The Importance of Epidemiology in Health

Epidemiology
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Epidemiology
Epidemiology is usually defined as studying "the distribution and determinants of a disease in a population." Therefore, epidemiology essentially focuses on the population, and epidemiologists identify that narratives about individuals cannot be employed to negate evidence about populations. For instance, a narrative about someone who smokes a pack of cigarettes a day and lives to be 100 years old, or that someone never smokes and eventually develops lung cancer does not dispute the evidence that people who smoke one cigarette pack/per day are ten times more vulnerable to develop lung cancer. Likewise, narratives about individual epidemiologists' ethical or unethical behavior cannot approve or negate evidence of general trends (Friis & Sellers, 2020).
Importance of Epidemiology in Health
Epidemiology is among the tools which are employed in public health. Understanding the population's disease burden is critical to health authorities, who seek to maximize the use of inadequate resources by classifying priority health plans for prevention and care. Epidemiology also focuses on the course and outcome of individual and group diseases (natural history). Thus, epidemiology is a baseline medical science whose objective is to improve the population’s health, mainly the health of the disadvantaged. According to the research question, various types of epidemiological studies could be employed to study certain health-related characteristics, i.e., etiology (case-control study), epidemic (cross-sectional study), incidence (cohort study), and intervention (clinical trial) (Murariu et al., 2019).
From several perspectives, epidemiological studies on population health are principally useful. First, it helps determine the number of patients in the population, that is, the prevalence of pathology. Research studies permit the revealing of disadvantaged groups from a socio-economic perspective and those at enlarged risk of infection. Second, epidemiological research can understand the real needs of professional treatment, the labor force in the health care system and help introduce priority programs for prevention and treatment assistance at this level. Third, analytical epidemiological research allows establishing pivotal relationships between diseases and risk factors, allowing new and more effective treatments or materials to be introduced into practice (Friis & Sellers 2020).
The interest of researchers in clinical epidemiology has increased in recent years, and the utilization of epidemiological methods in various clinical activities is a feature that considers medical staff and hospital administrators, and political makers. Descriptive analysis of epidemiology is required for the valuation of population health, which could impact the analytical studies or the possibility of diseases on the prevalence of diseases. This can be even more complicated and can target the normal relationship concerning diseases and associated risks. In addition, the proper handling of the clinical practices and experimental studies of the epidemiology can be very helpful in creating new drugs, therapeutic approaches, and dental equipment, which are more impactful and cost-effective (Murariu et al., 2019).
COVID-19 is the most recent in a series of persistent infectious diseases in human history. As the population and population density increase, the probability of epidemics will increase. Perhaps the most serious epidemic in history was the 1918’s influenza pandemic, which caused about 50 million people to die worldwide, with a case fatality rate of over 2.5% and possibly as high as 10%. This was before antibiotic days, before influenza vaccines and antiviral therapies were developed. Infectious diseases are still a major challenge to public health. To help define, contain, prevent, and eventually effectively treat patients with an epidemic, it is essential to comprehend the basic epidemiology of the epidemic. Experts from many institutions have worked together to classify the COVID-19 outbreak. The severity of most infectious diseases ranges from undetected diseases to death (Binns et al. 2020).
There is no doubt that the COVID-19 pandemic is among the biggest epidemics and global challenges confronting the health care sector worldwide. The current COVID-19 pandemic is in close relation with the disease triangle of epidemiology, stressing that the coexistence of three important factors is responsible for the occurrence of disease: host, pathogen, and the surrounding environment. Thus, the precautionary measures and treatment methodology of disease should be designed to break this disease cycle or triangle. Prevention is the key factor in confronting any epidemic whose causative agent is a virus. The emergence of this brutal virus reminded us once again that viral infections should not be undervalued or elapsed. Since the rapid and large scale spread of this pandemic, the health sector and staff must ensure on-time testing and take preventive measures to limit the spread of the virus to healthy persons (Pordanjani 2021)
Disease Triangle
The incidence of the disease depends on three key aspects, namely host, pathogen, and the surrounding environment. Pathologists regard these factors as the disease triangle, in which each factor is demonstrating one of the three triangle’s sides. The complex interface and interaction in these three factors govern the outcome of the disease and its impact on public health. The pathogen's ability to cause disease is the priority, and the degree of effective manifestation of the pathogen's capability to cause disease plays a vital role in the pathogen. Correspondingly, the host's susceptibility or resistance plays a leading role, and the host's disposing factors add to vulnerability. The third aspect of the triangle that is often overlooked is the environment, concerning how beneficial it is to the host and pathogens (Ahmed et al. 2020).
Pathogens possessing the ability to cause disease might affect some individuals. Conversely, if it has high virulence, it can kill numerous individuals—would the environment facilitate its transmission. SARS-CoV-2 can cause disaster if the virulence of the strain is high. In addition to the accessibility of a susceptible host, the environment is favorable in case of an over-aged population or comorbidity in current cases. The epidemic will certainly dwindle once the host is resistant and non-vulnerable to the under-spread SARS-CoV-2 strain. In case the present environment is unfavorable to spread the disease, the pathogen will face the same conditions as it would experience in a resistant host. The interaction among the various components of the disease triangle appears so simple; however, it decides the degree of destruction caused by a disease such as COVID-19 (Podile & Basu 2020).
The word "coronavirus" is derived from the Greek "korωνη," or the Latin "corōna” which means crown or halo. Coronavirus is a significant pathogen of humans and animals discovered in 1965. Coronavirus (CoV) is the largest viruses group that belongs to the Nidovirales order, including the Arterioviridae, Roniviridae, and Coronaviridae families. The subfamily Coronavirinae includes one of the two subfamilies of the Coronaviridae family, and the other is the Torovirinae. Coronavirinae subfamily is further categorized to form four distinct groups: alpha, beta, gamma, and delta coronavirus. These viruses were originally classified into these groups on a serology basis; however, they are classified based on phylogenetic clustering. Although viruses of the genera Alphacoronaviruses and Betacoronaviruses mainly infect mammals, Gammacoronavirus infects poultry, and members of the genus Deltacoronavirus have been found in both avian and mammalian hosts. A total of seven human coronaviruses have been discovered, comprising NL-63 and 229E from α-coronavirus, OC43-SARS-MERS, and HKUL, and lately SARS-CoV-2 from β-coronavirus. Coronavirus (COVID-19) is an enveloped RNA (ribonucleic acid) genome with a length of 29.8 kb. Fourteen open reading frames (ORF) are recognized, which constitute the virus genome, which can encode 27 proteins. There are important differences between the novel coronavirus genome in some regions and the SARS coronavirus genome. For instance, protein 8a exists in the SARS coronavirus; it does not exist in the new SARS-CoV-2 coronavirus. Phylogenetic investigation displays the two bat SARS coronaviruses are associated with the new SARS-CoV-2, i.e., bat-SL-COVZXC21 and bat-SL-COVZC45 (88-89% resemblance), while MERS (almost 50%) and SARS coronavirus (about 79%) are not very similar (Yuan et al. 2020).
Moreover, the coronavirus isolated from the anteater has a 99% nucleotide resemblance with the new SARS-CoV-2 coronavirus. Hence, the likelihood of transmission from anteaters as intermediate hosts to humans seems to exceed bats. The surface spike (S) glycoprotein of coronaviruses significantly binds to cell surface receptors and instills a decisive role in tissue orientation. Latest studies have also presented that the new SARS-CoV-2 coronavirus employs angiotensin-converting enzyme-2 (ACE-2), which is a possible receptor for targeting the cells. A phylogenetic investigation determined that bats were the original viral host. Another unidentified animal in the Wuhan seafood market was the intermediate host, which promoted the spread of the virus from bats to humans. Based on the results of metagenomic epidemiological studies, and seeing that the existence of live animals in the seafood market is the main center of zoonotic diseases, pangolins (Manis javanica) may act as an intermediate host role in this transmission (Zhao et al. 2020).