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Science

Epidemiology

Epidemiological and socio-economic characteristics of the COVID-19 spring outbreak in Quebec, Canada: A population-based study

Authors: Jantzen R et al

Publication date: 01 September 2020

Journal: medRxiv preprint

DOI: 10.1101/2020.08.26.20182675

Background: By mid-July 2020, more than 108,000 COVID-19 cases had been diagnosed in Canada with more than half in the province of Quebec. To be prepared for a potential second wave of COVID-19 in the fall, it seems of utmost importance to analyze the epidemiological and socio-economic characteristics of the spring outbreak in the population. Method: We conducted an online survey of the participants of the CARTaGENE population-based cohort, composed of middle-aged and older adults. We collected information on socio-demographic, lifestyle, health condition, COVID-related symptoms and COVID-19 testing. We studied the association between these factors and two outcomes: the status of having been tested for SARS-CoV-2 and the status of having received a positive test when having been tested. These associations were evaluated with univariate and multivariate analyzes using a hybrid tree-based regression model. Results: Among the 8,129 respondents from the CARTaGENE cohort, 649 were tested for COVID-19 and 41 were positive. Medical workers and individuals having a contact with a COVID-19 patient had the highest probabilities of being tested (32% and 42.4%, respectively) and of being positive (17.2% and 13.0%, respectively) among those tested. 7.6% of the participants declared that they have experienced at least one of the four COVID-related symptoms chosen by the Public Health authorities (fever, cough, dyspnea, anosmia) but were not tested. Results from the tree-based model analyzes adjusted on exposure factors show that the combination of dyspnea, dry cough and fever was highly associated with being tested whereas anosmia, fever, and headache were the most discriminant factors for having a positive test among those tested. During the spring outbreak, more than one third of the participants have experienced a decrease in access to health services. There were sex and age differences in the socio-economic and emotional impacts of the pandemic. Conclusion: We have shown some discrepancies between the symptoms associated with being tested and being positive. In particular, the anosmia is a major discriminant symptom for positivity whereas ear-nose-throat symptoms seem not to be COVID-related. The results also emphasize the need of increasing the accessibility of testing for the general population.

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COVID-19 infection dynamics in care homes in the East of England: a retrospective genomic epidemiology study

Authors: Hamilton WL et al

Publication date: 01 September 2020

Journal: medRxiv preprint

DOI: 10.1101/2020.08.26.20182279

Background COVID-19 poses a major challenge to infection control in care homes. SARS-CoV-2 is readily transmitted between people in close contact and causes disproportionately severe disease in older people. Methods Data and SARS-CoV-2 samples were collected from patients in the East of England (EoE) between 26th February and 10th May 2020. Care home residents were identified using address search terms and Care Quality Commission registration information. Samples were sequenced at the University of Cambridge or the Wellcome Sanger Institute and viral clusters defined based on genomic and time differences between cases. Findings 7,406 SARS-CoV-2 positive samples from 6,600 patients were identified, of which 1,167 (18.2%) were residents from 337 care homes. 30/71 (42.3%) care home residents tested at Cambridge University Hospitals NHS Foundation Trust (CUH) died. Genomes were available for 700/1,167 (60%) residents from 292 care homes, and 409 distinct viral clusters were defined. We identified several probable transmissions between care home residents and healthcare workers (HCW). Interpretation Care home residents had a significant burden of COVID-19 infections and high mortality. Larger viral clusters were consistent with within-care home transmission, while multiple clusters per care home suggested independent acquisitions.

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Covid-19 and children

Viral shedding and immunological features of children COVID-19 patients

Authors: Yang Y et al

Publication date: 31 August 2020

Journal: medRxiv preprint

DOI: 10.1101/2020.08.25.20181446

Abstract Background SARS-CoV-2 could infect people at all ages, and the viral shedding and immunological features of children COVID-19 patients were analyzed. Methods Epidemiological information and clinical data were collected from 35 children patients. Viral RNAs in respiratory and fecal samples were detected. Plasma of 11 patients were collected and measured for 48 cytokines. Results 40% (14/35) of the children COVID-19 patients showed asymptomatic infections, while pneumonia shown by CT scan occurred in most of the cases (32/35, 91.43%). Elevated LDH, AST, CRP, neutropenia, leukopenia, lymphopenia and thrombocytopenia occurred in some cases, and CD4 and CD8 counts were normal. A total of 22 cytokines were significantly higher than the healthy control, and IP-10, IFN-α2 of them in children were significantly lower than the adult patients. Meanwhile, MCP-3, HGF, MIP-1α, and IL-1ra were similar or lower than healthy control, while significantly lower than adult patients. Viral RNAs were detected as early as the first day after illness onset (d.a.o) in both the respiratory and fecal samples. Viral RNAs decreased as the disease progression and mostly became negative in respiratory samples within 18 d.a.o, while maintained relatively stable during the disease progression and still detectable in some cases during 36~42 d.a.o. Conclusion COVID-19 in children was mild, and asymptomatic infection was common. Immune responses were relatively normal in children COVID-19 patients. Cytokine storm also occurred in children patients, while much weaker than adult patients. Positive rate of viral RNAs in fecal samples was high, and profile of viral shedding were different between respiratory and gastrointestinal tract.

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Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study

Authors: Swan OV et al

Publication date: 27 August 2020

Journal: The BMJ

DOI: 10.1136/bmj.m3249

Objective :To characterise the clinical features of children and young people admitted to hospital with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK and explore factors associated with admission to critical care, mortality, and development of multisystem inflammatory syndrome in children and adolescents temporarily related to coronavirus disease 2019 (covid-19) (MIS-C).

Participants: 651 children and young people aged less than 19 years admitted to 138 hospitals and enrolled into the International Severe Acute Respiratory and emergency Infections Consortium (ISARIC) WHO Clinical Characterisation Protocol UK study with laboratory confirmed SARS-CoV-2.

Main outcome measures: Admission to critical care (high dependency or intensive care), in-hospital mortality, or meeting the WHO preliminary case definition for MIS-C.

Results: Median age was 4.6 (interquartile range 0.3-13.7) years, 35% (225/651) were under 12 months old, and 56% (367/650) were male. 57% (330/576) were white, 12% (67/576) South Asian, and 10% (56/576) black. 42% (276/651) had at least one recorded comorbidity. A systemic mucocutaneous-enteric cluster of symptoms was identified, which encompassed the symptoms for the WHO MIS-C criteria. 18% (116/632) of children were admitted to critical care. On multivariable analysis, this was associated with age under 1 month (odds ratio 3.21, 95% confidence interval 1.36 to 7.66; P=0.008), age 10-14 years (3.23, 1.55 to 6.99; P=0.002), and black ethnicity (2.82, 1.41 to 5.57; P=0.003). Six (1%) of 627 patients died in hospital, all of whom had profound comorbidity. 11% (52/456) met the WHO MIS-C criteria, with the first patient developing symptoms in mid-March. Children meeting MIS-C criteria were older (median age 10.7 (8.3-14.1) v 1.6 (0.2-12.9) years; P<0.001) and more likely to be of non-white ethnicity (64% (29/45) v 42% (148/355); P=0.004). Children with MIS-C were five times more likely to be admitted to critical care (73% (38/52) v 15% (62/404); P<0.001). In addition to the WHO criteria, children with MIS-C were more likely to present with fatigue (51% (24/47) v 28% (86/302); P=0.004), headache (34% (16/47) v 10% (26/263); P<0.001), myalgia (34% (15/44) v 8% (21/270); P<0.001), sore throat (30% (14/47) v (12% (34/284); P=0.003), and lymphadenopathy (20% (9/46) v 3% (10/318); P<0.001) and to have a platelet count of less than 150 × 109/L (32% (16/50) v 11% (38/348); P<0.001) than children who did not have MIS-C. No deaths occurred in the MIS-C group.

Conclusions: Children and young people have less severe acute covid-19 than adults. A systemic mucocutaneous-enteric symptom cluster was also identified in acute cases that shares features with MIS-C. This study provides additional evidence for refining the WHO MIS-C preliminary case definition. Children meeting the MIS-C criteria have different demographic and clinical features depending on whether they have acute SARS-CoV-2 infection (polymerase chain reaction positive) or are post-acute (antibody positive).

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Testing

Testing for responses to the wrong SARS-CoV-2 antigen?

Authors: Rosadas C et al

Publication date: 28 August 2020

Journal: The Lancet

DOI: 10.1016/S0140-6736(20)31830-4

Two commercial antibody tests (Abbott SARS-CoV-2 IgG, Abbott Diagnostics, Abbott Park, IL, USA; and Roche Elecsys Anti-SARS-CoV-2, Roche Diagnostics, Basel, Switzerland), both targeting antibodies to nucleoprotein (anti-NP), constitute the cornerstone of the UK Government's response to the COVID-19 pandemic. The test manufactured by Abbott, which is widely used in Europe and the USA, claims a specificity and sensitivity of greater than 99% at 14 days or more after symptoms started and has been validated by Public Health England.1

We received 2204 serum samples from staff and patients previously screened for anti-NP on the Abbott platform as part of the routine diagnostic service by the UK National Health Service. These samples, principally selected in the Abbott binding ratio range of 0·25–2·5, were further tested using an in-house double binding antigen ELISA (Imperial Hybrid DABA; Imperial College London, London, UK), which detects total antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor binding domain (RBD). This assay has a specificity of 100% (95% CI 99·6–100), defined by testing 825 serum samples that predated the COVID-19 pandemic, and a sensitivity of 98·9% (96·8–99·8) when evaluating 276 serum samples from individuals with RT-PCR-confirmed SARS-CoV-2 infection.

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Among 511 samples with Abbott binding ratios of 0·25 to less than 1·4, 294 (58%) had detectable anti-RBD antibodies (ranging from 34% for binding ratios 0·25–0·5 to 94% for binding ratios 1·25–1·4; appendix). Discordant samples were classified into five groups based on their Imperial Hybrid DABA binding ratio. Eight serum samples from each group were randomly selected and assayed by a second in-house assay, an S1 G and M capture ELISA, to verify the anti-RBD findings. Anti-S1 antibodies were detected in 28 (88%) of 32 samples that were reactive for anti-RBD but unreactive for anti-NP. The four serum samples not confirmed by the S1 capture ELISA had low binding ratios in the Imperial Hybrid DABA, the S1 non-reactivity being consistent with the lower sensitivity of the capture assay compared with the Imperial Hybrid DABA. Eight serum samples selected at random from 76 reactive only in the Abbott assay were unreactive for antibody to S1.

There are two possible explanations for these findings: either the Abbott assay results constitute false-positive reactions;2 or these patients did not mount a detectable humoral response to S1, as can happen with asymptomatic or mild infection.

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Immunity

A longitudinal study of SARS-CoV-2 infected patients shows high correlation between neutralizing antibodies and COVID-19 severity

Authors: Legros V et al

Publication date: 01 September 2020

Journal: medRxiv preprint

DOI: 10.1101/2020.08.27.20182493

Understanding the immune responses elicited by SARS-CoV-2 infection is critical in terms of protection from re-infection and, thus, for public health policy and for vaccine development against the COVID-19. Here, using either live SARS-CoV-2 particles or retroviruses pseudotyped with the SARS-CoV-2 S viral surface protein (Spike), we studied the neutralizing antibody (nAb) response in serum specimens from a cohort of 140 SARS-CoV-2 qPCR-confirmed patients, including patient with mild symptoms but also more severe form including those that require intensive care. We show that nAb titers were strongly correlated with disease severity and with anti-Spike IgG levels. Indeed, patients from intensive care units exhibited high nAb titers, whereas patients with milder disease symptoms displayed heterogenous nAb titers and asymptomatic or exclusive outpatient care patients had no or poor nAb levels. We found that the nAb activity in SARS-CoV-2-infected patients displayed a relatively rapid decline after recovery, as compared to individuals infected with alternative coronaviruses. We show the absence of cross-neutralization between endemic coronaviruses and SARS-CoV-2, indicating that previous infection by human coronaviruses may not generate protective nAb against SARS-CoV-2 infection. Finally, we found that the D614G mutation in the Spike protein, which has recently been identified as the major variant now found in Europe, does not allow neutralization escape. Altogether, our results contribute to the understanding of the immune correlate of SARS-CoV-2 induced disease and claim for a rapid evaluation of the role of the humoral response in the pathogenesis of SARS-CoV-2.

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Antibody response to SARS-CoV-2 infection in humans: a systematic review

Authors: Post N et al

Publication date: 30 August 2020

Journal: medRxiv preprint

DOI: 10.1101/2020.08.25.20178806

Introduction Progress in characterising the humoral immune response to Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) has been rapid but areas of uncertainty persist. This review comprehensively evaluated evidence describing the antibody response to SARS-CoV-2 published from 01/01/2020-26/06/2020. Methods Systematic review. Keyword-structured searches were carried out in MEDLINE, Embase and COVID-19 Primer. Articles were independently screened on title, abstract and full text by two researchers, with arbitration of disagreements. Data were double-extracted into a pre-designed template, and studies critically appraised using a modified version of the MetaQAT tool, with resolution of disagreements by consensus. Findings were narratively synthesised. Results 150 papers were included. Most studies (75%) were observational in design, and included papers were generally of moderate quality based on hospitalised patients. Few considered mild or asymptomatic infection. Antibody dynamics were well described in the acute phase, and up to around 3 months from disease onset, although inconsistencies remain concerning clinical correlates. Development of neutralising antibodies following SARS-CoV-2 infection is typical, although titres may be low. Specific and potent neutralising antibodies have been isolated from convalescent plasma. Cross reactivity but limited cross neutralisation occurs with other HCoVs. Evidence for protective immunity in vivo is limited to small, short-term animal studies, which show promising initial results in the immediate recovery phase. Interpretation Published literature on immune responses to SARS-CoV-2 is of variable quality with considerable heterogeneity with regard to methods, study participants, outcomes measured and assays used. Antibody dynamics have been evaluated thoroughly in the acute phase but longer follow up and a comprehensive assessment of the role of demographic characteristics and disease severity is needed. The role of protective neutralising antibodies is emerging, with implications for therapeutics and vaccines. Large, cross-national cohort studies using appropriate statistical analysis and standardised serological assays and clinical classifications should be prioritised.

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Vaccines

RNA-Based COVID-19 Vaccine BNT162b2 Selected for a Pivotal Efficacy Study

Authors: Walsh EE et al

Publication date: 28 August 2020

Journal: medRxiv preprint

DOI: 10.1101/2020.08.17.20176651

Background: Severe acute respiratory syndrome coronavirus 2 (SARS−CoV−2) infections and the resulting disease, coronavirus disease 2019 (COVID−19), have spread to millions of people globally. Multiple vaccine candidates are under development, but no vaccine is currently available. Methods: Healthy adults 18−55 and 65−85 years of age were randomized in an ongoing, placebo−controlled, observer−blinded dose−escalation study to receive 2 doses at 21−day intervals of placebo or either of 2 lipid nanoparticle−formulated, nucleoside−modified RNA vaccine candidates: BNT162b1, which encodes a secreted trimerized SARS−CoV−2 receptor-binding domain, or BNT162b2, which encodes a prefusion stabilized membrane-anchored SARS−CoV−2 full-length spike. In each of 13 groups of 15 participants, 12 received vaccine and 3 received placebo. Groups were distinguished by vaccine candidate, age of participant, and vaccine dose level. Interim safety and immunogenicity data of BNT162b1 in younger adults have been reported previously from US and German trials. We now present additional safety and immunogenicity data from the US Phase 1 trial that supported selection of the vaccine candidate advanced to a pivotal Phase 2/3 safety and efficacy evaluation. Results: In both younger and older adults, the 2 vaccine candidates elicited similar dose-dependent SARS−CoV−2−neutralizing geometric mean titers (GMTs), comparable to or higher than the GMT of a panel of SARS−CoV−2 convalescent sera. BNT162b2 was associated with less systemic reactogenicity, particularly in older adults. Conclusion: These results support selection of the BNT162b2 vaccine candidate for Phase 2/3 large−scale safety and efficacy evaluation, currently underway.

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Covid-19 and evidence based medicine

Will evidence‐based medicine be another casualty of COVID‐19?

Authors: Roger Watson and Niall McCrae

Publication date: 28 August 2020

Journal: JAN

DOI: 10.1111/jan.14543

It is often said that the first casualty of war is the truth. In April 2020, soon after the global pandemic began, we speculated (McCrae & Watson, 2020) that evidence, the concrete basis of truth, may already have been abandoned in governments’ rush to act in the context of public and media alarm. However, we were merely speculating as there was little research to which we could refer, our only reference‐point being historical pandemics predating modern evidence‐based medicine. Specifically, we queried the severity of the contagion, the effectiveness of lockdown measures and the necessity for universal and draconian protection measures.

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Social Impacts

Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey

Authors: Patrick SW et al

Publication date: 01 September 2020

Journal: Pediatrics

DOI: 10.1542/peds.2020-016824

Background: As the coronavirus disease pandemic spread across the United States and protective measures to mitigate its impact were enacted, parents and children experienced widespread disruptions in daily life. Our objective with this national survey was to determine how the pandemic and mitigation efforts affected the physical and emotional well-being of parents and children in the United States through early June 2020.

Methods: In June 2020, we conducted a national survey of parents with children age <18 to measure changes in health status, insurance status, food security, use of public food assistance resources, child care, and use of health care services since the pandemic began.

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 child care. 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 child care, 16% reported change in insurance status, and 11% reported worsening food security.

Conclusions: The coronavirus disease pandemic has had a substantial tandem impact on parents and children in the United States. As policy makers 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 and Health Authorities

Mortality

Weekly Updates by Select Demographic and Geographic Characteristics

Publication date: 26 August 2020

Source: Centers for Disease Control and Prevention

Provisional Death Counts for Coronavirus Disease 2019 (COVID-19)

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Vaccines

Phase 3 Clinical Testing in the US of AstraZeneca COVID-19 Vaccine Candidate Begins

Publication date: 31 August 2020

Source: National Institutes of Health

A multi-site, Phase 3 clinical trial evaluating an investigational COVID-19 vaccine known as AZD1222 has begun. The trial will enroll approximately 30,000 adult volunteers at 80 sites in the United States to evaluate if the candidate vaccine can prevent symptomatic coronavirus disease 2019 (COVID-19). The United Kingdom-based global biopharmaceutical company AstraZeneca is leading the trial as regulatory sponsor. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and the Biomedical Advanced Research and Development Authority (BARDA), part of the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response, are providing funding support for the trial.

“Safe and effective vaccines will be essential to meet the global need for widespread protection against COVID-19,” said NIAID Director Anthony S. Fauci, M.D. “Positive results from preclinical research led by NIH scientists supported the rapid development of this vaccine candidate, which has also showed promise in early-stage clinical trials.”

The Phase 3 trial is being implemented as part of Operation Warp Speed(link is external), a multi-agency collaboration led by HHS that aims to accelerate the development, manufacturing and distribution of medical countermeasures for COVID-19. The Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) public-private partnership also guided the development of the trial protocol to ensure a coordinated approach across multiple vaccine efficacy trials. NIH experts have emphasized the importance of a harmonized process to generate data for multiple investigational vaccines in parallel to assess the relative effectiveness of each.

“NIH is committed to supporting several Phase 3 vaccine trials to increase the odds that one or more will be effective in preventing COVID-19 and put us on the road to recovery from this devastating pandemic,” said NIH Director Francis S. Collins, M.D., Ph.D. “We also know that preventing this disease could require multiple vaccines and we’re investing in those that we believe have the greatest potential for success.”

Oxford University’s Jenner Institute and Oxford Vaccine Group developed AZD1222. The candidate vaccine was licensed to AstraZeneca for further development. The vaccine uses a non-replicating chimpanzee adenovirus to deliver a SARS-CoV-2 spike protein to induce an immune response. SARS-CoV-2 is the virus that causes COVID-19.

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Media – Science related

Lockdowns

A Doctors’ Open Letter to Daniel Andrews

Publication date: 01 September 2020

Source: Quadrant Online

Dear Premier,

We, the undersigned, are senior medical practitioners of various specialities who practice in Victoria and are deeply concerned with the Victorian government’s management of the SARS-CoV-2 (COVID-19) viral pandemic as a public health issue.

The purpose of this letter is to make you aware that not all medical practitioners are in agreement with the Chief Medical Officer and the Victorian government regarding the most effective way to control this disease. We believe that an alternative medical response is required that reflects what we know about the spread of the virus, those who have died from it, and the impact that the stage 3-4 lockdown restrictions are having on the physical and mental health of the general population.

For the sake of people in Victoria with other medical illnesses, it is vital that Stage 4 restrictions be lifted on schedule in mid-September.

This letter details our concerns and recommendations. We are ready to offer any assistance we can to help create and implement a revised, effective and just response to the Victorian situation; to this end we would be pleased to meet with you at your convenience to discuss the matter further.

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Mortality

Understanding changes to mortality during the pandemic

Authors: Joshua Kraindler, Claudia Barclay and Charles Tallack

Publication date: 17 August 2020

Source: The Health Foundation

Key points

From the beginning of March 2020 up until 24 July, there were almost 58,000 excess deaths in England and Wales. These refer to deaths in 2020 compared to the average deaths over the past 5 years during the same period. Over 51,000 of these deaths mentioned ‘COVID-19’ on the death certificate. This leaves approximately 7,000 additional deaths since March compared to the average of previous years. Currently, little is known about the causes of this increase.

Since March there have been over 26,000 excess deaths in care homes, of which about 15,000 were recorded with COVID-19. The patterns and trends of the remaining excess deaths point to a substantial proportion of these being unreported deaths with COVID-19.

There have also been significant increases in deaths in private homes, while deaths excluding COVID-19 have significantly declined in hospitals. This was still occurring in July, where average weekly deaths in private homes were about 700 above normal levels.

Normally, deaths in care homes and private homes account for about 45% of weekly deaths. This rose as high as 59% during some weeks this year, representing a significant shift and raising concerns over people not accessing hospital care.

With substantial increases in overall deaths, along with changes in the places where deaths have occurred, it is critical for health and social care policy that we understand the underlying causes of these changes in order to better direct care.

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Testing

Coronavirus cases are mounting but deaths remain stable. Why?

Authors: Prof Carl Heneghan and Tom Jefferson

Publication date: 01 September 2020

Source: The Spectator

Something rather odd is happening in the two Europeans nations worst hit by Covid-19. The UK and Italy have a rising number of cases but a stable and very low number of deaths, even weeks after the cases started rising again.

At the time of writing, the UK records 1750 new cases daily and one death in a population of 67 million. With a roughly similar population and an average of 602 cases a day, Italy has had just over four deaths a day over the last month. The ratio of cases to deaths is nowhere near what it was at the height of the pandemic. The other notable feature is a shift of cases to a younger population.

There can be several explanations for this trend. First, the viral agent may have mutated to a less virulent form. Although there are some published studies showing minor mutations, these are what you would expect from an RNA virus which is inherently unstable (think of the influenza viruses, which perpetually change their suits).

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Irish-based ROQU Group launches world-first 'Health Passport' digital platform to support increased global COVID-19 testing

Publication date: 28 August 2020

Source: PR Newswire

  • World-first technology developed by ROQU Group to protect society, economy, and jobs
  • Irish trial commences with national partners in healthcare, agriculture, education, childcare, logistics, entertainment, and other sectors
  • Irish-engineered digital platform, in partnership with advanced diagnostics, delivers test results within 15 minutes, allowing businesses to operate in a safely controlled environment

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U of Illinois Returns to School with 20,000 Saliva Tests Per Day

Author: Emma Yasinski

Publication date: 28 August 2020

Source: The Scientist

The University of Illinois Urbana-Champaign announced in June that when students, faculty, and staff returned to campus for the fall semester, every individual would undergo rapid saliva testing for COVID-19 twice a week in order to swiftly quell any outbreaks. To process the 20,000 tests conducted each day, the university repurposed its veterinary lab. To take the test, a person only needs to spit into a tube, then the sample is heated for 30 minutes and scientists add chemical reagents to prepare the sample for RT-qPCR. Each test costs $10. The school budgeted $6 million for startup costs and up to $10 million for testing throughout the semester.

The initiative is supported by a cell phone app that immediately notifies individuals of their test results and can alert them if they’ve been in close contact with someone who has tested positive. Those who test positive are quarantined. Now, that plan is being put in place as school is getting underway.

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Vaccines

We can programme plants to grow biomolecules. Is farming the future of vaccines?

Author: Caleb Davies

Publication date: 25 August 2020

Source: Horizon. The EU Research & Innovation Magazine

On the southern outskirts of the city of Owensboro in Kentucky, US, there is a square, nondescript building. Inside, rows and rows of small plants are growing under artificial lights. This is a new generation biotech venture: a molecular farm. Others are springing up across the US and elsewhere – and they farm vaccines. This means that if we find a coronavirus vaccine that works, their produce could be used by households worldwide.

The basic idea of molecular farming is to genetically modify plants so that, alongside all their usual biochemicals, their cells produce biomolecules that are useful to us. It’s not a new idea.

One reason it didn’t take off, says Professor Julian Ma at St George’s, University of London, UK, is that it can be difficult to control dosage with edible vaccines: ‘How do you stop somebody eating 20 bananas because they think it’s good for them? There was a moment where everybody got seriously excited. And then realised – oh no, it’s actually not going to be quite so straightforward.’

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Can Vaccines for Wildlife Prevent Human Pandemics?

Author: Rodrigo Pérez Ortega

Publication date: 24 August 2020

Source: Quanta Magazine

Scientists still debate whether the SARS-CoV-2 virus originated in a bat or a pangolin. But they are sure that this coronavirus is only the most recent example of a zoonosis — an infectious disease that passes from animals to humans. From HIV to Ebola virus, Nipah virus and bird flu, pathogens lurking in wildlife have repeatedly found a way to “spill over” into humans, as epidemiologists put it. Between 2009 and 2019, the U.S. Agency for International Development’s early-warning pandemic system, PREDICT, detected more than 1,000 new viruses with zoonotic potential in wild animals. The COVID-19 pandemic will not be the last one.

But what if we could prevent the next pandemic by stopping its spread in animals before it jumped to us? Could this be achieved with vaccines that spread through a wild population on their own? Some scientists think so.

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Virus research

NIH awards $7.5 million grant to EcoHealth Alliance, months after uproar over political interference

Author: Helen Branswell

Publication date: 27 August 2020

Source: STAT

The National Institutes of Health has awarded a $7.5 million grant to EcoHealth Alliance, a nonprofit organization focused on finding unknown viruses in nature, months after the cancellation of an earlier award to the group prompted an outcry over political interference.

EcoHealth had previously established a partnership with a virology laboratory in Wuhan, China — the city where the Covid-19 pandemic is believed to have begun — under the terms of a five-year grant from the NIH. That grant was due to run through 2024 but was abruptly canceled in April.

At the time, conspiracy theories were emerging that suggested that SARS-CoV-2, the virus that causes Covid-19, was either accidentally or deliberately released from the lab in Wuhan. There is no proof to support the theories, but the chairman of the Joint Chiefs of Staff confirmed in April that U.S. intelligence was investigating the claims. And at a news conference that month, President Trump, when asked about the EcoHealth grant, pledged to “end that grant very quickly.”

The NIH later told EcoHealth Alliance that its project — part of which involved looking for new coronaviruses in bats and other animal species in China — no longer fit with the NIH’s priorities and program goals.

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Media – Reporting

Lockdown

Liberty in lockdown

Author: Laura Dodsworth

Publication date: 01 September 2020

Source: The Critic

“When tyrannies take over it is because people volunteer their liberty voluntarily.” A bold pronouncement, but what we have come to expect from Lord Sumption, former Supreme Court judge, in his campaign to defend civil liberties under lockdown.

What could persuade people to volunteer their liberty? Fear, in a word. Emergency situations call for emergency measures. The government responded swiftly to a pandemic despite scant evidence of the infectiousness and severity of Covid-19. The regulations were nodded through parliament to applause rather than opposition. But have the UK’s emergency laws and regulations been proportionate, the least intrusive available, strictly necessary and based on scientific evidence?

Sumption was one of four lawyers and a civil rights campaigner to whom I talked who have been vocal in their opposition to the lockdown laws. All were outspoken about their concerns for the rule of law and democracy.

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Coronavirus: Winter plans revealed in leaked Sage report

Author: Deborah Cohen

Publication date: 29 August 2020

Source: BBC News

A leaked government report suggests a "reasonable worst case scenario" of 85,000 deaths across the UK this winter due to Covid-19.

The document also says while more restrictions could be re-introduced, schools would likely remain open.

But it says the report "is a scenario, not a prediction" and the data are subject to "significant uncertainty".

However some are critical of the modelling and say some of it is already out of date.

The document, which has been seen by BBC Newsnight, was prepared for the government by the Sage scientific advisory group, which aims to help the NHS and local authorities plan services, such as mortuaries and burial services, for the winter months ahead.

Among its key assumptions are that schools will remain open and that the government's tracing, isolation, and quarantine measures will only be 40% effective in cutting the spread of Covid outside households.

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Transmission

Do Masks Increase Risk of Transmission?

Publication date: 27 August 2020

Source: Lockdown Sceptics

The use of face coverings by the general public to help stop the spread of COVID-19 has become the most visible sign of the coronavirus pandemic, constantly reminding us that things are not normal. The idea behind the use of face coverings is that because a large number of COVID-19 sufferers (the majority?) have mild to no symptoms, wearing a face covering will prevent these individuals from inadvertently infecting others.

Current evidence is that COVID-19 is transmitted via two main routes: respiratory droplets and surface contact. Face coverings are assumed to be effective at capturing respiratory droplets, which is the rationale for their use. But what about their impact on transmission through surface contact?

The aim of face coverings is to prevent an asymptomatic individual from infecting others. For such an individual, their face covering would become saturated with respiratory droplets containing coronavirus and in fact, the more effective the face covering, the more virus it will have captured. So if an infectious individual touched their face covering, they would potentially be contaminating their fingers with coronavirus…which they could then transfer to the next thing they touched – like a door-handle, handrail or table.

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Covid-19 restrictions

WHO Special Envoy Heaps Praise on Sweden’s Covid Strategy

Authors: Charles Daly and Niclas Rolander

Publication date: 31 August 2020

Source: Bloomberg

One of the World Health Organization’s six special envoys on Covid-19 has highlighted Sweden’s virus response as a model that other countries should be emulating in the long run.

Dr. David Nabarro, speaking in a radio interview with Magic Talk in New Zealand, said, “For all countries, the real approach we’ve got to aim for is through behavior that’s adopted everywhere.”

Nabarro said the key to a sustainable coronavirus strategy is trust, and pointed to Sweden as a case in point. The Nordic nation imposed far fewer restrictions on movement than others, and instead relied on Swedes to act responsibly and embrace the guidelines laid out by the country’s health authorities.

“In Sweden, the government was able to trust the public and the public was able to trust the government,” Nabarro said.

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The West's response to Covid shows we have succumbed to a Medieval mass neurosis

Author: Janet Daley

Publication date: 29 August 2020

Source: The Telegraph

Can this really be happening? The British are famously – and proudly – the most difficult people in the world to terrorise or bully. The population that stood with tireless phlegm and humour against relentless bombardment, that made its historical mark with an unflinching rationality which never permits hysteria to sweep the public discourse – must now be chivied into leaving the confines of their own homes or the safe harbours of their immediate neighbourhoods.

Where did this come from? Well, on the one hand, it is perfectly clear: with an official government campaign deliberately designed not only to inculcate fear but to suggest that protection against the great threat was simple and clear-cut. And furthermore, obeying the “stay home” edict would not just protect you and your immediate family but the rest of society as well. So locking yourself away was a moral obligation as well as an insurance against personal danger. The combination of anxiety and appeal to conscience was unbeatable – even when it involved deprivations of liberty which would once have been unconscionable.

So where are we now? Trapped in a state of what appears to be a spiral of fear so profound that it has become a permanent condition.

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Details emerge of Vaccine Choice Canada lawsuit over coronavirus response

Author: Colin Butler

Publication date: 13 August 2020

Source: CBC News

CBC News has obtained an unredacted copy of a lawsuit launched by an anti-vaccination advocacy group against the government response to the coronavirus crisis, the details of which can now be independently verified and publicly reported for the first time.

The lawsuit was filed July 6 in the Ontario Superior Court of Justice in Toronto by Aylmer, Ont.-based Vaccine Choice Canada and seven individuals. The legal action is a challenge under Canada's Charter of Rights and Freedoms to the country's pandemic response measures, including compulsory face masks, the closure of businesses and the enforcement of physical distancing.

The plaintiffs are suing the governments of Canada and Ontario, the City of Toronto, senior politicians, a number of local Ontario health authorities, health officials and the CBC over their response to the pandemic.

The suit states that the closure of businesses to prevent the spread of the virus was "extreme, unwarranted and unjustified," that self-isolation measures imposed on individuals were "not scientific, nor medically based nor proven" and that the mandatory wearing of face coverings in some public spaces imposes "physical and psychological harm."

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Testing

Your Coronavirus Test Is Positive. Maybe It Shouldn’t Be

Author: Apporva Mandavilli

Publication date: 29 August 2020

Source: The New York Times

Some of the nation’s leading public health experts are raising a new concern in the endless debate over coronavirus testing in the United States: The standard tests are diagnosing huge numbers of people who may be carrying relatively insignificant amounts of the virus.

Most of these people are not likely to be contagious, and identifying them may contribute to bottlenecks that prevent those who are contagious from being found in time. But researchers say the solution is not to test less, or to skip testing people without symptoms, as recently suggested by the Centers for Disease Control and Prevention.

Instead, new data underscore the need for more widespread use of rapid tests, even if they are less sensitive.

“The decision not to test asymptomatic people is just really backward,” said Dr. Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health, referring to the C.D.C. recommendation.

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Vaccines

Covid vaccine rush could make pandemic worse, say scientists

Author: Sarah Boseley

Publication date: 30 August 2020

Source: The Guardian

The rush to immunise populations against Covid-19 could lead to the rollout of a vaccine that is not very effective and risk worsening the pandemic, leading scientists have said.

Politicians and commercial companies are competing to be the first to license a vaccine, but experts say the world would be better served by waiting until comprehensive results showed at least 30-50% effectiveness.

Ministers announced on Friday that the UK would take emergency powers to push any vaccine through the regulatory processes with unprecedented speed before the end of the year. Donald Trump wants to be able to announce the US has a vaccine before tthe presidential election on 3 November.

A vaccine is vital to stopping the pandemic, but Prof Sir Richard Peto of Oxford University and an adviser to the World Health Organization, said the first vaccine would be bought and used all over the world even if it had low efficacy.

Even if it protected only a minority of the population, it would be regarded as the standard by which later vaccines would be measured. That could even lead to inferior vaccines being approved, because they would not have to show that they were any better.

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Pfizer could score fast COVID-19 vaccine nod, thanks to Hahn's promise of October FDA review: analyst

Author: Arlene Weintraub

Publication date: 27 August 2020

Source: Fierce Pharma

FDA Commissioner Stephen Hahn, M.D., was fresh off a controversy over the emergency use authorization for convalescent plasma to treat COVID-19 when he made waves again, this time promising on Twitter that the agency would review coronavirus vaccines before the November election. And Pfizer executives appear to be in sync with that timeline, as they race to complete a phase 3 trial of their vaccine candidate.

Nicholas Kitchin, M.D., a senior director in Pfizer's vaccine R&D group, told the Centers for Disease Control on Wednesday that the clinical trial of the company’s BioNTech-partnered COVID vaccine, BNT162b2, is more than 50% enrolled.

The news followed several public comments from Pfizer’s CEO Albert Bourla regarding the company’s plan to seek FDA approval of the vaccine in October.

Hahn took to Twitter saying the agency’s reviewers are “encouraged by the rapid rate of enrollment” in clinical trials of COVID-19 vaccines.

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Lockdowns

UK lockdown was a ‘monumental mistake’ and must not happen again – Boris scientist says

Author: Lucy Johnston

Publication date: 26 August 2020

Source: The Express

Mark Woolhouse said lockdown was a “panic measure” but admitted it was the only option at the time because “we couldn’t think of anything better to do”.

But it is a crude measure that takes no accounts of the risk levels to different individuals, the University of Edinburgh professor said, meaning that back in March the nation was “concentrating on schools when we should have been concentrating on care homes”.

The professor of infectious disease epidemiology said that the Government must now focus on increasing testing and striving to unlock society safely rather than restricting it further.

Prof Woolhouse OBE, a member of the Scientific Pandemic Influenza Group on Behaviours that advises the Government, said: “Lockdown was a panic measure and I believe history will say trying to control Covid-19 through lockdown was a monumental mistake on a global scale, the cure was worse than the disease.

“I never want to see national lockdown again. It was always a temporary measure that simply delayed the stage of the epidemic we see now. It was never going to change anything fundamentally, however low we drove down the number of cases, and now we know more about the virus and how to track it we should not be in this position again.

“We absolutely should never return to a position where children cannot play or go to school.

“I believe the harm lockdown is doing to our education, health care access, and broader aspects of our economy and society will turn out to be at least as great as the harm done by Covid-19.”

He said that Sage, the government’s advisory board on dealing with Covid, needed to have members from a wider range of fields.

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Social Impacts

Thousands Join Massive London Rally against Covid Tyranny

Author: Niall McCrae

Publication date: 01 September 2020

Source: Gateway Pundit

The authorities weren’t expecting this. Over twenty thousand thronged Trafalgar Square in London to protest against the New Normal of curtailed civil liberties. Unable to control a contagious coronavirus, the government is controlling the people instead. But the backlash has begun.

The British took a long time to find their characteristic irreverence for authority. During lockdown a courageous few demonstrated at Speakers’ Corner, the historic reserve of free speech, and several were arrested. Among those handcuffed and taken to a police cell was Piers Corbyn, brother of leftie Jeremy (electorally vanquished leader of the Labour Party). Wearing an unfashionable cardigan throughout the heatwave, this gaunt but energetic 73-year-old is an unlikely hero, taking his message around the country with the punk-style protest group StandUpX.

Covid sceptics are portrayed in mainstream media as a small fringe of selfish fools and disaffected conspiracy theorists, but the large crowd was of every class and creed. The speakers included experienced doctors and nurses.

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Wait to 2022 to see an NHS consultant, patients told

Author: Henry Bodkin

Publication date: 30 August 2020

Source: The Telegraph

Patients with life-threatening conditions are being told they must wait until 2022 for a telephone consultation with a specialist, due to the impact of coronavirus.

Charities last night called for urgent action after it emerged that a pensioner with swelling of the blood vessels in his head had an appointment to discuss his drugs regimen postponed indefinitely, and a post-operative consultation delayed for 14 months.

Martyn Lincoln, who was diagnosed in May with giant cell arteritis (GCA), risks diabetes, cataracts and hair-loss unless he can reduce the daily dose of the steroids he takes to control the disease.

Yet despite hospital admissions for coronavirus peaking in mid-April, the 67-year-old’s local NHS trust can offer him no means of safely lowering his dose “in view of Covid-19 pressures”.

It comes amid warnings that the list of people waiting for NHS treatment could double to more than 10 million by the end of the year.

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