2020 Applicants post here!!

[MaglensaLarose]

Thank you

[woodlerhenry]

I want to encourage everyone who has applied. As Jason and Angie have already stated being patient is a requirement of the profession.  Think about how you will interact with patients in your care, their families and loved ones, your colleagues and other professionals you will be encountering every day. I applied last year and I did not get accepted into the program, it was a set back.  But I learned a lot from that experience. I believe I was able to grow and become a better applicant this year.  I have found this forum to be very helpful and informative. I have seen the joys of being accepted and the heartbreak of receiving a rollover notice.  Although I do not post,  I do read every post, and I have shared in those moments with many of you through this platform.  I have done extensive research into the physician assistant  program at Miami Dade College and I wouldn't want to attend anywhere else.  The dedication of the staff is second to none.  The students in the program have always reached out to those seeking to gain admission. The faculty is top notch, and the education and preparation you will receive is on par with any institution.  I am hopeful that this year I will be admitted into this amazing program. My thoughts and prayers are with every hopeful candidate, because you will be my classmates, my friends, my colleagues, and mentors. Best of luck to everyone.

[Kgonz156]

2 minutes ago, woodlerhenry said:

I want to encourage everyone who has applied. As Jason and Angie have already stated being patient is a requirement of the profession.  Think about how you will interact with patients in your care, their families and loved ones, your colleagues and other professionals you will be encountering every day. I applied last year and I did not get accepted into the program, it was a set back.  But I learned a lot from that experience. I believe I was able to grow and become a better applicant this year.  I have found this forum to be very helpful and informative. I have seen the joys of being accepted and the heartbreak of receiving a rollover notice.  Although I do not post,  I do read every post, and I have shared in those moments with many of you through this platform.  I have done extensive research into the physician assistant  program at Miami Dade College and I wouldn't want to attend anywhere else.  The dedication of the staff is second to none.  The students in the program have always reached out to those seeking to gain admission. The faculty is top notch, and the education and preparation you will receive is on par with any institution.  I am hopeful that this year I will be admitted into this amazing program. My thoughts and prayers are with every hopeful candidate, because you will be my classmates, my friends, my colleagues, and mentors. Best of luck to everyone.

Thank you for these kind and inspiring words, we truly appreciate it! 

[JuanLago]

I want to encourage everyone who has applied. As Jason and Angie have already stated being patient is a requirement of the profession.  Think about how you will interact with patients in your care, their families and loved ones, your colleagues and other professionals you will be encountering every day. I applied last year and I did not get accepted into the program, it was a set back.  But I learned a lot from that experience. I believe I was able to grow and become a better applicant this year.  I have found this forum to be very helpful and informative. I have seen the joys of being accepted and the heartbreak of receiving a rollover notice.  Although I do not post,  I do read every post, and I have shared in those moments with many of you through this platform.  I have done extensive research into the physician assistant  program at Miami Dade College and I wouldn't want to attend anywhere else.  The dedication of the staff is second to none.  The students in the program have always reached out to those seeking to gain admission. The faculty is top notch, and the education and preparation you will receive is on par with any institution.  I am hopeful that this year I will be admitted into this amazing program. My thoughts and prayers are with every hopeful candidate, because you will be my classmates, my friends, my colleagues, and mentors. Best of luck to everyone.

Well said. I hope we could be classmates as well. Best of luck to you!


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[Jason Diaz]

1 hour ago, woodlerhenry said:

I want to encourage everyone who has applied. As Jason and Angie have already stated being patient is a requirement of the profession.  Think about how you will interact with patients in your care, their families and loved ones, your colleagues and other professionals you will be encountering every day. I applied last year and I did not get accepted into the program, it was a set back.  But I learned a lot from that experience. I believe I was able to grow and become a better applicant this year.  I have found this forum to be very helpful and informative. I have seen the joys of being accepted and the heartbreak of receiving a rollover notice.  Although I do not post,  I do read every post, and I have shared in those moments with many of you through this platform.  I have done extensive research into the physician assistant  program at Miami Dade College and I wouldn't want to attend anywhere else.  The dedication of the staff is second to none.  The students in the program have always reached out to those seeking to gain admission. The faculty is top notch, and the education and preparation you will receive is on par with any institution.  I am hopeful that this year I will be admitted into this amazing program. My thoughts and prayers are with every hopeful candidate, because you will be my classmates, my friends, my colleagues, and mentors. Best of luck to everyone.

Thank you for sharing this.. What an awesome attitude to have and it should be an inspiration to all. Took me four years to get in so I get the ups and downs and all the emotions in between. You are spot on with the staff and the dedication and the curriculum is tough to prepare you to stand out in the field. We are praying for you all and will continue to be here to assist any way we can. In the mean time, continue preparing to crush those interviews

[WendyM]

I want to encourage everyone who has applied. As Jason and Angie have already stated being patient is a requirement of the profession.  Think about how you will interact with patients in your care, their families and loved ones, your colleagues and other professionals you will be encountering every day. I applied last year and I did not get accepted into the program, it was a set back.  But I learned a lot from that experience. I believe I was able to grow and become a better applicant this year.  I have found this forum to be very helpful and informative. I have seen the joys of being accepted and the heartbreak of receiving a rollover notice.  Although I do not post,  I do read every post, and I have shared in those moments with many of you through this platform.  I have done extensive research into the physician assistant  program at Miami Dade College and I wouldn't want to attend anywhere else.  The dedication of the staff is second to none.  The students in the program have always reached out to those seeking to gain admission. The faculty is top notch, and the education and preparation you will receive is on par with any institution.  I am hopeful that this year I will be admitted into this amazing program. My thoughts and prayers are with every hopeful candidate, because you will be my classmates, my friends, my colleagues, and mentors. Best of luck to everyone.

I applaud your encouraging words! Patience is key and even though I am also waiting for my invitation to interview I remain hopeful. If I am not chosen this cycle, I will take this as an opportunity to evaluate what I’ve done thus far and make a solid plan to come back as a stronger candidate. I completely agree with everything you said and concur about how great MDC PA faculty is including the current students whom have gone out of their way to attend q&a events to help us hopefuls. I too can’t imagine going anywhere else because I believe this program is one of the best there is! I truly hope we end up in the same cohort... I would be honored to have you as a classmate and colleague. Best of luck! [emoji1317]


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[luchoed]

On 2/12/2020 at 6:27 AM, Angie010 said:

I’m sorry that you feel this way about MDC and that you’re frustrated with your personal outcome. Miami Dade College is very competitive and only considers those with the skills necessary to succeed as a Physician Assistant once you graduate the program. Those skills extend beyond academics to include professionalism, patience, compassion, and many of the other skills required for this field. I would recommend that in the future all applicants demonstrate these skills in person and in all other platforms. As for the GRE, MDC has been ahead of the game, realizing that the it does not test students on the skills needed in medicine; this is why they have their own focused assessment. The Master’s program offered with Saint Francis is a real master’s degree and exactly what you need to sit for the Physician Assistant National Certifying (PANCE) exam. Every PA graduate in the nation sits for the same exam. MDC currently has a pass rate of 98% so they are definitely doing something right. Now for nursing, it is also a great field but keep in mind that if your goal is to reach Nurse Practitioner, that will be 2-4 years of nursing school plus an additional 2 years of schooling for your MSN.

For the rest of this year’s applicants, don’t be discouraged. Be patient, have faith, and continue preparing for your interview. It always takes a few weeks for the invites to go out. As Jason said, right now they’re managing the new applicants, the clinical year students, and us (c/o 2021). If any of us hear anything we will let you know. We’re all very excited for you and wish you the best of luck!



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I just got my invitation 

[Jason Diaz]

I just got my invitation 

Congrats! What date is your interview? We would love to meet you.

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[WendyM]

Hey guys... I just got my invitation to interview! I feel so blessed! Wow!


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[theoddshoe]

To all of you that are waiting to interview or are waiting post interview for a result: Keep on studying, reading, preparing, working. Keep doing all the things that will make you a good clinician: being patient, open to criticism, open to change and willing to flow with every and any eventuality. As a classmate of Angie and Jason, I can attest to what feels like a wild and crazy ride it was to get into the program, and STAY in the program. 

Be humble. Be flexible. Be a professional. Be ready to drive to campus at the drop of a hat.  It's easy to be frustrated, everyone that knows me can tell you that I'm the first to get heated!! Honestly I'll tell you this whole process is frustrating, but take it with grace an patience.  If you want to be a successful clinician, you will have to deal with a lot of frustration. 

If you have any questions, please ask me! I've talked to a lot of prospective class of 2022 and 2023 students and the pre-PA club and I'm glad that some of you have gotten your interviews!

Just keep swimming, soon you'll be MDC Sharks!

[woodlerhenry]

Thank you so much for this,  I am so inspired by all of the positive feedback from everyone in the program. 

[DRPREPA]

On 2/26/2020 at 2:47 PM, theoddshoe said:

To all of you that are waiting to interview or are waiting post interview for a result: Keep on studying, reading, preparing, working. Keep doing all the things that will make you a good clinician: being patient, open to criticism, open to change and willing to flow with every and any eventuality. As a classmate of Angie and Jason, I can attest to what feels like a wild and crazy ride it was to get into the program, and STAY in the program. 

Be humble. Be flexible. Be a professional. Be ready to drive to campus at the drop of a hat.  It's easy to be frustrated, everyone that knows me can tell you that I'm the first to get heated!! Honestly I'll tell you this whole process is frustrating, but take it with grace an patience.  If you want to be a successful clinician, you will have to deal with a lot of frustration. 

If you have any questions, please ask me! I've talked to a lot of prospective class of 2022 and 2023 students and the pre-PA club and I'm glad that some of you have gotten your interviews!

Just keep swimming, soon you'll be MDC Sharks!

Thank you so much!

[gansakc]

Good Evening, Future PAs!

Hope you are all well.

I know many of you are anxiously waiting for the list of accepted candidates to be released, so I wanted to give you a heads up.

This week they should be ranking the applicants and you should start receiving emails on Friday. 

Please note that this is not official information and my words here have nothing to do with the MDC PA Program. I am speaking out of my own head and based on previous experience.

If you have any questions, do not hesitate to send me a private message and I will get back to you as soon as possible.

Thanks and have a restful night.

[gansakc]

UPDATE TO MY PREVIOUS POST:

Please expect an email at the end of March. Right now the whole world (literally) is very busy making sure we prepare for the coronavirus pandemic, and that delays everything else.

Be patient and keep your hopes up. Continue studying and preparing for PA School. 

Also take this time to recharge, to reflect upon important things, and to take care of any unfinished business you might have - you will thank me for this advice once you are in the fall semester of PA School. 

If you need anything or feel like freaking out with this looong wait, talk to a friend about it. If you don't have a friend to talk to, take advantage of this free time to make new friends (or simply text me on the private message and I will be your friend for now LOL)

Now, seriously, I feel you and understand the anxiety.

Have a good night.

thanks 

[RachelLafrance]

Thank you all for your words of encouragement!  

Edited March 12, 2020 by RachelLafrance
Missing word

[gansakc]

Dear MDC PA c/o 2022 Applicants,

Good morning.

As you might have heard already, besides classes being cancelled across all Miami Dade College campuses, the Medical Campus shut down yesterday because someone who recently visited the campus was confirmed to have coronavirus infection. 

What does that mean to the PA Program, considering that the Medical Campus facility has been closed and employees are not allowed to go to work (this is my personal view, unofficial, and absolutely not given to me by any MDC employee)? 

1. Both juniors and senior students have been instructed to stay home until further notice (FACT)

2. The process of selection of students for Class of 2022 will probably be delayed, since faculty and administrative personnel were sent home as well until further notice (SPECULATION)

3. I have no idea when the acceptance and rejection letters will be sent to the applicants. It could be today (totally impossible in my opinion), at the end of the month (kind of possible but improbable), or maybe next month

On another note, as future physician assistants, PA Applicants belong to the health care community and are already representing our profession. Additionally, as citizens, you carry the responsibility of educating yourself and the people around you. That being said and I don't want to insult anyone's intelligence, I would like to ask you to do a few things starting today, if you allow me:

1. Read and learn about the coronavirus (from a trustworthy source such as CDC, NIH, Osmosis, MedCram, Medscape, your books): 

what type of virus is that?

what is its mechanism of replication?

how does it affect the cells in the body?

what is its incubation period?

how is it transmitted?

how can we prevent it from spreading?

is the panic around us justified, once we evaluate the answers available to the above questions?

how can we prepare for the event of a family member contracting the virus?

2. Be prepared to answer questions from those who do not know EVIDENCE-BASED medicine information about this pandemic

3. Read a bit of history to assess how humanity was affected in the past when new viruses appeared

4. Let's use this forum to educate each other and to keep ourselves from buying into the madness going around us right now

5. As one of my beloved mentors says, "We are medical people, guys. Our minds must work differently." Therefore, I ask you to please fight fear using information and reflection to win this battle

We will keep in touch. I count on you to be the leaders of yourself and of others around you at this time when people lose their minds over fear and speculation.

Thanks and have a beautiful day.

Sincerely,

[woodlerhenry]

Thank you Kele,

You are absolutely right, as future healthcare providers we should be educated on this health crisis and be able to educate others.  I researched some of the questions you asked and found the following information.

 

1. Read and learn about the coronavirus (from a trustworthy source such as CDC, NIH, Osmosis, MedCram, Medscape, your books): 

what type of virus is that?

The Covid-19 is a SARS-CoV-2 strain of Coronaviruses (CoVs) are the largest group of viruses belonging to the Nidovirales order, which includes Coronaviridae, Arteriviridae, and Roniviridae families. The Coronavirinae comprise one of two subfamilies in the Coronaviridae family, with the other being the Torovirinae. The Coronavirinae are further subdivided into four groups, the alpha, beta, gamma and delta coronaviruses. The viruses were initially sorted into these groups based on serology but are now divided by phylogenetic clustering.

Common human coronaviruses

1. 229E (alpha coronavirus)
2. NL63 (alpha coronavirus)
3. OC43 (beta coronavirus)
4. HKU1 (beta coronavirus)

Other human coronaviruses

5. MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)
6. SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS)
7. SARS-CoV-2 (the novel coronavirus that causes coronavirus disease 2019, or COVID-19)

People around the world commonly get infected with human coronaviruses 229E, NL63, OC43, and HKU1.

Sometimes coronaviruses that infect animals can evolve and make people sick and become a new human coronavirus. Three recent examples of this are 2019-nCoV, SARS-CoV, and MERS-CoV.

what is its mechanism of replication?

The coronavrirus life cycle consists of four major steps

1. Attachment and Entry
a. The initial attachment of the virion to the host cell is initiated by interactions between the S protein and its receptor.
b. The sites of receptor binding domains (RBD) within the S1 region of a coronavirus S protein vary depending on the virus, with some having the RBD at the N-terminus of S1 (MHV) while others (SARS-CoV) have the RBD at the C-terminus of S1
c.The S-protein/receptor interaction is the primary determinant for a coronavirus to infect a host species and also governs the tissue tropism of the virus. Many coronaviruses utilize peptidases as their cellular receptor. 
d. Many α-coronaviruses utilize aminopeptidase N (APN) as their receptor, SARS-CoV and HCoV-NL63 use angiotensin-converting enzyme 2 (ACE2) as their receptor, MHV enters through CEACAM1, and the recently identified MERS-CoV binds to dipeptidyl-peptidase 4 (DPP4) to gain entry into human cells.
e. Following receptor binding, the virus must next gain access to the host cell cytosol. This is generally accomplished by acid-dependent proteolytic cleavage of S protein by a cathepsin, TMPRRS2 or another protease, followed by fusion of the viral and cellular membranes
f. Cleavage at S2′ exposes a fusion peptide that inserts into the membrane, which is followed by joining of two heptad repeats in S2 forming an antiparallel six-helix bundle [6]. The formation of this bundle allows for the mixing of viral and cellular membranes, resulting in fusion and ultimately release of the viral genome into the cytoplasm.

2. Replicase Protein Expression
a.The next step in the coronavirus lifecycle is the translation of the replicase gene from the virion genomic RNA.
b. The replicase gene encodes two large ORFS, rep1a and rep1b, which express two co-terminal polyproteins, pp1a and pp1ab ). In order to express both polyproteins, the virus utilizes a slippery sequence (5′-UUUAAAC-3′) and an RNA pseudoknot that cause ribosomal frameshifting from the rep1a reading frame into the rep1b ORF.
c.  In most cases, the ribosome unwinds the pseudoknot structure, and continues translation until it encounters the rep1a stop codon. Occasionally the pseudoknot blocks the ribosome from continuing elongation, causing it to pause on the slippery sequence, changing the reading frame by moving back one nucleotide, −1 frameshift, before the ribosome is able to melt the pseudoknot structure and extend translation into rep1b, resulting in the translation of pp1ab.
d. Next, many of the nsps assemble into the replicase-transcriptase complex (RTC) to create an environment suitable for RNA synthesis, and ultimately are responsible for RNA replication and transcription of the sub-genomic RNAs. The nsps also contain other enzyme domains and functions, including those important for RNA replication.

3. Replication and Transcription

a. Viral RNA synthesis follows the translation and assembly of the viral replicase complexes. Viral RNA synthesis produces both genomic and sub-genomic RNAs.
b. Sub-genomic RNAs serve as mRNAs for the structural and accessory genes which reside downstream of the replicase polyproteins. c. All positive-sense sub-genomic RNAs are 3′ co-terminal with the full-length viral genome and thus form a set of nested RNAs, a distinctive property of the order Nidovirales. 
d. Perhaps the most novel aspect of coronavirus replication is how the leader and body TRS segments fuse during production of sub-genomic RNAs. This was originally thought to occur during positive-strand synthesis, but now it is largely believed to occur during the discontinuous extension of negative-strand RNA .

4. Assembly and Release
a. Following replication and subgenomic RNA synthesis, the viral structural proteins, S, E, and M are translated and inserted into the endoplasmic reticulum (ER).
b. These proteins move along the secretory pathway into the endoplasmic reticulum-Golgi intermediate compartment (ERGIC).
c. There, viral genomes encapsidated by N protein bud into membranes of the ERGIC containing viral structural proteins, forming mature virions].

How does it affect the cells in  the body?
a. Prior to the SARS-CoV outbreak, coronaviruses were only thought to cause mild, self-limiting respiratory infections in humans. Two of these human coronaviruses are α-coronaviruses (HCoV-229E and HCoV-NL63) while the other two are β-coronaviruses (HCoV-OC43 and HCoV-HKU1). HCoV-229E and HCoV-OC43 were isolated nearly 50 years ago] while HCoV-NL63 and HCoV-HKU1 were only recently identified following the SARS-CoV outbreak .
b. These viruses are endemic in the human populations, causing 15–30% of respiratory tract infections each year. They cause more severe disease in neonates, the elderly, and in individuals with underlying illnesses, with a greater incidence of lower respiratory tract infection in these populations. HCoV-NL63 is also associated with acute laryngotracheitis  
c. Based on the ability of MHV to cause demyelinating disease, it has been suggested that human CoVs may be involved in the development of multiple sclerosis (MS). However, no evidence to date suggests that human CoVs play a significant role in MS
d.  Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases. The following symptoms may appear 2-14 days after exposure.* Fever, Cough, Shortness of breath
*This is based on what has been seen previously as the incubation period of MERS-CoV viruses.

What is its incubation period?
There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine.

How is it transmitted?
A. Person-to-person spread
The virus is thought to spread mainly from person-to-person.

Between people who are in close contact with one another (within about 6 feet).
Through respiratory droplets produced when an infected person coughs or sneezes.
These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

B.Can someone spread the virus without being sick?
People are thought to be most contagious when they are most symptomatic (the sickest).
Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.
Spread from contact with contaminated surfaces or objects
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

C. How easily the virus spreads
How easily a virus spreads from person-to-person can vary. Some viruses are highly contagious (spread easily), like measles, while other viruses do not spread as easily. Another factor is whether the spread is sustained, spreading continually without stopping.

How can we prevent it from spreading?
a.There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19).
b. The best way to prevent illness is to avoid being exposed to this virus.
c. Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
d. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
e. Avoid touching your eyes, nose, and mouth with unwashed hands.

Is the panic around us justified, once we evaluate the answers available to the above questions?

As the number of cases increase, a sense of panic seems to be setting in with some. Local medial experts tell us we should not panic and simply be prepared.  As of now, they tell us that all we can do is approach this like we would the flu.

How can we prepare for the event of a family member contracting the virus?
As the coronavirus outbreak continues to evolve, help your family channel concern into preparation — especially for a potential mandatory coronavirus quarantine in your community. During this time of uncertainty, creating a household plan empowers your whole family to feel a little less stressed by taking positive steps that ease your minds
1. Preparation 101: Set Realistic Expectations

2. Follow Coronavirus Updates from Trusted Sources

3. Make Sure Each Family Member Knows and Practices Hygiene Measures

I thank you for issuing this challenge as I now feel empowered to answer questions about the coronavirus to anyone.  I hope that this information will empower others as well. 

[woodlerhenry]

4 hours ago, gansakc said:

Dear MDC PA c/o 2022 Applicants,

Good morning.

As you might have heard already, besides classes being cancelled across all Miami Dade College campuses, the Medical Campus shut down yesterday because someone who recently visited the campus was confirmed to have coronavirus infection. 

What does that mean to the PA Program, considering that the Medical Campus facility has been closed and employees are not allowed to go to work (this is my personal view, unofficial, and absolutely not given to me by any MDC employee)? 

1. Both juniors and senior students have been instructed to stay home until further notice (FACT)

2. The process of selection of students for Class of 2022 will probably be delayed, since faculty and administrative personnel were sent home as well until further notice (SPECULATION)

3. I have no idea when the acceptance and rejection letters will be sent to the applicants. It could be today (totally impossible in my opinion), at the end of the month (kind of possible but improbable), or maybe next month

On another note, as future physician assistants, PA Applicants belong to the health care community and are already representing our profession. Additionally, as citizens, you carry the responsibility of educating yourself and the people around you. That being said and I don't want to insult anyone's intelligence, I would like to ask you to do a few things starting today, if you allow me:

1. Read and learn about the coronavirus (from a trustworthy source such as CDC, NIH, Osmosis, MedCram, Medscape, your books): 

what type of virus is that?

what is its mechanism of replication?

how does it affect the cells in the body?

what is its incubation period?

how is it transmitted?

how can we prevent it from spreading?

is the panic around us justified, once we evaluate the answers available to the above questions?

how can we prepare for the event of a family member contracting the virus?

2. Be prepared to answer questions from those who do not know EVIDENCE-BASED medicine information about this pandemic

3. Read a bit of history to assess how humanity was affected in the past when new viruses appeared

4. Let's use this forum to educate each other and to keep ourselves from buying into the madness going around us right now

5. As one of my beloved mentors says, "We are medical people, guys. Our minds must work differently." Therefore, I ask you to please fight fear using information and reflection to win this battle

We will keep in touch. I count on you to be the leaders of yourself and of others around you at this time when people lose their minds over fear and speculation.

Thanks and have a beautiful day.

Sincerely,

Thank you Kele,

You are absolutely right, as future healthcare providers we should be educated on this health crisis and be able to educate others.  I researched some of the questions you asked and found the following information.

 

1. Read and learn about the coronavirus (from a trustworthy source such as CDC, NIH, Osmosis, MedCram, Medscape, your books): 

what type of virus is that?

The Covid-19 is a SARS-CoV-2 strain of Coronaviruses (CoVs) are the largest group of viruses belonging to the Nidovirales order, which includes Coronaviridae, Arteriviridae, and Roniviridae families. The Coronavirinae comprise one of two subfamilies in the Coronaviridae family, with the other being the Torovirinae. The Coronavirinae are further subdivided into four groups, the alpha, beta, gamma and delta coronaviruses. The viruses were initially sorted into these groups based on serology but are now divided by phylogenetic clustering.

Common human coronaviruses
229E (alpha coronavirus)
NL63 (alpha coronavirus)
OC43 (beta coronavirus)
HKU1 (beta coronavirus)
Other human coronaviruses
MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)
SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS)
SARS-CoV-2 (the novel coronavirus that causes coronavirus disease 2019, or COVID-19)
People around the world commonly get infected with human coronaviruses 229E, NL63, OC43, and HKU1.

Sometimes coronaviruses that infect animals can evolve and make people sick and become a new human coronavirus. Three recent examples of this are 2019-nCoV, SARS-CoV, and MERS-CoV.

what is its mechanism of replication?

The coronavrirus life cycle consists of four major steps

1. Attachment and Entry
a. The initial attachment of the virion to the host cell is initiated by interactions between the S protein and its receptor.
b. The sites of receptor binding domains (RBD) within the S1 region of a coronavirus S protein vary depending on the virus, with some having the RBD at the N-terminus of S1 (MHV) while others (SARS-CoV) have the RBD at the C-terminus of S1
c.The S-protein/receptor interaction is the primary determinant for a coronavirus to infect a host species and also governs the tissue tropism of the virus. Many coronaviruses utilize peptidases as their cellular receptor. 
d. Many α-coronaviruses utilize aminopeptidase N (APN) as their receptor, SARS-CoV and HCoV-NL63 use angiotensin-converting enzyme 2 (ACE2) as their receptor, MHV enters through CEACAM1, and the recently identified MERS-CoV binds to dipeptidyl-peptidase 4 (DPP4) to gain entry into human cells.
e. Following receptor binding, the virus must next gain access to the host cell cytosol. This is generally accomplished by acid-dependent proteolytic cleavage of S protein by a cathepsin, TMPRRS2 or another protease, followed by fusion of the viral and cellular membranes
f. Cleavage at S2′ exposes a fusion peptide that inserts into the membrane, which is followed by joining of two heptad repeats in S2 forming an antiparallel six-helix bundle [6]. The formation of this bundle allows for the mixing of viral and cellular membranes, resulting in fusion and ultimately release of the viral genome into the cytoplasm.

2. Replicase Protein Expression
a.The next step in the coronavirus lifecycle is the translation of the replicase gene from the virion genomic RNA.
b. The replicase gene encodes two large ORFS, rep1a and rep1b, which express two co-terminal polyproteins, pp1a and pp1ab ). In order to express both polyproteins, the virus utilizes a slippery sequence (5′-UUUAAAC-3′) and an RNA pseudoknot that cause ribosomal frameshifting from the rep1a reading frame into the rep1b ORF.
c.  In most cases, the ribosome unwinds the pseudoknot structure, and continues translation until it encounters the rep1a stop codon. Occasionally the pseudoknot blocks the ribosome from continuing elongation, causing it to pause on the slippery sequence, changing the reading frame by moving back one nucleotide, −1 frameshift, before the ribosome is able to melt the pseudoknot structure and extend translation into rep1b, resulting in the translation of pp1ab.
d. Next, many of the nsps assemble into the replicase-transcriptase complex (RTC) to create an environment suitable for RNA synthesis, and ultimately are responsible for RNA replication and transcription of the sub-genomic RNAs. The nsps also contain other enzyme domains and functions, including those important for RNA replication.

3. Replication and Transcription

a. Viral RNA synthesis follows the translation and assembly of the viral replicase complexes. Viral RNA synthesis produces both genomic and sub-genomic RNAs.
b. Sub-genomic RNAs serve as mRNAs for the structural and accessory genes which reside downstream of the replicase polyproteins. c. All positive-sense sub-genomic RNAs are 3′ co-terminal with the full-length viral genome and thus form a set of nested RNAs, a distinctive property of the order Nidovirales. 
d. Perhaps the most novel aspect of coronavirus replication is how the leader and body TRS segments fuse during production of sub-genomic RNAs. This was originally thought to occur during positive-strand synthesis, but now it is largely believed to occur during the discontinuous extension of negative-strand RNA .

4. Assembly and Release
a. Following replication and subgenomic RNA synthesis, the viral structural proteins, S, E, and M are translated and inserted into the endoplasmic reticulum (ER).
b. These proteins move along the secretory pathway into the endoplasmic reticulum-Golgi intermediate compartment (ERGIC).
c. There, viral genomes encapsidated by N protein bud into membranes of the ERGIC containing viral structural proteins, forming mature virions].

How does it affect the cells in  the body?
a. Prior to the SARS-CoV outbreak, coronaviruses were only thought to cause mild, self-limiting respiratory infections in humans. Two of these human coronaviruses are α-coronaviruses (HCoV-229E and HCoV-NL63) while the other two are β-coronaviruses (HCoV-OC43 and HCoV-HKU1). HCoV-229E and HCoV-OC43 were isolated nearly 50 years ago] while HCoV-NL63 and HCoV-HKU1 were only recently identified following the SARS-CoV outbreak .
b. These viruses are endemic in the human populations, causing 15–30% of respiratory tract infections each year. They cause more severe disease in neonates, the elderly, and in individuals with underlying illnesses, with a greater incidence of lower respiratory tract infection in these populations. HCoV-NL63 is also associated with acute laryngotracheitis  
c. Based on the ability of MHV to cause demyelinating disease, it has been suggested that human CoVs may be involved in the development of multiple sclerosis (MS). However, no evidence to date suggests that human CoVs play a significant role in MS
d.  Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases. The following symptoms may appear 2-14 days after exposure.* Fever, Cough, Shortness of breath
*This is based on what has been seen previously as the incubation period of MERS-CoV viruses.

What is its incubation period?
There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine.

How is it transmitted?
A. Person-to-person spread
The virus is thought to spread mainly from person-to-person.

Between people who are in close contact with one another (within about 6 feet).
Through respiratory droplets produced when an infected person coughs or sneezes.
These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

B.Can someone spread the virus without being sick?
People are thought to be most contagious when they are most symptomatic (the sickest).
Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.
Spread from contact with contaminated surfaces or objects
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

C. How easily the virus spreads
How easily a virus spreads from person-to-person can vary. Some viruses are highly contagious (spread easily), like measles, while other viruses do not spread as easily. Another factor is whether the spread is sustained, spreading continually without stopping.

How can we prevent it from spreading?
a.There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19).
b. The best way to prevent illness is to avoid being exposed to this virus.
c. Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
d. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
e. Avoid touching your eyes, nose, and mouth with unwashed hands.

Is the panic around us justified, once we evaluate the answers available to the above questions?

As the number of cases increase, a sense of panic seems to be setting in with some. Local medial experts tell us we should not panic and simply be prepared.  As of now, they tell us that all we can do is approach this like we would the flu.

How can we prepare for the event of a family member contracting the virus?
As the coronavirus outbreak continues to evolve, help your family channel concern into preparation — especially for a potential mandatory coronavirus quarantine in your community. During this time of uncertainty, creating a household plan empowers your whole family to feel a little less stressed by taking positive steps that ease your minds
1. Preparation 101: Set Realistic Expectations

2. Follow Coronavirus Updates from Trusted Sources

3. Make Sure Each Family Member Knows and Practices Hygiene Measures

I thank you for issuing this challenge as I now feel empowered to answer questions about the coronavirus to anyone.  I hope that this information will empower others as well. 

[gansakc]

On 3/13/2020 at 11:24 AM, woodlerhenry said:

Thank you Kele,

You are absolutely right, as future healthcare providers we should be educated on this health crisis and be able to educate others.  I researched some of the questions you asked and found the following information.

 

1. Read and learn about the coronavirus (from a trustworthy source such as CDC, NIH, Osmosis, MedCram, Medscape, your books): 

what type of virus is that?

The Covid-19 is a SARS-CoV-2 strain of Coronaviruses (CoVs) are the largest group of viruses belonging to the Nidovirales order, which includes Coronaviridae, Arteriviridae, and Roniviridae families. The Coronavirinae comprise one of two subfamilies in the Coronaviridae family, with the other being the Torovirinae. The Coronavirinae are further subdivided into four groups, the alpha, beta, gamma and delta coronaviruses. The viruses were initially sorted into these groups based on serology but are now divided by phylogenetic clustering.

Common human coronaviruses
229E (alpha coronavirus)
NL63 (alpha coronavirus)
OC43 (beta coronavirus)
HKU1 (beta coronavirus)
Other human coronaviruses
MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)
SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS)
SARS-CoV-2 (the novel coronavirus that causes coronavirus disease 2019, or COVID-19)
People around the world commonly get infected with human coronaviruses 229E, NL63, OC43, and HKU1.

Sometimes coronaviruses that infect animals can evolve and make people sick and become a new human coronavirus. Three recent examples of this are 2019-nCoV, SARS-CoV, and MERS-CoV.

what is its mechanism of replication?

The coronavrirus life cycle consists of four major steps

1. Attachment and Entry
a. The initial attachment of the virion to the host cell is initiated by interactions between the S protein and its receptor.
b. The sites of receptor binding domains (RBD) within the S1 region of a coronavirus S protein vary depending on the virus, with some having the RBD at the N-terminus of S1 (MHV) while others (SARS-CoV) have the RBD at the C-terminus of S1
c.The S-protein/receptor interaction is the primary determinant for a coronavirus to infect a host species and also governs the tissue tropism of the virus. Many coronaviruses utilize peptidases as their cellular receptor. 
d. Many α-coronaviruses utilize aminopeptidase N (APN) as their receptor, SARS-CoV and HCoV-NL63 use angiotensin-converting enzyme 2 (ACE2) as their receptor, MHV enters through CEACAM1, and the recently identified MERS-CoV binds to dipeptidyl-peptidase 4 (DPP4) to gain entry into human cells.
e. Following receptor binding, the virus must next gain access to the host cell cytosol. This is generally accomplished by acid-dependent proteolytic cleavage of S protein by a cathepsin, TMPRRS2 or another protease, followed by fusion of the viral and cellular membranes
f. Cleavage at S2′ exposes a fusion peptide that inserts into the membrane, which is followed by joining of two heptad repeats in S2 forming an antiparallel six-helix bundle [6]. The formation of this bundle allows for the mixing of viral and cellular membranes, resulting in fusion and ultimately release of the viral genome into the cytoplasm.

2. Replicase Protein Expression
a.The next step in the coronavirus lifecycle is the translation of the replicase gene from the virion genomic RNA.
b. The replicase gene encodes two large ORFS, rep1a and rep1b, which express two co-terminal polyproteins, pp1a and pp1ab ). In order to express both polyproteins, the virus utilizes a slippery sequence (5′-UUUAAAC-3′) and an RNA pseudoknot that cause ribosomal frameshifting from the rep1a reading frame into the rep1b ORF.
c.  In most cases, the ribosome unwinds the pseudoknot structure, and continues translation until it encounters the rep1a stop codon. Occasionally the pseudoknot blocks the ribosome from continuing elongation, causing it to pause on the slippery sequence, changing the reading frame by moving back one nucleotide, −1 frameshift, before the ribosome is able to melt the pseudoknot structure and extend translation into rep1b, resulting in the translation of pp1ab.
d. Next, many of the nsps assemble into the replicase-transcriptase complex (RTC) to create an environment suitable for RNA synthesis, and ultimately are responsible for RNA replication and transcription of the sub-genomic RNAs. The nsps also contain other enzyme domains and functions, including those important for RNA replication.

3. Replication and Transcription

a. Viral RNA synthesis follows the translation and assembly of the viral replicase complexes. Viral RNA synthesis produces both genomic and sub-genomic RNAs.
b. Sub-genomic RNAs serve as mRNAs for the structural and accessory genes which reside downstream of the replicase polyproteins. c. All positive-sense sub-genomic RNAs are 3′ co-terminal with the full-length viral genome and thus form a set of nested RNAs, a distinctive property of the order Nidovirales. 
d. Perhaps the most novel aspect of coronavirus replication is how the leader and body TRS segments fuse during production of sub-genomic RNAs. This was originally thought to occur during positive-strand synthesis, but now it is largely believed to occur during the discontinuous extension of negative-strand RNA .

4. Assembly and Release
a. Following replication and subgenomic RNA synthesis, the viral structural proteins, S, E, and M are translated and inserted into the endoplasmic reticulum (ER).
b. These proteins move along the secretory pathway into the endoplasmic reticulum-Golgi intermediate compartment (ERGIC).
c. There, viral genomes encapsidated by N protein bud into membranes of the ERGIC containing viral structural proteins, forming mature virions].

How does it affect the cells in  the body?
a. Prior to the SARS-CoV outbreak, coronaviruses were only thought to cause mild, self-limiting respiratory infections in humans. Two of these human coronaviruses are α-coronaviruses (HCoV-229E and HCoV-NL63) while the other two are β-coronaviruses (HCoV-OC43 and HCoV-HKU1). HCoV-229E and HCoV-OC43 were isolated nearly 50 years ago] while HCoV-NL63 and HCoV-HKU1 were only recently identified following the SARS-CoV outbreak .
b. These viruses are endemic in the human populations, causing 15–30% of respiratory tract infections each year. They cause more severe disease in neonates, the elderly, and in individuals with underlying illnesses, with a greater incidence of lower respiratory tract infection in these populations. HCoV-NL63 is also associated with acute laryngotracheitis  
c. Based on the ability of MHV to cause demyelinating disease, it has been suggested that human CoVs may be involved in the development of multiple sclerosis (MS). However, no evidence to date suggests that human CoVs play a significant role in MS
d.  Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases. The following symptoms may appear 2-14 days after exposure.* Fever, Cough, Shortness of breath
*This is based on what has been seen previously as the incubation period of MERS-CoV viruses.

What is its incubation period?
There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine.

How is it transmitted?
A. Person-to-person spread
The virus is thought to spread mainly from person-to-person.

Between people who are in close contact with one another (within about 6 feet).
Through respiratory droplets produced when an infected person coughs or sneezes.
These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

B.Can someone spread the virus without being sick?
People are thought to be most contagious when they are most symptomatic (the sickest).
Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.
Spread from contact with contaminated surfaces or objects
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

C. How easily the virus spreads
How easily a virus spreads from person-to-person can vary. Some viruses are highly contagious (spread easily), like measles, while other viruses do not spread as easily. Another factor is whether the spread is sustained, spreading continually without stopping.

How can we prevent it from spreading?
a.There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19).
b. The best way to prevent illness is to avoid being exposed to this virus.
c. Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
d. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
e. Avoid touching your eyes, nose, and mouth with unwashed hands.

Is the panic around us justified, once we evaluate the answers available to the above questions?

As the number of cases increase, a sense of panic seems to be setting in with some. Local medial experts tell us we should not panic and simply be prepared.  As of now, they tell us that all we can do is approach this like we would the flu.

How can we prepare for the event of a family member contracting the virus?
As the coronavirus outbreak continues to evolve, help your family channel concern into preparation — especially for a potential mandatory coronavirus quarantine in your community. During this time of uncertainty, creating a household plan empowers your whole family to feel a little less stressed by taking positive steps that ease your minds
1. Preparation 101: Set Realistic Expectations

2. Follow Coronavirus Updates from Trusted Sources

3. Make Sure Each Family Member Knows and Practices Hygiene Measures

I thank you for issuing this challenge as I now feel empowered to answer questions about the coronavirus to anyone.  I hope that this information will empower others as well. 

Dear Woodlerhenry,

Thank you so much for your post! I liked it a lot. 

Hope you have a good weekend.

[gansakc]

Hi guys, how are you?

Just wanted to update you on the class suspension situation. We are still sorting things out, and I haven't heard anything about your acceptance emails yet. 

Keep studying and preparing for when the time comes for you to move forward. Don't lose focus. 

We will keep in touch.

Best,

kele

[WendyM]

Hi guys, how are you?
Just wanted to update you on the class suspension situation. We are still sorting things out, and I haven't heard anything about your acceptance emails yet. 
Keep studying and preparing for when the time comes for you to move forward. Don't lose focus. 
We will keep in touch.
Best,
kele

Thank you Kele for the update! Much appreciated!!! Stay safe!


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[gansakc]

Hi dears,

Hope you are well.

Just checking on you. 

If there is anything we can do for you please let us know.

Stay hopeful and strong. This crisis will be over and we better be prepared for when it happens

Have a productive weekend.

Sincerely,

Kele

[JuanLago]

Hi dears,
Hope you are well.
Just checking on you. 
If there is anything we can do for you please let us know.
Stay hopeful and strong. This crisis will be over and we better be prepared for when it happens [emoji846]
Have a productive weekend.
Sincerely,
Kele

Hi Kele,
I hope you are doing well as well. Let’s pray for everything to be over sooner than later and we can be prepared for the news.
Kind regards, Juan


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[woodlerhenry]

1 hour ago, gansakc said:

Hi dears,

Hope you are well.

Just checking on you. 

If there is anything we can do for you please let us know.

Stay hopeful and strong. This crisis will be over and we better be prepared for when it happens

Have a productive weekend.

Sincerely,

Kele

Hi Kele!

Thanks for checking on us.  You have been so amazing to this class. I hope you and your family are doing well. This epidemic has really shown me how important medicine is to me. I wish I could be out there helping patients. I know this too shall pass. The significance of why we want to peruse this passion for medicine goes beyond anything personal. This passion is for humanity. 

[gansakc]

Thanks, Juan and Woodlerhenry! I appreciate you checking on me. We are doing well, thank God.

Talk to you soon