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Effects of a major deletion in the SARS-CoV-2 genome on the severity of infection and the inflammatory response: an observational cohort study

Authors: Young BE et al

Publication date: 18 August 2020

Journal: The Lancet

DOI: 10.1016/S0140-6736(20)31757-8

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with a 382-nucleotide deletion (∆382) in the open reading frame 8 (ORF8) region of the genome have been detected in Singapore and other countries. We investigated the effect of this deletion on the clinical features of infection.

Methods: We retrospectively identified patients who had been screened for the ∆382 variant and recruited to the PROTECT study—a prospective observational cohort study conducted at seven public hospitals in Singapore. We collected clinical, laboratory, and radiological data from patients' electronic medical records and serial blood and respiratory samples taken during hospitalisation and after discharge. Individuals infected with the ∆382 variant were compared with those infected with wild-type SARS-CoV-2. Exact logistic regression was used to examine the association between the infection groups and the development of hypoxia requiring supplemental oxygen (an indicator of severe COVID-19, the primary endpoint). Follow-up for the study's primary endpoint is completed.

Findings: Between Jan 22 and March 21, 2020, 278 patients with PCR-confirmed SARS-CoV-2 infection were screened for the ∆382 deletion and 131 were enrolled onto the study, of whom 92 (70%) were infected with the wild-type virus, ten (8%) had a mix of wild-type and ∆382-variant viruses, and 29 (22%) had only the ∆382 variant. Development of hypoxia requiring supplemental oxygen was less frequent in the ∆382 variant group (0 [0%] of 29 patients) than in the wild-type only group (26 [28%] of 92; absolute difference 28% [95% CI 14–28]). After adjusting for age and presence of comorbidities, infection with the ∆382 variant only was associated with lower odds of developing hypoxia requiring supplemental oxygen (adjusted odds ratio 0·07 [95% CI 0·00–0·48]) compared with infection with wild-type virus only.

Interpretation: The ∆382 variant of SARS-CoV-2 seems to be associated with a milder infection. The observed clinical effects of deletions in ORF8 could have implications for the development of treatments and vaccines.

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Nosocomial COVID-19 infection: examining the risk of mortality. The COPE-Nosocomial study (COVID in Older PEople)

Authors: Carter B et al

Publication date: 21 July 2020

Journal: Journal of Hospital Infection

DOI: 10.1016/j.jhin.2020.07.013

Background: Hospital admissions for non-coronavirus disease 2019 (COVID-19) pathology have decreased significantly. It is believed that this may be due to public anxiety about acquiring COVID-19 infection in hospital and the subsequent risk of mortality.

Aim: To identify patients who acquire COVID-19 in hospital (nosocomial COVID-19 infection (NC)) and their risk of mortality compared to those with community-acquired COVID-19 (CAC) infection.

Methods: The COPE-Nosocomial Study was an observational cohort study. The primary outcome was the time to all-cause mortality (estimated with an adjusted hazard ratio (aHR)), and secondary outcomes were day 7 mortality and the time-to-discharge. A mixed-effects multivariable Cox's proportional hazards model was used, adjusted for demographics and comorbidities.

Findings: The study included 1564 patients from 10 hospital sites throughout the UK, and one in Italy, and collected outcomes on patients admitted up to April 28th, 2020. In all, 12.5% of COVID-19 infections were acquired in hospital; 425 (27.2%) patients with COVID died. The median survival time in NC patients was 14 days compared with 10 days in CAC patients. In the primary analysis, NC infection was associated with lower mortality rate (aHR: 0.71; 95% confidence interval (CI): 0.51–0.98). Secondary outcomes found no difference in day 7 mortality (adjusted odds ratio: 0.79; 95% CI: 0.47–1.31), but NC patients required longer time in hospital during convalescence (aHR: 0.49, 95% CI: 0.37–0.66).

Conclusion: The minority of COVID-19 cases were the result of NC transmission. No COVID-19 infection comes without risk, but patients with NC had a lower risk of mortality compared to CAC infection; however, caution should be taken when interpreting this finding.

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Covid-19 patients

Obesity doubles mortality in patients hospitalized for SARS‐CoV‐2 in Paris hospitals, France: a cohort study on 5795 patients

Authors: Czernichow S et al

Publication date: 20 August 2020

Journal: Obesity

DOI: 10.1002/oby.23014

Background: Preliminary data from different cohorts of small sample size or with short follow‐up indicate poorer prognosis in people with obesity compared to other patients. This study aims to precisely describe the strength of association between obesity in patients hospitalised with Covid‐19 and mortality and clarify the risk according to usual cardiometabolic risk factors in a large cohort.

Methods: This is a prospective cohort study including 5795 patients aged 18‐79 years hospitalized from 1st February 2020 to 30 April 2020 in Paris area, with confirmed infection by SARS‐CoV‐2. Adjusted regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for mortality rate at 30 days across BMI classes, without and with imputation for missing BMI.

Results: 891 deaths occurred at 30 days. Mortality was significantly raised in people with obesity with the following OR in BMI 30‐35, 35‐40 and >40 kg/m2: 1.89 (95%CI 1.45‐2.47), 2.79 (1.95‐3.97) and 2.55 (1.62‐3.95), respectively (18.5‐25 kg/m2, as the reference class). This increase holds for all age classes.

Conclusion: Obesity doubles mortality in patients hospitalized with Covid‐19.

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Elevated ACE2 expression in the olfactory neuroepithelium: implications for anosmia and upper respiratory SARS-CoV-2 entry and replication

Authors: Chen M et al

Publication date: 18 August 2020

Journal: European Respiratory Journal

DOI: 10.1183/13993003.01948-2020

ACE2 protein is expressed at high levels in the human olfactory epithelium relative to upper airway epithelial cells. This may explain COVID-19-associated olfactory dysfunction, while suggesting a SARS-CoV-2 reservoir site and potential intranasal therapy.

The ongoing outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a major threat to global health [1]. The mechanism of cellular entry by SARS-CoV-2 is through binding to angiotensin-converting enzyme 2 (ACE2) [2, 3], a metalloproteinase ectoenzyme that primarily functions in the regulation of angiotensin II, but also has non-catalytic roles such as intestinal neutral amino acid transport. The level of ACE2 protein and its subcellular localisation in the respiratory tract may be a key determinant of susceptibility to infection, symptoms, and outcomes in COVID-19. In humans, ACE2 protein is broadly expressed in the lung, kidney, and small intestine [4]. Pathological analysis of COVID-19 postmortem samples shows substantial damage in the lung [5], suggesting that the airway is the principal entry and target of SARS-CoV-2. However, analysis of multiple single cell RNA-seq datasets reveal overall low ACE2 RNA transcription in nasal airway epithelium, with further reduced expression in lower airway club cells and rare expression in alveolar epithelial cells [6]. This pattern of ACE2 expression provides evidence that the upper, rather than the lower, airway is the initial site of SARS-CoV-2 infection.

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A dynamic COVID-19 immune signature includes associations with poor prognosis

Authors: Laing AG et al

Publication date: 17 August 2020

Journal: Nature Medicine

DOI: 10.1038/s41591-020-1038-6

Improved understanding and management of COVID-19, a potentially life-threatening disease, could greatly reduce the threat posed by its etiologic agent, SARS-CoV-2. Toward this end, we have identified a core peripheral blood immune signature across 63 hospital-treated patients with COVID-19 who were otherwise highly heterogeneous. The signature includes discrete changes in B and myelomonocytic cell composition, profoundly altered T cell phenotypes, selective cytokine/chemokine upregulation and SARS-CoV-2-specific antibodies. Some signature traits identify links with other settings of immunoprotection and immunopathology; others, including basophil and plasmacytoid dendritic cell depletion, correlate strongly with disease severity; while a third set of traits, including a triad of IP-10, interleukin-10 and interleukin-6, anticipate subsequent clinical progression. Hence, contingent upon independent validation in other COVID-19 cohorts, individual traits within this signature may collectively and individually guide treatment options; offer insights into COVID-19 pathogenesis; and aid early, risk-based patient stratification that is particularly beneficial in phasic diseases such as COVID-19.

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Older Age and Frailty are the Chief Predictors of Mortality in COVID-19 Patients Admitted to an Acute Medical Unit in a Secondary Care Setting- A Cohort Study

Authors: Chinnadurai R et al

Publication date: 12 August 2020

Journal: BMC Geriatrics

DOI: 10.21203/rs.3.rs-35710/v1

Background: There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations.

Methods: We describe the clinical characteristics of all consecutive COVID-19 positive patients (n=215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (alive or deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) charts were generated by following the outcome in all patients until 12 May 2020.

Results: The median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (63 vs 37%, p<0.001), with a higher prevalence of cardiovascular disease (50 vs 33%, p<0.001) and respiratory diseases (38 vs 25 %, p=0.034). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p=0.03), frailty (OR 5.1; p<0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p=0.01) were strong and independent predictors of inpatient mortality. KM charts showed a clear difference in survival outcome in the frail older patients.

Conclusion: Older age and frailty are strong and independent risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.

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Evaluation of the virulence of SARS-CoV-2 in France, from all-cause mortality 1946-2020

Authors: Rancourt DG, Baudin M and Mercier J

Publication date: 20 August 2020

Source: Researchgate

DOI: 10.13140/RG.2.2.16836.65920/1

We analyzed historic and recent all-cause mortality data for France, and other jurisdictions for comparison, using model fitting to quantify winter-burden deaths, and deaths from exceptional events. In this way, COVID-19 is put in historic perspective. We prove that the "COVID-peak" feature that is present in the all-cause mortality data of certain mid-latitude Northern hemisphere jurisdictions, including France, cannot be a natural epidemiological event occurring in the absence of a large non-pathogenic perturbation. We are certain that this "COVID-peak" is artificial because it: i. occurs sharply (one-month width) at an unprecedented location in the seasonal cycle of all-cause mortality (centered at the end of March), 2 ii. is absent in many jurisdictions (34 of the USA States have no "COVID-peak"), and iii. varies widely in magnitude from jurisdiction to jurisdiction in which it occurs. We suggest that:

  • the unprecedented strict mass quarantine and isolation of both sick and healthy elderly people, together and separately, killed many of them
  • that this quarantine and isolation is the cause of the "COVID-peak" event that we have quantified
  • and that the medical mechanism is mainly via psychological stress and social isolation of individuals with health vulnerabilities. According to our calculations, this caused some 30.2 K deaths in France in March and April 2020.

However, even including the "COVID-peak", the 2019-2020 winter-burden all-cause mortality is not statistically larger than usual. Therefore SARS-CoV-2 is not an unusually virulent viral respiratory disease pathogen. By analyzing the all-cause mortality data from 1946 to 2020, we also identified a large and steady increase in all-cause mortality that began in approximately 2008, which is too large to be explained by population growth in the relevant age structure, and which may be related to the economic crash of 2008 and its long-term societal consequences

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Covid-19 and children

Pediatric SARS-CoV-2: Clinical Presentation, Infectivity, and Immune Responses

Authors: Yonker LM et al

Publication date: 19 August 2020

Journal: The Journal of Pediatrics

DOI: 10.1016/j.jpeds.2020.08.037

Objectives: As schools plan for re-opening, understanding the potential role children play in the coronavirus infectious disease 2019 (COVID-19) pandemic and the factors that drive severe illness in children is critical.

Study design: Children ages 0-22 years with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection presenting to urgent care clinics or being hospitalized for confirmed/suspected SARS-CoV-2 infection or multisystem inflammatory syndrome in children (MIS-C) at Massachusetts General Hospital (MGH) were offered enrollment in the MGH Pediatric COVID-19 Biorepository. Enrolled children provided nasopharyngeal, oropharyngeal, and/or blood specimens. SARS-CoV-2 viral load, ACE2 RNA levels, and serology for SARS-CoV-2 were quantified.

Results: A total of 192 children (mean age 10.2 +/- 7 years) were enrolled. Forty-nine children (26%) were diagnosed with acute SARS-CoV-2 infection; an additional 18 children (9%) met criteria for MIS-C. Only 25 (51%) of children with acute SARS-CoV-2 infection presented with fever; symptoms of SARS-CoV-2 infection, if present, were non-specific. Nasopharyngeal viral load was highest in children in the first 2 days of symptoms, significantly higher than hospitalized adults with severe disease (P = .002). Age did not impact viral load, but younger children had lower ACE2 expression (P=0.004). IgM and IgG to the receptor binding domain (RBD) of the SARS-CoV-2 spike protein were increased in severe MIS-C (P<0.001), with dysregulated humoral responses observed.

Conclusion: This study reveals that children may be a potential source of contagion in the SARS-CoV-2 pandemic in spite of milder disease or lack of symptoms, and immune dysregulation is implicated in severe post-infectious MIS-C.

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Lockdown measures reduced the risk of covid-19, but had unintended consequences for children

Authors: Ladhani S et al

Publication date: 6 August 2020

Journal: The BMJ Opinion

The coronavirus disease 2019 (covid-19) pandemic is undoubtedly the biggest public health crisis since the second world war, and its consequences will be felt for many years to come. The outbreak spread at unprecedented speed across continents, resulting in illness and death, particularly among the frail and elderly. An unusual feature of the pandemic, however, has been the relative sparing of children and young people by SARS-CoV-2, who account for only 1-3% of covid-19 cases, with only 5% of those tested developing severe or critical disease, and very few deaths reported worldwide, compared to other causes of childhood deaths, and to covid-19 case-fatality rates of up to 15% in older adults. [1-5] 

Unlike many other viral respiratory infections such as influenza, children appear less likely to be infected with SARS-CoV-2 than adults and there is accumulating evidence from household transmission studies and outbreak investigations in educational settings that children do not contribute significantly to community transmission. [6,7] That the lockdown has significantly reduced the risk of SARS-CoV-2 in children is undeniable and it is likely that incidence of other highly transmissible viral infections, especially respiratory and gastrointestinal infections, were also reduced during lockdown.

These benefits, however, are overshadowed by the negative consequences of the lockdown. First and foremost is the direct impact on their health. Emergency departments in the UK experienced unprecedented reductions of >50% in attendances during lockdown. [8] In Scotland, children’s emergency department attendances fell proportionally more than any other age-group.  This raises concerns that children with critical illnesses were not accessing health services on time and, therefore, suffering potentially avoidable harm.



Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study

Authors: Hanley B et al

Publication date: 20 August 2020

Journal: The Lancet Microbe

DOI: 10.1016/S2666-5247(20)30115-4

Background: Severe COVID-19 has a high mortality rate. Comprehensive pathological descriptions of COVID-19 are scarce and limited in scope. We aimed to describe the histopathological findings and viral tropism in patients who died of severe COVID-19.

Methods: In this case series, patients were considered eligible if they were older than 18 years, with premortem diagnosis of severe acute respiratory syndrome coronavirus 2 infection and COVID-19 listed clinically as the direct cause of death. Between March 1 and April 30, 2020, full post-mortem examinations were done on nine patients with confirmed COVID-19, including sampling of all major organs. A limited autopsy was done on one additional patient. Histochemical and immunohistochemical analyses were done, and histopathological findings were reported by subspecialist pathologists. Viral quantitative RT-PCR analysis was done on tissue samples from a subset of patients.

Findings: The median age at death of our cohort of ten patients was 73 years (IQR 52–79). Thrombotic features were observed in at least one major organ in all full autopsies, predominantly in the lung (eight [89%] of nine patients), heart (five [56%]), and kidney (four [44%]). Diffuse alveolar damage was the most consistent lung finding (all ten patients); however, organisation was noted in patients with a longer clinical course. We documented lymphocyte depletion (particularly CD8-positive T cells) in haematological organs and haemophagocytosis. Evidence of acute tubular injury was noted in all nine patients examined. Major unexpected findings were acute pancreatitis (two [22%] of nine patients), adrenal micro-infarction (three [33%]), pericarditis (two [22%]), disseminated mucormycosis (one [10%] of ten patients), aortic dissection (one [11%] of nine patients), and marantic endocarditis (one [11%]). Viral genomes were detected outside of the respiratory tract in four of five patients. The presence of subgenomic viral RNA transcripts provided evidence of active viral replication outside the respiratory tract in three of five patients.

Interpretation: Our series supports clinical data showing that the four dominant interrelated pathological processes in severe COVID-19 are diffuse alveolar damage, thrombosis, haemophagocytosis, and immune cell depletion. Additionally, we report here several novel autopsy findings including pancreatitis, pericarditis, adrenal micro-infarction, secondary disseminated mucormycosis, and brain microglial activation, which require additional investigation to understand their role in COVID-19.

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SARS-CoV-2 specific memory B cells frequency in recovered patient remains stable while antibodies decay over time

Authors: Mentesh AV et al

Publication date: 25 August 2020

Journal: medRxiv preprint

DOI: 10.1101/2020.08.23.20179796

The breadth of the humoral immune response following SARS-CoV-2 infection was indicated to be important for recovery from COVID-19. Recent studies have provided valuable insights regarding the dynamics of the antibody response in symptomatic COVID-19 patients. However, the information regarding the dynamics of the serological and cellular memory in COVID-19 recovered patients in scarce. It is imperative to determine the persistence of humoral memory in COVID-19 recovered patients as it will help to evaluate the susceptibility of recovered patients to re-infection. Here, we describe the dynamics of both the SARS-CoV-2 specific serological and B cell response in COVID-19 recovered patients. We found that symptomatic SARS-CoV-2 patients mount a robust antibody response following infection however, the serological memory decays in recovered patients over the period of 6 months. On the other hand, the B cell response as observed in the SARS-CoV-2 specific memory B cell compartment, was found to be stable over time. Moreover, the frequency of SARS-CoV-2 specific B cell plasmablasts was found to be associated with the SARS-CoV-2 specific antibody levels. These data, suggests that the differentiation of short-lived plasmablasts to become long-lived plasma cells is impaired and the main contributor of antibody production are the short-lived plasmablasts. Overall, our data provides insights regarding the humoral memory persistence in recovered COVID-19 patients. Notwithstanding the insights from this study, it is still to be determined if the persistence of SARS-CoV-2 memory B cells can be considered as a correlate of protection in the absence of serological memory.

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Loss of Bcl-6-expressing T follicular helper cells and germinal centers in COVID-19

Authors: Kaneko N et al

Publication date: 14 August 2020

Journal: Cell

DOI: 10.1016/j.cell.2020.08.025

Humoral responses in COVID-19 disease are often of limited durability, as seen with other human coronavirus epidemics. To address the underlying etiology, we examined postmortem thoracic lymph nodes and spleens in acute SARS-CoV-2 infection and observed the absence of germinal centers, a striking reduction in Bcl-6 germinal center B cells but preservationofAID Bcells. Absence of germinal centers correlated with an early specific lock in Bcl-6 TFH cell differentiation together with an increase in T-bet TH1 cells and aberrant extra-follicular TNF-α accumulation. Parallel peripheral blood studies revealed loss of transitional and follicular B cells in severe disease and accumulation of SARS-CoV-2-specific “disease- related” B cell populations. These data identify defective Bcl-6 dysregulated humoral immune induction early in COVID-19 disease, providing a mechanistic explanation for the limited durability of antibody responses in coronavirus infections and suggest that achieving herd immunity through natural infection may be difficult.

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Trait reactance and trust in doctors as predictors of vaccination behavior, vaccine attitudes, and use of complementary and alternative medicine in parents of young children

Authors: Soveri A et al

Publication date: 27 July 2020

Journal: PLOS One

DOI: 10.1371/journal.pone.0236527

Objective: The aim of the present study was to investigate whether anti-vaccination attitudes and behavior, and positive attitudes to complementary and alternative medicine (CAM), are driven by trait reactance and a distrust in medical doctors.

Methods: The sample consisted of 770 Finnish parents who filled out an online survey. Structural equation modeling (SEM) was used to examine if trait reactance plays a role in vaccination decisions, vaccine attitudes, and in the use of CAM, and whether that relationship is mediated by trust in medical doctors.

Results: Parents with higher trait reactance had lower trust in doctors, more negative attitudes to vaccines, a higher likelihood of not accepting vaccines for their children and themselves, and a higher likelihood to use CAM treatments that are not included in evidence-based medicine. Our analyses also revealed associations between vaccination behavior and CAM use and vaccine attitudes and CAM use, but there was no support for the previous notion that these associations would be explained by trait reactance and trust in doctors.

Conclusions: Taken together, higher trait reactance seems to be relevant for attitudes and behaviors that go against conventional medicine, because trait reactance is connected to a distrust in medical doctors. Our findings also suggest that high trait reactance and low trust in doctors function differently for different people: For some individuals they might be associated with anti-vaccination attitudes and behavior, while for others they might be related to CAM use. We speculate that this is because people differ in what is important to them, leading them to react against different aspects of conventional medicine.

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Government and Health Authorities


COVID-19 situation update for the EU/EEA and the UK, as of 26 August 2020

Publication date: 26 August 2020 (updated daily)

Source: European Centre for Disease Prevention and Control

As of 26 August 2020, 2 097 431 cases have been reported in the EU/EEA and the UK: Spain (412 553), United Kingdom (327 798), Italy (261 174), France (248 158), Germany (236 429), Sweden (86 891), Belgium (82 353), Romania (80 390), Netherlands (67 476), Poland (63 073), Portugal (55 912), Ireland (28 201), Austria (25 838), Czechia (22 548), Denmark (16 480), Bulgaria (15 386), Norway (10 395), Greece (8 987), Croatia (8 530), Finland (7 981), Luxembourg (7 838), Hungary (5 215), Slovakia (3 452), Lithuania (2 694), Slovenia (2 686), Estonia (2 294), Iceland (2 077), Malta (1 705), Cyprus (1 474), Latvia (1 342) and Liechtenstein (101).

As of 26 August 2020, 180 933 deaths have been reported in the EU/EEA and the UK: United Kingdom (41 449), Italy (35 445), France (30 544), Spain (28 924), Belgium (9 878), Germany (9 280), Netherlands (6 198), Sweden (5 814), Romania (3 367), Poland (1 977), Portugal (1 805), Ireland (1 777), Austria (733), Denmark (623), Hungary (614), Bulgaria (563), Czechia (416), Finland (335), Norway (264), Greece (243), Croatia (175), Slovenia (128), Luxembourg (124), Lithuania (85), Estonia (64), Latvia (33), Slovakia (33), Cyprus (21), Iceland (10), Malta (10) and Liechtenstein (1).

*The COVID-19 cases reported for Malta do not include COVID-19 positive migrant cases who have disembarked in Malta and have been quarantined upon arrival.

On 17 August 2020, in Malta, the total number of cases resulted in a lower case count compared to the previous day. This may be due to a revision in historical data.

The cases reported in the table below for Spain include cases from the previous 14 days with available data at the time of data collection. On 12 August 2020, Spain retro corrected the cumulative number of deaths leading to a negative increase of deaths.

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FDA Issues Emergency Use Authorization for Convalescent Plasma as Potential Promising COVID–19 Treatment, Another Achievement in Administration’s Fight Against Pandemic

Publication date: 23 August 2020

Source: US Food & Drug Administration

Today, the U.S. Food and Drug Administration issued an emergency use authorization (EUA) for investigational convalescent plasma for the treatment of COVID-19 in hospitalized patients as part of the agency’s ongoing efforts to fight COVID-19. Based on scientific evidence available, the FDA concluded, as outlined in its decision memorandum, this product may be effective in treating COVID-19 and that the known and potential benefits of the product outweigh the known and potential risks of the product.

Today’s action follows the FDA’s extensive review of the science and data generated over the past several months stemming from efforts to facilitate emergency access to convalescent plasma for patients as clinical trials to definitively demonstrate safety and efficacy remain ongoing.

The EUA authorizes the distribution of COVID-19 convalescent plasma in the U.S. and its administration by health care providers, as appropriate, to treat suspected or laboratory-confirmed COVID-19 in hospitalized patients with COVID-19.

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Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19: A Randomized Clinical Trial

Authors: Spinner CD et al

Publication date: 21 August 2020

Journal: JAMA

DOI: 10.1001/jama.2020.16349

Importance: Remdesivir demonstrated clinical benefit in a placebo-controlled trial in patients with severe coronavirus disease 2019 (COVID-19), but its effect in patients with moderate disease is unknown.

Objective: To determine the efficacy of 5 or 10 days of remdesivir treatment compared with standard care on clinical status on day 11 after initiation of treatment.

Design, Setting, and Participants: Randomized, open-label trial of hospitalized patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and moderate COVID-19 pneumonia (pulmonary infiltrates and room-air oxygen saturation >94%) enrolled from March 15 through April 18, 2020, at 105 hospitals in the United States, Europe, and Asia. The date of final follow-up was May 20, 2020.

Interventions: Patients were randomized in a 1:1:1 ratio to receive a 10-day course of remdesivir (n = 197), a 5-day course of remdesivir (n = 199), or standard care (n = 200). Remdesivir was dosed intravenously at 200 mg on day 1 followed by 100 mg/d.

Main Outcomes and Measures: The primary end point was clinical status on day 11 on a 7-point ordinal scale ranging from death (category 1) to discharged (category 7). Differences between remdesivir treatment groups and standard care were calculated using proportional odds models and expressed as odds ratios. An odds ratio greater than 1 indicates difference in clinical status distribution toward category 7 for the remdesivir group vs the standard care group.

Results: Among 596 patients who were randomized, 584 began the study and received remdesivir or continued standard care (median age, 57 [interquartile range, 46-66] years; 227 [39%] women; 56% had cardiovascular disease, 42% hypertension, and 40% diabetes), and 533 (91%) completed the trial. Median length of treatment was 5 days for patients in the 5-day remdesivir group and 6 days for patients in the 10-day remdesivir group. On day 11, patients in the 5-day remdesivir group had statistically significantly higher odds of a better clinical status distribution than those receiving standard care (odds ratio, 1.65; 95% CI, 1.09-2.48; P = .02). The clinical status distribution on day 11 between the 10-day remdesivir and standard care groups was not significantly different (P = .18 by Wilcoxon rank sum test). By day 28, 9 patients had died: 2 (1%) in the 5-day remdesivir group, 3 (2%) in the 10-day remdesivir group, and 4 (2%) in the standard care group. Nausea (10% vs 3%), hypokalemia (6% vs 2%), and headache (5% vs 3%) were more frequent among remdesivir-treated patients compared with standard care.

Conclusions and Relevance: Among patients with moderate COVID-19, those randomized to a 10-day course of remdesivir did not have a statistically significant difference in clinical status compared with standard care at 11 days after initiation of treatment. Patients randomized to a 5-day course of remdesivir had a statistically significant difference in clinical status compared with standard care, but the difference was of uncertain clinical importance.

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Children and covid-19

Q&A: Children and masks related to COVID-19

Publication date: 21 August 2020

Source: The World Health Organization

Should children wear a mask?

WHO advises that people always consult and abide by local authorities on recommended practices in their area. An international and multidisciplinary expert group brought together by WHO reviewed evidence on COVID-19 disease and transmission in children and the limited available evidence on the use of masks by children.

Based on this and other factors such as childrens’ psychosocial needs and developmental milestones, WHO and UNICEF advise the following:

Children aged 5 years and under should not be required to wear masks. This is based on the safety and overall interest of the child and the capacity to appropriately use a mask with minimal assistance.

WHO and UNICEF advise that the decision to use masks for children aged 6-11 should be based on the following factors:

Whether there is widespread transmission in the area where the child resides

The ability of the child to safely and appropriately use a mask

Access to masks, as well as laundering and replacement of masks in certain settings (such as schools and childcare services)

Adequate adult supervision and instructions to the child on how to put on, take off and safely wear masks

Potential impact of wearing a mask on learning and psychosocial development, in consultation with teachers, parents/caregivers and/or medical providers

Specific settings and interactions the child has with other people who are at high risk of developing serious illness, such as the elderly and those with other underlying health conditions

WHO and UNICEF advise that children aged 12 and over should wear a mask under the same conditions as adults, in particular when they cannot guarantee at least a 1-metre distance from others and there is widespread transmission in the area.

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SARS-CoV-2 infection and transmission in educational settings: cross-sectional analysis of clusters and outbreaks in England

Authors: Ismail SA et al

Publication date: 12 August 2020

Source: Public Health England

Background: There are limited data on SARS-CoV-2 infection and transmission in educational settings. This information is critical for policy makers and practitioners to ensure the safety of staff, students and the wider community during the COVID-19 pandemic.

Methods: Public Health England initiated enhanced national surveillance following the reopening of educational settings during the summer mini-term on 01 June 2020. COVID-19 related situations in educational settings across England were reviewed daily and followed-up until 31 July 2020. SARS-CoV-2 infection and outbreak rates were calculated for staff and students attending early year settings, primary and secondary schools during June 2020.

Findings: There were 67 single confirmed cases, 4 co-primary cases and 30 COVID-19 outbreaks during June 2020, with a strong correlation between number of outbreaks and regional COVID-19 incidence (0.51 outbreaks for each SARS-CoV-2 infection per 100,000 in the community; p=0.001). Overall, SARS-CoV-2 infections and outbreaks were uncommon across all educational settings. Staff members had an increased risk of SARS-CoV-2 infections compared to students in any educational setting, and the majority of cases linked to outbreaks were in staff. The probable transmission direction for the 30 confirmed outbreaks was: staff-to-staff (n=15), staff-to-student (n=7), student-to-staff (n=6) and student-to-student (n=2).

Interpretation: SARS-CoV-2 infections and outbreaks were uncommon in educational settings during the first month after the easing of national lockdown in England. The strong correlation with regional SARS-CoV-2 incidence emphasises the importance of controlling community transmission to protect educational settings. Additional interventions should focus on reducing transmission in and among staff members.

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Major New Survey of Care Home Leaders Confirms Severe Impact of Covid-19

Publication date: 24 August 2020

Source: The Queen’s Nursing Institute

The Queen’s Nursing Institute (QNI) has published a major new report on the effect of the Covid-19 pandemic on the UK’s nursing and residential homes.

In May and June of 2020, a survey of the QNI’s Care Home Nurses Network was carried out by the QNI International Community Nursing Observatory (ICNO) to understand more about the impact of Covid-19 on the Care Home Nurse workforce within the UK. This survey was launched in the early weeks of the pandemic in response to grave concerns about the safety of the workforce and the gaps in provision that it was facing. The survey responses confirm that for the majority of respondents, the pandemic has been a very challenging experience. They indicated that their work and wellbeing has been worse or much worse than at normal times, during the survey period.

Having to accept patients from hospitals with unknown Covid-19 status, being told about plans not to resuscitate residents without consulting families, residents or care home staff, lack of guidance on issues like personal protection and issues of poor access to pay if they became ill were some of the major issues the care home workforce faced during March and April 2020.

While two thirds of respondents said they ‘always’ had access to appropriate personal protective equipment (PPE) and most others said that it was usually available, a small minority were not provided with PPE and had to improvise, by obtaining it themselves or by making it. The need for appropriate PPE in care homes is of critical importance in staff and resident safety: 21% of respondents said that their home accepted people discharged from hospital who had tested positive for Covid-19.

Read the report


Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study

Authors: Hanley B et al

Publication date: 20 August 2020

Journal: The Lancet Microbe

DOI: 10.1016/S2666-5247(20)30115-4

Background: Severe COVID-19 has a high mortality rate. Comprehensive pathological descriptions of COVID-19 are scarce and limited in scope. We aimed to describe the histopathological findings and viral tropism in patients who died of severe COVID-19.

Methods: In this case series, patients were considered eligible if they were older than 18 years, with premortem diagnosis of severe acute respiratory syndrome coronavirus 2 infection and COVID-19 listed clinically as the direct cause of death. Between March 1 and April 30, 2020, full post-mortem examinations were done on nine patients with confirmed COVID-19, including sampling of all major organs. A limited autopsy was done on one additional patient. Histochemical and immunohistochemical analyses were done, and histopathological findings were reported by subspecialist pathologists. Viral quantitative RT-PCR analysis was done on tissue samples from a subset of patients.

Findings: The median age at death of our cohort of ten patients was 73 years (IQR 52–79). Thrombotic features were observed in at least one major organ in all full autopsies, predominantly in the lung (eight [89%] of nine patients), heart (five [56%]), and kidney (four [44%]). Diffuse alveolar damage was the most consistent lung finding (all ten patients); however, organisation was noted in patients with a longer clinical course. We documented lymphocyte depletion (particularly CD8-positive T cells) in haematological organs and haemophagocytosis. Evidence of acute tubular injury was noted in all nine patients examined. Major unexpected findings were acute pancreatitis (two [22%] of nine patients), adrenal micro-infarction (three [33%]), pericarditis (two [22%]), disseminated mucormycosis (one [10%] of ten patients), aortic dissection (one [11%] of nine patients), and marantic endocarditis (one [11%]). Viral genomes were detected outside of the respiratory tract in four of five patients. The presence of subgenomic viral RNA transcripts provided evidence of active viral replication outside the respiratory tract in three of five patients.

Interpretation: Our series supports clinical data showing that the four dominant interrelated pathological processes in severe COVID-19 are diffuse alveolar damage, thrombosis, haemophagocytosis, and immune cell depletion. Additionally, we report here several novel autopsy findings including pancreatitis, pericarditis, adrenal micro-infarction, secondary disseminated mucormycosis, and brain microglial activation, which require additional investigation to understand their role in COVID-19.

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Media – Science related


Four Stylized Facts about Covid-19

Authors: Andrew Atkeson, Karen Kopecky and Tao Zha

Publication date: August 2020

Source: National Bureau of Economic Research

We document four facts about the COVID-19 pandemic worldwide relevant for those studying the impact of non-pharmaceutical interventions (NPIs) on COVID-19 transmission. First: across all countries and U.S. states that we study, the growth rates of daily deaths from COVID-19 fell from a wide range of initially high levels to levels close to zero within 20-30 days after each region experienced 25 cumulative deaths. Second: after this initial period, growth rates of daily deaths have hovered around zero or below everywhere in the world. Third: the cross section standard deviation of growth rates of daily deaths across locations fell very rapidly in the first 10 days of the epidemic and has remained at a relatively low level since then. Fourth: when interpreted through a range of epidemiological models, these first three facts about the growth rate of COVID deaths imply that both the effective reproduction numbers and transmission rates of COVID-19 fell from widely dispersed initial levels and the effective reproduction number has hovered around one after the first 30 days of the epidemic virtually everywhere in the world. We argue that failing to account for these four stylized facts may result in overstating the importance of policy mandated NPIs for shaping the progression of this deadly pandemic.

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Covid-19 and education

COVID-19 Outbreaks Occur as Students Return to Campus

Author: Lisa Winter

Publication date: 18 August 2020

Source: The Scientist

As college campuses across the US welcome students back for the start of the semester, numerous universities are faced with isolating individuals who are testing positive for COVID-19, Inside Higher Ed reports. For the University of North Carolina at Chapel Hill (UNC), the spread of multiple clusters of COVID-19 cases has caused the school to transition to online-only classes for the duration of the semester, effective Wednesday, August 19.

After the first week of in-person classes, UNC announced four COVID-19 outbreaks, resulting in the quarantine of three residence halls and one off-campus fraternity house, totaling 130 students and five staff members since August 10. The Daily Tar Heel, UNC’s student newspaper, tweeted Monday afternoon that in the wake of these cases, the university is suspending in-person instruction.

Some of the earliest COVID-19 outbreaks on college campuses involved football players who returned to school up to two months before their peers for summer workouts, The New York Times reported earlier this summer.

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Phase I clinical trial initiated for monoclonal antibody combination for the prevention and treatment of COVID-19

Publication date: 25 August 2020

Source: Astrazeneca

The first participants have been dosed in a Phase I trial of AZD7442, a combination of two monoclonal antibodies (mAbs) in development for the prevention and treatment of COVID-19.

The trial, called NCT04507256, will evaluate the safety, tolerability and pharmacokinetics of AZD7442.1 The trial will include up to 48 healthy participants in the UK aged 18 to 55 years and is funded by the Defense Advanced Research Projects Agency (DARPA), part of the US Department of Defense, and the Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant Secretary for Preparedness and Response at the US Department of Health and Human Services.

Mene Pangalos, Executive Vice President, BioPharmaceuticals R&D, said: “This trial is an important milestone in the development of our monoclonal antibody combination to prevent or treat COVID-19. This combination of antibodies, coupled to our proprietary half-life extension technology, has the potential to improve both the effectiveness and durability of use in addition to reducing the likelihood of viral resistance.”

Should AZD7442 prove to be tolerated and have a favourable safety profile in the trial, AstraZeneca will progress it into larger late-stage Phase II and Phase III trials to evaluate its efficacy as a potential preventative and treatment approach against COVID-19.

Synthesised in the laboratory, mAbs aim to mimic natural antibodies. The treatment has the potential to be given as a preventative option for people exposed to the virus, and to treat and prevent disease progression in patients already infected by the virus.

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Covid-19 and pregnancy

COVID-19: a watershed moment for women’s rights in childbirth

Authors: Daniela Drandić and Fleur van Leeuwen

Publication date: 11 August 2020

Source: Medical Anthropology

“People — and their rights — must be front and center,” said the UN Secretary-General on 23 April 2020. Since the start of the COVID-19 pandemic, drastic measures have been taken by public bodies and health authorities to contain the spread of the virus. Many of these have had serious repercussions for internationally recognized human rights.

The position of the rights of women in childbirth is in this context a precarious one. Stories have emerged in mainstream media – supported by personal accounts received by global and European birthrights organizations – of women having their labor induced, being forced to have cesarean sections, giving birth alone, and being separated from their babies immediately after birth. For Human Rights in Childbirth (HRiC), Drandić (co-author of this piece) collected data on global experiences of childbirth during COVID-19. In this essay, we focus on accounts received by HRiC and reports in mainstream media coming from Europe that warn of serious infringements of women’s rights in childbirth.

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Behavioural science

Doubt cast on use of some 'nudges' during Covid-19 crisis

Publication date: 12 August 2020

Source: King’s College London

The effectiveness of using certain behavioural science “nudges” to change attitudes or behaviour in relation to Covid-19 has been called into question by two new studies.

In a series of experiments, researchers from King’s College London tested nudges that have previously been shown to encourage people to think or act in desired ways.

They found that when used in the context of the coronavirus crisis, they did not have the expected effects.

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Cambridge-developed SARS-CoV-2 vaccine receives £1.9million from UK government for clinical trial

Publication date: 26 August 2020

Source: University of Cambridge

Cambridge-developed vaccine candidate against SARS-CoV-2 could begin clinical trials in the UK in late autumn or early next year, thanks to a £1.9million award from the UK government.

Innovate UK, the UK government’s innovation agency, has provided the funding for a collaboration between Cambridge spin-out company DIOSynVax (which is contributing an additional £400,000 to the trial), the University of Cambridge and the University Hospital Southampton NHS Foundation Trust.

SARS-CoV-2 is a coronavirus, a class of virus named after their appearance: spherical objects, on the surface of which sit ‘spike’ proteins. The virus uses these spikes to attach to and invade cells in our body. One vaccine strategy is to block this attachment; however, not all immune responses against this virus and against this spike protein are protective – antibodies to the wrong part of the spike protein have been implicated in triggering hyper-inflammatory immune responses causing life-threatening COVID-19 disease. Added to this, SARS-CoV-2 is mutating and changes in the virus spike protein during the COVID-19 pandemic have already been observed to be widespread.

To develop their new vaccine candidate – DIOS-CoVax2 – the team use banks of genetic sequences of all known coronaviruses, including those from bats, the natural hosts of many relatives of human coronaviruses. The team have developed libraries of computer-generated antigen structures encoded by synthetic genes that can train the human immune system to target key regions of the virus and to produce beneficial anti-viral responses. These immune responses include neutralising antibodies, which block virus infection, and T-cells, which remove virus-infected cells. This ‘laser-specific’ computer generated approach is able to help avoid the adverse hyper-inflammatory immune responses that can be triggered by recognition of the wrong parts on the coronavirus’s surface.

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Coronavirus: China has been giving potential vaccine to key workers since July

Author: Helen Davidson

Publication date: 24 August 2020

Source: The Guardian

The Chinese government has been administering a coronavirus vaccine candidate to selected groups of key workers since July, a senior health official has said.

Zheng Zhongwei, the head of the National Health Commission’s science and technology centre, told state media organisation CCTV on Sunday the government had authorised “emergency use” of a Sars-Cov-2 vaccine for workers including health workers and border officials.

The country has gone seven days without reporting a locally transmitted case, and border workers are considered to be in a high-risk category, said Zheng, who leads the vaccination development taskforce.

It appears to be the first confirmation of vaccine use by China outside clinical trials.

There were no details on which particular vaccine candidate was used or how many people received it, but Zheng said it had been administered in line with the law, under powers that allow limited use of the unapproved vaccines during serious public health events.

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COVID-19 vaccines could become mandatory. Here’s how it might work

Author: Jillian Kramer

Publication date: 16 August 2020

Source: National Geographic

YOU WALK TOWARD the arena, ready for a big game, tickets in hand. But what you see is a long line wrapping around the corner of the building and a bottleneck at the entrance as people search their pockets and purses for a small piece of paper. To be cleared to enter, you’ll also need that document—proof that you’ve received a COVID-19 vaccination.

This is the future as some experts see it: a world in which you’ll need to show you’ve been inoculated against the novel coronavirus to attend a sports game, get a manicure, go to work, or hop on a train.

“We’re not going to get to the point where the vaccine police break down your door to vaccinate you,” says Arthur Caplan, a bioethicist at New York University’s School of Medicine. But he and several other health policy experts envision vaccine mandates could be instituted and enforced by local governments or employers—similar to the current vaccine requirements for school-age children, military personnel, and hospital workers.

In the United States, most vaccine mandates come from the government. The Advisory Committee on Immunization Practices (ACIP) makes recommendations for both pediatric and adult vaccines, and state legislatures or city councils determine whether to issue mandates. These mandates are most commonly tied to public school attendance, and all 50 states require students to receive some vaccines, with exemptions for medical, religious, and philosophical reasons.

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Media – Reporting


Get on with your lives! Professor says as coronavirus 'not as deadly as first thought'

Author: Lucy Johnston

Publication date: 23 August 2020

Source: Mail Online

CORONAVIRUS is not as deadly as was thought and the public fear that is stopping the country returning to normal is unfounded, a leading expert says. Carl Heneghan, Professor of Evidence-based medicine at Oxford University, called for the government to intervene and "proactively reassure the population".

He said exaggerated fears of Covid have led to "people going about their daily lives misunderstanding and overestimating their risk”.

And he said introducing local lockdowns could do more harm than good by forcing people into their homes, potentially infecting other vulnerable people that live with them.

Professor Heneghan - whose work led to a lowering of the official death toll after he revealed Covid deaths were being counted even if someone had subsequently died of other causes - spoke as he released new data revealing the infection fatality rate had fallen from 2-3 per cent in the height of the pandemic to 0.3.

He said if the downward trend continues the pandemic may end up no worse than a bad flu season.

Reasons for the fall, he said, could not only be down to the consequences of lockdown because cases are continuing to drop despite society opening up.

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COVID: The Case Against the UK Government

Publication date:  22 August 2020

Source: The Human Unleashed

Has the U.K. Government acted in good faith over the COVID-19 crisis?

In this post, we'll examine the UK Government's actions around the COVID crisis alongside various data published by official sources. The goal is to get insight into whether the Government has acted honestly and in good faith.

For now let's put aside the science around whether the disease known as COVID-19 is caused by the novel coronavirus (SARS-CoV-2) and focus on the evidence as it emerged.

Let's keep two alternative possibilities in mind as we look at the facts.

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We now have the best evidence yet that everyone develops long-term coronavirus immunity after infection — and it's not just about antibodies

Author: Aylin Woodward

Publication date: 19 August 2020

Source: Business Insider

Scientists may now have an answer to one of the most crucial lingering questions about COVID-19: whether people develop long-term immunity.

Early research suggested that coronavirus antibodies – blood proteins that protect the body from subsequent infections – could fade within months. But in their concern about those findings’ implications, many people failed to consider our immune system’s multi-layered defence against invading pathogens.

Specifically, they discounted the role of white blood cells, which have impressive power of recollection that can help your body mount another attack against the coronavirus should it ever return. Memory T cells are an especially key type, since they identify and destroy infected cells and inform B cells about how to craft new virus-targeting antibodies.

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NHS asked care homes to place 'Do Not Resuscitate' orders on all residents at height of pandemic

Author: Sarah Knapton

Publication date: 23 August 2020

Source: The Telegraph

Care homes were asked by NHS managers and GPs to place blanket ‘Do not resuscitate’ (DNR) orders on all their residents at the height of the coronavirus pandemic to keep hospital beds free, a new report has found.

The Queen’s Nursing Institute (QNI) – the world’s oldest nursing charity – discovered one in 10 care home staff surveyed was ordered to change DNR plans without discussion with family members, nursing staff, or with the residents themselves.

Half of staff members who said they had been asked to change DNRs worked in homes for the elderly, while half worked in homes for younger people with learning or cognitive disabilities.

Staff also warned that some hospitals were operating a ‘no admissions’ policy for care home residents – even for non-Covid-19 conditions such as heart attacks – and some said they had struggled to make appointments with GPs for elderly people.

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‘Lockdown was always a temporary measure that wasn’t sustainable’ – epidemiologist Prof Mark Woolhouse

Presenter: Krishnan Guru-Murthy

Publication date: 31 July 2020

Source: 4 News

Krishnan spoke to professor Mark Woolhouse, who’s an infectious disease epidemiologist at Edinburgh University and is a member of the Government’s scientific advisory group.

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Oxford coronavirus vaccine data could go to regulators this year

Authors: Alistair Smout and Sarah Young

Publication date: 25 August 2020

Source: Reuters

Trial data for the University of Oxford and AstraZeneca’s possible coronavirus vaccine could be given to regulators this year but corners cannot be cut to speed up approval for emergency use, a scientist leading the trials said on Tuesday.

The Oxford vaccine produced an immune response in its first human trials, underlining its position as one of the leading candidates in the race to combat a virus that has led to hundreds of thousands of deaths and crippled the global economy.

“It is just possible that if the cases accrue rapidly in the clinical trials, that we could have that data before regulators this year,” Andrew Pollard, director of the Oxford Vaccine Group, told BBC Radio of progress in larger, late-stage trials.

“Then there would be a process that they go through in order to make a full assessment of the data.”

The trials hit the headlines earlier this week when the Financial Times reported the Trump administration was considering fast-tracking the vaccine for use in the United States ahead of the Nov. 3 presidential election.

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Exclusive: Fauci says rushing out a vaccine could jeopardize testing of others

Authors: Julie Steenhuysen and Carl O’Donnell

Publication date: 25 August 2020

Source: Reuters

The top U.S. infectious diseases expert is warning that distributing a COVID-19 vaccine under special emergency use guidelines before it has been proved safe and effective in large trials is a bad idea that could have a chilling effect on the testing of other vaccines.

Scientists and health experts have expressed concern that President Donald Trump will apply pressure on the U.S. Food and Drug Administration to deliver a vaccine before November to boost his chances of re-election.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, declined to comment on the president, but said there are risks in rushing out a vaccine despite the urgent need.

“The one thing that you would not want to see with a vaccine is getting an EUA (emergency use authorization) before you have a signal of efficacy,” Fauci told Reuters in a phone interview.

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Coronavirus: We will see 'real problems' with COVID-19 this winter, chief medical officer says

Author: Sharon Morris

Publication date: 23 August 2020

Source: Sky News

England's chief medical officer has warned it is unlikely there will be an "effective and safe" coronavirus vaccine before the winter of 2021.

Professor Chris Whitty said this winter would see "real problems" with COVID-19, the illness caused by the coronavirus, and that the UK should assume no vaccine would be available.

Instead, he said there was a "reasonable chance" that a vaccine could be available for winter of 2021-22.

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Coronavirus ‘will be with us forever in some form or another’, says former chief scientific adviser

Author: Kate Devlin

Publication date: 22 August 2020

Source: The Independent

The UK will be battling Covid-19 forever, a member of the government’s Scientific Advisory Group for Emergencies (Sage) has warned as he reiterated predictions regular inoculations will be needed against the virus.

Sir Mark Walport, a former chief scientific adviser, said the disease was not “going to be a disease like smallpox which could be eradicated by vaccination”.

His warning came as a former government minister warned the UK may need to increase the number of coronavirus tests a day from 150,000 to up to 10 million to fight the global pandemic.

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Russia launches a SECOND Covid vaccine: New jab developed at top-secret biological weapons plant 'avoids side-effects of first one' that Putin announced to widespread scepticism

Author: Will Stewart

Publication date: 22 August 2020

Source: Mail Online

Russia says a second Covid-19 vaccine is on its way which 'avoids the side-effects of the first one'.

Earlier this month, Vladimir Putin rushed to launch the Sputnik5 vaccine in a blaze of publicity, but criticism soon followed after test subjects reported numerous side effects.

Russia's release of the drug was met with widespread scepticism as to its efficacy and its likely the second vaccine, dubbed EpiVacCorona, will be similarly doubted.

The World Health Organization said last month that a working vaccine will not be available until at least early 2021.  

Russia is developing EpiVacCorona in a former top-secret Soviet biological weapons research plant in Siberia, which is now a world-leading virology institute.

Clinical trials of Russia's second vaccine will be completed in September but 57 volunteers who used as human guinea-pigs report no side-effects, scientists have claimed.

Read more… 

The Rush for a Vaccine Leaves Little Recourse for Anyone It Harms

Authors: Valerie Bauman and Susan Decket

Publication date: 14 August 2020

Source: Bloomberg

Americans who suffer adverse reactions to coronavirus vaccines that the U.S. is racing to develop will have a hard time getting compensated for injuries from the drugs.

That’s because pandemic-related claims for vaccines will be routed to a rarely used federal program set up to encourage drugmakers to help combat public health emergencies. It spares pharmaceutical and device makers from costly liability lawsuits in exchange for taxpayers compensating injured patients -- though it doesn’t guarantee there’s funding to do so.

Since it began in 2009, the program has paid out less than $6 million, and it has yet to receive any dedicated U.S. government funding for Covid-19.

“In the best case scenario, this is going to be a big deal,” said Richard Topping, a former Justice Department attorney who represented the U.S. during disputes over the debunked link between vaccines and autism in children. “Worst case scenario? It will be a crisis.”

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Covid-19 and children

Sweden’s Results Suggest We Should Stop Quarantining Healthy Children

Author: Jon Miltimore

Publication date: 19 August 2020

Source: Foundation for Economic Education

Fall hasn’t even arrived yet, but some US schools are already announcing closures during the sixth month of the coronavirus pandemic.

On Sunday, news broke that a Georgia school district announced it will close a third high school after 25 students tested positive for the coronavirus.

“On behalf of the Superintendent, please be advised that we are, effective immediately, temporarily closing in-person learning at Creekview High School,” the school said in a statement.

The announcement came shortly after media reported that a 15-year-old Georgia boy in Gwinnett County died from COVID-19. Reports said the child had pre-existing conditions. (There were conflicting reports on this front, but the Atlanta Journal-Constitution appears to have received clarification from the state confirming the child did have pre-existing conditions.)

It should be noted, however, that it appears the 15-year-old did not get the virus at school. Media reports indicate that Gwinnett County, home of Georgia’s largest school district, was in a virtual-only school format.

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Covid-19 and education

Face Masks 'Not Necessary' For Children And Staff When Schools Reopen, Says Minister

Author: Arj Singh

Publication date: 24 August 2020

Source: Huffpost

Coronavirus has changed everything. Make sense of it all with the Waugh Zone, our evening politics briefing. Sign up now.

Face masks are “not necessary” for staff and pupils when schools in England reopen next month, an education minister has said.

Nick Gibb said as long as schools put in place the hygiene measures outlined in government guidance in early July, face coverings will not be required to stop the spread of coronavirus.

Face masks are currently compulsory on public transport and in shops and other settings.

But the schools minister was backed by child health professor Calum Semple, who sits on the government’s Scientific Advisory Group for Emergencies (Sage), who said the evidence for wearing masks in school was “fairly weak”.

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Social Impacts

New Thinking on Covid Lockdowns: They’re Overly Blunt and Costly

Author: Greg Ip

Publication date: 24 August 2020

Source: The Wall Street Journal

In response to the novel and deadly coronavirus, many governments deployed draconian tactics never used in modern times: severe and broad restrictions on daily activity that helped send the world into its deepest peacetime slump since the Great Depression.

The equivalent of 400 million jobs have been lost world-wide, 13 million in the U.S. alone. Global output is on track to fall 5% this year, far worse than during the financial crisis, according to the International Monetary Fund.

Despite this steep price, few policy makers felt they had a choice, seeing the economic crisis as a side effect of the health crisis. They ordered nonessential businesses closed and told people to stay home, all without the extensive analysis of benefits and risks that usually precedes a new medical treatment.

There wasn’t time to gather that sort of evidence: Faced with a poorly understood and rapidly spreading pathogen, they prioritized saving lives.

Five months later, the evidence suggests lockdowns were an overly blunt and economically costly tool. They are politically difficult to keep in place for long enough to stamp out the virus. The evidence also points to alternative strategies that could slow the spread of the epidemic at much less cost. As cases flare up throughout the U.S., some experts are urging policy makers to pursue these more targeted restrictions and interventions rather than another crippling round of lockdowns.

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