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Over the past century, the great pandemics and most epidemics (defined as virus presence and disease induction presenting more than the expected number of infections in a population) were caused by the sudden outbreak of an RNA virus such as the pandemics of influenza, polio, and HIV/AIDS and the epidemics of influenza, Ebola, Dengue, Zika, West Nile, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and Chikungunya Of course, there are other infections that remain endemic problems in parts of the world, which are caused by bacteria (like tuberculosis) or parasites (like malaria) As everyone knows, the newest and among the most severe pandemic coronavirus disease 2019 (COVID-19) is again caused by an RNA virus, first identified by Chinese medical scientists and shown to be both highly contagious and dangerous (1–4) Why its relatives, SARS and MERS, rather quickly declined and disappeared as a global threat, while COVID-19 became global and persisted unabetted is unknown What is clear are the following: 1) the Chinese scientific and public health groups such as China CDC were quick and effective for China (see references at the end for a few of the key early papers);2) the rapid publication (January 10, 2020) of the sequence of the genome of the virus enabled the world to rapidly design vaccine plans and more sophisticated diagnostics;3) their grasp of transmission by aerosols;4) asymptomatic persons could be infectious;and 5) their identification of numerous coronaviruses in bats as the key carriers benefited all As this virus spread globally, medical scientists were quick to see that it could induce a two-phase disease First is the establishment of infection and showing mild symptoms, but in many cases progressing to a severe inflammatory disease involving numerous organs but especially lung damage and sometimes leading to death Progress on developing safe, specific, and potent anti-viral drugs for the early first-stage disease has been slow and disappointing, whereas treatment of the inflammatory stage with dexamethasone has had some significant benefit, but this will soon greatly improve (see below)

The Great Coronavirus Pandemic of 2019−2021: the Future and the Requirement for China-America Cooperation