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Opinion: To stop the next pandemic, we need to unravel the origins of COVID-19

Author: David A Relman

Publication date: 03 November 2020

Journal: PNAS

DOI: 10.1073/pnas.2021133117

We find ourselves ten months into one of the most catastrophic global health events of our lifetime and, disturbingly, we still do not know how it began. What’s even more troubling is that despite the critical importance of this question, efforts to investigate the origins of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and of the associated disease, coronavirus disease 2019 (COVID-19), have become mired in politics, poorly supported assumptions and assertions, and incomplete information.

SARS-CoV-2 is a betacoronavirus whose apparent closest relatives, RaTG13 and RmYN02, are reported to have been collected from bats in 2013 and 2019, respectively, in Yunnan Province, China (1). COVID-19 was first reported in December 2019 more than 1,000 miles away in Wuhan City, Hubei Province, China. Beyond these facts, the “origin story” is missing many key details, including a plausible and suitably detailed recent evolutionary history of the virus, the identity and provenance of its most recent ancestors, and surprisingly, the place, time, and mechanism of transmission of the first human infection. Even though a definitive answer may not be forthcoming, and even though an objective analysis requires addressing some uncomfortable possibilities, it is crucial that we pursue this question. Preventing the next pandemic depends on understanding the origins of this one.

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Dynamically evolving novel overlapping gene as a factor in the SARS-CoV-2 pandemic

Authors: Nelson CW

Publication date: 01 October 2020

Journal: eLife

DOI: 10.7554/eLife.59633

Understanding the emergence of novel viruses requires an accurate and comprehensive annotation of their genomes. Overlapping genes (OLGs) are common in viruses and have been associated with pandemics but are still widely overlooked. We identify and characterize ORF3d, a novel OLG in SARS-CoV-2 that is also present in Guangxi pangolin-CoVs but not other closely related pangolin-CoVs or bat-CoVs. We then document evidence of ORF3d translation, characterize its protein sequence, and conduct an evolutionary analysis at three levels: between taxa (21 members of Severe acute respiratory syndrome-related coronavirus), between human hosts (3978 SARS-CoV-2 consensus sequences), and within human hosts (401 deeply sequenced SARS-CoV-2 samples). ORF3d has been independently identified and shown to elicit a strong antibody response in COVID-19 patients. However, it has been misclassified as the unrelated gene ORF3b, leading to confusion. Our results liken ORF3d to other accessory genes in emerging viruses and highlight the importance of OLGs.

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Covid-19 patients

Quick COVID-19 Healers Sustain Anti-SARS-CoV-2 Antibody Production

Authors: Chen Y et al

Publication date: 03 November 2020

Journal: Cell

DOI: 10.1016/j.cell.2020.10.051

Antibodies are key immune effectors that confer protection against pathogenic threats. The nature and longevity of the antibody response to SARS-CoV-2 infection is not well defined. We charted longitudinal antibody responses to SARS-CoV-2 in 92 subjects after symptomatic COVID-19. Antibody responses to SARS-CoV-2 are unimodally distributed over a broad range, with symptom severity correlating directly with virus-specific antibody magnitude. Seventy-six subjects followed longitudinally to ∼100 days demonstrated marked heterogeneity in antibody duration dynamics. Virus-specific IgG decayed substantially in most individuals, whereas a distinct subset had stable or increasing antibody levels in the same time frame despite similar initial antibody magnitudes. These individuals with increasing responses recovered rapidly from symptomatic COVID-19 disease, harbored increased somatic mutations in virus-specific memory B cell antibody genes, and had persistent higher frequencies of previously activated CD4+ T cells. These findings illuminate an efficient immune phenotype that connects rapid symptom clearance to differential antibody durability dynamics.

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UK report on 14,039 patients critically ill with COVID-19

Institution: Intensive Care National Audit & Research Centre (ICNARC)

Publication date: 06 November 2020


Pre-existing conditions are associated with COVID patients’ hospitalization, despite confirmed clearance of SARS-CoV-2 virus

Authors: Pawlowski C et al

Publication date: 03 November 2020

Journal: medRxiv preprint

DOI: 10.1101/2020.10.28.20221655

The current diagnostic gold-standard for SARS-CoV-2 clearance from infected patients is two consecutive negative PCR test results. However, there are anecdotal reports of hospitalization from protracted COVID complications despite such confirmed viral clearance, presenting a clinical conundrum. We conducted a retrospective analysis of 266 COVID patients to compare those that were admitted/re-admitted post-viral clearance (hospitalized post-clearance cohort, n=93) with those that were hospitalized pre-clearance but were not re-admitted post-viral clearance (non-hospitalized post-clearance cohort, n=173). In order to differentiate these two cohorts, we used neural network models for the augmented curation of comorbidities and complications with positive sentiment in the EHR physician notes. In the year preceding COVID onset, acute kidney injury (n=15 (16.1%), p-value: 0.03), anemia (n=20 (21.5%), p-value: 0.02), and cardiac arrhythmia (n=21 (22.6%), p-value: 0.05) were significantly enriched in the physician notes of the hospitalized post-clearance cohort. This study highlights that these specific pre-existing conditions are associated with amplified hospitalization risk in COVID patients, despite their successful SARS-CoV-2 viral clearance. Our finding that pre-COVID anemia amplifies risk of post-COVID hospitalization is particularly concerning given the high prevalence and endemic nature of anemia in many low- and middle-income countries (per the World Bank definition; e.g. India, Brazil), which are unfortunately also seeing high rates of SARS-CoV-2 infection and COVID-induced mortality. This study motivates follow-up prospective research into the specific risk factors we have identified that appear to predispose some patients towards the after effects of COVID-19.

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Covid-19 and children

Preexisting and de novo humoral immunity to SARS-CoV-2 in humans

Authors: Ng KW et al

Publication date: 06 November 2020

Journal: Science

DOI: 10.1126/science.abe1107

Zoonotic introduction of novel coronaviruses may encounter preexisting immunity in humans. Using diverse assays for antibodies recognizing SARS-CoV-2 proteins, we detect preexisting humoral immunity. SARS-CoV-2 spike glycoprotein (S)-reactive antibodies were detectable by a flow cytometry-based method in SARS-CoV-2-uninfected individuals and were particularly prevalent in children and adolescents. They were predominantly of the IgG class and targeted the S2 subunit. By contrast, SARS-CoV-2 infection induced higher titers of SARS-CoV-2 S-reactive IgG antibodies, targeting both the S1 and S2 subunits, and concomitant IgM and IgA antibodies, lasting throughout the observation period. Notably, SARS-CoV-2-uninfected donor sera exhibited specific neutralizing activity against SARS-CoV-2 and SARS-CoV-2 S pseudotypes. Distinguishing preexisting and de novo immunity will be critical for our understanding of susceptibility to and the natural course of SARS-CoV-2 infection.

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Association between living with children and outcomes from COVID-19: an OpenSAFELY cohort study of 12 million adults in England

Authors: Forbes H et al

Publication date: 02 November 2020

Journal: medRxiv preprint

DOI: 10.1101/2020.11.01.20222315

Background: Close contact with children may provide cross-reactive immunity to SARs-CoV-2 due to more frequent prior coryzal infections from seasonal coronaviruses. Alternatively, close contact with children may increase risk of SARs-CoV-2 infection. We investigated whether risk of infection with SARs-CoV-2 and severe outcomes differed between adults living with and without children.

Methods: Working on behalf of NHS England, we conducted a population-based cohort study using primary care data and pseudonymously-linked hospital and intensive care admissions, and death records, from patients registered in general practices representing 40% of England. Using multivariable Cox regression, we calculated fully-adjusted hazard ratios (HR) of outcomes from 1st February-3rd August 2020 comparing adults living with and without children in the household.

Findings: Among 9,157,814 adults ≤65 years, living with children 0-11 years was not associated with increased risks of recorded SARS-CoV-2 infection, COVID-19 related hospital or ICU admission but was associated with reduced risk of COVID-19 death (HR 0.75, 95%CI 0.62-0.92). Living with children aged 12-18 years was associated with a small increased risk of recorded SARS-CoV-2 infection (HR 1.08, 95%CI 1.03-1.13), but not associated with other COVID-19 outcomes. Living with children of any age was also associated with lower risk of dying from non-COVID-19 causes. Among 2,567,671 adults >65 years there was no association between living with children and outcomes related to SARS-CoV-2. We observed no consistent changes in risk following school closure.

Interpretation: For adults living with children there is no evidence of an increased risk of severe COVID-19 outcomes. These findings have implications for determining the benefit-harm balance of children attending school in the COVID-19 pandemic.

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Versatile and multivalent nanobodies efficiently neutralize SARS-CoV-2

Authors: Xiang Y et al

Publication date: 05 November 2020

Journal: Science

DOI: 10.1126/science.abe4747

Cost-effective, efficacious therapeutics are urgently needed against the COVID-19 pandemic. Here, we used camelid immunization and proteomics to identify a large repertoire of highly potent neutralizing nanobodies (Nbs) to the SARS-CoV-2 spike (S) protein receptor-binding domain (RBD). We discovered Nbs with picomolar to femtomolar affinities that inhibit viral infection at sub-ng/ml concentration and determined a structure of one of the most potent in complex with RBD. Structural proteomics and integrative modeling revealed multiple distinct and non-overlapping epitopes and indicated an array of potential neutralization mechanisms. We constructed multivalent Nb constructs that achieved ultrahigh neutralization potency (IC50s as low as 0.058 ng/ml) and may prevent mutational escape. These thermostable Nbs can be rapidly produced in bulk from microbes and resist lyophilization, and aerosolization.

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Clinical Impact Potential of Supplemental Nutrients as Adjuncts of Therapy in High-Risk COVID-19 for Obese Patients

Authors: Sahin E et al

Publication date: 22 October 2020

Journal: Frontiers in Nutrition

DOI: 10.3389/fnut.2020.580504

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China at the end of 2019 caused a major global pandemic and continues to be an unresolved global health crisis. The supportive care interventions for reducing the severity of symptoms along with participation in clinical trials of investigational treatments are the mainstay of COVID-19 management because there is no effective standard therapy for COVID-19. The comorbidity of COVID-19 rises in obese patients. Micronutrients may boost the host immunity against viral infections, including COVID-19. In this review, we discuss the clinical impact potential of supplemental nutrients as adjuncts of therapy in high-risk COVID-19 for obese patients.

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Evolution of Antibody Immunity to SARS-CoV-2

Authors: Gaebler C et al

Publication date: 05 November 2020

Journal: medRxiv preprint

DOI: 10.1101/2020.11.03.367391

SARS-CoV-2 has infected 47 million individuals and is responsible for over 1.2 million deaths to date. Infection is associated with development of variable levels of antibodies with neutralizing activity that can protect against infection in animal models. Antibody levels decrease with time, but the nature and quality of the memory B cells that would be called upon to produce antibodies upon re-infection has not been examined. Here we report on the humoral memory response in a cohort of 87 individuals assessed at 1.3 and 6.2 months after infection. We find that IgM, and IgG anti-SARS-CoV-2 spike protein receptor binding domain (RBD) antibody titers decrease significantly with IgA being less affected. Concurrently, neutralizing activity in plasma decreases by five-fold in pseudotype virus assays. In contrast, the number of RBD-specific memory B cells is unchanged. Memory B cells display clonal turnover after 6.2 months, and the antibodies they express have greater somatic hypermutation, increased potency and resistance to RBD mutations, indicative of continued evolution of the humoral response. Analysis of intestinal biopsies obtained from asymptomatic individuals 3 months after COVID-19 onset, using immunofluorescence, electron tomography or polymerase chain reaction, revealed persistence of SARS-CoV-2 in the small bowel of 7 out of 14 volunteers. We conclude that the memory B cell response to SARS-CoV-2 evolves between 1.3 and 6.2 months after infection in a manner that is consistent with antigen persistence.

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Improving Survival of Critical Care Patients With Coronavirus Disease 2019 in England. A National Cohort Study, March to June 2020

Authors: Dennis JM PhD et al

Publication date: 26 October 2020

Journal: Critical Care Medicine

DOI: 10.1097/CCM.0000000000004747

Objectives: To measure temporal trends in survival over time in people with severe coronavirus disease 2019 requiring critical care (high dependency unit or ICU) management, and to assess whether temporal variation in mortality was explained by changes in patient demographics and comorbidity burden over time.

Design: Retrospective observational cohort; based on data reported to the COVID-19 Hospitalisation in England Surveillance System. The primary outcome was in-hospital 30-day all-cause mortality. Unadjusted survival was estimated by calendar week of admission, and Cox proportional hazards models were used to estimate adjusted survival, controlling for age, sex, ethnicity, major comorbidities, and geographical region.

Measurements and Main Results: Twenty-one thousand eighty-two critical care patients (high dependency unit n = 15,367; ICU n = 5,715) were included. Unadjusted survival at 30 days was lowest for people admitted in late March in both high dependency unit (71.6% survival) and ICU (58.0% survival). By the end of June, survival had improved to 92.7% in high dependency unit and 80.4% in ICU. Improvements in survival remained after adjustment for patient characteristics (age, sex, ethnicity, and major comorbidities) and geographical region.

Conclusions: There has been a substantial improvement in survival amongst people admitted to critical care with coronavirus disease 2019 in England, with markedly higher survival rates in people admitted in May and June compared with those admitted in March and April. Our analysis suggests this improvement is not due to temporal changes in the age, sex, ethnicity, or major comorbidity burden of admitted patients.

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COVID-19 Data Collection, Comorbidity & Federal Law: A Historical Retrospective

Authors: Ealy H et al

Publication date: 12 October 2020

Journal: Science, Public Health Policy, and The Law

According to the Centers for Disease Control and Prevention (CDC) on August 23, 2020, “For 6% of the deaths, COVID-19 was the only cause mentioned. For deaths with conditions or causes in addition to COVID-19 , on average, there were 2.6 additional conditions or causes per death.”[1] For a nation tormented by restrictive public health policies mandated for healthy individuals and small businesses, this is the most important statistical revelation of

this crisis. This revelation significantly impacts the published fatalities count due to COVID-19. More importantly, it exposes major problems with the process by which the CDC was able to generate inaccurate data during a crisis. The CDC has advocated for social isolation, social distancing, and personal protective equipment use as primary mitigation strategies in response to the COVID-19 crisis, while simultaneously refusing to acknowledge the promise of inexpensive pharmaceutical and natural treatments. These mitigation strategies were promoted largely in response to projection model fatality forecasts that have proven to be substantially inaccurate. Further investigation into the legality of the methods used to create these strategies raised additional concerns and questions. Why would the CDC decide against using a system of data collection & reporting they authored, and which has been in use nationwide for 17 years without incident, in favor of an untested & unproven system exclusively for COVID-19 without discussion and peer-review? Did the CDC’s decision to abandon a known and proven effective system also breach several federal laws that ensure data accuracy and integrity? Did the CDC knowingly alter rules for reporting cause of death in the presence of comorbidity exclusively for COVID-19? If so, why?

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Accuracy of UK Rapid Test Consortium (UK-RTC) “AbC-19 Rapid Test” for detection of previous SARS-CoV-2 infection in key workers: test accuracy study

Authors: Mulchandani R et al

Publication date: 11 November 2020

Journal: The BMJ

DOI: 10.1136/bmj.m4262

Objective: To assess the accuracy of the AbC-19 Rapid Test lateral flow immunoassay for the detection of previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Participants: 2847 key workers (healthcare staff, fire and rescue officers, and police officers) in England in June 2020 (268 with a previous polymerase chain reaction (PCR) positive result (median 63 days previously), 2579 with unknown previous infection status); and 1995 pre-pandemic blood donors.

Main outcome measures: AbC-19 sensitivity and specificity, estimated using known negative (pre-pandemic) and known positive (PCR confirmed) samples as reference standards and secondly using the Roche Elecsys anti-nucleoprotein assay, a highly sensitive laboratory immunoassay, as a reference standard in samples from key workers.

Results: Test result bands were often weak, with positive/negative discordance by three trained laboratory staff for 3.9% of devices. Using consensus readings, for known positive and negative samples sensitivity was 92.5% (95% confidence interval 88.8% to 95.1%) and specificity was 97.9% (97.2% to 98.4%). Using an immunoassay reference standard, sensitivity was 94.2% (90.7% to 96.5%) among PCR confirmed cases but 84.7% (80.6% to 88.1%) among other people with antibodies. This is consistent with AbC-19 being more sensitive when antibody concentrations are higher, as people with PCR confirmation tended to have more severe disease whereas only 62% (218/354) of seropositive participants had had symptoms. If 1 million key workers were tested with AbC-19 and 10% had actually been previously infected, 84 700 true positive and 18 900 false positive results would be projected. The probability that a positive result was correct would be 81.7% (76.8% to 85.8%).

Conclusions: AbC-19 sensitivity was lower among unselected populations than among PCR confirmed cases of SARS-CoV-2, highlighting the scope for overestimation of assay performance in studies involving only PCR confirmed cases, owing to “spectrum bias.” Assuming that 10% of the tested population have had SARS-CoV-2 infection, around one in five key workers testing positive with AbC-19 would be false positives.

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Good Reasons to Vaccinate: Mandatory or Payment for Risk?

Author: Julian Savulescu

Publication date: 05 November 2020

Journal: Journal of Medical Ethics

DOI: 10.1136/medethics-2020-106821

Mandatory vaccination, including for COVID-19, can be ethically justified if the threat to public health is grave, the confidence in safety and effectiveness is high, the expected utility of mandatory vaccination is greater than the alternatives and the penalties or costs for non-compliance are proportionate. I describe an algorithm for justified mandatory vaccination. Penalties or costs could include withholding of benefits, imposition of fines, provision of community service or loss of freedoms. I argue that under conditions of risk or perceived risk of a novel vaccination, a system of payment for risk in vaccination may be superior. I defend a payment model against various objections, including that it constitutes coercion and undermines solidarity. I argue that payment can be in cash or in kind, and opportunity for altruistic vaccinations can be preserved by offering people vaccinated the opportunity to donate any cash payment back to the health service.

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Covid science

Science Denial and COVID Conspiracy Theories. Potential Neurological Mechanisms and Possible Responses

Author: Bruce L Miller MD

Publication date: 02 November 2020

Journal: JAMA

DOI: 10.1001/jama.2020.21332

The US public health response to coronavirus disease 2019 (COVID-19) has been dismal, characterized by antimask behavior, antivaccine beliefs, conspiracy theories about the origins of COVID-19, and vocal support by elected officials for unproven therapies. Less than half of the people in the US heed health recommendations to wear a mask when out in public.1 Antiscience rhetoric has consequences. While only 4% of the world’s population resides in the US, the US has accounted for 20% of the world’s deaths related to COVID-19 and has performed less well than several other wealthy nations.2 Low science literacy contributes to denial of science. The relationship between antiscience viewpoints and low science literacy underscores new findings regarding the brain mechanisms that form and maintain false beliefs.

Science Literacy Is Essential

COVID-19 science is complex, and the public is presented with a dizzying array of graphs, statistics, and proposed therapies. Also, communications by scientists changed as they learned about the infectivity and virulence of COVID-19, exacerbating mistrust of scientists by some. In 2015, in a survey of 11 000 12th-grade students who took the National Assessment of Educational Progress (NAEP) science assessment, only 22% were proficient or better in science, and 40% were rated as having “below basic knowledge.”3 Education matters. In a study that included 9654 US adults, 48% of those who had a high school education or less believed there was some truth to the conspiracy theory that COVID-19 was planned but only 15% among those with some postgraduate training endorsed this idea.

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Government and Health Authorities


Ofsted: Children hardest hit by COVID-19 pandemic are regressing in basic skills and learning

Publication date: 10 November 2020

Source: UK Government

Ofsted has today published its second report in a series looking at the effects of the COVID-19 pandemic across the sectors it inspects and regulates, from early years and children’s social care, through to post 16 education.

The report finds that some children, of all ages and backgrounds, have lost some basic skills and learning as a result of school closures and restrictions on movement.

Ofsted carried out more than 900 visits to education and social care providers during September and October. These visits are not judgemental and do not result in an inspection grade. Instead, they are a way for inspectors to hear how providers are coping with this challenging start to the new academic year. Overwhelmingly, leaders and managers have said they find the visits helpful and constructive.

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Social impacts

Performance Tracker 2020. How public services have coped with coronavirus

Publication date: 02 November 2020

Source: Institute for Government

The coronavirus crisis has resulted in backlogs across public services, including at record levels in the criminal courts. The government needs a plan to address these and should provide funding to make permanent the successful reforms introduced during the pandemic.

Performance Tracker 2020, published with the Chartered Institute of Public Finance and Accountancy, analyses the disruptions in hospitals, general practice, adult social care, schools and criminal courts, and the changes made in response.

The government has approved £68.7bn of extra funding since March and suspended governance and regulatory requirements, while long-contemplated technologies, most notably delivering services remotely via video, telephone and text message, have been adopted. New ways of working, including greater collaboration and data sharing, have also helped save critical public services from collapse.

Nonetheless, huge backlogs have developed. Patients are waiting longer to start treatment in hospital and waiting lists are likely to increase for years to come as GPs refer patients who stayed away during the pandemic. The crown court case backlog is now equivalent to 56,000 cases, 42% higher than it was before coronavirus and the biggest in at least two decades.

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Media – Science related


Where did COVID come from? WHO investigation begins but faces challenges

Authors: Smriti Mallapaty

Publication date: 11 November 2020

Source: Nature

The World Health Organization (WHO) has released its plan to investigate the origins of the COVID pandemic. The search will start in Wuhan — the Chinese city where the new coronavirus SARS-CoV-2 was first identified — and expand across China and beyond. Tracing the virus’s path is important for preventing future viral spillovers, but scientists say the WHO team faces a daunting task.

Most researchers think the virus originated in bats, but how it jumped to people is unknown. Other coronaviruses have passed from an intermediate animal host; for example, the virus that caused an outbreak of severe acute respiratory syndrome (SARS) in 2002–04 probably came to people from raccoon dogs (Nyctereutes procyonoides) or civets.

“Finding an animal with a SARS-CoV-2 infection is like looking for a needle in the world’s largest haystack. They may never find a ‘smoking bat’” or other animal, says Angela Rasmussen, a virologist at Columbia University in New York City. “It will be key for the investigators to establish a collaborative relationship with scientists and government officials in China.”

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Spread of mutated coronavirus in Danish mink ‘hits all the scary buttons,’ but fears may be overblown

Author: Helen Branswell

Publication date: 05 November 2020

Source: STAT

Denmark set off alarm bells this week with its announcement that it is culling the nation’s entire mink herd — the largest in the world — to stop spread of the SARS-CoV-2 virus in the prized fur species because of potentially dangerous mutations.

Inter-species jumps of viruses make scientists nervous — as do suggestions of potentially significant mutations that result from those jumps. In this case, Danish authorities say they’ve found some genetic changes that might undermine the effectiveness of Covid-19 vaccines currently in development.

But is this latest twist in the Covid-19 saga reason to be deeply concerned? Several experts STAT consulted suggested the answer to that question is probably not.

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The Mystery of Taiwan

Author: Amelia Janaskie

Publication date: 07 November 2020

Source: The American Institute for Economic Research

In 2020, most countries in the world locked down their societies with the goal of controlling the Covid-19 pandemic. There were some outliers. Sweden, Belarus, Tanzania, and some US states deployed little in the way of “nonpharmaceutical interventions.”

Another fascinating outlier – often cited as a case in which a government handled the pandemic the correct way – was Taiwan. Indeed, Taiwan presents an anomaly in the mitigation and overall handling of the Covid-19 pandemic.

In terms of stringency, Taiwan ranks among the lowest in the world, with fewer controls than Sweden and far lower than the U.S.

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Publication date: 11 November 2020

Source: Pfizer

Pfizer (NYSE: PFE) and BioNTech SE (Nasdaq: BNTX) today announced that they have reached an agreement with the European Commission to supply 200 million doses of their investigational BNT162b2 mRNA-based vaccine candidate against SARS-CoV-2 to European Union (EU) Member States, with an option for the European Commission to request an additional 100 million doses. Deliveries are anticipated to start by the end of 2020, subject to clinical success and regulatory authorization.

Vaccine doses for Europe will be produced in BioNTech’s German manufacturing sites, as well as in Pfizer’s manufacturing site in Belgium. If the BNT162b2 vaccine candidate receives approval from the European Medicines Agency (EMA), then doses will be ordered by the EU Member States who have elected to receive the vaccine as part of this agreement.

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Pfizer and Biontech announce vaccine candidate against covid-19 achieved success in first interim analysis from phase 3 study

Publication date: 09 november 2020

Source: Pfizer

After discussion with the FDA, the companies recently elected to drop the 32-case interim analysis and conduct the first interim analysis at a minimum of 62 cases. Upon the conclusion of those discussions, the evaluable case count reached 94 and the DMC performed its first analysis on all cases. The case split between vaccinated individuals and those who received the placebo indicates a vaccine efficacy rate above 90%, at 7 days after the second dose. This means that protection is achieved 28 days after the initiation of the vaccination, which consists of a 2-dose schedule. As the study continues, the final vaccine efficacy percentage may vary. The DMC has not reported any serious safety concerns and recommends that the study continue to collect additional safety and efficacy data as planned. The data will be discussed with regulatory authorities worldwide.

“Today is a great day for science and humanity. The first set of results from our Phase 3 COVID-19 vaccine trial provides the initial evidence of our vaccine’s ability to prevent COVID-19,” said Dr. Albert Bourla, Pfizer Chairman and CEO. “We are reaching this critical milestone in our vaccine development program at a time when the world needs it most with infection rates setting new records, hospitals nearing over-capacity and economies struggling to reopen. With today’s news, we are a significant step closer to providing people around the world with a much-needed breakthrough to help bring an end to this global health crisis. We look forward to sharing additional efficacy and safety data generated from thousands of participants in the coming weeks.”

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Endemic disease

Robin Shattock says 'we could be living with COVID-19 for years to come'

Author: Stephen Johns

Publication date: 04 November 2020

Source: Imperial College London

Imperial’s COVID-19 vaccine lead, Professor Robin Shattock, has told MPs we could be living with the virus for years to come.

Professor Shattock, speaking to the Science and Technology Committee, said that a vaccine would make life much better and reduce fatalities but we are still likely to be living with the virus for the next few years.

Professor Shattock, from the Department of Infectious Disease, also updated MPs on the progress of Imperial's vaccine.

Professor Shattock said: "Right now we don’t know which if any of these vaccines will work, and what success will like, whether that’s success at preventing disease or preventing transmission.

"One of the advantages of the technology we are developing is it can be used for repeated boosting immunisations, either to boost existing vaccines or itself.

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Media – Reporting


U.S. Right to Know Sues NIH for Documents about Origins of SARS-CoV-2

Author: Gary Ruskin

Publication date: 05 November 2020

Source: US Right to Know

U.S. Right to Know, an investigative public health nonprofit group, filed a lawsuit today against the National Institutes of Health (NIH) for violating provisions of the Freedom of Information Act.

The lawsuit, filed in U.S. District Court in Washington, D.C., seeks correspondence with or about organizations such as the Wuhan Institute of Virology and the Wuhan Center for Disease Control and Prevention, as well as the EcoHealth Alliance, which partnered with and funded the Wuhan Institute of Virology.

Today’s litigation against the NIH is one part of our efforts to try to uncover what is known about the origins of SARS-CoV-2, and the risks of biosafety labs and gain-of-function research, which seeks to augment the infectivity or lethality of potential pandemic pathogens. Since July, we have filed 36 state, federal and international public records requests about these subjects.

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Liverpool's mass-testing scheme is branded a 'shambles' as Covid-stricken patients are allowed to mix with the uninfected in hour-long queues: Top scientists warn ambitious project could be a costly failure

Author: Sam Blanchard

Publication date: 06 November 2020

Source: Mail Online

England's first city-wide mass-swabbing scheme was branded a 'shambles' by the people of Liverpool today who claimed they were forced to mingle in hour-long queues with potentially infected Covid-19 patients.

The Merseyside city - once the nation's coronavirus hotspot - today began offering rapid Covid-19 tests to all 500,000 of its residents in the first major step forward for No10's ambitious 'Operation Moonshot'. Everyone is being encouraged to get tested, regardless of whether they have symptoms or not.

But residents have today complained to MailOnline that asymptomatic and symptomatic people were not segregated as they queued at testing centres for their swab, potentially opening the door for the coronavirus to spread more easily.

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Liberté! An open letter by 200 French lawyers protesting against lockdown

Publication date: 07 November 2020

Source: The Spectator

After saying there was 'no question of lockdown', Emmanuel Macron has announced what many feared: the implementation of a new national and mandatory lockdown. We are lawyers and jurists of all specialities and from all parts of France and write to express our indignation at the injustice of this measure. After being astonished by the first lockdown, we believe that such violations of our freedoms and ways of life are neither viable nor legitimate. Lockdown will have major collateral consequences that will be more harmful than the virus itself.

While we agree with the President’s statement that nothing is 'more important than human life'. But a national lockdown is an approach reduced to the biology of life alone, forgetting that health is also, according to the WHO definition, 'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity'. Protecting life therefore implies taking into account all its aspects, which are as much social, cultural, spiritual, political and economic as they are health-related.

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Compulsory vaccine is the worst thing, says virologist

Authors: Alexandra Brzozowski and Sarantis Michalopoulos

Publication date: 11 November 2020

Source: Euractiv

“The worst thing you can do is make the vaccine compulsory,” virologist Marc Van Ranst told VRT Niews.

“That’s fuel to the anti-vaccine movement, as it’s what they’ve been warning about for years. It would send a very bad signal,” he added.

According to figures from Belgium’s public health institute Sciensano, 50% of people surveyed would certainly get vaccinated, 17% would not, and 33% are in doubt.

“The 17% who will not be vaccinated is not a problem”, he explained. “But you will have to convince the other 33%. And from the past, you learn that you will eventually persuade those people. That will work.”

The issue of whether vaccination for COVID-19 should be mandatory or voluntary in order to achieve the highest possible vaccination rates has taken centre stage lately.

A recent worldwide poll found mixed feelings among EU member states. In Poland and Hungary, 56% of those surveyed said they would get a vaccine, and 59% in France. In Spain, the percentage is 72% while in Great Britain it is 85%.

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UK says YES to jab... but you go first, Boris! Poll shows three-quarters of Britons would agree to have the Covid-19 vaccine - but 40% want politicians to take it first to prove it's safe

Authors: Simon Walters and Kate Pickels

Publication date: 10 November 2020

Source: Mail Online

Three in four Britons would take the Covid vaccine, including nearly nine in ten elderly, according to a Daily Mail poll.

Only 7 per cent said they would not have it under any circumstances. The poll also showed that Pfizer’s breakthrough jab was the best news of the year for many – and as significant as the fall of the Iron Curtain.

However there was a note of caution, with seven in ten feeling lockdown restrictions should stay in place for now.

Four in ten said the Prime Minister and fellow politicians should take the vaccination first to show it was safe.

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State Bar Passes Mandatory COVID-19 Vaccination Recommendation

Author: Jason Grant

Publication date: 07 November 2020

Source: New York Law Journal

The New York State Bar Association on Saturday passed a resolution urging the state to consider making it mandatory for all New Yorkers to undergo COVID-19 vaccination when a vaccine becomes available, even if people object to it for “religious, philosophical or personal reasons.”

The resolution, which was passed by a majority of the bar association’s 277-member House of Delegates, includes conditions limiting its scope. Those include that the state government should only consider making vaccinations mandatory if voluntary COVID-19 vaccinations fall short of producing needed levels of population immunity; that an assessment of the health threat to various communities be made so that perhaps the mandate can be targeted; and that a mandate only be considered after there is expert consensus about the vaccine’s safety and efficacy.

In a statement Saturday afternoon, Mary Beth Morrissey, chair of the bar association’s Health Law Section’s Task Force on COVID-19, which in May released a controversial report that had first proposed the idea of a vaccine mandate, said, “The authority of the state to respond to a public health crisis is well-established in constitutional law,”

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Covid: China's Sinovac vaccine trial halted in Brazil

Publication date: 10 November 2020

Source: BBC News

The Brazilian clinical trial for a high-profile Chinese Covid-19 vaccine has been suspended after health authorities reported a "severe adverse" incident.

Brazilian health regulator Anvisa said the incident took place on 29 October, but did not give further details.

The Sinovac vaccine is one of several in final-stage testing globally.

But China has already been using it to immunise thousands of people at home in an emergency use programme.

There was no immediate response from Sinovac Biotech, the Chinese pharmaceutical firm developing the CoronaVac vaccine.

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Face Masks: A Danger to Our Planet, Our Children & Ourselves

Author: Cory Morningstar

Publication date: 06 November 2020

Source: Off Guardian

It seems like only yesterday that a massive campaign against single-use plastic straws was trending. The much forgotten anti-straw trend was based on astronomical numbers; a suggested 500 million straws used each day in the US alone, with more than half a billion plastic straws being consumed and discarded, every day around the entire globe.

An estimated 8.3 billion plastic straws had come to pollute the planet’s beautiful beaches. The backlash against the straws appeared to be drive by the horrific impacts on the marine environment in particular.

Personal protective equipment (PPE) in 2020, in particular face masks, have become a new genre of pollution. The majority of face masks being purchase and disposed of are single-use surgical masks made of melt-blown fabric manufactured from polypropylene, a type of thermoplastic. The vast majority of all disposable face masks being consumed have two outer layers with a filter between them (polypropylene), made from nonwoven plastic fibres.

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Teachers disagree with union leadership over closing of schools, new poll reveals

Author: Camilla Turner

Publication date: 07 November 2020

Source: The Telegraph

Teachers are at odds with the UK’s largest union as more back keeping schools open than not, according to a new poll.

Just 39 per cent of teachers believe schools should close during the November lockdown, while 46 per cent believe they should remain open, according to a survey by Teacher Tapp. A further 15 per cent neither agreed nor disagreed or could not answer.

Over 6,000 teachers were asked whether they agree with the Government’s plan to keep children in the classroom during the national shut down.

Headteachers were more likely to back schools staying open, with 69 per cent in favour compared to 42 per cent of classroom teachers.

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Social Impacts

UK unemployment rate continues to surge

Publication date: 10 November 2020

Source: BBC News

The UK's unemployment rate rose to 4.8% in the three months to September, up from 4.5%, as coronavirus continued to hit the jobs market.

Redundancies rose to a record high of 314,000 in the same period, the Office for National Statistics (ONS) said.

Firms made more workers redundant in anticipation of the end of the furlough scheme, which was originally supposed to finish at the end of October.

It has now been extended until the end of March.

Analysts said the extension had come "too late in the day" to save some jobs and further big rises in unemployment were likely in the coming months.

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'Toxic lockdown' sees huge rise in babies harmed or killed

Author: Hannah Richardson

Publication date: 06 November 2020

Source: BBC News

There was an alarming 20% rise in babies being killed or harmed during the first lockdown, Ofsted's chief inspector Amanda Spielman has revealed.

Sixty four babies were deliberately harmed in England - eight of whom died. Some 40% of the 300 incidents reported involved infants, up a fifth on 2019.

Ms Spielman believes a "toxic mix" of isolation, poverty and mental illness caused the March to October spike.

Health staff and social workers were hampered by Covid restrictions.

And many regular visits could not take place, while others were carried out remotely, using the telephone or video links.

Read more… (link to Amanda Spielman’s speech)


Covid data 'exaggerating' risk, medics and academics tell Boris Johnson

Author: Edward Malnick

Publication date: 07 November 2020

Source: The Telegraph

Official data is "exaggerating" the current risk posed by Covid-19, a coalition of almost 500 senior doctors and scientists warned on Saturday, claiming talk of a second wave is "misleading".

In a joint letter to Boris Johnson, the medics and academics say the Government's approach to the pandemic has become "disproportionate" and is "causing more harm than good".

They warn that mass testing is "distorting the current risk" from the virus, with tests likely to be producing high numbers of "false positive" results and providing a poor indication of whether someone is infectious, and say the Government must do more to place increasing infection and deaths "in the context of the normal seasonal illness/death rate".

Read the open letter