2020, the year COVID-19 tuned us into science: Part 3

Balls represent the six lessons learned about COVID-19 this year
We've learned many lessons about COVID-19 in just one year. (Image: AdobeStock/Illustration: Fawn Gracey, Boston Children's)

Since the arrival of a new, unknown, dangerous virus in January, we entered the realm of  COVID-19 science. Part 1 and Part 2 of this series recapped what we learned about how the virus spreads, how to test for it and treat it, and how COVID-19 plays out in children. This month, vaccines began to be available — not a moment too soon, but much sooner than expected. But there is still so much to learn — about the vaccines and COVID-19 in general.

Lesson #5: Rapid development of coronavirus vaccines

In November, we received encouraging news: three potential COVID-19 vaccines (from AstraZeneca, Moderna, and Pfizer) completed Phase 3 trials, showing efficacy of up to 95 percent when tested against a placebo in large numbers of adult patients. The FDA approved both vaccines this month, and immunizations have finally begun, mainly in health care workers. So far, aside from a small number of allergic reactions, no major safety concerns have been reported.

But hurdles lie ahead. The three vaccines above each require two doses, and some vaccines require extreme sub-zero storage temperatures. We don’t yet know how long protection will last, or what safety problems might surface as millions of people get vaccinated. Scientists continue to learn about how the immune system reacts to SARS-CoV-2, including runaway immune reactions in some people known as “cytokine storms.” We need to know that the vaccines are safe and don’t trigger these harmful responses. Finally, testing in children is only beginning, and we may need to wait for some time before approval for vaccine use in children.

INTRO
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Test your COVID-19 vocabulary!

How much have you learned about the coronavirus in 2020? This quiz will test your knowledge. Click below to continue.

How much have you learned about the coronavirus in 2020? This quiz will test your knowledge. Click below to continue.

How much have you learned about the coronavirus in 2020? This quiz will test your knowledge. Click below to continue.

Pandemic
#1 Pandemic
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a) a disease that affects a large number of people in a community
b) a disease affecting multiple countries or continents

a) a disease that affects a large number of people in a community
b) a disease affecting multiple countries or continents

a) a disease that affects a large number of people in a community
b) a disease affecting multiple countries or continents

Pandemic-answer
Answer: b) a disease affecting multiple countries/continents.
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A disease outbreak in a community or region is an epidemic. COVID-19 started as an epidemic in Wuhan, China, but it quickly spread to Europe and the Americas and became a pandemic.

A disease outbreak in a community or region is an epidemic. COVID-19 started as an epidemic in Wuhan, China, but it quickly spread to Europe and the Americas and became a pandemic.

A disease outbreak in a community or region is an epidemic. COVID-19 started as an epidemic in Wuhan, China, but it quickly spread to Europe and the Americas and became a pandemic.

Herd immunity
#2 Herd immunity
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a) Protection from an infectious disease due to most other people being immune
b) Protection from diseases in farm animals

a) Protection from an infectious disease due to most other people being immune
b) Protection from diseases in farm animals

a) Protection from an infectious disease due to most other people being immune
b) Protection from diseases in farm animals

Herd immunity-answer
Answer: a) protection from infection due to other people being immune.
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Experts hope that if enough people in a community become immune to COVID-19 (through vaccination or having the disease), then even people who aren’t immune will be indirectly protected, because they’re unlikely to be exposed to the virus.

Experts hope that if enough people in a community become immune to COVID-19 (through vaccination or having the disease), then even people who aren’t immune will be indirectly protected, because they’re unlikely to be exposed to the virus.

Experts hope that if enough people in a community become immune to COVID-19 (through vaccination or having the disease), then even people who aren’t immune will be indirectly protected, because they’re unlikely to be exposed to the virus.

Spike protein
#3 Spike protein
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a) a protein on the surface of SARS-CoV-2
b) a protein used to immunize people against COVID-19

a) a protein on the surface of SARS-CoV-2
b) a protein used to immunize people against COVID-19

a) a protein on the surface of SARS-CoV-2
b) a protein used to immunize people against COVID-19

Spike-answer
Answer: Both are correct!
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The SARS-CoV-2 coronavirus that causes COVID-19 has rod-like spike proteins on its surface that latch onto cells, via a receptor called ACE2, and help the virus get inside.

And also, the new COVID-19 vaccines use genetic material that encodes the spike protein to get our immune systems to make antibodies to the virus.

The SARS-CoV-2 coronavirus that causes COVID-19 has rod-like spike proteins on its surface that latch onto cells, via a receptor called ACE2, and help the virus get inside.

And also, the new COVID-19 vaccines use genetic material that encodes the spike protein to get our immune systems to make antibodies to the virus.

The SARS-CoV-2 coronavirus that causes COVID-19 has rod-like spike proteins on its surface that latch onto cells, via a receptor called ACE2, and help the virus get inside.

And also, the new COVID-19 vaccines use genetic material that encodes the spike protein to get our immune systems to make antibodies to the virus.

Antigen test
#4 Antigen test
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a) A test that looks for genetic material from coronaviruses
b) A test that looks for proteins made by a virus

a) A test that looks for genetic material from coronaviruses
b) A test that looks for proteins made by a virus

a) A test that looks for genetic material from coronaviruses
b) A test that looks for proteins made by a virus

Antigen test-answer
Answer: b) A test that looks for proteins made by a virus.
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COVID-19 antigen tests typically look for coronavirus proteins, such as the spike protein. They are usually done with a nasal or throat swab.

COVID-19 antigen tests typically look for coronavirus proteins, such as the spike protein. They are usually done with a nasal or throat swab.

COVID-19 antigen tests typically look for coronavirus proteins, such as the spike protein. They are usually done with a nasal or throat swab.

Polymerase chain reaction (PCR)
#5 Polymerase chain reaction (PCR)
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a) An experimental drug that cuts the coronavirus, rendering it harmless
b) A type of test for COVID-19 that detects portions of the virus’s genetic code

a) An experimental drug that cuts the coronavirus, rendering it harmless
b) A type of test for COVID-19 that detects portions of the virus’s genetic code

a) An experimental drug that cuts the coronavirus, rendering it harmless
b) A type of test for COVID-19 that detects portions of the virus’s genetic code

PCR - answer
Answer: b) A COVID-19 test that detects portions of the virus’s genetic code.
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PCR tests use special reagents, called primers and probes, that attach to specific parts of the virus’s genetic code. The test then makes millions to billions of copies of this code so it is more readily identifiable. These tests are sometimes called nucleic acid amplification tests (NAATs), and are the most common type of COVID-19 test available now.

PCR tests use special reagents, called primers and probes, that attach to specific parts of the virus’s genetic code. The test then makes millions to billions of copies of this code so it is more readily identifiable. These tests are sometimes called nucleic acid amplification tests (NAATs), and are the most common type of COVID-19 test available now.

PCR tests use special reagents, called primers and probes, that attach to specific parts of the virus’s genetic code. The test then makes millions to billions of copies of this code so it is more readily identifiable. These tests are sometimes called nucleic acid amplification tests (NAATs), and are the most common type of COVID-19 test available now.

Cytokine storm
#6 Cytokine storm
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a) An excessive, harmful immune response
b) A weather pattern that increases the spread of COVID-19

a) An excessive, harmful immune response
b) A weather pattern that increases the spread of COVID-19

a) An excessive, harmful immune response
b) A weather pattern that increases the spread of COVID-19

Cytokine storm-answer
Answer: a) An excessive, harmful immune response.
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In some people with COVID-19, the immune system overreacts in trying to contain the virus. Immune cells, summoned by messengers called cytokines, flood the lungs and other organs, attacking even healthy tissue. Cytokine storms can cause severe illness and even death.

In some people with COVID-19, the immune system overreacts in trying to contain the virus. Immune cells, summoned by messengers called cytokines, flood the lungs and other organs, attacking even healthy tissue. Cytokine storms can cause severe illness and even death.

In some people with COVID-19, the immune system overreacts in trying to contain the virus. Immune cells, summoned by messengers called cytokines, flood the lungs and other organs, attacking even healthy tissue. Cytokine storms can cause severe illness and even death..

Score yourself
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How did you do??

6 correct answers: Excellent! You’re really up on COVID-19 science.
3-5 correct answers: Good! You’ve been paying attention to the news about COVID-19.
0-2 correct answers: There’s always more to learn! Trusted go-to sources on COVID-19 include the Centers for Disease Control and Prevention and the World Health Organization websites.

6 correct answers: Excellent! You’re really up on COVID-19 science.
3-5 correct answers: Good! You’ve been paying attention to the news about COVID-19.
0-2 correct answers: There’s always more to learn! Trusted go-to sources on COVID-19 include the Centers for Disease Control and Prevention and the World Health Organization websites.

6 correct answers: Excellent! You’re really up on COVID-19 science.
3-5 correct answers: Good! You’ve been paying attention to the news about COVID-19.
0-2 correct answers: There’s always more to learn! Trusted go-to sources on COVID-19 include the Centers for Disease Control and Prevention and the World Health Organization websites.

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Lesson #6: What we still don’t know: Looking to 2021

As much as we’ve learned about COVID-19 in 2020, there’s even more we don’t know. We don’t yet understand why preexisting conditions like diabetes or kidney disease put people at higher risk. Or why some of us with no apparent risk factors get so sick with COVID-19 and MIS-C. Boston Children’s Hospital is playing a leading role in two large national studies looking closely at how the immune system reacts to SARS-CoV-2 and how children in particular handle the virus. Another study is looking for genetic changes that might make some children vulnerable to MIS-C and what might protect them.

Assuming the new vaccines are effective, will enough people accept them that we attain herd immunity — enough to protect the whole population? Will an increased understanding of the virus lead to treatments that make COVID-19 manageable? Will we have accurate tests that we can rely on? In the coming year, we’ll continue to watch the science unfold.

Read the rest of the series:

Part 1: How COVID-19 spreads and the science of staying safe; COVID-19 tests

Part 2: COVID-19 treatments; COVID in children and the emergence of MIS-C

Learn more about Boston Children’s response to COVID-19 and more about COVID-19 research at Boston Children’s.

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