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Science |
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Covid-19 disease |
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Modeling the Onset of Symptoms of COVID-19 Authors: Larson JR et al Publication date: 13 August 2020 Source: Frontiers in Public Health DOI: 10.3389/fpubh.2020.00473 COVID-19 is a pandemic viral disease with catastrophic global impact. This disease is more contagious than influenza such that cluster outbreaks occur frequently. If patients with symptoms quickly underwent testing and contact tracing, these outbreaks could be contained. Unfortunately, COVID-19 patients have symptoms similar to other common illnesses. Here, we hypothesize the order of symptom occurrence could help patients and medical professionals more quickly distinguish COVID-19 from other respiratory diseases, yet such essential information is largely unavailable. To this end, we apply a Markov Process to a graded partially ordered set based on clinical observations of COVID-19 cases to ascertain the most likely order of discernible symptoms (i.e., fever, cough, nausea/vomiting, and diarrhea) in COVID-19 patients. We then compared the progression of these symptoms in COVID-19 to other respiratory diseases, such as influenza, SARS, and MERS, to observe if the diseases present differently. Our model predicts that influenza initiates with cough, whereas COVID-19 like other coronavirus-related diseases initiates with fever. However, COVID-19 differs from SARS and MERS in the order of gastrointestinal symptoms. Our results support the notion that fever should be used to screen for entry into facilities as regions begin to reopen after the outbreak of Spring 2020. Additionally, our findings suggest that good clinical practice should involve recording the order of symptom occurrence in COVID-19 and other diseases. If such a systemic clinical practice had been standard since ancient diseases, perhaps the transition from local outbreak to pandemic could have been avoided. |
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Epidemiology |
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Authors: Leidner R et al Publication date: 18 August 2020 Journal: medRxiv preprint DOI: 10.1101/2020.08.16.20176107 Frontline healthcare workers (HCW) are a high-risk population for SARS-CoV-2 infection. Here we present results from a large serosurveillance study of 10,019 asymptomatic HCW conducted during April-May 2020, in eight hospital medical centers across the state of Oregon, USA during the initial peak of the pandemic. Free and voluntary testing was performed at 14 +/- 3 day intervals, over a 4-week window at each site, utilizing a lab-developed ELISA based on the Epitope Diagnostics COVID-19 nucleocapsid IgG detection Kit. We identified 253 SARS-CoV-2 IgG seropositive individuals among 10,019 total participants, representing a cross-sectional seroprevalence of 2.53%. Subgroup analysis identified differential seropositivity by job role, ranging from 8.03% among housekeepers, odds ratio 3.17 (95% CI 1.59-5.71), to 0.00% among anesthesiologists, odds ratio 0.00 (95% CI 0-0.26), both of which were significant. Over the course of the study, 17 seroconversions (0.25%) and 101 seroreversions (1.50%) were identified. Self-reported SARS-CoV-2 swab qPCR testing, when compared with subsequent serology on study, showed only modest agreement, κ = 0.47 (95% CI 0.32-0.62). Overall, these findings demonstrate relatively low seroprevalence and very low seroconversion rates among HCW in Oregon, USA, over a period in which aggressive social distancing measures were in place. The high rate of seroreversion observed in this cohort, and the relatively high discordance between SARS-CoV-2 serology and swab qPCR, highlight limitations of current detection methods, and stress the need for development of novel assessment methodologies to more accurately identify exposure (and/or immunity) to SARS-CoV-2 in this population. Authors: Du Z et al Publication date: 12 August 2020 Journal: EClinicalMedicine DOI: 10.1016/j.eclinm.2020.100479 Background: Pandemic SARS-CoV-2 was first reported in Wuhan, China on December 31, 2019. Twenty-one days later, the US identified its first case––a man who had traveled from Wuhan to the state of Washington. Recent studies in the Wuhan and Seattle metropolitan areas retrospectively tested samples taken from patients with COVID-like symptoms. In the Wuhan study, there were 4 SARS-CoV-2 positives and 7 influenza positives out of 26 adults outpatients who sought care for influenza-like-illness at two central hospitals prior to January 12, 2020. The Seattle study reported 25 SARS-CoV-2 positives and 442 influenza positives out of 2353 children and adults who reported acute respiratory illness prior to March 9, 2020. Here, we use these findings to extrapolate the early prevalence of symptomatic COVID-19 in Wuhan and Seattle. Methods: For each city, we estimate the ratio of COVID-19 to influenza infections from the retrospective testing data and estimate the age-specific prevalence of influenza from surveillance reports during the same time period. Combining these, we approximate the total number of symptomatic COVID-19 infections. Findings: In Wuhan, there were an estimated 1386 [95% CrI: 420-3793] symptomatic cases over 30 of COVID-19 between December 30, 2019 and January 12, 2020. In Seattle, we estimate that 2268 [95% CrI: 498, 6069] children under 18 and 4367 [95% CrI: 2776, 6526] adults were symptomatically infected between February 24 and March 9, 2020. We also find that the initial pandemic wave in Wuhan likely originated with a single infected case who developed symptoms sometime between October 26 and December 13, 2019; in Seattle, the seeding likely occurred between December 25, 2019 and January 15, 2020. Interpretation:The spread of COVID-19 in Wuhan and Seattle was far more extensive than initially reported. The virus likely spread for months in Wuhan before the lockdown. Given that COVID-19 appears to be overwhelmingly mild in children, our high estimate for symptomatic pediatric cases in Seattle suggests that there may have been thousands more mild cases at the time. |
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Transmission |
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Authors: Luo L PhD et al Publication date: 13 August 2020 Journal: Annals of Internal Medicine DOI: 10.7326/M20-2671 Background: Risk for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to close contacts of infected persons has not been well estimated. Objective: To evaluate the risk for transmission of SARS-CoV-2 to close contacts in different settings. Participants:3 410 close contacts of 391 index cases were traced between 13 January and 6 March 2020. Data on the setting of the exposure, reverse transcriptase polymerase chain reaction testing, and clinical characteristics of index and secondary cases were collected. Results: Among 3410 close contacts, 127 (3.7% [95% CI, 3.1% to 4.4%]) were secondarily infected. Of these 127 persons, 8 (6.3% [CI, 2.1% to 10.5%]) were asymptomatic. Of the 119 symptomatic cases, 20 (16.8%) were defined as mild, 87 (73.1%) as moderate, and 12 (10.1%) as severe or critical. Compared with the household setting (10.3%), the secondary attack rate was lower for exposures in healthcare settings (1.0%; odds ratio [OR], 0.09 [CI, 0.04 to 0.20]) and on public transportation (0.1%; OR, 0.01 [CI, 0.00 to 0.08]). The secondary attack rate increased with the severity of index cases, from 0.3% (CI, 0.0 to 1.0%) for asymptomatic to 3.3% (CI, 1.8% to 4.8%) for mild, 5.6% (CI, 4.4% to 6.8%) for moderate, and 6.2% (CI, 3.2% to 9.1%) for severe or critical cases. Index cases with expectoration were associated with higher risk for secondary infection (13.6% vs. 3.0% for index cases without expectoration; OR, 4.81 [CI, 3.35 to 6.93]). Conclusion: Household contact was the main setting for transmission of SARS-CoV-2, and the risk for transmission of SARS-CoV-2 among close contacts increased with the severity of index cases. Authors: Sebhatu A et al Publication date: 11 August 2020 Journal: PNAS DOI: 10.1073/pnas.2010625117 We analyze the adoption of nonpharmaceutical interventions in the Organisation for Economic Co-operation and Development (OECD) countries during the early phase of the coronavirus disease 2019 (COVID-19) pandemic. Given the complexity associated with pandemic decisions, governments are faced with the dilemma of how to act quickly when their core decision-making processes are based on deliberations balancing political considerations. Our findings show that, in times of severe crisis, governments follow the lead of others and base their decisions on what other countries do. Governments in countries with a stronger democratic structure are slower to react in the face of the pandemic but are more sensitive to the influence of other countries. We provide insights for research on international policy diffusion and research on the political consequences of the COVID-19 pandemic. |
| Covid-19 patients |
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Assessment of COVID-19 Hospitalizations by Race/Ethnicity in 12 States Authors: Pinar Karaca-Mandic PhD, Archelle Georgiou MD and Soumya Sen PhD Publication date: 17 August 2020 Journal: JAMA Internal Medicine DOI: 10.1001/jamainternmed.2020.3857 This analysis identified considerable disparities in the prevalence of COVID-19 across racial/ethnic subgroups of the population in 12 US states. These findings are consistent with an earlier Centers for Disease Control and Prevention analysis of 580 hospitalizations between March 1 and March 30, 2020, that found disproportionately high COVID-19 hospitalizations for the Black population.5 Similarly, a study of 1052 confirmed COVID-19 cases between January 1 and April 8, 2020, at a California health system reported higher odds of hospitalization in non-Hispanic Black individuals compared with non-Hispanic White individuals.6 In addition, we observed high hospitalization rates for Hispanic individuals in most of the states analyzed and high hospitalization rates for American Indian and Alaskan Native populations in select states. These findings highlight the need for increased data reporting and consistency within and across all states. Only 12 of 50 US states have consistently reported hospitalizations by race/ethnicity during our study period. New Jersey and Florida recently started reporting data on COVID-19 hospitalizations by race/ethnicity. The present study is limited in that there was no adjustment for age, sex, comorbidities, and socioeconomic factors within each racial/ethnic group that are likely to be associated with COVID-19 hospitalizations. A large body of research has identified racial/ethnic health disparities in the risk of infection associated with a higher prevalence of comorbidities, less access to health care, adverse economic conditions, and service-related occupations.2 The unique clinical, financial, and social implications of COVID-19 for racial/ethnic populations that are often systematically marginalized in society must be well understood to design and establish effective and equitable infrastructure solutions. Authors: Levin AT et al Publication date: 14 August 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 using seroprevalence results from eight national studies (Belgium, England, Hungary, Italy, Netherlands, Portugal, Spain, and Sweden), fifteen seroprevalence studies of specific locations in Europe and the United States, and three countries (Iceland, New Zealand, and Republic of Korea) that have engaged in comprehensive tracking and tracing of COVID-19 infections. The estimated IFR is close to zero for younger adults but rises exponentially with age, reaching about 0.3% for ages 50-59, 1.3% for ages 60-69, 4% for ages 70-79, 10% for ages 80-89. Our findings indicate that COVID-19 is not just dangerous for the elderly and infirm but also for healthy middle-aged adults. Consequently, the overall IFR for a given location is intrinsically linked to the age-specific pattern of infections, and hence protecting vulnerable age groups could substantially reduce the incidence of mortality. Association Between Youth Smoking, Electronic Cigarette Use, and Coronavirus Disease 2019 Authors: Shivani Mathur Gaiha PhD, Jing Cheng PhD and Bonnie Halpern-Felsher PhD Publication date: 11 August 2020 Journal: Journal of Adolescent Health DOI: 10.1016/j.jadohealth.2020.07.002 Purpose: This study aimed to assess whether youth cigarette and electronic cigarette (e-cigarette) use are associated with coronavirus disease 2019 (COVID-19) symptoms, testing, and diagnosis. Methods: An online national survey of adolescents and young adults (n = 4,351) aged 13–24 years was conducted in May 2020. Multivariable logistic regression assessed relationships among COVID-19–related symptoms, testing, and diagnosis and cigarettes only, e-cigarettes only and dual use, sociodemographic factors, obesity, and complying with shelter-in-place. Results: COVID-19 diagnosis was five times more likely among ever-users of e-cigarettes only (95% confidence interval [CI]: 1.82–13.96), seven times more likely among ever-dual-users (95% CI: 1.98–24.55), and 6.8 times more likely among past 30-day dual-users (95% CI: 2.40–19.55). Testing was nine times more likely among past 30-day dual-users (95% CI: 5.43–15.47) and 2.6 times more likely among past 30-day e-cigarette only users (95% CI: 1.33–4.87). Symptoms were 4.7 times more likely among past 30-day dual-users (95% CI: 3.07–7.16). Conclusions: COVID-19 is associated with youth use of e-cigarettes only and dual use of e-cigarettes and cigarettes, suggesting the need for screening and education. |
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Therapeutics |
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Vitamin D Supplementation in COVID-19 Patients Authors: Ohaegbulam KC et al Publication date: 13 August 2020 Journal: American Journal of Therapeutics DOI: 10.1097/MJT.0000000000001222 Background: Coronavirus disease 2019 (COVID-19) has infected more than 4.4 million people and caused more than 300,000 deaths partly through acute respiratory distress syndrome with propensity to affect African American and Hispanic communities disproportionately. Patients with worse outcomes have exhibited higher blood plasma levels of proinflammatory cytokines. Activation of the vitamin D receptor expressed on immune cells has been shown to directly reduce the secretion of inflammatory cytokines, such as interleukin-6, and indirectly affect C-reactive protein. Areas of Uncertainty: The significance of the vitamin D pathway in patients diagnosed with COVID-19. Therapeutic Innovation: Vitamin D supplementation in patients after diagnosis of COVID-19. Patients and Pharmacological Interventions: We report 4 vitamin D deficient patients diagnosed with COVID-19 in April 2020 who were provided with either cholecalciferol of 1000 IU daily (standard dose) or ergocalciferol 50,000 IU daily for 5 days (high dose) as part of supplementation. Clinical Outcomes: Patients that received a high dose of vitamin D supplementation achieved normalization of vitamin D levels and improved clinical recovery evidenced by shorter lengths of stay, lower oxygen requirements, and a reduction in inflammatory marker status. Conclusions: Vitamin D supplementation may serve as a viable alternative for curtailing acute respiratory distress syndrome in patients in underserved communities where resources to expensive and sought-after medications may be scarce. Randomized clinical trials will serve as an appropriate vessel to validate the efficacy of the therapeutic regimen and dissection of the pathway. Reply to Jakovac and to Rocha et al.: Can vitamin D prevent or manage COVID-19 illness? Authors: Slominski AT Publication date: 13 August 2020 Journal: American Journal of Physiology Endocrinology and Metabolism DOI: 10.1152/ajpendo.00348.2020 To the editor: The outstanding articles by Jakovac (4) and Rocha et al. (8) emphasize an association between vitamin D deficiency/insufficiency and enhanced coronavirus disease (COVID-19) severity, which is also presented in recent reports (1, 3), and led to unofficial recommendations for taking vitamin D supplements (https://doi.org/10.1016/S2213-8587(20)30183-2). Therefore, we want to further discuss this issue on different levels. COVID-19 pandemic. As the COVID-19 pandemic accelerates, it is important to explore different therapeutic options that are effective, economical, and without significant side effects. The clinical spectrum of COVID-19 presentation is wide, ranging from asymptomatic infection to severe viral pneumonia associated with respiratory failure from acute respiratory distress syndrome (ARDS) and multi-organ failure. Older people, racial minorities, and patients with a variety of comorbidities are at higher risk of being vitamin D deficient. The same populations are affected disproportionally by severe symptoms and increased mortality from the COVID-19. |
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Covid-19 and children |
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COVID-19 in children: analysis of the first pandemic peak in England Authors: Ladhani SN et al Publication date: 12 August 2020 Journal: Archives of Disease in Childhood DOI: 10.1136/archdischild-2020-320042 Objectives :To assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England. Participants: Children with COVID-19 between January and May 2020. Main outcome measures: Trends in confirmed COVID-19 cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity rates in children compared with adults; community prevalence of SARS-CoV-2 in children with acute respiratory infection (ARI) compared with adults, case-fatality rate in children with confirmed COVID-19 and excess childhood deaths compared with the previous 5 years. Results: Children represented 1.1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020. In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24.0%) were positive. In children aged <16 years, 35,200 tests were performed and 1408 (4.0%) were positive for SARS-CoV-2, compared to 19.1%–34.9% adults. Childhood cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%–45.5% in adults. Eight children died and four (case-fatality rate, 0.3%; 95% CI 0.07% to 0.7%) were due to COVID-19. We found no evidence of excess mortality in children. Conclusions: Children accounted for a very small proportion of confirmed cases despite the large numbers of children tested. SARS-CoV-2 positivity was low even in children with ARI. Our findings provide further evidence against the role of children in infection and transmission of SARS-CoV-2. |
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Testing |
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Authors: McAndrews KM et al Publication date: 14 August 2020 Journal: JCI Insight DOI: 10.1172/jci.insight.142386 Evaluation of potential immunity against the novel severe acute respiratory syndrome (SARS) coronavirus that emerged in 2019 (SARS-CoV-2) is essential for health, as well as social and economic recovery. Generation of antibody response to SARS-CoV-2 (seroconversion) may inform on acquired immunity from prior exposure, and antibodies to the SARS-CoV-2 spike protein receptor binding domain (S-RBD) are speculated to neutralize virus infection. Some serology assays rely solely on SARS-CoV-2 nucleocapsid protein (N-protein) as the antibody detection antigen; however, whether such immune responses correlate with S-RBD response and COVID-19 immunity remains unknown. Here, we generated a quantitative serological enzyme-linked immunosorbent assay (ELISA) using recombinant S-RBD and N-protein for the detection of circulating antibodies in 138 serial serum samples from 30 RT-PCR confirmed SARS-CoV-2 hospitalized patients, as well as 464 healthy and non-COVID-19 serum samples that were collected between June 2017 and June 2020. Quantitative detection of IgG antibodies to the two different viral proteins showed a moderate correlation. Antibodies to N-protein were detected at a rate of 3.6% in healthy and non-COVID-19 sera collected during the pandemic in 2020, whereas 1.6% of these sera were positive for S-RBD. Approximately 86% of individuals positive for S-RBD binding antibodies exhibited neutralizing capacity, but only 74% of N-protein positive individuals exhibited neutralizing capacity. Collectively, our studies show that detection of N-protein binding antibodies does not always correlate with presence of S-RBD neutralizing antibodies, and cautions against the extensive use of N-protein based serology testing for determination of potential COVID-19 immunity. |
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Immunity |
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Functional SARS-CoV-2-specific immune memory persists after mild COVID-19 Authors: Rodda LB et al Publication date: 15 August 2020 Journal: medRxiv preprint DOI: 10.1101/2020.08.11.20171843 The recently emerged SARS-CoV-2 virus is currently causing a global pandemic and cases continue to rise. The majority of infected individuals experience mildly symptomatic coronavirus disease 2019 (COVID-19), but it is unknown whether this can induce persistent immune memory that might contribute to herd immunity. Thus, we performed a longitudinal assessment of individuals recovered from mildly symptomatic COVID-19 to determine if they develop and sustain immunological memory against the virus. We found that recovered individuals developed SARS-CoV-2-specific IgG antibody and neutralizing plasma, as well as virus-specific memory B and T cells that not only persisted, but in some cases increased numerically over three months following symptom onset. Furthermore, the SARS-CoV-2-specific memory lymphocytes exhibited characteristics associated with potent antiviral immunity: memory T cells secreted IFN-γ and expanded upon antigen re-encounter, while memory B cells expressed receptors capable of neutralizing virus when expressed as antibodies. These findings demonstrate that mild COVID-19 elicits memory lymphocytes that persist and display functional hallmarks associated with antiviral protective immunity. Authors: Addetia A et al Publication date: 14 August 2020 Journal: medRxiv preprint DOI: 10.1101/2020.08.13.20173161 The development of vaccines against SARS-CoV-2 would be greatly facilitated by the identification of immunological correlates of protection in humans. However, to date, studies on protective immunity have only been performed in animal models and correlates of protection have not been established in humans. Here, we describe an outbreak of SARS-CoV-2 on a fishing vessel associated with a high attack rate. Predeparture serological and viral RT-PCR testing along with repeat testing after return to shore was available for 120 of the 122 persons on board over a median follow-up of 32.5 days (range 18.8 to 50.5 days). A total of 104 individuals had an RT-PCR positive viral test with Ct <35 or seroconverted during the follow-up period, yielding an attack rate on board of 85.2% (104/122 individuals). Metagenomic sequencing of 39 viral genomes suggested the outbreak originated largely from a single viral clade. Only three crewmembers tested seropositive prior to the boat’s departure in initial serological and also had neutralizing and spike-reactive antibodies in follow-up assays. None of these crewmembers with neutralizing antibody titers showed evidence of bona fide viral infection or experienced any symptoms during the viral outbreak. Therefore, the presence of neutralizing antibodies from prior infection was significantly associated with protection against re-infection (Fisher’s exact test, p=0.002). Authors: Ward H et al Publication date: 13 August 2020 Journal: medRxiv preprint DOI: Background: England, UK has experienced a large outbreak of SARS-CoV-2 infection. As in USA and elsewhere, disadvantaged communities have been disproportionately affected. Methods: National REal-time Assessment of Community Transmission-2 (REACT-2) seroprevalence study using self-administered lateral flow immunoassay (LFIA) test for IgG among a random population sample of 100,000 adults over 18 years in England, 20 June to 13 July 2020. Results: Completed questionnaires were available for 109,076 participants, yielding 5,544 IgG positive results and adjusted (for test performance), re-weighted (for sampling) prevalence of 6.0% (95% CI: 5.8, 6.1). Highest prevalence was in London (13.0% [12.3, 13.6]), among people of Black or Asian (mainly South Asian) ethnicity (17.3% [15.8, 19.1] and 11.9% [11.0, 12.8] respectively) and those aged 18-24 years (7.9% [7.3, 8.5]). Care home workers with client-facing roles had adjusted odds ratio of 3.1 (2.5, 3.8) compared with non-essential workers. One third (32.2%, [31.0-33.4]) of antibody positive individuals reported no symptoms. Among symptomatic cases, the majority (78.8%) reported symptoms during the peak of the epidemic in England in March (31.3%) and April (47.5%) 2020. We estimate that 3.36 million (3.21, 3.51) people have been infected with SARS-CoV-2 in England to end June 2020, with an overall infection fatality ratio of 0.90% (0.86, 0.94). Conclusion: The pandemic of SARS-CoV-2 infection in England disproportionately affected ethnic minority groups and health and care home workers. The higher risk of infection in these groups may explain, at least in part, their increased risk of hospitalisation and mortality from COVID-19. Selective and cross-reactive SARS-CoV-2 T cell epitopes in unexposed humans Authors: Mateus J et al Publication date: 04 August 2020 Journal: Science DOI: 10.1126/science.abd3871 Many unknowns exist about human immune responses to the SARS-CoV-2 virus. SARS-CoV-2 reactive CD4+ T cells have been reported in unexposed individuals, suggesting pre-existing cross-reactive T cell memory in 20-50% of people. However, the source of those T cells has been speculative. Using human blood samples derived before the SARS-CoV-2 virus was discovered in 2019, we mapped 142 T cell epitopes across the SARS-CoV-2 genome to facilitate precise interrogation of the SARS-CoV-2-specific CD4+ T cell repertoire. We demonstrate a range of pre-existing memory CD4+ T cells that are cross-reactive with comparable affinity to SARS-CoV-2 and the common cold coronaviruses HCoV-OC43, HCoV-229E, HCoV-NL63, or HCoV-HKU1. Thus, variegated T cell memory to coronaviruses that cause the common cold may underlie at least some of the extensive heterogeneity observed in COVID-19 disease. |
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Vaccines |
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Authors: Xia S et al Publication date: 13 August 2020 Journal: JAMA DOI: 10.1001/jama.2020.15543 Objective: To evaluate the safety and immunogenicity of an investigational inactivated whole-virus COVID-19 vaccine in China. Interventions: In the phase 1 trial, 96 participants were assigned to 1 of the 3 dose groups (2.5, 5, and 10 μg/dose) and an aluminum hydroxide (alum) adjuvant–only group (n = 24 in each group), and received 3 intramuscular injections at days 0, 28, and 56. In the phase 2 trial, 224 adults were randomized to 5 μg/dose in 2 schedule groups (injections on days 0 and 14 [n = 84] vs alum only [n = 28], and days 0 and 21 [n = 84] vs alum only [n = 28]). Design, Setting, and Participants: Interim analysis of ongoing randomized, double-blind, placebo-controlled, phase 1 and 2 clinical trials to assess an inactivated COVID-19 vaccine. The trials were conducted in Henan Province, China, among 96 (phase 1) and 224 (phase 2) healthy adults aged between 18 and 59 years. Study enrollment began on April 12, 2020. The interim analysis was conducted on June 16, 2020, and updated on July 27, 2020. Main Outcomes and Measures: The primary safety outcome was the combined adverse reactions 7 days after each injection, and the primary immunogenicity outcome was neutralizing antibody response 14 days after the whole-course vaccination, which was measured by a 50% plaque reduction neutralization test against live severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: Among 320 patients who were randomized (mean age, 42.8 years; 200 women [62.5%]), all completed the trial up to 28 days after the whole-course vaccination. The 7-day adverse reactions occurred in 3 (12.5%), 5 (20.8%), 4 (16.7%), and 6 (25.0%) patients in the alum only, low-dose, medium-dose, and high-dose groups, respectively, in the phase 1 trial; and in 5 (6.0%) and 4 (14.3%) patients who received injections on days 0 and 14 for vaccine and alum only, and 16 (19.0%) and 5 (17.9%) patients who received injections on days 0 and 21 for vaccine and alum only, respectively, in the phase 2 trial. The most common adverse reaction was injection site pain, followed by fever, which were mild and self-limiting; no serious adverse reactions were noted. The geometric mean titers of neutralizing antibodies in the low-, medium-, and high-dose groups at day 14 after 3 injections were 316 (95% CI, 218-457), 206 (95% CI, 123-343), and 297 (95% CI, 208-424), respectively, in the phase 1 trial, and were 121 (95% CI, 95-154) and 247 (95% CI, 176-345) at day 14 after 2 injections in participants receiving vaccine on days 0 and 14 and on days 0 and 21, respectively, in the phase 2 trial. There were no detectable antibody responses in all alum-only groups. Conclusions and Relevance: In this interim report of the phase 1 and phase 2 trials of an inactivated COVID-19 vaccine, patients had a low rate of adverse reactions and demonstrated immunogenicity; the study is ongoing. Efficacy and longer-term adverse event assessment will require phase 3 trials. Phase 1/2 study of COVID-19 RNA vaccine BNT162b1 in adults Authors: Mulligan MJ et al Publication date: 12 August 2020 Journal: Nature DOI: 10.1038/s41586-020-2639-4 In March 2020, the World Health Organization (WHO) declared a pandemic of coronavirus disease 2019 (COVID-19), due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1. With rapidly accumulating cases and deaths reported globally2, a vaccine is urgently needed. We report the available safety, tolerability, and immunogenicity data from an ongoing placebo-controlled, observer-blinded dose escalation study among 45 healthy adults, 18 to 55 years of age, randomized to receive 2 doses, separated by 21 days, of 10 µg, 30 µg, or 100 µg of BNT162b1, a lipid nanoparticle-formulated, nucleoside-modified mRNA vaccine that encodes trimerized SARS-CoV-2 spike glycoprotein receptor-binding domain (RBD). Local reactions and systemic events were dose-dependent, generally mild to moderate, and transient. A second vaccination with 100 µg was not administered due to increased reactogenicity and a lack of meaningfully increased immunogenicity after a single dose compared to the 30 μg dose. RBD-binding IgG concentrations and SARS-CoV-2 neutralizing titers in sera increased with dose level and after a second dose. Geometric mean neutralizing titers reached 1.9- to 4.6-fold that of a panel of COVID-19 convalescent human sera at least 14 days after a positive SARS-CoV-2 PCR. |
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Government and Health Authorities |
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Immunity |
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Immune cells for common cold may recognize SARS-CoV-2 Publication date: 18 August 2020 Source: National Institutes of Health The virus responsible for the COVID-19 pandemic, SARS-CoV-2, is part of a large family of coronaviruses. Coronaviruses usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. However, SARS-CoV-2 can cause serious illness and even death. Why people’s COVID-19 symptoms vary so greatly isn’t fully understood. Your body’s disease defense system, the immune system, makes B and T cells when exposed to pathogens like viruses and bacteria. B cells make antibodies, which neutralize the microbes, rendering them harmless. T cells have a variety of functions, including killing infected cells and activating or recruiting other immune cells. Once your body fends off a microbe, it retains some disease fighting cells as memory cells. The next time you’re exposed to it, a memory cell is ready to fight the disease again. This gives your immune system a head start in combating the disease. |
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Social impacts |
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Coronavirus and depression in adults, Great Britain: June 2020 Publication date: 18 August 2020 Source: Office for National Statistics (UK) Main points
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Media – Science related |
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Origins |
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Andrew Kimbrell on the Origins of COVID-19 Publication date: 11 August 2020 Source: Corporate Crime Reporter Did it come from nature? Or did it leak from a lab in Wuhan, China? The International Center for Technology Assessment is placing its bets on a leak from a lab in Wuhan. “After considerable research, including a thorough review of the selected research materials and discussions with experts in the field, we have come to agree with the view that the virus causing COVID-19 did not evolve naturally but rather is the product of one of the high-security bio-medical laboratories in Wuhan, China,” the group said in a statement issued last month. “We believe that there is a preponderance of circumstantial and scientific evidence demonstrating that the ‘laboratory virus’ hypothesis is not only possible but probable. By contrast, recent refutation of the hypothesis that the virus originated at a Wuhan wet market and new findings that the virus has not been found in nature despite significant effort to do so, makes the view that the virus evolved naturally unlikely.” |
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Transmission |
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Studies of Surgical Masks Efficacy Author: Chris of the family Masters Publication date: 11 August 2020 Source: 12160.info As a person who went to medical school, I was shocked when I read Neil Orr’s study, published in 1981 in the Annals of the Royal College of Surgeons of England. Dr. Orr was a surgeon in the Severalls Surgical Unit in Colchester. And for six months, from March through August 1980, the surgeons and staff in that unit decided to see what would happen if they did not wear masks during surgeries. They wore no masks for six months, and compared the rate of surgical wound infections from March through August 1980 with the rate of wound infections from March through August of the previous four years. And they discovered, to their amazement, that when nobody wore masks during surgeries, the rate of wound infections was less than half what it was when everyone wore masks. Their conclusion: “It would appear that minimum contamination can best be achieved by not wearing a mask at all” and that wearing a mask during surgery “is a standard procedure that could be abandoned.” I was so amazed that I scoured the medical literature, sure that this was a fluke and that newer studies must show the utility of masks in preventing the spread of disease. But to my surprise the medical literature for the past forty-five years has been consistent: masks are useless in preventing the spread of disease and, if anything, are unsanitary objects that themselves spread bacteria and viruses. |
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Mortality |
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Public Health England has changed its definition of deaths: here’s what it means Authors: Carl Heneghan and Jason Oke Publication date: 12 August 2020 Source: The Centre for Evidence-Based Medicine Public Health England has changed its definition of deaths. The new definition is now death in a person with a laboratory-confirmed positive COVID-19 test and died within (equal to or less than) 28 days of the first positive specimen date will now be reported The new data can be accessed here. What this means is that England has had 36,695 deaths using this definition as opposed to the previous reported 42,072 – a difference of 5,377. When you observe this difference you can see it is more marked in June, July and August. For example, under the old PHE system, 2,086 deaths were reported in England in July by date of death, with the 28 days cut off this number is 574 – nearly a quarter of what was previously reported. The last two days illustrate the difference this change makes to the deaths by reporting date. As opposed to 100 deaths on the 11th of August, 11 would now be reported; today, whereas 72 were reported, only 15 will be reported under the new system. |
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Testing |
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Publication date: 19 August 2020 Source: Lockdown Sceptics The data continues to unfold exactly in line with a 0.17% false positive rate for the PCR test. Here’s the chart. To recap: The definition of “false positive” is important to clarify. One type of false positive would involve detection of not only SARS-CoV-2 but other coronaviruses as well. Perhaps someone who has carefully studied the PCR primers and range of extant human coronavirus sequences could judge how likely this is to occur. A second type of false positive would be the detection of non-infectious viral fragments that can remain in one’s respiratory passages for two-three months after the infection has been eliminated by the immune system. However, the class of false positives most people talk about entails contamination of PCR reactions with trace amounts of viral material – which in PCR labs almost always comes from previous reaction products. The PCR assay works by amplifying a few copies of virus molecules by millions or billions of fold, so it is pretty much impossible to completely avoid having some reaction products escape and contaminate the laboratory or some of the utilised reagents. These then get into, and become amplified in, subsequent test samples, causing false positive results. So let us call these “contamination positives”. Since the PCR assays are performed in different laboratories in many places, contamination positives would cause clusters of false positives to pop up in different locations at different times. Sound familiar? Largest study on home coronavirus antibody testing publishes first findings Author: Justine Alford Publication date: 13 August 2020 Source: Imperial College London More than 100,000 people across England have tested themselves for SARS-CoV-2 antibodies at home as part of a major research programme. Led by Imperial College London, the REACT (REal Time Assessment of Community Transmission) study is using antibody finger-prick tests to track past infections and monitor the progress of the pandemic. It’s the first nation-wide antibody surveillance study to be rolled out across England using self-testing at home. The findings, available in a non-peer-reviewed report submitted to medRxiv, show that slightly under 6% of the population had antibodies to the virus and had likely previously had COVID-19 by the end of June, an estimated 3.4 million people. London had the highest numbers at over twice the national average (13%), while the South West had the lowest (3%). Key workers in care homes and health care were among those most likely to have already been infected with the coronavirus. And Black, Asian and minority ethnic (BAME) individuals were between two and three times as likely to have had COVID-19 compared to white people. |
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Therapeutics |
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Preliminary Report of Chinese High Dose Vitamin C for Covid-19 Treatment Studies Author: Richard Z Cheng MD PhD Publication date: 16 August 2020 Source: Orthomolecular Medicine News Service (OMNS August 16, 2020) Covid-19 has caused more than 700,000 deaths and USD$86 trillion economic losses worldwide in just over half a year! And yet, there are still no specific drugs or treatments that the top medical advisors (medical agencies) in US are willing to recommend. Really? No specific treatments for Covid-19? Effective, safe and inexpensive treatments for viral infections including Covid-19 do exist. But these medical advisors (medical agencies) either have turned a blind eye or are suppressing these treatments intentionally or not. Since my early reports of high dose IV vitamin C (HDIVC) for Covid-19 treatment, by Dr. Zhiyong Peng's group in Wuhan and Dr. Enqian Mao's group in Shanghai [1,2], I have been receiving regular inquiries about the results. The studies have been analyzed and papers have been written up. These studies show very promising results including statistically significant reduction in mortality and inflammation of Covid-19 patients treated with HDIVC, with no significant side effect. But no major medical journals have agreed to publish the papers. While we are waiting for journals to publish these important studies, I'd like to share some of the key results of these studies, as they may help the world in combating Covid-19. A randomized, controlled clinical trial was carried out in 3 different hospitals in Hubei Province, China, with (Dr. ZY Peng et al). A total of 54 confirmed critical Covid-19 patients were enrolled. Patients with severe acute respiratory syndrome were randomly assigned to either HDIVC or placebo in a 1:1 ratio. HDIVC group received 12 grams of vitamin C in 50 ml IV infusion every 12 hours for 7 days at a rate of 12 ml per hour. The placebo group received sterile water in the same manner. The primary outcome is invasive mechanical ventilation days in 28 days (IMVFD28), the secondary outcome is 28-day mortality, organ failure and inflammation progression. Hydroxychloroquine: A Morality Tale Author: Norman Doidge Publication date: 14 July 2020 Source: Tablet Early in the coronavirus pandemic, a survey of the world’s frontline physicians showed hydroxychloroquine to be the drug they considered the most effective at treating COVID-19 patients. That was in early April, shortly after a French study showed it was safe and effective in lowering the virus count, at times in combination with azithromycin. Next we were told hydroxychloroquine was likely ineffective, and also dangerous, and that that French study was flawed and the scientist behind it worthy of mockery. More studies followed, with contradictory results, and then out came what was hailed by some as a definitive study of 96,000 patients showing the drug was most certainly dangerous and ineffective, and indeed that it killed 30% more people than those who didn’t take it. Within days, that study was retracted, with the editor of one of the two most respected medical journals in the Western world conceding it was “a monumental fraud.” And on it went. This revolutionary new coronavirus cure is already saving lives Author: Chris Smith Publication date: 14 August 2020 Source: BGR The novel coronavirus is an incredibly scary illness given the complex way it operates. It’s incredibly infectious and it can cause severe complications that can lead to death. It even kills younger patients and people who have no other underlying conditions. And some of the people who manage to recover after what could be a months-long battle with COVID-19 will have to deal with secondary health problems that could last a lifetime. That’s why you should avoid other people as much as possible, wash your hands often, and wear face masks until treatments and vaccines become available — and even after that. The good news is that doctors and researchers have not run out of ideas in their quest to beat the novel virus. Plenty of promising therapies are in clinical trials right alongside vaccines, as the world will need therapeutics that can cure the infection as well as drugs that can prevent it. Not all of them are “miracle drugs,” and remdesivir and dexamethasone are the best examples of that. They’re drugs that work and can save lives, but they won’t save everyone. And we’ve often told you that we don’t even need a single miracle drug. Instead, combinations of effective medicines could reduce complications and the risk of death. But it turns out there may be a drug that does qualify as a “miracle COVID-19 cure,” one that might save plenty of severe COVID-19 patients. |
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Coronavirus research |
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Engineered COVID-19-Infected Mouse Bites Researcher Amid ‘Explosion’ Of Risky Coronavirus Research Author: Jonathan Latham PhD Publication date: 13 August 2020 Source: Independent Science News University researchers genetically engineer a human pandemic virus. They inject the new virus into a laboratory mouse. The infected mouse then bites a researcher…..It is a plot worthy of a Hollywood blockbuster about risky coronavirus research. But according to newly obtained minutes of the Institutional Biosafety Committee (IBC) of the University of North Carolina (UNC), Chapel Hill, these exact events need not be imagined. They occurred for real between April 1st and May 6th this year. The identity of the bitten coronavirus researcher has not been revealed except that they were working in a high security BSL-3 virus lab when the accident happened. According to Richard Ebright, an epidemiologist from Rutgers University, the UNC incident underscores an important development in virus research since the pandemic began: “There has been an explosion of research involving fully infectious SARS-CoV-2 over the last six months. Research with infectious SARS-CoV-2 now is occurring in every, or almost every, BSL-3 facility in the US and overseas.” |
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Vaccines |
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Imperial College of London Vaccine to be Tested in Uganda by December 2020 Publication date: 11 August 2020 Source: Trial Site News The Uganda Virus Research Institute (UVRI) aligned with Imperial College of London to launch the country’s first COVID-19 vaccine clinical trial by December 2020. With the final internal processes and procedures underway, Professor Pontiano Kaleebu reports the team is authoring the protocol directing the trial associated with the vaccine under development by Imperial College London of the United Kingdom. The first phase trial will center on safety and immunogenicity. COVID-19 in Uganda With over 42 million people, Uganda has a good-sized population, but the cases of COVID-19 have not spread very far or wide. There are various hypotheses for this, which TrialSite won’t delve into here. According to public records, the entire nation has 1,313 cases and nine deaths. However, the fear is that the virus could spread, and the nation’s health authorities don’t want to take any chances. Legacy of Mistrust In a recent article in the Monitor, the local news reminded all about some of the ethical violations involving clinical trials in past years. Africans have resented any effort to unethically test subjects with foreign vaccines. Russia Approves World’s First Coronavirus Vaccine Author: Jef Akst Publication date: 11 August 2020 Source: The Scientist Russian President Vladimir Putin announced today (August 11) that his country had won the global race to approve a vaccine against COVID-19, several news outlets have reported. Despite having only been in clinical trials for less than two months, the vaccine developed by the Gamaleya Institute in Moscow is safe, Putin said at a televised cabinet meeting, noting that it has already been given to one of his daughters, according to Reuters and The Washington Post. The government plans to first vaccinate high-risk groups such as healthcare workers and teachers, with mass vaccination starting in October after large-scale production begins, according to the Associated Press. “It works effectively enough, forms a stable immunity and, I repeat, it has gone through all necessary tests,” Putin said at the meeting, according to The New York Times. Researchers around the world, including in Russia, expressed worries that Gamaleya and its collaborators may be cutting corners of vaccine development, with no safety or immunity data yet released from ongoing early stage trials, and no Phase 3 trial yet underway. “Fast-tracked approval will not make Russia the leader in the (vaccine) race, it will just expose consumers of the vaccine to unnecessary danger,” Russia’s Association of Clinical Trials Organizations said Monday as it cautioned against the vaccine’s premature approval, according to the AP. |
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Media – Reporting |
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Immunity |
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Herd immunity must be why Covid-19 is on the wane in Cape Town – doctor Author: Jarryd Neves Publication date: 18 August 2020 Source: BizNews I read the article in Biznews of 30 July 2020 entitled “Cape Town puzzled over easing of its coronavirus crisis”. In the article it states that authorities do not know why the Cape Town coronavirus crisis is easing. The article notes that numbers are declining despite most businesses having re-opened. The article states that the trajectory of the disease has got many people puzzled. A theory put forward for the decline is that people are adhering to social distancing and wearing of masks. I would like to suggest a more plausible explanation for the trajectory of the epidemic in Cape Town. Social distancing measures are unlikely to be the correct explanation at this phase of the epidemic since far more social contact and intermixing are occurring now than was the case during level 4 and 5 of the lockdown and yet the numbers are still declining. So we are seeing declining numbers in the face of less stringent social distancing now compared to a few months ago. I believe that there is only one plausible explanation for the decline in coronavirus numbers in Cape Town, and that is that the herd immunity threshold (HIT) has been reached in the Cape Town region. Optimism on Covid-19 immunity climbs as studies show antibodies protect and T-cells last longer Authors: Georgina Hayes and Paul Nuki Publication date: 17 August 2020 Source: The Telegraph Scientists are growing increasingly confident about the human immune response to SARS-CoV-2 after studies showed antibodies provide “real-world” protection against the virus and cellular immunity may be long-lasting, even in mild cases. A study of a Covid-19 outbreak on a Seattle fishing boat involving more than 100 sailors has all but proven that antibodies provide protection against re-infection. Meanwhile, an encouraging body of evidence has found that T and B cells remain in the blood even once antibodies fade. “This is exactly what you would hope for,” Marion Pepper, an immunologist at the University of Washington and an author on one of the new studies, told The New York Times. “All the pieces are there to have a totally protective immune response.” “This is very promising,” echoed Smita Iyer, an immunologist at the University of California, Davis “This calls for some optimism about herd immunity, and potentially a vaccine.” What if ‘Herd Immunity’ Is Closer Than Scientists Thought? Author: Apoorva Madavilli Publication date: 17 August 2020 Source: The New York Times We’ve known from the beginning how the end will arrive. Eventually, the coronavirus will be unable to find enough susceptible hosts to survive, fading out wherever it briefly emerges. To achieve so-called herd immunity — the point at which the virus can no longer spread because there are not enough vulnerable humans — scientists have suggested that perhaps 70 percent of a given population must be immune, through vaccination or because they survived the infection. Now some researchers are wrestling with a hopeful possibility. In interviews with The New York Times, more than a dozen scientists said that the threshold is likely to be much lower: just 50 percent, perhaps even less. If that’s true, then it may be possible to turn back the coronavirus more quickly than once thought. We are massively overreacting to new Covid 'outbreaks' Author: Ross Clark Publication date: 13 August 2020 Source: The Telegraph The Imperial College study published this morning claiming that 3.4 million people (six per cent of the UK population) have antibodies indicating that they have been exposed to Covid-19 provides no great revelation. The Office of National Statistics (ONS) has already published similar figures suggesting that 6.5 per cent of the population has been infected. Nevertheless, it is yet more confirmation of how irrelevant are the official statistics for Covid 19 cases – and what a nonsense it is to rely on them for policymaking. According to the Government’s Covid "dashboard", updated at 4pm on Wednesday, 313,798 people in Britain have had the disease. This is less than one tenth of the number suggested by the Imperial study. In other words, for all Matt Hancock’s efforts to ramp up testing, the vast majority of cases have not been detected. This should come as no surprise. Back in March, the Government ordered people with mild symptoms not to bother the NHS; just to stay at home and wait to get better. Moreover, a significant proportion of people infected with Covid-19 show no symptoms whatsoever (the Imperial study claims 30 per cent fall into this category, but evidence from Italy and China suggests it could be as high as 70 to 80 per cent). This group will have seen no reason to get tested. |
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Transmission |
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The Sneaky Trick a Public Health Official Used to Make Mask Mandates Look Super Effective Author: Jon Miltimore Publication date: 14 August 2020 Source: Foundation for Economic Education As of early August, 34 US states mandate the use of masks in public to limit the spread of COVID-19. The efficacy of face masks has been a subject of debate in the health community during the pandemic. Because health experts disagree on their effectiveness, countries and health agencies around the world, including the World Health Organization and the CDC, have done a reversal on their mask recommendations during the pandemic. Reasonable and persuasive cases can be made both for and against the use of masks in the general population. Unfortunately, the science of masks and viruses is becoming less clear because of the politicized nature of the debate. A case in point is the Kansas public health official who made news last week after he was accused of using a deceptive chart to make it appear counties with mask mandates had lower COVID-19 case rates than they actually did. Author: Matt Burrows Publication date: 12 August 2020 Source: Newshub Director-General of Health Dr Ashley Bloomfield announced the change at a press conference on Thursday, moments after revealing there are 13 new cases of coronavirus linked to an outbreak in south Auckland. The use of quarantine facilities marks a major departure from how positive cases were managed by health officials when New Zealand was last at level 3, as cases earlier in the year were told to simply self-isolate in their homes. Dr Bloomfield says the mandatory quarantine will apply to both new cases and, if necessary, close family members who might be at risk. "[It] shows how serious we are about limiting any risk of ongoing transmission - even in self-isolation and including to others in the household," he added. "A reminder, these facilities have been set up specifically and have excellent processes and resources in place to look after people with COVID-19, including health staff on site at all times. "It will help us avoid any further inadvertent spread into the community as part of our overall response." |
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Lockdowns |
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'History will judge the hysteria' Publication date: 16 August 2020 Source: Arutz Sheva Prof. Udi Qimron will soon head the Department of Clinical Microbiology and Immunology at Tel Aviv University. In an interview with Yediot Ahronot, Qimron shed further light on the coronavirus. "There is a very great interest for anyone who has supported the draconian measures taken around the world to say that Sweden's policy has failed. Because if it succeeded, and trillions went down the drain for no reason, someone will have to answer for it.” “That is why all over the world they prefer to claim that [Sweden] was wrong. But in the end, the truth came to the surface. In a world where decision makers, their advisers and the media were able to admit their mistake and the initial panic that gripped them, we would have long since returned to routine. The ongoing destruction due to the inability to admit this mistake, despite the epidemic’s small mortality numbers, is outrageous. History will judge the hysteria." "If we had not been told that there was an epidemic in the country, you would not have known there was such an epidemic and you would not have done anything about it," he said emphatically. "The fact that this issue runs all day in the media inflates it beyond its natural dimensions. If black death had raged here, as in the 14th century, you would not have had to follow the situation in the news, the bodies would have piled up in the streets. We were not and we are not in this situation today." Prof. Qimron noted that the total number of coronavirus deaths does not exceed 0.1% of the total population in any country, and the death rate from coronavirus is less than 0.01% of the total world population, meaning that 99.99% of the world's population so far has survived the epidemic and the virus is negligibly lethal. |
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Therapeutics |
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Doctors Pen Open Letter To Fauci Regarding The Use Of Hydroxychloroquine for Treating COVID-19 Author: Tyler Durden Publication date: 12 August 2020 Source: Zero Hedge Dear Dr. Fauci: You were placed into the most high-profile role regarding America’s response to the Coronavirus pandemic. Americans have relied on your medical expertise concerning the wearing of masks, resuming employment, returning to school, and of course medical treatment. You are largely unchallenged in terms of your medical opinions. You are the de facto “COVID-19 Czar”. This is unusual in the medical profession in which doctors’ opinions are challenged by other physicians in the form of exchanges between doctors at hospitals, medical conferences, as well as debate in medical journals. You render your opinions unchallenged, without formal public opposition from physicians who passionately disagree with you. It is incontestable that the public is best served when opinions and policy are based on the prevailing evidence and science, and able to withstand the scrutiny of medical professionals. As experience accrued in treating COVID-19 infections, physicians worldwide discovered that high-risk patients can be treated successfully as an outpatient, within the first 5 to 7 days of the onset of symptoms, with a “cocktail” consisting of hydroxychloroquine, zinc, and azithromycin (or doxycycline). Multiple scholarly contributions to the literature detail the efficacy of the hydroxychloroquine-based combination treatment. |
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Vaccines |
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Author: Charlie Coë Publication date: 19 August 2020 Source: Mail Online
AstraZeneca to be exempt from coronavirus vaccine liability claims in most countries Authors: Ludwig Burger and Pushkala Aripaka Publication date: 30 July 2020 Source: Reuters AstraZeneca has been granted protection from future product liability claims related to its COVID-19 vaccine hopeful by most of the countries with which it has struck supply agreements, a senior executive told Reuters. With 25 companies testing their vaccine candidates on humans and getting ready to immunise hundred millions of people once the products are shown to work, the question of who pays for any claims for damages in case of side effects has been a tricky point in supply negotiations. “This is a unique situation where we as a company simply cannot take the risk if in ... four years the vaccine is showing side effects,” Ruud Dobber, a member of Astra’s senior executive team, told Reuters. “In the contracts we have in place, we are asking for indemnification. For most countries it is acceptable to take that risk on their shoulders because it is in their national interest,” he said, adding that Astra and regulators were making safety and tolerability a top priority. |
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Environment |
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Coronavirus face masks: an environmental disaster that might last generations Authors: Keiron Philip Roberts, Cressida Bowyer, Simon Kolstoe and Steve Fletcher Publication date: 14 August 2020 Source: The Conversation Face coverings are now a legal requirement in many public spaces around the world. But even before they became compulsory, masks were causing litter problems on land and at sea. One February beach clean in Hong Kong found 70 masks along 100 metres of shoreline, with 30 more appearing a week later. In the Mediterranean, masks have reportedly been seen floating like jellyfish. Despite millions of people being told to use face masks, little guidance has been given on how to dispose of or recycle them safely. And as countries begin to lift lockdown restrictions, billions of masks will be needed each month globally. Without better disposal practices, an environmental disaster is looming. The majority of masks are manufactured from long-lasting plastic materials, and if discarded can persist in the environment for decades to hundreds of years. This means they can have a number of impacts on the environment and people. |
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Social Impacts |
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CDC: A Quarter of Young Adults Say They Contemplated Suicide This Summer During Pandemic Author: Jon Miltimore Publication date: 15 August 2020 Source: Foundation for Economic Education In economics, we talk a lot about unintended consequences. It’s easy to forget that societies are complex ecosystems. Legislators often pass sweeping changes hoping to achieve one result, not realizing it will create countless other consequences not intended. Some of the unintended consequences will be positive, but many of them will not be. A case in point can be found in new government statistics that show a surge in suicidal thoughts among young adults during the COVID-19 pandemic. Global firms expected to sue UK for coronavirus losses Author: Jamie Doward Publication date: 15 August 2020 Source: The Guardian Governments around the world – including the UK – face a wave of lawsuits from foreign companies who complain that their profits have been hit by the pandemic. Webinars and presentations shared with clients reveal that leading global law firms anticipate governments around the world will soon face claims over their response to the Covid-19 crisis. The actions are being brought under investor state dispute settlement (ISDS) clauses which are embedded in trade and investment agreements and allow foreign investors and firms to sue other countries’ governments. The claims are heard in highly secretive ad hoc tribunals before a panel of three judges. Often it is not apparent that a case is being brought until the panel sits. NHS bosses warn mental [health] staff facing ‘burnout’ amid coronavirus pandemic Author: John Johnston Publication date: 12 August 2020 Source: PoliticsHome NHS bosses have warned of "unprecedented challenges" facing mental health services in the wake of the coronavirus pandemic. The NHS Confederation, which represents health services in England, Northern Ireland and Wales, called for "intensive investment" from the Government to prepare mental health teams for a surge in patients. In a new report, the group said an initial drop in referrals at the start of the crisis had now reversed, with some health providers reporting they were treating more patients than pre-pandemic levels. And they said some services were seeing a 20% increase in patients, despite being forced to cut their capacity by 10-30% due to infection control and social distancing measures. It comes after the Centre for Mental Health estimated an additional 500,000 people could require support for mental health over the next two years as a result of the pandemic. GDP monthly estimate, UK: June 2020 Publication date: 12 August 2020 Source: Office for National Statistics
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