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Iranian Journal of Public Health، جلد ۴۹، شماره ۶، صفحات ۱۰۵۳-۱۰۵۹
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عنوان انگلیسی Health Care Policy Makers’ Response to COVID-19 Pandemic; Pros and Cons of “Flattening the Curve” from the “Selective Pressure” Point of View: A Review
چکیده انگلیسی مقاله COVID-19, a respiratory infection caused by the virus SARS-CoV-2, causes a variety of symptoms in infected people. We have recently addressed our concerns over unintentional “Directed Accelerated Evolution” of the SARS-CoV-2 and introduced a modified treatment method for ARDS associated with COVID-19. COVID-19 outbreak could last for a long time in communities. Due to growing requests for medical equipment such as ventilators and ICU beds, “flattening the epidemic curve” has been considered as an effective strategy to adjust the level of health care demand to potential capacity of the system. In this paper, we compare possible outcomes of “Without Precaution” and “With Precaution” epidemic models. When there are no precautions, a higher number of people would be infected. RNA viruses such as SARS-CoV-2 have extremely high mutation rates. Accordingly, the combination of a higher number of infected people and any effort for inactivation of the viruses is expected to exert a strong selective pressure on SARS-CoV-2 that can lead to more mutations. These mutations can be either pathogenicity attenuating mutations (PAMs) or pathogenicity promoting mutations (PPMs). On the other hand, when flattening strategy is used, the number of infected people will be lower than the previous model, but both type of mutations may occur, although with lower frequency. Although the occurrence of PAMs helps the development of herd immunity, possible occurrence of PPMs needs serious tracking, especially in patients with severe COVID-19, to prevent new endemic with more virulent mutant viruses.
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نویسندگان مقاله | Seyed Alireza Mortazavi
Department of Medical Physics and Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran


| Abdolkarim Ghadimi-Moghadam
Pediatric Infectious Ward, Yasuj University of Medical Sciences, Yasuj, Iran


| Masoud Haghani
Department of Radiology, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran


| Azim Kaveh Ahangar
Vice Chancellery for Research, Shiraz University of Medical Sciences, Shiraz, Iran


| SMJ Mortazavi
Department of Medical Physics and Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran


| Abdollah Jafarzadeh
Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
نشانی اینترنتی http://ijph.tums.ac.ir/index.php/ijph/article/view/20531
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