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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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Healthcare

Mapped: Diabetes Rates by Country in 2021

Diabetes affects millions of people around the world, but the spread isn’t equal. This map highlights diabetes rates by country in 2021.

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Shareable diabetic population

Mapping Diabetes Rates by Country in 2021

Despite advancements in healthcare lengthening life expectancy across the world, there are still many diseases that are hard to beat. One of these growing and costly diseases is diabetes, but each country is being hit differently.

One of the leading causes of death and disability globally, over half a billion people are living with diabetes today. The World Bank’s IDF Diabetes Atlas reveals that diabetes was responsible for 6.7 million deaths in 2021 alone.

In this graphic, Alberto Rojo Moro uses this World Bank Atlas to map diabetes rates by country, highlighting the countries with the highest rates of the disease.

What is Diabetes?

Diabetes (also known as diabetes mellitusis) a long-lasting condition that affects how the body turns food into energy.

Normally, our bodies break down the food we consume into glucose (a sugar) and release it into our blood. When our level of blood sugar rises, insulin produced by our pancreas signals the body to use excess glucose as energy or store it for later consumption.

Diabetes restricts the pancreas from producing this life-saving insulin properly, thus causing high blood sugar levels. These high glucose levels can eventually impact the heart, kidney, and vision. There are two main types of diabetes:

  • Type 1 Diabetes: The immune system attacks and destroys the cells in your pancreas that make insulin. Causes are believed to be genetic and environmental.
  • Type 2 Diabetes: The body becomes resistant to insulin or doesn’t produce enough insulin to regulate blood sugar levels. It is caused by a mix of lifestyle factors (including obesity, physical inactivity, poor diet, and smoking) and genetics.

Type 2 diabetes is by far the most common form of the disease, making up between 90-95% of global cases.

Diabetes Rates by Country

With close to 33 million (31%) of its adult population suffering from diabetes, Pakistan was the country with the highest prevalence of diabetes.

RankCountry% of Diabetic Population Aged 20-79
1🇵🇰 Pakistan30.8
2🇵🇫 French Polynesia25.2
3🇰🇼 Kuwait24.9
4🇳🇷 Nauru23.4
5🇳🇨 New Caledonia23.4
6🇲🇭 Marshall Islands23.0
7🇲🇺 Mauritius22.6
8🇰🇮 Kiribati22.1
9🇪🇬 Egypt20.9
10🇦🇸 American Samoa20.3
11🇹🇻 Tuvalu20.3
12🇸🇧 Solomon Islands19.8
13🇶🇦 Qatar19.5
14🇬🇺 Guam19.1
15🇲🇾 Malaysia19.0
16🇸🇩 Sudan18.9
17🇸🇦 Saudi Arabia18.7
18🇫🇯 Fiji17.7
19🇵🇼 Palau17.0
20🇲🇽 Mexico16.9
21🇵🇬 Papua New Guinea16.7
22🇦🇪 United Arab Emirates16.4
23🇰🇳 Saint Kitts and Nevis16.1
24🇫🇲 Micronesia15.6
25🇻🇺 Vanuatu15.6
26🇯🇴 Jordan15.4
27🇹🇴 Tonga15.0
28🇸🇾 Syria14.9
29🇧🇿 Belize14.5
30🇹🇷 Turkey14.5
31🇧🇩 Bangladesh14.2
32🇧🇧 Barbados14.0
33🇴🇲 Oman13.8
34🇵🇷 Puerto Rico13.3
35🇬🇹 Guatemala13.1
36🇧🇲 Bermuda13.0
37🇰🇾 Cayman Islands13.0
38🇸🇷 Suriname12.7
39🇹🇹 Trinidad and Tobago12.7
40🇬🇩 Grenada12.6
41🇻🇮 United States Virgin Islands12.4
42🇹🇿 Tanzania12.3
43🇿🇲 Zambia11.9
44🇦🇬 Antigua and Barbuda11.7
45🇰🇲 Comoros11.7
46🇨🇼 Curacao11.7
47🇩🇲 Dominica11.7
48🇬🇾 Guyana11.7
49🇱🇨 Saint Lucia11.7
50🇸🇬 Singapore11.6
51🇧🇭 Bahrain11.3
52🇱🇰 Sri Lanka11.3
53🇧🇳 Brunei11.1
54🇯🇲 Jamaica11.1
55🇦🇫 Afghanistan10.9
56🇨🇱 Chile10.8
57🇿🇦 South Africa10.8
58🇮🇶 Iraq10.7
59🇺🇸 United States10.7
60🇨🇳 China10.6
61🇮🇩 Indonesia10.6
62🇩🇴 Dominican Republic10.5
63🇧🇹 Bhutan10.4
64🇪🇸 Spain10.3
65🇦🇱 Albania10.2
66🇦🇩 Andorra9.7
67🇹🇭 Thailand9.7
68🇹🇳 Tunisia9.6
69🇻🇪 Venezuela9.6
70🇳🇮 Nicaragua9.3
71🇲🇻 Maldives9.2
72🇵🇸 Palestine9.2
73🇼🇸 Samoa9.2
74🇧🇦 Bosnia and Herzegovina9.1
75🇮🇷 Iran9.1
76🇲🇪 Montenegro9.1
77🇲🇦 Morocco9.1
78🇵🇹 Portugal9.1
79🇷🇸 Serbia9.1
80🇺🇾 Uruguay9.0
81🇭🇹 Haiti8.9
82🇧🇸 Bahamas8.8
83🇧🇷 Brazil8.8
84🇨🇷 Costa Rica8.8
85🇻🇬 British Virgin Islands8.7
86🇱🇾 Libya8.7
87🇳🇵 Nepal8.7
88🇨🇾 Cyprus8.6
89🇰🇵 North Korea8.6
90🇹🇱 Timor8.6
91🇮🇱 Israel8.5
92🇸🇨 Seychelles8.5
93🇨🇴 Colombia8.3
94🇵🇦 Panama8.2
95🇱🇧 Lebanon8.0
96🇲🇹 Malta8.0
97🇻🇨 Saint Vincent and the Grenadines8.0
98🇭🇰 Hong Kong7.8
99🇲🇴 Macao7.8
100🇨🇦 Canada7.7
101🇨🇺 Cuba7.6
102🇵🇾 Paraguay7.5
103🇧🇬 Bulgaria7.4
104🇩🇯 Djibouti7.4
105🇸🇲 San Marino7.4
106🇰🇭 Cambodia7.3
107🇲🇼 Malawi7.3
108🇩🇿 Algeria7.1
109🇨🇿 Czechia7.1
110🇲🇲 Myanmar7.1
111🇵🇭 Philippines7.1
112🇭🇺 Hungary7.0
113🇺🇿 Uzbekistan7.0
114🇩🇪 Germany6.9
115🇲🇳 Mongolia6.9
116🇵🇱 Poland6.8
117🇰🇷 South Korea6.8
118🇳🇦 Namibia6.7
119🇹🇲 Turkmenistan6.7
120🇯🇵 Japan6.6
121🇰🇿 Kazakhstan6.6
122🇰🇬 Kyrgyzstan6.6
123🇹🇯 Tajikistan6.6
124🇧🇮 Burundi6.5
125🇪🇷 Eritrea6.5
126🇪🇪 Estonia6.5
127🇷🇴 Romania6.5
128🇷🇼 Rwanda6.5
129🇸🇴 Somalia6.5
130🇸🇸 South Sudan6.5
131🇦🇺 Australia6.4
132🇬🇷 Greece6.4
133🇮🇹 Italy6.4
134🇸🇻 El Salvador6.3
135🇮🇲 Isle of Man6.3
136🇬🇧 United Kingdom6.3
137🇱🇦 Laos6.2
138🇲🇨 Monaco6.2
139🇳🇿 New Zealand6.2
140🇫🇮 Finland6.1
141🇱🇮 Liechtenstein6.1
142🇲🇰 North Macedonia6.1
143🇻🇳 Vietnam6.1
144🇱🇻 Latvia5.9
145🇱🇺 Luxembourg5.9
146🇨🇫 Central African Republic5.8
147🇹🇩 Chad5.8
148🇨🇩 Democratic Republic of Congo5.8
149🇱🇹 Lithuania5.8
150🇸🇰 Slovakia5.8
151🇬🇪 Georgia5.7
152🇦🇲 Armenia5.6
153🇦🇿 Azerbaijan5.6
154🇧🇾 Belarus5.6
155🇲🇩 Moldova5.6
156🇷🇺 Russia5.6
157🇺🇦 Ukraine5.6
158🇧🇴 Bolivia5.5
159🇨🇲 Cameroon5.5
160🇨🇬 Congo5.5
161🇬🇶 Equatorial Guinea5.5
162🇬🇦 Gabon5.5
163🇮🇸 Iceland5.5
164🇸🇹 Sao Tome and Principe5.5
165🇦🇷 Argentina5.4
166🇾🇪 Yemen5.4
167🇩🇰 Denmark5.3
168🇫🇷 France5.3
169🇧🇼 Botswana5.3
170🇳🇪 Niger5.2
171🇭🇳 Honduras5.1
172🇪🇹 Ethiopia5.0
173🇸🇪 Sweden5.0
174🇭🇷 Croatia4.8
175🇵🇪 Peru4.8
176🇦🇴 Angola4.6
177🇦🇹 Austria4.6
178🇸🇿 Eswatini4.6
179🇱🇸 Lesotho4.6
180🇲🇬 Madagascar4.6
181🇨🇭 Switzerland4.6
182🇺🇬 Uganda4.6
183🇳🇱 Netherlands4.5
184🇪🇨 Ecuador4.4
185🇦🇼 Aruba4.3
186🇰🇪 Kenya4.0
187🇫🇴 Faroe Islands3.8
188🇧🇪 Belgium3.6
189🇳🇬 Nigeria3.6
190🇳🇴 Norway3.6
191🇬🇱 Greenland3.3
192🇲🇿 Mozambique3.3
193🇸🇳 Senegal3.1
194🇮🇪 Ireland3.0
195🇬🇭 Ghana2.6
196🇧🇫 Burkina Faso2.1
197🇨🇻 Cape Verde2.1
198🇨🇮 Cote d'Ivoire2.1
199🇬🇳 Guinea2.1
200🇬🇼 Guinea-Bissau2.1
201🇱🇷 Liberia2.1
202🇲🇱 Mali2.1
203🇲🇷 Mauritania2.1
204🇸🇱 Sierra Leone2.1
205🇹🇬 Togo2.1
206🇿🇼 Zimbabwe2.1
207🇬🇲 Gambia1.9
208🇧🇯 Benin1.1

The situation in Pakistan is currently not expected to improve in the near future. By 2045, the country is estimated to have 62 million people suffering from diabetes due to numerous reasons including malnutrition.

This chronic disease has also reached alarming levels in many Oceanic island countries and territories, including French Polynesia, New Caledonia, and American Samoa. Each has a diabetic prevalence above 20%, with reasons ranging from malnutrition to obesity.

Meanwhile, African nations like Benin and The Gambia recorded the lowest prevalence of diabetes in the world. In 2021, African countries had a combined total of 23.6 million adults with diabetes, less than 2% of the continent’s population. However, this number is predicted to double to 55 million by 2045.

Most Diabetic Countries in Absolute Terms

In China, diabetes was prevalent in 10.6% of the nation’s adult population in 2021. While this only puts the country in 60th place in terms of prevalence rate, this is equivalent to roughly 140 million adults with diabetes because of the country’s large population.

Similarly, India’s 9.6% prevalence of diabetes equaled 77 million adults suffering from the disease in the country, more than double the number of Pakistan’s diabetic citizens.

A similar story follows in the Americas, where Mexico has the highest adult prevalence of diabetes at 16.9% or 14.1 million people. Though the U.S. has a lower rate at 10.7%, its higher population gives it an estimated 32.2 million adults with diabetes.

Breaking down diabetes rates by country highlights that this a global health challenge. To address the growing burden of diabetes, we need to focus on prevention, early detection, and management of diabetes.

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