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Visualizing How COVID-19 Antiviral Pills and Vaccines Work at the Cellular Level

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Current Strategies to Tackle COVID-19

Since the pandemic started in 2020, a number of therapies have been developed to combat COVID-19.

The leading options for preventing infection include social distancing, mask-wearing, and vaccination. They are still recommended during the upsurge of the coronavirus’s latest mutation, the Omicron variant.

But in December 2021, The United States Food and Drug Administration (USDA) granted Emergency Use Authorization to two experimental pills for the treatment of new COVID-19 cases.

These medications, one made by Pfizer and the other by Merck & Co., hope to contribute to the fight against the coronavirus and its variants. Alongside vaccinations, they may help to curb extreme cases of COVID-19 by reducing the need for hospitalization.

Despite tackling the same disease, vaccines and pills work differently:

VaccinesPills
Taken by injectionTaken by mouth
Used for prevention Used for treatment only
Create an enhanced immune system by stimulating antibody productionDisrupt the assembly of new viral particles

How a Vaccine Helps Prevent COVID-19

The main purpose of a vaccine is to prewarn the body of a potential COVID-19 infection by creating antibodies that target and destroy the coronavirus.

In order to do this, the immune system needs an antigen.

It’s difficult to do this risk-free since all antigens exist directly on a virus. Luckily, vaccines safely expose antigens to our immune systems without the dangerous parts of the virus.

In the case of COVID-19, the coronavirus’s antigen is the spike protein that covers its outer surface. Vaccines inject antigen-building instructions* and use our own cellular machinery to build the coronavirus antigen from scratch.

When exposed to the spike protein, the immune system begins to assemble antigen-specific antibodies. These antibodies wait for the opportunity to attack the real spike protein when a coronavirus enters the body. Since antibodies decrease over time, booster immunizations help to maintain a strong line of defense.

*While different vaccine technologies exist, they all do a similar thing: introduce an antigen and build a stronger immune system.

How COVID Antiviral Pills Work

Antiviral pills, unlike vaccines, are not a preventative strategy. Instead, they treat an infected individual experiencing symptoms from the virus.

Two drugs are now entering the market. Merck & Co.’s Lagevrio®, composed of one molecule, and Pfizer’s Paxlovid®, composed of two.

These medications disrupt specific processes in the viral assembly line to choke the virus’s ability to replicate.

The Mechanism of Molnupiravir

RNA-dependent RNA Polymerase (RdRp) is a cellular component that works similar to a photocopying machine for the virus’s genetic instructions. An infected host cell is forced to produce RdRp, which starts generating more copies of the virus’s RNA.

Molnupiravir, developed by Merck & Co., is a polymerase inhibitor. It inserts itself into the viral instructions that RdRp is copying, jumbling the contents. The RdRp then produces junk.

The Mechanism of Nirmatrelvir + Ritonavir

A replicating virus makes proteins necessary for its survival in a large, clumped mass called a polyprotein. A cellular component called a protease cuts a virus’s polyprotein into smaller, workable pieces.

Pfizer’s antiviral medication is a protease inhibitor made of two pills:

  1. The first pill, nirmatrelvir, stops protease from cutting viral products into smaller pieces.
  2. The second pill, ritonavir, protects nirmatrelvir from destruction by the body and allows it to keep working.

With a faulty polymerase or a large, unusable polyprotein, antiviral medications make it difficult for the coronavirus to replicate. If treated early enough, they can lessen the virus’s impact on the body.

The Future of COVID Antiviral Pills and Medications

Antiviral medications seem to have a bright future ahead of them.

COVID-19 antivirals are based on early research done on coronaviruses from the 2002-04 SARS-CoV and the 2012 MERS-CoV outbreaks. Current breakthroughs in this technology may pave the way for better pharmaceuticals in the future.

One half of Pfizer’s medication, ritonavir, currently treats many other viruses including HIV/AIDS.

Gilead Science is currently developing oral derivatives of remdesivir, another polymerase inhibitor currently only offered to inpatients in the United States.

More coronavirus antivirals are currently in the pipeline, offering a glimpse of control on the looming presence of COVID-19.

Author’s Note: The medical information in this article is an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Please talk to your doctor before undergoing any treatment for COVID-19. If you become sick and believe you may have symptoms of COVID-19, please follow the CDC guidelines.

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Demographics

Charted: Global Tobacco Use by Country and Sex

This visual shows tobacco use by country and sex, highlighting which countries still have a high prevalence of smoking.

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Chart of tobacco use by country and sex in 2022

Charting Global Tobacco Use by Country and Sex

This was originally posted on our Voronoi app. Download the app for free on iOS or Android and discover incredible data-driven charts from a variety of trusted sources.

Globally, rates of tobacco use have been falling for decades. Today, it is estimated that one-in-five people around the world use tobacco products, according to data from the World Health Organization (WHO).

That’s still enough people to have a sizable impact on both global healthcare and the environment. And the prevalence of tobacco use by country, and by sex, varies widely.

This chart shows current tobacco use in selected countries around the world using WHO estimates for 2022.

Which People Smoke the Most?

Below we examine the entire dataset of global countries by 2022 tobacco use. Estimates are of people aged 15 years and older and include both smoked and smokeless tobacco (including vaping). Countries that had no data for 2022 have been omitted.

In almost every country, males use tobacco more than females. Globally, 36% of men are tobacco users compared to just 8% of women.

CountryTotal Prevalence (%)Male (%)Female (%)
🇦🇫 Afghanistan22.138.35.9
🇦🇱 Albania22.438.76.6
🇩🇿 Algeria21.641.90.7
🇦🇩 Andorra33.633.333.8
🇦🇷 Argentina23.128.218.1
🇦🇲 Armenia22.549.31.7
🇦🇺 Australia12.514.810.3
🇦🇹 Austria22.023.720.5
🇦🇿 Azerbaijan19.339.60.1
🇧🇸 Bahamas10.720.62.1
🇧🇭 Bahrain18.125.74.9
🇧🇩 Bangladesh31.148.914.2
🇧🇧 Barbados6.511.71.7
🇧🇾 Belarus27.947.212.0
🇧🇪 Belgium24.727.422.1
🇧🇿 Belize8.715.51.9
🇧🇯 Benin5.59.51.7
🇧🇹 Bhutan19.627.211.0
🇧🇴 Bolivia12.220.44.1
🇧🇦 Bosnia and Herzegovina35.141.029.5
🇧🇼 Botswana18.130.26.5
🇧🇷 Brazil12.315.79.1
🇧🇳 Brunei Darussalam17.131.32.2
🇧🇬 Bulgaria34.038.130.2
🇧🇫 Burkina Faso13.521.75.5
🇧🇮 Burundi10.015.25.0
🇨🇻 Cabo Verde10.516.25.0
🇰🇭 Cambodia16.127.35.5
🇨🇲 Cameroon5.610.21.1
🇨🇦 Canada11.413.79.2
🇹🇩 Chad6.812.31.4
🇨🇱 Chile28.230.625.8
🇨🇳 China24.947.32.0
🇨🇴 Colombia8.212.14.5
🇰🇲 Comoros16.226.26.2
🇨🇬 Congo15.028.22.0
🇨🇰 Cook Islands25.530.321.4
🇨🇷 Costa Rica8.813.24.5
🇨🇮 Cöte d'Ivoire8.616.40.7
🇭🇷 Croatia32.634.231.1
🇨🇺 Cuba18.526.910.4
🇨🇾 Cyprus34.046.022.1
🇨🇿 Czechia27.531.723.3
🇨🇩 Democratic Republic of the Congo11.119.92.6
🇩🇰 Denmark16.216.416.0
🇩🇴 Dominican Republic10.214.06.5
🇪🇨 Ecuador10.117.62.6
🇪🇬 Egypt24.748.90.3
🇸🇻 El Salvador8.315.61.9
🇪🇪 Estonia25.632.919.1
🇸🇿 Eswatini8.616.21.4
🇪🇹 Ethiopia4.67.81.4
🇫🇯 Fiji27.341.713.1
🇫🇮 Finland19.623.915.4
🇫🇷 France29.231.327.3
🇬🇲 Gambia9.618.70.6
🇬🇪 Georgia29.054.77.1
🇩🇪 Germany18.821.316.4
🇬🇭 Ghana3.15.90.3
🇬🇷 Greece29.633.126.3
🇬🇹 Guatemala12.022.71.7
🇬🇼 Guinea-Bissau7.514.80.6
🇬🇾 Guyana10.519.32.2
🇭🇹 Haiti7.312.62.3
🇭🇳 Honduras12.222.71.7
🇭🇺 Hungary29.434.724.5
🇮🇸 Iceland9.49.49.4
🇮🇳 India23.936.810.4
🇮🇩 Indonesia38.573.63.4
🇮🇷 Iran (Islamic Republic of)13.924.83.1
🇮🇶 Iraq18.736.01.6
🇮🇪 Ireland18.220.516.1
🇮🇱 Israel19.826.413.3
🇮🇹 Italy20.424.116.8
🇯🇲 Jamaica9.515.83.5
🇯🇵 Japan16.826.57.7
🇯🇴 Jordan36.357.813.4
🇰🇿 Kazakhstan21.738.26.9
🇰🇪 Kenya9.216.62.1
🇰🇮 Kiribati38.251.625.7
🇰🇼 Kuwait22.735.62.1
🇰🇬 Kyrgyzstan26.451.33.3
🇱🇦 Lao People's Democratic Republic25.843.28.4
🇱🇻 Latvia30.345.617.2
🇱🇧 Lebanon34.043.125.7
🇱🇸 Lesotho22.942.04.8
🇱🇷 Liberia7.112.51.7
🇱🇹 Lithuania27.940.117.3
🇱🇺 Luxembourg21.823.320.3
🇲🇬 Madagascar25.741.79.9
🇲🇼 Malawi7.113.01.7
🇲🇾 Malaysia22.643.80.7
🇲🇻 Maldives29.343.610.1
🇲🇱 Mali7.614.40.7
🇲🇹 Malta23.225.520.6
🇲🇭 Marshall Islands30.451.88.6
🇲🇷 Mauritania9.417.22.0
🇲🇺 Mauritius20.038.12.8
🇲🇽 Mexico14.623.16.9
🇲🇳 Mongolia29.352.67.3
🇲🇪 Montenegro32.130.933.2
🇲🇦 Morocco13.125.31.0
🇲🇲 Myanmar43.969.419.2
🇳🇦 Namibia12.521.34.7
🇳🇷 Nauru49.550.348.7
🇳🇵 Nepal24.942.79.4
🇳🇱 Netherlands (Kingdom of the)20.122.517.7
🇳🇿 New Zealand11.412.710.2
🇳🇪 Niger7.714.01.3
🇳🇬 Nigeria2.95.40.4
🇳🇴 Norway14.014.813.2
🇴🇲 Oman11.017.40.4
🇵🇰 Pakistan16.927.76.2
🇵🇼 Palau17.026.37.3
🇵🇦 Panama5.18.41.9
🇵🇬 Papua New Guinea40.455.424.9
🇵🇾 Paraguay10.617.43.8
🇵🇪 Peru7.011.62.6
🇵🇭 Philippines20.436.24.3
🇵🇱 Poland23.227.619.1
🇵🇹 Portugal20.927.115.5
🇶🇦 Qatar18.824.62.3
🇰🇷 Republic of Korea18.932.75.4
🇲🇩 Republic of Moldova27.852.76.3
🇷🇴 Romania27.537.418.5
🇷🇺 Russian Federation27.242.014.8
🇷🇼 Rwanda12.017.76.7
🇱🇨 Saint Lucia13.624.83.0
🇼🇸 Samoa22.231.013.2
🇸🇹 Sao Tome and Principe7.112.61.8
🇸🇦 Saudi Arabia17.428.42.1
🇸🇳 Senegal6.011.70.6
🇷🇸 Serbia36.638.834.6
🇸🇨 Seychelles20.834.65.7
🇸🇱 Sierra Leone11.417.35.5
🇸🇬 Singapore16.427.94.0
🇸🇰 Slovakia30.235.425.4
🇸🇮 Slovenia18.120.215.9
🇸🇧 Solomon Islands37.655.319.6
🇿🇦 South Africa20.335.16.5
🇪🇸 Spain24.927.522.5
🇱🇰 Sri Lanka19.137.82.4
🇸🇪 Sweden22.128.315.9
🇨🇭 Switzerland23.326.320.4
🇹🇭 Thailand18.937.71.8
🇹🇱 Timor-Leste37.664.59.8
🇹🇬 Togo5.610.20.9
🇹🇴 Tonga30.746.815.5
🇹🇳 Tunisia20.139.71.6
🇹🇷 Türkiye30.741.919.6
🇹🇲 Turkmenistan5.410.60.5
🇹🇻 Tuvalu33.848.319.0
🇺🇬 Uganda5.39.01.8
🇺🇦 Ukraine22.038.38.5
🇦🇪 United Arab Emirates11.715.52.5
🇬🇧 United Kingdom13.115.011.4
🇹🇿 United Republic of Tanzania7.513.12.2
🇺🇸 United States of America23.028.617.5
🇺🇾 Uruguay19.323.016.0
🇺🇿 Uzbekistan16.231.81.0
🇻🇳 Viet Nam22.844.32.2
🇾🇪 Yemen20.833.77.9
🇿🇲 Zambia12.021.82.7
🇿🇼 Zimbabwe9.219.00.8

From a regional perspective, we can see many countries in Europe and Asia have higher rates of tobacco use. Indonesia and Myanmar specifically have some of the highest tobacco use rates in the world, with 73.6% of Indonesian men estimated to smoke or use tobacco.

In many Asian countries we also see a greater difference between male and female smokers compared to the rest of the world. In China for example, 47.3% of males are estimated to use tobacco compared to just 2.0% of females.

On the other hand, the Americas and especially Africa have a lower prevalence of tobacco use. Nigeria at 2.9% had the lowest rate of tobacco use in the world in 2022.

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