, and lifespan

    I think people have a longer life with a college degree due more to the opportunities they have versus the actual knowledge they gained while at university. For example, suppose a student is studying engineering. In that case, I doubt their thermodynamics class will provide much vital information that directly impacts their health. But on the flip side, they now have to knowledge to be an engineer, work at a high-paying job, afford insurance and health care, eat a well-balanced/nutritional diet, save for retirement, and have a less stressful life compared to people with financial instability. I believe that a student's financial income before college increases the likelihood of completing a four-year education, but it does not inherently mean that they will or will not succeed in school. Plenty of students from high-income families fail out, and some first-generation students succeed while at school.

  There may be class differences that persist in our cohorts after higher education.  For example, the first-generation students may not experience the exponential wealth increase through generations as students who had parents with a college degree. Students who were the first to complete higher education may be expected to support their parents, siblings, and other family members after college since they are making the most money in the family. Compared to a student who does not have to support their family because of financials, this would be very draining for the first-gen student. There are also other socio-economic influences of a society that are not erased due to completing a degree. Institutionalized racism in health care systems still disproportionately affects people of color, especially black women. For example, black women are not appropriately screened for heart attacks as their symptoms present differently from white populations.