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Science |
| Origins |
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Evolutionary origins of the SARS-CoV-2 sarbecovirus lineage responsible for the COVID-19 pandemic Authors: Boni MF et al Publication date: 28 July 2020 Journal: Nature Microbiology DOI: 10.1038/s41564-020-0771-4 There are outstanding evolutionary questions on the recent emergence of human coronavirus SARS-CoV-2 including the role of reservoir species, the role of recombination and its time of divergence from animal viruses. We find that the sarbecoviruses—the viral subgenus containing SARS-CoV and SARS-CoV-2—undergo frequent recombination and exhibit spatially structured genetic diversity on a regional scale in China. SARS-CoV-2 itself is not a recombinant of any sarbecoviruses detected to date, and its receptor-binding motif, important for specificity to human ACE2 receptors, appears to be an ancestral trait shared with bat viruses and not one acquired recently via recombination. To employ phylogenetic dating methods, recombinant regions of a 68-genome sarbecovirus alignment were removed with three independent methods. Bayesian evolutionary rate and divergence date estimates were shown to be consistent for these three approaches and for two different prior specifications of evolutionary rates based on HCoV-OC43 and MERS-CoV. Divergence dates between SARS-CoV-2 and the bat sarbecovirus reservoir were estimated as 1948 (95% highest posterior density (HPD): 1879–1999), 1969 (95% HPD: 1930–2000) and 1982 (95% HPD: 1948–2009), indicating that the lineage giving rise to SARS-CoV-2 has been circulating unnoticed in bats for decades. |
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Transmission |
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Author: Ian D Swain Publication date: 27 July 2020 Journal: Journal of Medical Engineering & Technology DOI: 10.1080/03091902.2020.1797198 Since the start of the COVID-19 pandemic there has been much debate in the media on whether masks should be worn to stop the spread of the virus. There are two ways in which they could work. Firstly, to protect the person wearing the mask, and secondly, to reduce the likelihood of the person wearing the mask passing the disease on to anyone else. This is not an easy issue to address and many factors come into play such as droplet size, aerosol transmission and the viral load, as well as the specific properties of any given mask. The method used in this study was to measure the change in relative humidity when wearing a mask, compared to no mask, in various scenarios, based on the assumption that as the virus is air-borne the smaller the increase in humidity the less the spread of the virus. The results above show that the use of a mask, excluding some simple home-made ones, significantly reduces the spread of humidity. However, their effectiveness is device specific and needs to be considered in greater detail for each type of mask, especially the direction of escaping air when forward flow is blocked. Authors: Xiaowen Wang, Enrico G Ferro and Guohai Zhou Publication date: 14 July 2020 Journal: JAMA DOI: 10.1001/jama.2020.12897 The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has severely affected health care workers (HCWs).1 As a result, hospital systems began testing HCWs2 and implementing infection control measures to mitigate workforce depletion and prevent disease spread.3 Mass General Brigham (MGB) is the largest health care system in Massachusetts, with 12 hospitals and more than 75 000 employees. In March 2020, MGB implemented a multipronged infection reduction strategy involving systematic testing of symptomatic HCWs and universal masking of all HCWs and patients with surgical masks.4 This study assessed the association of hospital masking policies with the SARS-CoV-2 infection rate among HCWs. Face coverings and mask to minimise droplet dispersion and aerosolisation: a video case study Authors: Bahl P et al Publication date: 09 July 2020 Journal: Thorax DOI: 10.1136/thoraxjnl-2020-215748 To evaluate the effectiveness of the Centers for Disease Control and Prevention (CDC) recom- mended one- and two-layer cloth face covering against a three-ply surgical mask, we challenged the cloth covering against speaking, coughing and sneezing. The one-layer covering was made using ‘quick cut T-shirt face covering (no-sew method)’ and the two-layer covering was prepared using the sew method prescribed by CDC.1 To provide visual evidence of the efficacy of face coverings we used a tailored LED lighting system (GS Vitec MultiLED PT) along with a high-speed camera (nac MEMRECAM HX-7s) to capture the light scattered by droplets and aerosols expelled during speaking, coughing and sneezing while wearing different types of masks (figure 1 and online supplementary video). The video for speaking was captured at 850 frames/s (fps) and for coughing and sneezing a frame rate of 1000 fps was used due to the higher expulsion speeds. |
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Covid-19 patients |
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UK report on 10,557 patients critically ill with COVID-19 Institution: Intensive Care National Audit & Research Centre (ICNARC) Publication date: 24 July 2020 Read more... The Contribution of the Age Distribution of Cases to COVID-19 Case Fatality Across Countries Authors: Sudharsanan N et al Publication date: 22 July 2020 Journal: Annals of Internal Medicine DOI: 10.7326/M20-2973 Selective testing and identifying of older cases considerably warps estimates of the lethality of COVID-19 within populations and comparisons across countries. Removing age distortions and focusing on differences in age-adjusted case fatality will be essential for accurately comparing countries' performance in caring for patients with COVID-19 and for monitoring the epidemic over time. Unexpected Features of Cardiac Pathology in COVID-19 Infection Authors: Fox SE et al Publication date: 21 July 2020 Journal: Circulation DOI: 10.1161/CIRCULATIONAHA.120.049465 This Research Letter expands our previous report of 10 hearts [1] by adding an additional 12 hearts (for a total of 22 hearts) from deaths confirmed due to COVID-19 infection. We identify key gross and microscopic changes that challenge the notion that typical myocarditis is present in severe SARS-CoV-2 infection. We speculate on alternative mechanisms for cardiac injury that should be investigated to provide a better understanding of the cardiac manifestations of COVID-19. In each case, consent for autopsy was granted by the next of kin. These studies were determined exempt by the IRB at LSU Health Sciences Center and Tulane University. Representative sections of the left and right ventricles were submitted for routine histology. All sections were stained with hematoxylin and eosin (H&E) and examined by an experienced cardiovascular pathologist. A subset of the sections were selected for additional immunostaining for lymphocytes, endothelial cells and DNA/RNA using CD4, CD8, and CD31 antibodies and DRAQ5 (Bio status)/StrandBrite Green (ATT Bioquest) labeling, respectively. |
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Mitigation strategies |
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Authors: Chaudry R et al Publication date: 21 July 2020 Journal: EClinicalMedicine DOI: 10.1016/j.eclinm.2020.100464 Background: A country level exploratory analysis was conducted to assess the impact of timing and type of national health policy/actions undertaken towards COVID-19 mortality and related health outcomes. Methods: Information on COVID-19 policies and health outcomes were extracted from websites and country specific sources. Data collection included the government's action, level of national preparedness, and country specific socioeconomic factors. Data was collected from the top 50 countries ranked by number of cases. Multivariable negative binomial regression was used to identify factors associated with COVID-19 mortality and related health outcomes. Findings: Increasing COVID-19 caseloads were associated with countries with higher obesity (adjusted rate ratio [RR]=1.06; 95%CI: 1.01–1.11), median population age (RR=1.10; 95%CI: 1.05–1.15) and longer time to border closures from the first reported case (RR=1.04; 95%CI: 1.01–1.08). Increased mortality per million was significantly associated with higher obesity prevalence (RR=1.12; 95%CI: 1.06–1.19) and per capita gross domestic product (GDP) (RR=1.03; 95%CI: 1.00–1.06). Reduced income dispersion reduced mortality (RR=0.88; 95%CI: 0.83–0.93) and the number of critical cases (RR=0.92; 95% CI: 0.87–0.97). Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people. However, full lockdowns (RR=2.47: 95%CI: 1.08–5.64) and reduced country vulnerability to biological threats (i.e. high scores on the global health security scale for risk environment) (RR=1.55; 95%CI: 1.13–2.12) were significantly associated with increased patient recovery rates. Interpretation: In this exploratory analysis, low levels of national preparedness, scale of testing and population characteristics were associated with increased national case load and overall mortality. |
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Therapeutics |
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Authors: Adusumilli NC et al Publication date: 15 July 2020 Journal: Nitric Oxide DOI: 10.1016/j.niox.2020.07.003 The ongoing outbreak of COVID-19 has quickly become a daunting challenge to global health. In the absence of targeted therapy and a reported 5.5% case fatality rate in the United States, treatments preventing rapid cardiopulmonary failure are urgently needed. Clinical features, pathology and homology to better understood pathogens suggest that uncontrolled inflammation and a cytokine storm likely drive COVID-19's unrelenting disease process. Interventions that are protective against acute lung injury and ARDS can play a critical role for patients and health systems during this pandemic. Nitric oxide is an antimicrobial and anti-inflammatory molecule with key roles in pulmonary vascular function in the context of viral infections and other pulmonary disease states. This article reviews the rationale for exogenous nitric oxide use for the pathogenesis of COVID-19 and highlights its potential for contributing to better clinical outcomes and alleviating the rapidly rising strain on healthcare capacity. |
| Micronutrients |
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Micronutrients as immunomodulatory tools for COVID-19 management Authors: Gasmi A et al Publication date: 22 July 2020 Journal: Clinical Immunology DOI: 10.1016/j.clim.2020.108545 COVID-19 rapidly turned to a global pandemic posing lethal threats to overwhelming health care capabilities, despite its relatively low mortality rate. The clinical respiratory symptoms include dry cough, fever, anosmia, breathing difficulties, and subsequent respiratory failure. No known cure is available for COVID-19. Apart from the anti-viral strategy, the supports of immune effectors and modulation of immunosuppressive mechanisms is the rationale immunomodulation approach in COVID-19 management. Diet and nutrition are essential for healthy immunity. However, a group of micronutrients plays a dominant role in immunomodulation. The deficiency of most nutrients increases the individual susceptibility to virus infection with a tendency for severe clinical presentation. Despite a shred of evidence, the supplementation of a single nutrient is not promising in the general population. Individuals at high-risk for specific nutrient deficiencies likely benefit from supplementation. The individual dietary and nutritional status assessments are critical for determining the comprehensive actions in COVID-19. |
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Immunity |
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Seroprevalence of Antibodies to SARS-CoV-2 in 10 Sites in the United States, March 23-May 12, 2020 Authors: Havers FP et al Publication date: 21 July 2020 Journal: JAMA Internal Medicine DOI: 10.1001/jamainternmed.2020.4130 Question: What proportion of persons in 10 US sites had detectable antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from March 23 to May 12, 2020? Findings: In this cross-sectional study of 16 025 residual clinical specimens, estimates of the proportion of persons with detectable SARS-CoV-2 antibodies ranged from 1.0% in the San Francisco Bay area (collected April 23-27) to 6.9% of persons in New York City (collected March 23-April 1). Six to 24 times more infections were estimated per site with seroprevalence than with coronavirus disease 2019 (COVID-19) case report data. Meaning: For most sites, it is likely that greater than 10 times more SARS-CoV-2 infections occurred than the number of reported COVID-19 cases; most persons in each site, however, likely had no detectable SARS-CoV-2 antibodies. |
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Vaccines |
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Covid-19 Vaccines: Injury compensation issues Author: Christopher Hodges Publication date: 10 July 2020 Journal: SSRN DOI: 10.2139/ssrn.3647042 This analysis summarises the particular injury compensation arrangements that are needed to support adequate take-up of vaccines for COVID-19 and the compensation of those who are unlucky enough to suffer harm arising out of their use. It indicates the inadequacies of the standard liability rules and arrangements, and the advantages of compensation schemes. It notes the widespread use of vaccine compensation schemes but also differences in their design and evolution, before summarising the state of the art on the design of such a scheme for Europeans and on how it may be funded. Read more... |
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Social Impact |
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Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey Authors: Patrick SW et al Publication date: 01 July 2020 Journal: Pediatrics DOI: 10.1542/peds.2020-016824 Results: Since March 2020, 27% of parents reported worsening mental health for themselves, and 14% reported worsening behavioral health for their children. The proportion of families with moderate or severe food insecurity increased from 6% before March 2020 to 8% after, employer- sponsored insurance coverage of children decreased from 63% to 60%, and 24% of parents reported a loss of regular childcare. Worsening mental health for parents occurred alongside worsening behavioral health for children in nearly 1 in 10 families, among whom 48% reported loss of regular childcare, 16% reported change in insurance status, and 11% reported worsening food security. Conclusions: The COVID-19 pandemic has had a substantial tandem impact on parents and children in the US. As policymakers consider additional measures to mitigate the health and economic effects of the pandemic, they should consider the unique needs of families with children. |
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Government/Health authorities |
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Covid-19 patients Duration of Isolation and Precautions for Adults with COVID-19 Publication date: 22 July 2020 Source: Centers for Disease Control and prevention Accumulating evidence supports ending isolation and precautions for persons with COVID-19 using a symptom-based strategy. This update incorporates recent evidence to inform the duration of isolation and precautions recommended to prevent transmission of SARS-CoV-2 to others, while limiting unnecessary prolonged isolation and unnecessary use of laboratory testing resources. Authors: Razzaghi H PhD et al Publication date: 24 July 2020 Source: Centers for Disease Control and Prevention MMWR weekly report DOI: 10.15585/mmwr.mm6929a1 What is already known about this topic? Older adults and those with chronic obstructive pulmonary disease, heart disease, diabetes, chronic kidney disease, and obesity are at higher risk for severe COVID-19–associated illness. What is added by this report? The median model-based estimate of the prevalence of any of five underlying medical conditions associated with increased risk for severe COVID-19–associated illness among U.S. adults was 47.2% among 3,142 U.S. counties. The estimated number of persons with these conditions followed population distributions, but prevalence was higher in more rural counties. What are the implications for public health practice? The findings can help local decision-makers identify areas at higher risk for severe COVID-19 illness in their jurisdictions and guide resource allocation and implementation of community mitigation strategies. |
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Vaccines |
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Over £100 million cash boost to manufacture millions of doses of COVID-19 vaccine Publication date: 23 July 2020 Source: UK Government New state-of-the-art centre to scale up COVID-19 vaccine and gene therapy manufacturing gets £100 million investment additional £4.7 million for new training facilities and an online learning platform to boost vaccine and cell and gene therapy skills new centre and skills vital for the UK’s ability respond to diseases like coronavirus, and potential future pandemics The UK’s capability to manufacture vaccines has received a substantial boost today (Thursday 23 July), as the government announces an additional £100 million to ensure that any successful COVID-19 vaccine can be produced at scale in the UK. The investment will fund a state-of-the-art Cell and Gene Therapy Catapult Manufacturing Innovation Centre to accelerate the mass production of a successful COVID-19 vaccine in the UK. Due to open in December 2021, the Centre will have the capacity to produce millions of doses each month, ensuring the UK has the capabilities to manufacture vaccines and advanced medicines, including for emerging diseases, far into the future. |
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Environment |
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Global quieting of high-frequency seismic noise due to COVID-19 pandemic lockdown measures Authors: Lecocq T et al Publication date: 23 July 2020 Journal: Science DOI: 10.1126/science.abd2438 Human activity causes vibrations that propagate into the ground as high-frequency seismic waves. Measures to mitigate the COVID-19 pandemic caused widespread changes in human activity, leading to a months-long reduction in seismic noise of up to 50%. The 2020 seismic noise quiet period is the longest and most prominent global anthropogenic seismic noise reduction on record. While the reduction is strongest at surface seismometers in populated areas, this seismic quiescence extends for many kilometers radially and hundreds of meters in depth. This provides an opportunity to detect subtle signals from subsurface seismic sources that would have been concealed in noisier times and to benchmark sources of anthropogenic noise. A strong correlation between seismic noise and independent measurements of human mobility suggests that seismology provides an absolute, real-time estimate of population dynamics. |
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Media – Science related |
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Origins |
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Trump ‘owes us an apology.’ Chinese scientist at the center of COVID-19 origin theories speaks out Author: Jon Cohen Publication date: 24 July 2020 Source: Science The coronavirus pandemic has thrust virologist Shi Zhengli into a fierce spotlight. Shi, who’s been nicknamed “Bat Woman,” heads a group that studies bat coronaviruses at the Wuhan Institute of Virology (WIV), in the city in China where the pandemic began, and many have speculated that the virus that causes COVID-19 accidentally escaped from her lab—a theory promoted by U.S. President Donald Trump. Some have even suggested it could have been engineered there. China has forcefully rejected such claims, but Shi (pronounced SHIH) herself has said very little publicly. Now, Shi has broken her silence about the details of her work. On 15 July, she emailed Science answers to a series of written questions about the virus’ origin and the research at her institute. In them, Shi hit back at speculation that the virus leaked from WIV. She and her colleagues discovered the virus in late 2019, she says, in samples from patients who had a pneumonia of unknown origin. “Before that, we had never been in contact with or studied this virus, nor did we know of its existence,” Shi wrote. |
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Pandemic science |
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Big Data and Collaboration Seek to Fight COVID-19 Author: Emma Yasinski Publication date: 21 July 2020 Source: The Scientist Although cough and fever have been considered the most tell-tale signs of COVID-19, in May, researchers published a study suggesting that loss of smell and taste were better able to predict who would test positive for the disease. The insight came from data shared by millions of individuals who logged on to a phone app to report what, if any, symptoms they were experiencing on a given day. The Covid Symptom Tracker app now has nearly 4 million users. Researchers are extracting the massive amounts of data they gather to anticipate COVID-19 outbreaks in particular communities and to explore different risk factors for the disease. “We were one of the earliest bodies to actually identify the importance of a loss of taste or smell as a predictor,” says Andrew Chan, a physician and epidemiologist at Massachusetts General Hospital and the lead researcher on the project. “We developed the Covid Symptom study app as a means of rapidly collecting data on a large population of individuals, to gather real-time information about COVID in the setting of a rapidly unfolding pandemic.” The app has helped scientists understand the risks healthcare workers face as well as the effects of some underlying factors such as obesity and diabetes. The data aren’t readily available to any researcher, but the team has developed a number of partnerships with those conducting clinical trials and longitudinal research, and is “interested in partnering with investigators who are taking a different approach to COVID,” says Chan. |
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Transmission |
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When It Comes to Masks, There Is No "Settled Science" Author: Chris Calton Publication date: 28 July 2020 Source: Mises Wire As the “fifteen days to slow the spread” continues to extend indefinitely, the issue of mask mandates has become increasingly contentious. The debate has been exacerbated by the inconsistency of the recommendations of authorities (political, scientific, and imaginary). Early in the pandemic, both the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) advised against the use of masks, except by those who are particularly vulnerable (the elderly and immunocompromised) and their caretakers. Many of us with some understanding of economics made such arguments at the outset of the debate, not necessarily because of any epidemiological expertise. When you understand the principle of scarcity, policies mandating that healthy teenagers vie for medical products with their more vulnerable grandparents is a formula for exacerbating the most severe outcome of any viral infection. In fairness, many medical experts raised exactly these concerns, even if they did not enjoy the media attention of their more demagogic counterparts. Making sense of the research on COVID-19 and masks Authors: Benjamin W Abbott, Mitchell Greenhalgh, S Isaac St Clair and Jonas Bush Publication date: 19 July 2020 Source: Brigham Young University In the first few months of the pandemic, there was scientific uncertainty about the usefulness of public masking. Conflicting guidance was given by several official sources1–3. There is now convincing evidence from multiple controlled experiments4–6 and field observations7–11 that wearing masks reduces the transmission of COVID-19 for healthcare workers and the public. Most of this evidence is COVID-19 specific and has emerged in the past few months1,7. Masks prevent infected people from spreading the virus to others by trapping the respiratory droplets (tiny moisture particles) that are produced when we cough, speak, and breathe10,12,13. Cloth masks can stop 90% or more of the dispersal of droplets carrying the virus12,14. There is some evidence that cloth masks also protect the wearer from infection7,8, though this is less certain. Masks are highly safe, with only minor and uncommon side effects1,15,16. In addition to many medical studies, public masking has been proven safe among children, adults, and the elderly in cultures where this practice has long been common10,17. However, some sensitive individuals should not wear masks, such as those with severely compromised respiratory systems18 and individuals who cannot remove or adjust their own masks (children under 2 and people with severe disabilities)13. Researchers from hospitals, universities, the private sector, and government agencies have concluded that masks could be one of the most powerful and cost-effective tools to stop COVID-19 and accelerate the economic recovery1,4,5,9,10,17. There is universal agreement, however, that masking alone will not be enough to stop the pandemic. Masking is most effective when combined with physical distancing, frequent handwashing, rapid testing, and coordinated contact tracing. |
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Mortality |
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If COVID Fatalities Were 90.2% Lower, How Would You Feel About Schools Reopening? Authors: Ealy H et al Publication date: 24 July 2020 Source: Children’s Health Defense The CDC has instructed hospitals, medical examiners, coroners and physicians to collect and report COVID-19 data by significantly different standards than all other infectious diseases and causes of death. These new and unnecessary guidelines were instituted by the CDC in private, and without open discussion among qualified professionals that are free from conflicts of interest. These new and unnecessary guidelines were additionally instituted despite the existence of effective rules for data collection and reporting, successfully used by all hospitals, medical examiners, coroners, and physicians for more than 17 years. As a result, elected officials have enacted many questionable policies that have injured our country’s economy, our country’s educational system, our country’s mental and emotional health, and the American citizen’s personal expression of Constitutionally-protected rights to participate in our own governance. This paper will present significant evidence to support the position that if the CDC simply employed their 2003 industry standard for data collection and reporting, which has been successfully used nationwide for 17 years; the total fatalities attributed to COVID-19 would be reduced by an estimated 90.2%, and questions would be non-existent regarding schools reopening and whether or not Americans should be allowed to work. |
| Therapeutics |
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The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion Author: Harvey A Risch, MD, PhD, Professor of Epidemiology, Yale School of Public Health Publication date: 23 July 2020 Source: Newsweek As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly. I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc. On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, "Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis." That article, published in the world's leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety. |
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Vaccines |
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Imperial COVID-19 vaccine trial expands to additional sites Author: Kate Wighton Publication date: 24 July 2020 Source: Imperial College London Imperial College London's COVID-19 vaccine trial is expanding to additional sites throughout England. From next week, the ground-breaking vaccine, which has received more than £40m in Government funding in addition to £5m in philanthropic donations, will be trialled in six additional centres. Preclinical studies have shown that the vaccine produced highly specific antibodies against SARS-CoV-2 in mice, which were able to neutralise the virus. The vaccine will be trialled in more than 200 people across six locations: Chelsea and Westminster Hospital NHS Foundation Trust, Imperial College Healthcare NHS Trust, St George’s University Hospital NHS Foundation Trust, University College London NHS Foundation Trust, University of Surrey and University Hospital Southampton NHS Foundation Trust. Researchers investigate flu jab uptake to learn lessons for COVID-19 vaccine Publication date: 24 July 2020 Source: Medical Xpress Researchers at the University of East Anglia (UEA) are investigating uptake of the flu vaccine among care home staff in a bid to see if lessons can be learned to encourage people to have a COVID-19 immunisation. This winter could see flu season coincide with a second wave of COVID-19, so ensuring high flu vaccine uptake will be critical to reduce pressure on the NHS and other services. The global pandemic has highlighted how vulnerable care homes are to infection. Despite this, there is very little data on flu vaccination rates for care home and other social care setting staff. A survey previously conducted by Public Health England found it was at best 20 percent, and there has been little evidence of improvement. Vaccines stop diseases safely — why all the suspicion? Author: Joan Donovan Publication date: 22 July 2020 Source: Nature At rallies this year to demand the end of lockdowns in the United States, placards reading “Facts over Fear” and “I need a haircut” jostled with the alarmingly ubiquitous “Vaccines cause injury and death”. It was a manifestation of one of the increasingly pressing challenges of the COVID-19 pandemic: digitally enabled protest, mobilized around misinformation. How should public-health leaders respond? That is the question tackled by Stuck, written before the pandemic, when vaccines seemed to be more fought than sought in wealthy Western nations. In it, anthropologist Heidi Larson, director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, surveys the factors — social, psychological, political, historical and cultural — that influence attitudes to vaccines, mainly in high-income countries. |
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Media – Reporting |
| Pandemic |
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Sweden’s Actual COVID-19 Results Compared to What Modelers Predicted in April Author: Jon Miltimore Publication date: 29 July 2020 Source: Foundation for Economic Education At a press conference last week, Anders Tegnell said a massive decline in new COVID-19 cases shows Sweden’s “lighter touch” strategy is doing what it was designed to do. “It really is yet another sign that the Swedish strategy is working,” Tegnell, Sweden’s top epidemiologist, said. “It is possible to slow contagion fast with the measures we are taking in Sweden.” Unlike most nations in the world, Sweden avoided a hard lockdown. The nation of 10 million people instead opted for a strategy that sought to encourage social distancing through public information, cooperation, and individual responsibility. Restaurants, bars, public pools, libraries, and most schools remained open with certain capacity limits. Sweden’s decision to forego lockdowns brought a barrage of scrutiny and criticism. Its approach was described as a “cautionary tale” by The New York Times. But as I’ve pointed out, the criticism stemmed less from the results of Sweden’s experiment than the nature of the experiment. There are ample examples of nations (and US states) that have suffered far more from COVID-19 than Sweden even though these countries (and states) initiated hard lockdowns requiring citizens to shelter at home. Perhaps the best way to measure the success of Sweden’s policies is to compare the outcome models predicted to the actual results. Sweden Unveils ‘Promising’ Covid-19 Data as New Cases Plunge Author: Charles Daly Publication date: 28 July 2020 Source: Bloomberg As other countries face renewed outbreaks, Sweden’s latest Covid-19 figures suggest it’s rapidly bringing the virus under control. “That Sweden has come down to these levels is very promising,” state epidemiologist Anders Tegnell told reporters in Stockholm on Tuesday. The Health Agency of Sweden says that since hitting a peak in late June, the infection rate has fallen sharply. That’s amid an increase in testing over the period. “The curves are going down and the curves for the seriously ill are beginning to approach zero,” Tegnell said. Read more… |
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Transmission |
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Panic over rising Covid-19 case numbers is as irrational as it is dangerous Author: Ross Clark Publication date: 28 July 2020 Source: The Telegraph Why is anyone interested in the number of recorded cases of Covid 19? It might sound a daft question, given that we are in the middle of a pandemic, but it ought to be clear to anyone who spends a few minutes digging around the figures that it is a meaningless statistic. Count deaths, by all means, hospital admissions, ICU admissions – but as for the official figures of how many people have tested positive for the disease, it is pointless worrying about them. Why? First, because we are only – and only ever have been – detecting a small fraction of total cases of infection with SARS-CoV-2, the virus which causes Covid 19. Take the UK. Officially, as of Monday evening, there have been 300,111 recorded cases of Covid 19. Yet serological tests by Public Health England suggest that 6.5 per cent of the population of England have antibodies suggesting they have at some point been infected with the virus – which works out at 4.2 million. In other words, the official count has only managed to capture one in 14 cases of the disease. Why so few? Because in the vast majority of cases – between 70 and 80 per cent according to some estimates – Covid 19 causes no symptoms whatsoever. Those infected have no reason to assume they are infected, no need to seek medical attention and no reason to seek being tested. Face Masks Really Do Matter. The Scientific Evidence Is Growing Author: Caitlin McCabe Publication date: 27 July 2020 Source: The Wall Street Journal Face masks are emerging as one of the most powerful weapons to fight the new coronavirus, with growing evidence that facial coverings help prevent transmission—even if an infected wearer is in close contact with others. Robert Redfield, director of the Centers for Disease Control and Prevention, said he believes the pandemic could be brought under control over the next four to eight weeks if “we could get everybody to wear a mask right now.” His comments, made in mid-July with the Journal of the American Medical Association, followed an editorial he and others wrote there emphasizing “ample evidence” of asymptomatic spread and highlighting new studies showing how masks help reduce transmission. The research Dr. Redfield cited included a newly published study suggesting that universal use of surgical masks helped reduce rates of confirmed coronavirus infections among health-care workers at the Mass General Brigham health-care system in Massachusetts. Authors: Mark Duell, Vivek Chaudhary & Danyal Hussain Publication date: 24 July 2020 Source: Daily Mail Brawls broke out in supermarket aisles across England today as shoppers confronted other customers for not wearing masks, while staff at a McDonald's kicked out diners for not covering their faces. Senior police figures urged retailers to enforce the new laws forcing customers to wear face masks in all shops, stations, banks and post offices, but there was confusion across the country with different businesses having different policies on coverings. Sainsbury's, Asda, Co-Op and Costa Coffee are among the firms saying they would not police the coronavirus rules, which also require people to cover their faces in all transport hubs, shopping centres and petrol stations. |
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Mortality |
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COVID-19 deaths in England and Wales: resolving discrepancies in deaths outside of hospital Authors: Daniel Howdon and Carl Heneghan Publication date: 28 July 2020 Source: The Centre for Evidence-Based Medicine We note two potentially important issues about data collected in England and Wales. Both of these suggest potential areas of concern in non-hospital settings. First, many more individuals, compared to a baseline of the weekly five-year average, appear to be dying at home. Second, a large discrepancy is apparent in COVID-19 deaths according to whether these are measured using a death certificate-based method or a positive test-based method. Explaining these issues has implications for public policy regarding COVID-19 mitigation and public health more broadly. Data sources The Office for National Statistics (ONS) publish data on all deaths registered in England and Wales on a weekly basis. This dataset comprises a count of death certificate mentions of COVID-19, irrespective of whether it is considered to be an underlying or contributory cause of death. Such data can be termed “death certificate-based”. All other data regarding COVID-19 related deaths published in England and Wales rely on whether an individual has had a positive test for the disease. Such data can be termed “positive test-based”. |
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Return to school |
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Colleges Plan for Virus Testing, But Strategies Vary Widely Author: Collin Binkley Publication date: 27 July 2020 Source: APNews For students heading to Colby College in Maine this fall, coronavirus testing is expected to be a routine part of campus life. All students will be required to provide a nasal swab every other day for two weeks, and then twice a week after that. All told, the college says it will provide 85,000 tests, nearly as many as the entire state of Maine has since the pandemic started. Colby, a private school of 2,000 students, joins a growing number of colleges announcing aggressive testing plans to catch and isolate COVID-19 cases before they spread. Harvard University says all students living on campus will be tested when they arrive and then three times a week. Boston University plans to test most students at least once a week. But whether colleges should be testing every student — and whether there's capacity for it — is a subject of debate. Some colleges plan to test students only if they show symptoms or come into close contact with someone who has tested positive. But some researchers say that approach could quickly cause outbreaks caused by students who don't show symptoms. Teachers' unions call for compulsory face masks for schoolchildren Authors: Amy Jones and Sam Meadows Publication date: 26 July 2020 Source: The Telegraph A fresh row broke out over face masks on Sunday night as teaching unions urged ministers to consider making them mandatory for children in all secondary schools. It came as at least 10 schools decided to break with official Government guidance in order to make face coverings compulsory or "strongly encouraged" when pupils return in September. Unions said recent announcements requiring the wearing of masks on public transport and in shops had "highlighted the need for similar protections to be in place in schools and colleges". Patrick Roach, the general secretary of the NASUWT teachers' union, said: "The Government's guidance for schools is now out of step with wider public health guidance and guidance to other employers where it is recognised that, where physical distancing cannot be assured, face masks should be worn. "Teachers and other staff working in schools also want to be assured that, when they return to the workplace in September, they will be afforded the same level of protection as other workers, and that the guidance for schools will be brought into line with guidance for other workplaces." |
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Vaccines |
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Covid-19 vaccines may cause mild side effects, experts say, stressing need for education, not alarm Author: Helen Branswell Publication date: 27 July 2020 Source: STAT While the world awaits the results of large clinical trials of Covid-19 vaccines, experts say the data so far suggest one important possibility: The vaccines may carry a bit of a kick. In vaccine parlance, they appear to be “reactogenic,” meaning they have induced short-term discomfort in a percentage of the people who have received them in clinical trials. This kind of discomfort includes headache, sore arms, fatigue, chills, and fever. As long as the side effects of eventual Covid-19 vaccines are transient and not severe, these would not be sources of alarm — in fact, they may be signals of an immune system lurching into gear. It’s a simple fact that some vaccines are more unpleasant to take than others. Think about the pain of a tetanus shot, for instance. Author: Alan McGuinness Publication date: 24 July 2020 Source: Sky News The prime minister has described opponents of vaccines as "nuts", encouraging people to get the jab to help "protect the NHS". "There's all these anti-vaxxers now. They are nuts, they are nuts," Boris Johnson told nurses at a GP surgery in London. The PM was speaking as the government announced an expansion of its winter flu vaccination programme, intending to double the number of people who have the jab. Pharma promises lawmakers, again and again, industry won’t cut corners with Covid-19 vaccines Author: Damian Garde Publication date: 21 July 2020 Source: STAT The pharmaceutical industry does not want you to worry about the safety or efficacy of a future Covid-19 vaccine. Officials from five major vaccine makers — AstraZeneca, Johnson & Johnson, Merck, Moderna, and Pfizer — all used their testimony before a House investigative subcommittee on Tuesday to push back on concerns that the Food and Drug Administration might prematurely approve a vaccine for the novel coronavirus and thereby put Americans at risk. “The American public should take great confidence in the FDA’s guidance, which clearly lays out guidance for effectiveness and, importantly, for safety,” said John Young, Pfizer’s chief business officer. The company’s speed is due to taking an uncommon financial risk, not cutting corners in the normal process of developing a vaccine, Young said, a statement echoed by the other four executives. |
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Social Impacts |
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People with treatable cancers will die due to Government scaremongering, warns NHS nurse Author: Jessica Carpani Publication date: 23 July 2020 Source: The Telegraph People with treatable cancers are going to die because hospitals have been laid empty due to Government scaremongering, an NHS nurse has warned. An NHS nurse called Holly* has said that throughout the lockdown period “hospitals were empty” beyond the ICU units and Covid wards and that people have died as a result. Speaking to Telegraph columnist Allison Pearson on the Planet Normal podcast, which you can listen to on the audio player above, the experienced district nurse, said: “We’ve been saying for months now that services just aren’t running at anywhere near normal capacity and we’re building up more problems than Covid has caused by a mile. “We have a lot of deaths in my area but we’re going to have an awful lot more from cancers that are going undiagnosed and strokes that haven’t been treated. “It cuts both ways. We have hospitals that didn’t want to have patients come in and we have patients who don’t want to come in to hospital because of I think what’s been an awful lot of scaremongering from the Government, unfortunately. Holly* added that there was “no reason” why routine treatments including cancer screenings could not have been done throughout lockdown. Read more… Young Australians told to be resilient as COVID-19 wipes out jobs and housing hopes Author: Michael Tanner Publication date: 23 July 2020 Source: Michael West Media Australia’s youth have been hit hardest by the unemployment crisis and are bankrolling the financial advantages enjoyed by older generations yet are told the pandemic is a good opportunity to grow and develop coping mechanisms. Michael Tanner reports on a new form of victim blaming. The mental health of young people – already teetering on the precipice of a health crisis – has surely been pushed over the brink with the onset of the COVID-19 pandemic. A recent Swinburne University survey found that in June more than 40% of 18 to 24-year-olds surveyed thought at least once in the past month that they would be better off dead, or wished they were dead. Almost half. Those in older age groups have also shown increases in depression, anxiety and stress, but not the catastrophic increases of rates in younger people. The Grattan Institute has estimated those aged 15 to 24 will be the hardest hit by the unemployment crisis: in the past four months 11.8% of the jobs worked by those under 30 have disappeared. Coronavirus: Domestic abuse helpline sees lockdown surge Authors: June Kelly and Sally Graham Publication date: 23 July 2020 Source: BBC News More than 40,000 calls and contacts were made to the National Domestic Abuse Helpline during the first three months of lockdown, most by women seeking help, new figures show. In June, calls and contacts were nearly 80% higher than usual, says the charity Refuge, which runs the helpline. And as restrictions ease, there is a surge in women seeking refuge places to escape their abusers, the charity says. The government says it prioritised help for domestic-abuse victims in lockdown. 'Vile crime' In a statement, the Home Office said it had recognised early on the risks of a nationwide lockdown for victims of domestic abuse and focused on ensuring vital support services remained available. "From our ground-breaking legislation in the Domestic Abuse Bill, to additional financial support and regular engagement with charities throughout the coronavirus pandemic, the government remains resolute in combating this vile crime," said the Minister for Safeguarding, Victoria Atkins. |
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