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Science |
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Origins |
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Evolutionary origins of the SARS-CoV-2 sarbecovirus lineage responsible for the COVID-19 pandemic Authors: Boni MF 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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Pandemic |
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Author: Thomas Wieland Publication date: 09 July 2020 Journal: medRxiv preprint DOI: 10.1101/2020.07.05.20146837 Aims: Nonpharmaceutical interventions against the spread of SARS-CoV-2 in Germany included the cancellation of mass events (from March 8), closures of schools and child day care facilities (from March 16) as well as a “lockdown” (from March 23). This study attempts to assess the effectiveness of these interventions in terms of revealing their impact on infections over time. Methods: Dates of infections were estimated from official German case data by incorporating the incubation period and an empirical reporting delay. Exponential growth models for infections and reproduction numbers were estimated and investigated with respect to change points in the time series. Results: A significant decline of daily and cumulative infections as well as reproduction numbers is found at March 8 (CI [7, 9]), March 10 (CI [9, 11] and March 3 (CI [2, 4]), respectively. Further declines and stabilizations are found in the end of March. There is also a change point in new infections at April 19 (CI [18, 20]), but daily infections still show a negative growth. From March 19 (CI [18, 20]), the reproduction numbers fluctuate on a level below one. Conclusions: The decline of infections in early March 2020 can be attributed to relatively small interventions and voluntary behavioural changes. Additional effects of later interventions cannot be detected clearly. Liberalizations of measures did not induce a re-increase of infections. Thus, the effectiveness of most German interventions remains questionable. Moreover, assessing of interventions is impeded by the estimation of true infection dates and the influence of test volume. Read more... |
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Transmission |
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Household transmission of SARS-CoV-2: a systematic review and meta-analysis of secondary attack rate Authors: Madewell ZJ et al Publication date: 01 August 2020 Journal: medRxiv preprint DOI: 10.1101/2020.07.29.20164590 Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spread by direct, indirect, or close contact with infected people via infected respiratory droplets or saliva. Crowded indoor environments with sustained close contact and conversations are a particularly high-risk setting. Methods: We performed a meta-analysis through July 29, 2020 of SARS-CoV-2 household secondary attack rate (SAR), disaggregating by several covariates (contact type, symptom status, adult/child contacts, contact sex, relationship to index case, index case sex, number of contacts in household, coronavirus). Findings: We identified 40 relevant published studies that report household secondary transmission. The estimated overall household SAR was 18.8% (95% confidence interval [CI]: 15.4%-22.2%), which is higher than previously observed SARs for SARS-CoV and MERS-CoV. We observed that household SARs were significantly higher from symptomatic index cases than asymptomatic index cases, to adult contacts than children contacts, to spouses than other family contacts, and in households with one contact than households with three or more contacts. Interpretation: To prevent the spread of SARS-CoV-2, people are being asked to stay at home worldwide. With suspected or confirmed infections referred to isolate at home, household transmission will continue to be a significant source of transmission. Authors: Heald-Sargent T et al Publication date: 30 July 2020 Journal: JAMA Pediatrics DOI: 10.1001/jamapediatrics.2020.3651 Children are susceptible to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but generally present with mild symptoms compared with adults. Children drive spread of respiratory and gastrointestinal illnesses in the population, but data on children as sources of SARS-CoV-2 spread are sparse. Early reports did not find strong evidence of children as major contributors to SARS-CoV-2 spread, but school closures early in pandemic responses thwarted larger-scale investigations of schools as a source of community transmission. As public health systems look to reopen schools and day cares, understanding transmission potential in children will be important to guide public health measures. Here, we report that replication of SARS-CoV-2 in older children leads to similar levels of viral nucleic acid as adults, but significantly greater amounts of viral nucleic acid are detected in children younger than 5 years. The risk of COVID-19 transmission in train passengers: an epidemiological and modelling study Authors: Hu M et al Publication date: 29 July 2020 Journal: Clinical Infectious Diseases DOI: 10.1093/cid/ciaa1057 Background: Train is a common mode of public transport across the globe; however, the risk of COVID-19 transmission among individual train passengers remains unclear. Methods We quantified the transmission risk of COVID-19 on high-speed train passengers using data from 2,334 index patients and 72,093 close contacts who had co-travel times of 0–8 hours from 19 December 2019 through 6 March 2020 in China. We analysed the spatial and temporal distribution of COVID-19 transmission among train passengers to elucidate the associations between infection, spatial distance, and co-travel time. Results: The attack rate in train passengers on seats within a distance of 3 rows and 5 columns of the index patient varied from 0 to 10.3% (95% confidence interval [CI] 5.3% – 19.0%), with a mean of 0.32% (95%CI 0.29% – 0.37%). Passengers in seats on the same row as the index patient had an average attack rate of 1.5% (95%CI 1.3% – 1.8%), higher than that in other rows (0.14%, 95%CI 0.11% – 0.17%), with a relative risk (RR) of 11.2 (95%CI 8.6 –14.6). Travellers adjacent to the index patient had the highest attack rate (3.5%, 95%CI 2.9% – 4.3%) of COVID-19 infections (RR 18.0, 95%CI 13.9 – 23.4) among all seats. The attack rate decreased with increasing distance, but it increased with increasing co-travel time. The attack rate increased on average by 0.15% (p = 0.005) per hour of co-travel; for passengers at adjacent seats, this increase was 1.3% (p = 0.008), the highest among all seats considered. Conclusions: COVID-19 has a high transmission risk among train passengers, but this risk shows significant differences with co-travel time and seat location. During disease outbreaks, when travelling on public transportation in confined spaces such as trains, measures should be taken to reduce the risk of transmission, including increasing seat distance, reducing passenger density, and use of personal hygiene protection. |
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Covid-19 patients |
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UK report on 10,624 patients critically ill with COVID-19 Institution: Intensive Care National Audit & Research Centre (ICNARC) Publication date: 31 July 2020 Read more... Overweight and obesity are risks factors of severe illness in patients with COVID‐19 Authors: Wang J et al Publication date: 31 July 2020 Journal: Obesity DOI: 10.1002/oby.22979 Objective: We aimed to observe the clinical characteristics of coronavirus disease 2019 (COVID‐19) patients with overweight and obesity. Methods: Consecutive COVID‐19 patients from 10 hospitals of Jiangsu province, China were enrolled. Results: 297 COVID‐19 patients were included. 39.39% and 13.47% of patients were overweight and obese, respectively. The proportions of bilateral pneumonia (92.50% vs. 73.57%, P=0.033) and type 2 diabetes (17.50% vs. 3.57%, P=0.006) were higher in patients with obesity than lean patients. The proportions of severe illness in patients with overweight (12.82% vs. 2.86%, P=0.006) and obesity (25.00% vs. 2.86%, P<0.001) were significantly higher than lean patients. More patients with obesity developed respiratory failure (20.00% vs. 2.86%, P<0.001) and acute respiratory distress syndrome (5.00% vs. 0%, P=0.024) than lean patients. The median days of hospitalization were longer in patients with obesity than lean patients (17.00 days vs. 14.00 days, P=0.029). Overweight (OR 4.222, 95%CI 1.322‐13.476, P=0.015) and obesity (OR 9.216, 95% CI 2.581‐32.903, P=0.001) were independent risk factors of severe illness. Obesity (HR 6.607, 95% CI 1.955‐22.329, P=0.002) was an independent risk factor of respiratory failure. Conclusion: Overweight and obesity were independent risk factors of severe illness in COVID‐19 patients. More attention should be paid to these patients. Severe immunosuppression and not a cytokine storm characterize COVID-19 infections Authors: Remy KE et al Publication date: 20 July 2020 Journal: JCI Insight DOI: 10.1172/jci.insight.140329 COVID-19-associated morbidity and mortality have been attributed to a pathologic host response. Two divergent hypotheses have been proposed: a hyper-inflammatory ‘cytokine-storm’-mediated injury versus failure of host protective immunity resulting in unrestrained viral dissemination and organ injury. A key explanation for the inability to address this controversy has been the lack of diagnostic tools to evaluate immune function in COVID-19 infections. ELISpot, a highly sensitive, functional immunoassay was employed in 27 COVID-19, 51 septic, 18 critically-ill non-septic (CINS), and 27 healthy controls to evaluate adaptive and innate immune status by quantitating T cell IFN-ɣ and monocyte TFN-α production. Circulating T cell subsets were profoundly reduced in COVID-19 patients. Additionally, stimulated blood mononuclear cells produced less than 40% to 50% of the IFN-ɣ and TNF-α observed in septic and CINS patients, consistent with markedly impaired immune effector cell function. Approximately 25% of COVID-19 patients had increased IL-6 levels greater than 1,000 pg/mL that were not associated with elevations in other canonical pro-inflammatory cytokines. Collectively, these findings support the hypothesis that COVID-19 suppresses host functional adaptive and innate immunity. Importantly, Interleukin-7 administered ex vivo restored T cell IFN-ɣ production in COVID-19 patients. Thus, ELISpot may functionally characterize host immunity in COVID-19 and inform prospective therapies. Obesity, the most common comorbidity in SARS-CoV-2: is leptin the link? Authors: Candida J Rebello, John P Kirwan and Frank L Greenway Publication date: 03 July 2020 Journal: International Journal of Obesity DOI: 10.1038/s41366-020-0640-5 Overweight and obesity are major risk factors for diabetes, cardiovascular disease, and lung disease. These diseases are the most commonly reported health conditions that predispose individuals with SARS-CoV-2 infection to require hospitalization including intensive care unit admissions. The innate immune response is the host’s first line of defense against a human coronavirus infection. However, most coronaviruses are armed with one strategy or another to overcome host antiviral defense, and the pathogenicity of the virus is related to its capacity to suppress host immunity. The multifaceted nature of obesity including its effects on immunity can fundamentally alter the pathogenesis of acute respiratory distress syndrome and pneumonia, which are the major causes of death due to SARS-CoV-2 infection. Elevated circulating leptin concentrations are a hallmark of obesity, which is associated with a leptin-resistant state. Leptin is secreted by adipocytes in proportion to body fat and regulates appetite and metabolism through signaling in the hypothalamus. However, leptin also signals through the Jak/STAT and Akt pathways, among others, to modulate T cell number and function. Thus, leptin connects metabolism with the immune response. Therefore, it seems appropriate that its dysregulation would have serious consequences during an infection. We propose that leptin may be the link between obesity and its high prevalence as a comorbidity of the SARS-CoV-2 infection. In this article, we present a synthesis of the mechanisms underpinning susceptibility to respiratory viral infections and the contribution of the immunomodulatory effects of obesity to the outcome. |
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Mortality |
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Authors: Levin AT et al Publication date: 30 July 2020 Journal: medRxiv preprint DOI: 10.1101/2020.07.23.20160895 This paper assesses the age specificity of the infection fatality rate (IFR) for COVID-19. Our benchmark meta-regression synthesizes the age-specific IFRs from six recent large-scale seroprevalence studies conducted in Belgium, Geneva, Indiana, New York, Spain, and Sweden. The estimated IFR is close to zero for children and younger adults but rises exponentially with age, reaching about 0.3 percent for ages 50-59, 1.3 percent for ages 60-69, 4.6 percent for ages 70-79, and 25 percent for ages 80 and above. We compare those predictions to the age-specific IFRs implied by recent seroprevalence estimates for nine other U.S. locations, three smale-scale studies, and three countries (Iceland, New Zealand, and Republic of Korea) that have engaged in comprehensive tracking and tracing of COVID-19 infections. We also review seroprevalence studies of 32 other locations whose design was not well-suited for estimating age-specific IFRs. Our findings indicate that COVID-19 is not just dangerous for the elderly and infirm but also for healthy middle-aged adults, for whom the fatality rate is more than 50 times greater than the risk of dying in an automobile accident. Consequently, the overall IFR for a given location is intrinsically linked to the age-specific pattern of infections. In a scenario where the U.S. infection rate reaches 20 percent, our analysis indicates that protecting vulnerable age groups could prevent more than 200,000 deaths. |
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Therapeutics |
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Authors: Rathnayake AD et al Publication date: 03 August 2020 Journal: Science Translational Medicine DOI: 10.1126/scitranslmed.abc5332 Pathogenic coronaviruses are a major threat to global public health, as exemplified by Severe Acute Respiratory Syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and the newly emerged SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19). We describe herein the structure-guided optimization of a series of inhibitors of the coronavirus 3C-like protease (3CLpro), an enzyme essential for viral replication. The optimized compounds were effective against several human coronaviruses including MERS-CoV, SARS-CoV and SARS-CoV-2 in an enzyme assay and in cell-based assays using Huh-7 and Vero E6 cell lines. Two selected compounds showed antiviral effects against SARS-CoV-2 in cultured primary human airway epithelial cells. In a mouse model of MERS-CoV infection, administration of a lead compound one day after virus infection increased survival from 0 to 100% and reduced lung viral titers and lung histopathology. These results suggest that this series of compounds has the potential to be developed further as antiviral drugs against human coronaviruses. Sulfated polysaccharides effectively inhibit SARS-CoV-2 in vitro Authors: Kwon PS et al Publication date: 24 July 2020 Journal: Cell Discovery DOI: 10.1038/s41421-020-00192-8 COVID-19, caused by the SARS-CoV-2 virus, has now spread worldwide with catastrophic human and economic impacts and currently has infected over 10 million people and killed over 500,0001. In an effort to mitigate disease symptoms and impede viral spread, efforts in vaccine development and drug discovery are being conducted at a rapid pace2. Recently, we showed that the well-known anticoagulant heparin has exceptional binding affinity to the spike protein (S-protein) of SARS-CoV-23. The S-protein of SARS-CoV-2 bound more tightly to immobilized heparin (KD = ~10−11 M) than the S-proteins of either SARS-CoV (KD = ~10−7 M) or MERS-CoV (KD = ~10-9 M). However, it is not known whether the tight binding of heparin to the SARS-CoV-2 S-protein translates into potent antiviral activity. In the current study, we evaluated the in vitro antiviral properties of heparin and other closely related polysaccharides to assess the relevance of heparin-related GAGs and other sulfated polysaccharides as part of the pharmacopeia of potential therapeutics that target SARS-CoV-2. Vero-CCL81, which expresses both ACE2 and TMPRSS24, were used for viral replication at high titer5 for use in antiviral assays. |
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Covid-19, children and schools |
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Authors: Panovska-Griffiths J et al Publication date: 03 August 2020 Journal: The Lancet Child & Adolescent Health DOI: 10.1016/S2352-4642(20)30250-9 Background: As lockdown measures to slow the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection begin to ease in the UK, it is important to assess the impact of any changes in policy, including school reopening and broader relaxation of physical distancing measures. We aimed to use an individual-based model to predict the impact of two possible strategies for reopening schools to all students in the UK from September, 2020, in combination with different assumptions about relaxation of physical distancing measures and the scale-up of testing. Methods: In this modelling study, we used Covasim, a stochastic individual-based model for transmission of SARS-CoV-2, calibrated to the UK epidemic. The model describes individuals' contact networks stratified into household, school, workplace, and community layers, and uses demographic and epidemiological data from the UK. We simulated six different scenarios, representing the combination of two school reopening strategies (full time and a part-time rota system with 50% of students attending school on alternate weeks) and three testing scenarios (68% contact tracing with no scale-up in testing, 68% contact tracing with sufficient testing to avoid a second COVID-19 wave, and 40% contact tracing with sufficient testing to avoid a second COVID-19 wave). We estimated the number of new infections, cases, and deaths, as well as the effective reproduction number (R) under different strategies. In a sensitivity analysis to account for uncertainties within the stochastic simulation, we also simulated infectiousness of children and young adults aged younger than 20 years at 50% relative to older ages (20 years and older). Findings: With increased levels of testing (between 59% and 87% of symptomatic people tested at some point during an active SARS-CoV-2 infection, depending on the scenario), and effective contact tracing and isolation, an epidemic rebound might be prevented. Assuming 68% of contacts could be traced, we estimate that 75% of individuals with symptomatic infection would need to be tested and positive cases isolated if schools return full-time in September, or 65% if a part-time rota system were used. If only 40% of contacts could be traced, these figures would increase to 87% and 75%, respectively. However, without these levels of testing and contact tracing, reopening of schools together with gradual relaxing of the lockdown measures are likely to induce a second wave that would peak in December, 2020, if schools open full-time in September, and in February, 2021, if a part-time rota system were adopted. In either case, the second wave would result in R rising above 1 and a resulting second wave of infections 2·0–2·3 times the size of the original COVID-19 wave. When infectiousness of children and young adults was varied from 100% to 50% of that of older ages, we still found that a comprehensive and effective test–trace–isolate strategy would be required to avoid a second COVID-19 wave. Interpretation: To prevent a second COVID-19 wave, relaxation of physical distancing, including reopening of schools, in the UK must be accompanied by large-scale, population-wide testing of symptomatic individuals and effective tracing of their contacts, followed by isolation of diagnosed individuals. Transmission of SARS-CoV-2 in Australian educational settings: a prospective cohort study Authors: Macartney K Prof et al Publication date: 03 August 2020 Journal: The Lance Child & Adolescent Health DOI: 10.1016/S2352-4642(20)30251-0 Background: School closures have occurred globally during the COVID-19 pandemic. However, empiric data on transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children and in educational settings are scarce. In Australia, most schools have remained open during the first epidemic wave, albeit with reduced student physical attendance at the epidemic peak. We examined SARS-CoV-2 transmission among children and staff in schools and early childhood education and care (ECEC) settings in the Australian state of New South Wales (NSW). Methods: Laboratory-confirmed paediatric (aged ≤18 years) and adult COVID-19 cases who attended a school or ECEC setting while considered infectious (defined as 24 h before symptom onset based on national guidelines during the study period) in NSW from Jan 25 to April 10, 2020, were investigated for onward transmission. All identified school and ECEC settings close contacts were required to home quarantine for 14 days, and were monitored and offered SARS-CoV-2 nucleic acid testing if symptomatic. Enhanced investigations in selected educational settings included nucleic acid testing and SARS-CoV-2 antibody testing in symptomatic and asymptomatic contacts. Secondary attack rates were calculated and compared with state-wide COVID-19 rates. Findings: 15 schools and ten ECEC settings had children (n=12) or adults (n=15) attend while infectious, with 1448 contacts monitored. Of these, 633 (43·7%) of 1448 had nucleic acid testing, or antibody testing, or both, with 18 secondary cases identified (attack rate 1·2%). Five secondary cases (three children; two adults) were identified (attack rate 0·5%; 5/914) in three schools. No secondary transmission occurred in nine of ten ECEC settings among 497 contacts. However, one outbreak in an ECEC setting involved transmission to six adults and seven children (attack rate 35·1%; 13/37). Across all settings, five (28·0%) of 18 secondary infections were asymptomatic (three infants [all aged 1 year], one adolescent [age 15 years], and one adult). Interpretation: SARS-CoV-2 transmission rates were low in NSW educational settings during the first COVID-19 epidemic wave, consistent with mild infrequent disease in the 1·8 million child population. With effective case-contact testing and epidemic management strategies and associated small numbers of attendances while infected, children and teachers did not contribute significantly to COVID-19 transmission via attendance in educational settings. These findings could be used to inform modelling and public health policy regarding school closures during the COVID-19 pandemic. Association Between Statewide School Closure and COVID-19 Incidence and Mortality in the US Authors: Auger KA et al Publication date: 29 July 2020 Journal: JAMA DOI: 10.1001/jama.2020.14348 Objective: To determine if school closure and its timing were associated with decreased COVID-19 incidence and mortality. Design, Setting, and Participants: US population–based observational study conducted between March 9, 2020, and May 7, 2020, using interrupted time series analyses incorporating a lag period to allow for potential policy-associated changes to occur. To isolate the association of school closure with outcomes, state-level nonpharmaceutical interventions and attributes were included in negative binomial regression models. States were examined in quartiles based on state-level COVID-19 cumulative incidence per 100 000 residents at the time of school closure. Models were used to derive the estimated absolute differences between schools that closed and schools that remained open as well as the number of cases and deaths if states had closed schools when the cumulative incidence of COVID-19 was in the lowest quartile compared with the highest quartile. Results: COVID-19 cumulative incidence in states at the time of school closure ranged from 0 to 14.75 cases per 100 000 population. School closure was associated with a significant decline in the incidence of COVID-19 (adjusted relative change per week, −62% [95% CI, −71% to −49%]) and mortality (adjusted relative change per week, −58% [95% CI, −68% to −46%]). Both of these associations were largest in states with low cumulative incidence of COVID-19 at the time of school closure. For example, states with the lowest incidence of COVID-19 had a −72% (95% CI, −79% to −62%) relative change in incidence compared with −49% (95% CI, −62% to −33%) for those states with the highest cumulative incidence. In a model derived from this analysis, it was estimated that closing schools when the cumulative incidence of COVID-19 was in the lowest quartile compared with the highest quartile was associated with 128.7 fewer cases per 100 000 population over 26 days and with 1.5 fewer deaths per 100 000 population over 16 days. Conclusions and Relevance: Between March 9, 2020, and May 7, 2020, school closure in the US was temporally associated with decreased COVID-19 incidence and mortality; states that closed schools earlier, when cumulative incidence of COVID-19 was low, had the largest relative reduction in incidence and mortality. However, it remains possible that some of the reduction may have been related to other concurrent nonpharmaceutical interventions. A large COVID-19 outbreak in a high school 10 days after schools’ reopening, Israel, May 2020 Authors: Stein-Zamir C et al Publication date: 23 July 2020 Journal: Eurosurveillance On 13 March 2020, Israel’s government declared closure of all schools. Schools fully reopened on 17 May 2020. Ten days later, a major outbreak of coronavirus disease (COVID-19) occurred in a high school. The first case was registered on 26 May, the second on 27 May. They were not epidemiologically linked. Testing of the complete school community revealed 153 students (attack rate: 13.2%) and 25 staff members (attack rate: 16.6%) who were COVID-19 positive. |
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Testing |
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UK Biobank SARS-CoV-2 Serology Study Publication date:21 July 2020 Source: UK Biobank UK Biobank are collecting blood samples from approximately 20,200 individuals on a monthly basis for at least six months to determine the extent of past infection with SARS-CoV-2 across different regions of the UK. A total of 20,203 participants were selected to participate and asked to provide a sample. To date, 17,862 samples have been collected over the period 27 May to 06 July. Of the 17,862 samples provided, 86 samples failed quality control checks, resulting in 17,776 samples available for analysis. An overview of the socio-demographic characteristics of these participants is shown below (Table 1). |
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Immunity |
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SARS-CoV-2-reactive T cells in healthy donors and patients with COVID-19 Authors: Braun J et al Publication date: 29 July 2020 Journal: Nature DOI: 10.1038/s41586-020-2598-9 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the rapidly unfolding coronavirus disease 2019 (COVID-19) pandemic1,2. Clinical manifestations of COVID-19 vary, ranging from asymptomatic infection to respiratory failure. The mechanisms determining such variable outcomes remain unresolved. Here, we investigated SARS-CoV-2 spike glycoprotein (S)-reactive CD4+ T cells in peripheral blood of patients with COVID-19 and SARS-CoV-2-unexposed healthy donors (HD). We detected SARS-CoV-2 S-reactive CD4+ T cells in 83% of patients with COVID-19 but also in 35% of HD. S-reactive CD4+ T cells in HD reacted primarily to C-terminal S epitopes, which show a higher homology to spike glycoproteins of human endemic coronaviruses, compared to N-terminal epitopes. S-reactive T cell lines generated from SARS-CoV-2-naive HD responded similarly to C-terminal S of human endemic coronaviruses 229E and OC43 and SARS-CoV-2, demonstrating the presence of S-cross-reactive T cells, probably generated during past encounters with endemic coronaviruses. The role of pre-existing SARS-CoV-2 cross-reactive T cells for clinical outcomes remains to be determined in larger cohorts. However, the presence of S-cross-reactive T cells in a sizable fraction of the general population may affect the dynamics of the current pandemic, and has important implications for the design and analysis of upcoming COVID-19 vaccine trials. Herd immunity thresholds for SARS-CoV-2 estimated from unfolding epidemics Authors: Aguas R et al Publication date: 24 July 2020 Journal: medRxiv preprint DOI: 10.1101/2020.07.23.20160762. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads, the susceptible subpopulation declines causing the rate at which new infections occur to slow down. Variation in individual susceptibility or exposure to infection exacerbates this effect. Individuals that are more susceptible or more exposed tend to be infected and removed from the susceptible subpopulation earlier. This selective depletion of susceptibles intensifies the deceleration in incidence. Eventually, susceptible numbers become low enough to prevent epidemic growth or, in other words, the herd immunity threshold is reached. Here we fit epidemiological models with inbuilt distributions of susceptibility or exposure to SARS-CoV-2 outbreaks to estimate basic reproduction numbers (𝑹𝟎) alongside coefficients of individual variation (CV) and the effects of containment strategies. Herd immunity thresholds are then calculated as 𝟏 − (𝟏⁄𝑹𝟎)𝟏⁄#𝟏$𝑪𝑽𝟐' or 𝟏 − (𝟏⁄𝑹𝟎)𝟏⁄#𝟏$𝟐𝑪𝑽𝟐', depending on whether variation is on susceptibility or exposure. Our inferences result in herd immunity thresholds around 10-20%, considerably lower than the minimum coverage needed to interrupt transmission by random vaccination, which for 𝑹𝟎 higher than 2.5 is estimated above 60%. We emphasize that the classical formula, 𝟏 − 𝟏⁄𝑹𝟎, remains applicable to describe herd immunity thresholds for random vaccination, but not for immunity induced by infection which is naturally selective. These findings have profound consequences for the governance of the current pandemic given that some populations may be close to achieving herd immunity despite being under more or less strict social distancing measures. |
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Vaccines |
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Single-shot Ad26 vaccine protects against SARS-CoV-2 in rhesus macaques Authors: Mercado NB et al Publication date: 30 July 2020 Journal: Nature DOI: 10.1038/s41586-020-2607-z A safe and effective vaccine for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be required to end the coronavirus disease 2019 (COVID-19) pandemic1–8. For global deployment and pandemic control, a vaccine that requires only a single immunization would be optimal. Here we show the immunogenicity and protective efficacy of a single dose of adenovirus serotype 26 (Ad26) vector-based vaccines expressing the SARS-CoV-2 spike (S) protein in nonhuman primates. Fifty-two rhesus macaques were immunized with Ad26 vectors encoding S variants or sham control and were challenged with SARS-CoV-2 by the intranasal and intratracheal routes9,10. The optimal Ad26 vaccine induced robust neutralizing antibody responses and provided complete or near-complete protection in bronchoalveolar lavage and nasal swabs following SARS-CoV-2 challenge. Vaccine-elicited neutralizing antibody titres correlated with protective efficacy, suggesting an immune correlate of protection. These data demonstrate robust single-shot vaccine protection against SARS-CoV-2 in nonhuman primates. The optimal Ad26 vector-based vaccine for SARS-CoV-2, termed Ad26.COV2.S, is currently being evaluated in clinical trials. Evaluation of the mRNA-1273 Vaccine against SARS-CoV-2 in Nonhuman Primates Authors: Corbett KS et al Publication date: 28 July 2020 Journal: New England Journal of Medicine DOI: 10.1056/NEJMoa2024671 Background: Vaccines to prevent coronavirus disease 2019 (Covid-19) are urgently needed. The effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines on viral replication in both upper and lower airways is important to evaluate in nonhuman primates. Method: Nonhuman primates received 10 or 100 μg of mRNA-1273, a vaccine encoding the prefusion-stabilized spike protein of SARS-CoV-2, or no vaccine. Antibody and T-cell responses were assessed before upper- and lower-airway challenge with SARS-CoV-2. Active viral replication and viral genomes in bronchoalveolar-lavage (BAL) fluid and nasal swab specimens were assessed by polymerase chain reaction, and histopathological analysis and viral quantification were performed on lung-tissue specimens. Results: The mRNA-1273 vaccine candidate induced antibody levels exceeding those in human convalescent-phase serum, with live-virus reciprocal 50% inhibitory dilution (ID50) geometric mean titers of 501 in the 10-μg dose group and 3481 in the 100-μg dose group. Vaccination induced type 1 helper T-cell (Th1)–biased CD4 T-cell responses and low or undetectable Th2 or CD8 T-cell responses. Viral replication was not detectable in BAL fluid by day 2 after challenge in seven of eight animals in both vaccinated groups. No viral replication was detectable in the nose of any of the eight animals in the 100-μg dose group by day 2 after challenge, and limited inflammation or detectable viral genome or antigen was noted in lungs of animals in either vaccine group. Conclusions: Vaccination of nonhuman primates with mRNA-1273 induced robust SARS-CoV-2 neutralizing activity, rapid protection in the upper and lower airways, and no pathologic changes in the lung. Structure-based design of prefusion-stabilized SARS-CoV-2 spikes Authors: Hsieh CL et al Publication date: 23 July 2020 Journal: Science DOI: 10.1126/science.abd0826 The COVID-19 pandemic has led to accelerated efforts to develop therapeutics and vaccines. A key target of these efforts is the spike (S) protein, which is metastable and difficult to produce recombinantly. Here, we characterized 100 structure-guided spike designs and identified 26 individual substitutions that increased protein yields and stability. Testing combinations of beneficial substitutions resulted in the identification of HexaPro, a variant with six beneficial proline substitutions exhibiting ~10-fold higher expression than its parental construct and the ability to withstand heat stress, storage at room temperature, and three freeze-thaw cycles. A 3.2 Å-resolution cryo-EM structure of HexaPro confirmed that it retains the prefusion spike conformation. High-yield production of a stabilized prefusion spike protein will accelerate the development of vaccines and serological diagnostics for SARS-CoV-2. |
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Social Impacts |
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Google searches for suicide and suicide risk factors in the early stages of the COVID-19 pandemic Authors: Emily A Halford, Alison M Lake and Madelyn S Gould Publication date: 24 July 2020 Journal: PLoS One DOI: 10.1371/journal.pone.0236777 A novel coronavirus (SARS-CoV-2), which causes the COVID-19 respiratory illness, emerged in December of 2019 and has since spread globally. The dramatic lifestyle changes and stressors associated with this pandemic pose a threat to mental health and have the potential to exacerbate risk factors for suicide. We used autoregressive integrated moving average (ARIMA) models to assess Google Trends data representing searches in the United States for 18 terms related to suicide and known suicide risk factors following the emergence of COVID-19. Although the relative proportion of Google searches for suicide-related queries was lower than predicted during the early pandemic period, searches for the following queries representative of financial difficulty were dramatically elevated: “I lost my job” (226%; 95%CI, 120%-333%), “laid off” (1164%; 95%CI, 395%-1932%), “unemployment” (1238%; 95%CI, 560%-1915%), and “furlough” (5717%; 95%CI, 2769%-8665%). Searches for the Disaster Distress Helpline, which was promoted as a source of help for those impacted by COVID-19, were also remarkably elevated (3021%; 95%CI, 873%-5169%). Google searches for other queries representative of help-seeking and general mental health concerns were moderately elevated. It appears that some indices of suicidality have fallen in the United States in this early stage of the pandemic, but that COVID-19 may have caused an increase in suicide risk factors that could yield long-term increases in suicidality and suicide rates. An Improved Measure of Deaths Due to COVID-19 in England and Wales Authors: Williams S et al Publication date: 02 July 2020 Journal: SSRN DOI: 10.2139/ssrn.3635548 We address the question of: ‘how many deaths in England and Wales are due to COVID-19?’ There are two approaches to measuring COVID deaths – ‘COVID associated deaths’ and ‘excess deaths’. An excess deaths type framework is preferable, as there is substantial measurement error in COVID associated deaths, due to issues relating to the identification of deaths that are directly attributable to COVID-19. A limitation of the current excess deaths metric (a comparison of deaths to a 5 year average for the same week), is that it attributes the entirety of the variation in mortality to COVID-19. This likely means that the metric is overstated because there are a range of other drivers of mortality. We address this by estimating novel empirical Poisson models for all-cause deaths (in totality; by age category; for males; and females) that account for other drivers including the lockdown Government policy response. The models are novel because they include COVID identifier variables (which are a variation on a dummy variable). We use these identifiers to estimate weekly deviations in COVID deaths (about the mean weekly estimate pertaining to the COVID dummy variable in our baseline model). Results from two sets of identifiers indicate that, over the periods when our weekly estimates of total COVID deaths and the current excess deaths measure differ (week ending 17th or 24th April 2020 – week ending 8th May 2020), the former is considerably below the latter – on average per week 4670 deaths (54%) lower, or 4727 deaths (63%) lower, respectively. |
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Media – Science related |
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Immunity |
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Boosting immune system a potential treatment strategy for COVID-19 Author: Jim Dryden Publication date: 04 August 2020 Source: Washington University School of Medicine As the COVID-19 pandemic continues to claim lives around the world, much research has focused on the immune system’s role in patients who become seriously ill. A popular theory has it that the immune system gets so revved up fighting the virus that, after several days, it produces a so-called cytokine storm that results in potentially fatal organ damage, particularly to the lungs. But new findings from a team of researchers led by scientists at Washington University School of Medicine in St. Louis point to another theory and suggest that patients become ill because their immune systems can’t do enough to protect them from the virus, landing them in intensive care units. They suggest that boosting immunity could be a potential treatment strategy for COVID-19. Such a strategy has been proposed in two recently published papers, one published online in JAMA Network Open and the other published online in the journal JCI Insight. |
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Pandemic |
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Canaries in the Mine: Mañana Waves Author: Dr Rudolph Kalveks Publication date: 01 August 2020 Source: Lockdown Skeptics FT 29/7/2020: “Europe battles to contain surge in Covid-19 cases. Experts surprised at how fast the lifting of restrictions led to a rise in infections.” Telegraph 1/8/2020: “The virus warning light is flashing.” Let us see what the “Canaries in the Mine” (i.e. the coronavirus death statistics, courtesy of Worldometer) tell us about the actual development of the epidemic in Europe and other parts of the world. First of all, bearing in mind the usual caveats about reliability, we should recap the death statistics in our selection of countries. These are summarised as time series in Figure 1 below, where a logarithmic scale has been used. (An upward sloping straight line on such a graph would indicate an exponential growth rate). Sweden’s Actual COVID-19 Results Compared to What Modelers Predicted in April Author: Jon Miltmore 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. |
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Transmission |
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COVID cases in England aren’t rising: here’s why Author: Carl Heneghan Publication date: 02 August 2020 Source: The Centre for Evidence- Based Medicine The government has restricted movements on millions of people in England: COVID is apparently on the rise. But what happens when you start digging into the data. I have used the following data sets to piece together the number of tests, cases and results for Pillar 1* (done in healthcare settings) and Pillar 2* (tests are done in the community). Coronavirus cases in the UK: daily updated statistics Looking at the data for July, by the date the PCR test to detect the virus SARs-CoV-2 is reported, shows a trend for an increased number of cases detected – (from about 500 to nearly 750 a day). If you look at the data by the date the specimen is taken the trend is still apparent (the number of cases varies when assessed by specimen date compared to the date of the reported test). Now all things being equal, the increase in cases is about 250 per day over a month – not an exponential rise, and no sudden jump. But is this a real increase or could it be down to something else – can an increase in testing explain the rise? |
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Testing |
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90 minute COVID-19 tests: Government orders 5.8 million DnaNudge kits Author: Andrew Scheuber Publication date: 03 August 2020 Source: Imperial College London The government has placed a £161 million order for 5.8 million high-speed DnaNudge COVID-19 test kits to be used in NHS hospitals from September. This major order will see DnaNudge’s lab-free, rapid and reliable PCR test, which delivers results in under 90 minutes and can work in about an hour, rolled out nationally in urgent patient care and elective surgery settings, with further deployments in out-of-hospital settings. DnaNudge, an Imperial startup headquartered in White City, recently obtained a CE mark for its COVID Nudge test, enabling its additional use in non-clinical locations, including care homes and other public emergency services. The COVID Nudge test adapts DnaNudge’s consumer service, which was launched last year to analyse and map users’ genetic profile to key nutrition-related health traits such as obesity, diabetes, hypertension and cholesterol, enabling customers to be “nudged” by their DNA towards healthier eating. |
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Mortality |
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The scandal of excess deaths at home Author: Dr Waqar Rashid Publication date: 30 July 2020 Source: The Spectator How does one measure health in the midst of the extraordinary times we live in? The usual markers: visits to doctors, waiting lists, and number of people in hospital, have all changed beyond recognition and there is mounting concern that amidst the justifiable concern over coronavirus, other diseases are being forgotten. Trying to determine what exactly is going on is not easy but thanks to the Centre of Evidence Based Medicine (CEBM) at Oxford University and its publishing of an estimate of non-Covid-19 related death figures over the last five weeks, we have been given a dramatic insight into an unseen and largely unreported rise in deaths occurring at home which appear to now outnumber fatalities due to the virus itself. There has always been some scepticism about the accuracy of the death toll related to coronavirus, both in this country and across the world. This has been written about previously in The Spectator. Often a positive PCR test for Covid-19 is sufficient to attribute a death to the disease, regardless of other possible causes or health issues. It has also been acceptable to attribute a death to the virus if the person’s symptoms matched, but no diagnostic test has taken place. It opened up the whole – and unanswerable – issue of how many people died with Covid or due to the virus. |
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Media – Reporting |
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Pandemic |
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Secrecy has harmed UK government's response to Covid-19 crisis, says top scientist Author: Ian Sample Publication date: 02 August 2020 Source: The Guardian One of the country’s most senior scientists has criticised government for the “shroud of secrecy” drawn over major decisions in the coronavirus crisis and urged ministers to be more open about the reasons behind their policies. Sir Paul Nurse, the nobel laureate and director of the Francis Crick Institute in London, said important decisions throughout the pandemic had been made in what appeared to be a “black box” of scientists, civil servants and politicians, and called for more transparency and scrutiny. The failure to be more open about pivotal decisions, and the basis on which they were reached, meant it had been impossible to challenge emerging policy, he said, a situation that fuelled poor decisions and put public trust at risk. Nurse’s comments came as other senior researchers raised further concerns about the way expert advice is handled in the UK and how the lack of transparency has allowed ministers to claim their policies are driven by scientific evidence. Author: J B Handley Publication date: 30 July 2020 Source: Children’s Health Defense If you’re hoping the COVID-19 pandemic will go on forever, this post may disappoint you. And, I get it. We have gone frothing-at-the-mouth nuts over a slightly above-normal virulence virus, with a unique and obvious age-distribution pattern that should have made containment easy and panic completely unnecessary. And, if you’re living in the United States, like I am, you probably think my declaration that this pandemic is “over” to be somewhere between wishful thinking and incredibly premature, and I hear you, too, although forgive me if I’m not sure you’re the one thinking clearly, given some of the things I’ve recently read. I promise to support my assertion with data, and the wisdom of people far more expert than me who are having a harder time being heard in the present climate of…bats#@t crazy. Have we lost our collective minds? Yes. You may not be one of them. In fact, I’m guessing the people who actually take the time to read my blog posts are the few remaining who haven’t been subsumed by the panic, but can we agree that most have? Jeffrey A. Tucker of the American Institute for Economic Research put it best in his excellent essay on July 10 titled, When will the Madness End?: |
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Lockdowns |
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Johnson and Sunak met 'to discuss how to avoid new lockdown' Author: Rajeev Syal Publication date: 02 August 2020 Source: The Guardian Boris Johnson and the chancellor, Rishi Sunak, met to run through possible options for averting another lockdown in England that could stall any potential economic recovery should there be a second wave of coronavirus infections. The prime minister is considering new lockdown measures after a rise in Covid-19 cases forced him to slow the lockdown easing on Friday, with proposed relaxations for the leisure and beauty sectors delayed. Sources said Johnson met with Sunak on Wednesday to run through various options that could be introduced. According to the Sunday Times, measures under consideration include asking older people to shield once again and lockdown-like conditions for London should there be a second wave. The Sunday Telegraph reported that under the proposals, a greater number of people would be asked to take part in the shielding programme, based on their age or particular risk factors that have been identified since March. Greater Manchester declares major incident after rise in Covid-19 cases Author: Nazia Parveen Publication date: 02 August 2020 Source: The Guardian A major incident has been declared in Greater Manchester in response to increases in coronavirus infection rates across “multiple localities”. The decision to up the readiness of emergency and public services to react to the escalating Covid-19 transmission rate in the region comes after the government announced new lockdown restrictions for parts of north-west England on Thursday. Gold command meetings of senior figures from the police, local authorities and other agencies to discuss the pandemic have been taking place over the weekend. Major incidents are often declared as a result of a terror attack or natural disaster and mean a region can access extra national resources if necessary, with the police able to draft in the army if they need support. Exclusive: Top WHO disease detective warns against return to national lockdowns Author: Sarah Newey Publication date: 01 August 2020 Source: The Telegraph The World Health Organisation has urged countries not to reimpose national lockdowns in an attempt to stem the spread of Covid-19 due to the health, social and economic repercussions. In an exclusive interview with The Telegraph Dr Maria Van Kerkhove, who helps lead the WHO’s pandemic response team as the head of the emerging diseases unit, said that countries should instead adopt localised strategies. By the end of March, as the coronavirus outbreak spiralled out of control across the globe, well over 100 countries had imposed a full or partial lockdown – affecting billions of people. Dr Van Kerkhove described these measures as a “blunt, sheer force instrument” that bought countries time to build the public health infrastructure needed to tackle Covid-19. But reflecting on events since the WHO declared a global health emergency six months ago – when fewer than 8,000 cases and 170 deaths had been reported – she added that the economic, health and social costs of lockdown have been “massive”. “Lockdowns are not something that WHO recommended, but they needed to be used in a number of countries because the outbreaks were growing so quickly,” Dr Van Kerkhove said. “But we're hopeful that countries will not need to implement national lockdowns again.” Coronavirus: Pubs 'may need to shut' to allow schools to reopen Publication date: 01 August 2020 Source: BBC News Pubs or "other activities" in England may need to close to allow schools to reopen next month, a scientist advising the government has said. Prof Graham Medley told the BBC there may need to be a "trade-off", with the re-opening of schools seen as a "priority" for children's wellbeing. It came after England's chief medical officer said the country was "near the limit" of opening up society. On Friday, the PM said further easing of the lockdown would be delayed. Measures due to come in this weekend, including the reopening of casinos, bowling alleys, skating rinks and some close-contact services, as well as the return of indoor performances and pilots of large gatherings in sports venues and conference centres, would be postponed for at least a fortnight, Boris Johnson said. The expansion of wedding receptions to allow up to 30 people was also put on hold. Mr Johnson told a Downing Street press conference on Friday he needed to "squeeze the brake pedal" on easing restrictions, following a rise in coronavirus cases |
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Testing |
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Coronavirus: New 90-minute tests for Covid-19 and flu 'hugely beneficial' Publication date: 03 August 2020 Source: BBC News New 90-minute tests that can detect coronavirus and flu will be rolled out in hospitals and care homes from next week. The "on-the-spot" swab and DNA tests will help distinguish between Covid-19 and other seasonal illnesses, the government said. The health secretary said this would be "hugely beneficial" over the winter. Currently, a third of tests take longer than 24 hours to process. The announcement comes as the government pushed back a July target to regularly test all care home staff and residents - a key move to identify so-called silent spreaders, those who are infected but do not show symptoms. This is unlikely to be achieved until September because the number of testing kits has become more limited. Pseudo-epidemics: Why COVID-19 is guaranteed to never end Author: Mike Hearn Publication date: 26 July 2020 Source: Medium The whooping cough ripped through the hospital like wildfire. It started with an internist and spread from there, with a severe cough quickly developing in other healthcare workers. Whilst not deadly for healthy adults the disease can be fatal for the elderly, the frail and very young children, so the health system moved quickly. There was no time to lose — within weeks over 1,000 staff were furloughed and quarantined. 142 people tested positive for the disease, thousands of people were given antibiotics and ICU beds were closed. It was a swift and effective response by highly trained public health professionals, armed with the best tools modern medicine could provide. Only one thing went wrong. None of it was real. |
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Vaccines |
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Indian Billionaires Bet Big on Head Start in Coronavirus Vaccine Race Author: Jeffrey Gettleman Publication date: 01 August 2020 Source: The New York Times PUNE, India — In early May, an extremely well-sealed steel box arrived at the cold room of the Serum Institute of India, the world’s largest vaccine maker. Inside, packed in dry ice, sat a tiny 1-milliliter vial from Oxford, England, containing the cellular material for one of the world’s most promising coronavirus vaccines. Scientists in white lab coats brought the vial to Building 14, carefully poured the contents into a flask, added a medium of vitamins and sugar and began growing billions of cells. Thus began one of the biggest gambles yet in the quest to find the vaccine that will bring the world’s Covid-19 nightmare to an end. The Serum Institute, which is exclusively controlled by a small and fabulously rich Indian family and started out years ago as a horse farm, is doing what a few other companies in the race for a vaccine are doing: mass-producing hundreds of millions of doses of a vaccine candidate that is still in trials and might not even work. But if it does, Adar Poonawalla, Serum’s chief executive and the only child of the company’s founder, will become one of the most tugged-at men in the world. He will have on hand what everyone wants, possibly in greater quantities before anyone else. His company, which has teamed up with the Oxford scientists developing the vaccine, was one of the first to boldly announce, in April, that it was going to mass-produce a vaccine before clinical trials even ended. Now, Mr. Poonawalla’s fastest vaccine assembly lines are being readied to crank out 500 doses each minute, and his phone rings endlessly. |
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Social Impacts |
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‘The Biggest Monster’ Is Spreading. And It’s Not the Coronavirus Author: Apoorva Mandavilli Publication date: 03 August 2020 Source: The New York Times It begins with a mild fever and malaise, followed by a painful cough and shortness of breath. The infection prospers in crowds, spreading to people in close reach. Containing an outbreak requires contact tracing, as well as isolation and treatment of the sick for weeks or months. This insidious disease has touched every part of the globe. It is tuberculosis, the biggest infectious-disease killer worldwide, claiming 1.5 million lives each year. Until this year, TB and its deadly allies, H.I.V. and malaria, were on the run. The toll from each disease over the previous decade was at its nadir in 2018, the last year for which data are available. Yet now, as the coronavirus pandemic spreads around the world, consuming global health resources, these perennially neglected adversaries are making a comeback. Life under lockdown report – children’s experience of the pandemic and lockdown in the UK Publication date: July 2020 Source: Save the Children Although children in the UK have thankfully been spared the worst o the direct health effects of the coronavirus pandemic, their lives have been uprooted in almost every aspect. This short report explores children’s experiences of the pandemic and lockdown, drawing on a series of online sessions with friends and supporters. The intention is to curate a piece of social history to ensure that children’s experiences, in all their diversity, aren’t neglected in our collective understanding of the social impacts of the pandemic. We also want to ensure those experience shape our national conversation about the ‘new normal’ as we’re concerned that they have been missing from decision-making so far. We have you’ll join the debate about #LifeUnderLockdown. |
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