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Science |
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Mutations |
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No evidence for increased transmissibility from recurrent mutations in SARS-CoV-2 Authors: van Dorp L et al Publication date: 25 November 2020 Journal: Nature Communications DOI: 10.1038/s41467-020-19818-2 COVID-19 is caused by the coronavirus SARS-CoV-2, which jumped into the human population in late 2019 from a currently uncharacterised animal reservoir. Due to this recent association with humans, SARS-CoV-2 may not yet be fully adapted to its human host. This has led to speculations that SARS-CoV-2 may be evolving towards higher transmissibility. The most plausible mutations under putative natural selection are those which have emerged repeatedly and independently (homoplasies). Here, we formally test whether any homoplasies observed in SARS-CoV-2 to date are significantly associated with increased viral transmission. To do so, we develop a phylogenetic index to quantify the relative number of descendants in sister clades with and without a specific allele. We apply this index to a curated set of recurrent mutations identified within a dataset of 46,723 SARS-CoV-2 genomes isolated from patients worldwide. We do not identify a single recurrent mutation in this set convincingly associated with increased viral transmission. Instead, recurrent mutations currently in circulation appear to be evolutionary neutral and primarily induced by the human immune system via RNA editing, rather than being signatures of adaptation. At this stage we find no evidence for significantly more transmissible lineages of SARS-CoV-2 due to recurrent mutations. |
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Transmission |
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Authors: Maharaj AS et al Publication date: 04 December 2020 Journal: medRxiv preprint DOI: 10.1101/2020.12.02.20242735 Background: Syndromic surveillance systems for COVID-19 are being increasingly used to track and predict outbreaks of confirmed cases. Seasonal circulating respiratory viruses share syndromic overlap with COVID-19, and it is unknown how they will impact the performance of syndromic surveillance tools. Here we investigated the role of non-SARS-CoV-2 respiratory virus test positivity on COVID-19 two independent syndromic surveillance systems in Ontario, Canada. Methods: We compared the weekly number of reported COVID-19 cases reported in the province of Ontario against two syndromic surveillance metrics: 1) the proportion of respondents with a self-reported COVID-like illness (CLI) from COVID Near You (CNY) and 2) the proportion of emergency department visits for upper respiratory conditions from the Acute Care Enhanced Surveillance (ACES) system. Separately, we plotted the percent positivity for other seasonal respiratory viruses over the same time period and reported Pearson correlation coefficients before and after the uncoupling of syndromic tools to COVID-19 cases. Results: There were strong positive correlations of both CLI and ED visits for upper respiratory causes with COVID-19 cases up to and including a rise in entero/rhinovirus (r = 0.86 and 0.87, respectively). There was a strong negative correlation of both CLI and ED visits for upper respiratory causes with COVID-19 cases (r = -0.85 and -0.91, respectively) during a fall in entero/rhinovirus. Interpretation: Two methods of syndromic surveillance showed strong positive correlations with COVID-19 confirmed case counts before and during a rise in circulating entero/rhinovirus. However, as positivity for enterovirus/rhinovirus fell in late September 2020, syndromic signals became uncoupled from COVID-19 cases and instead tracked the fall in enter/rhinovirus. This finding provides proof-of-principle that regional transmission of seasonal respiratory viruses may complicate the interpretation of COVID-19 surveillance data. It is imperative that surveillance systems incorporate other respiratory virus testing data in order to more accurately track and forecast COVID-19 disease activity. |
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Covid-19 patients |
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Authors: Carrasco-Sánchez FJ et al Publication date: 04 December 2020 Journal: Annals of Medicine DOI: 10.1080/07853890.2020.1836566 Background: Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. Methods: This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140–180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. Results: Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140–180 mg) and 41.1% (>180 mg/dL), p<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank, p<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31–1.73) (BG 140–180 mg/dL; HR 1.48; 95%CI: 1.29–1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. Conclusions: Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes. Pathways to Severe COVID‐19 for People with Obesity Authors: Robert W O’Rourke and Carey N Lumeng Publication date: 03 December 2020 Journal: Obesity DOI: 10.1002/oby.23099 Increased morbidity and mortality from SARS‐CoV‐2 coronavirus disease (COVID‐19) in people with obesity has illuminated the intersection of obesity with impaired responses to infections. While data is being rapidly generated on mechanisms by which COVID‐19 impacts health, there is a critical need to better understand the pulmonary, vascular, metabolic, and immunologic aspects that drive the increased risk for complications from COVID‐19 in people with obesity. In this review, we provide a broad overview of the intersection between COVID‐19 and physiology of obesity to highlight potential mechanisms by which COVID‐19 disease severity is increased by obesity, and to identify areas for future investigation towards developing tailored therapy for people with obesity who develop COVID‐19. Authors: Demichev V et al Publication date: 12 November 2020 Journal: medRxiv preprint DOI: 10.1101/2020.11.09.20228015 COVID-19 is highly variable in its clinical presentation, ranging from asymptomatic infection to severe organ damage and death. There is an urgent need for predictive markers that can guide clinical decision-making, inform about the effect of experimental therapies, and point to novel therapeutic targets. Here, we characterize the time-dependent progression of COVID-19 through different stages of the disease, by measuring 86 accredited diagnostic parameters and plasma proteomes at 687 sampling points, in a cohort of 139 patients during hospitalization. We report that the time-resolved patient molecular phenotypes reflect an initial spike in the systemic inflammatory response, which is gradually alleviated and followed by a protein signature indicative of tissue repair, metabolic reconstitution and immunomodulation. Further, we show that the early host response is predictive for the disease trajectory and gives rise to proteomic and diagnostic marker signatures that classify the need for supplemental oxygen therapy and mechanical ventilation, and that predict the time to recovery of mildly ill patients. In severely ill patients, the molecular phenotype of the early host response predicts survival, in two independent cohorts and weeks before outcome. We also identify age-specific molecular response to COVID-19, which involves increased inflammation and lipoprotein dysregulation in older patients. Our study provides a deep and time resolved molecular characterization of COVID-19 disease progression, and reports biomarkers for risk-adapted treatment strategies and molecular disease monitoring. Our study demonstrates accurate prognosis of COVID-19 outcome from proteomic signatures recorded weeks earlier. |
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Mortality |
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Risk factors for severe illness and death in COVID-19: a systematic review and meta-analysis Authors: Degarege A et al Publication date: 04 December 2020 Journal: medRxiv preprint DOI: 10.1101/2020.12.03.20243659 Objectives: This systematic review and meta-analysis synthesized the evidence on the impact of demographics and comorbidities with clinical outcomes of COVID-19, including severe illness, admission to the intensive care unit (ICU), and death. Methods: The PRISMA guidelines were followed to conduct and report this meta-analysis. The protocol is registered in PROSPERO International prospective register of systematic reviews (ID=CRD42020184440). Two authors independently searched literature from PubMed, Embase, Cochrane library and CINHAL on May 6, 2020; removed duplicates; screened titles, abstracts and full text using criteria; and extracted data from eligible articles. A random-effects model was used to estimate the summary odds ratio (OR). Variations among studies were examined using Cochrane Q and I2. Results: Out of 4,275 articles obtained from the databases and screened, 71 studies that involved 216,843 patients were abstracted and then, where appropriate, analyzed by meta-analysis. The COVID-19 related outcomes reported were death in 26 studies, severe illness in 41 studies, and admission to ICU in 11 studies. Death was significantly correlated with hypertension (OR 2.60; 95% CI 1.95,3.25; I2 = 52.6%; n= 13 studies), cardiovascular disease (5.16; 4.10,6.22; 0.0%; 6), diabetes (2.11; 1.35,2.87; 67.4%; 12), chronic respiratory disease (2.83; 2.14, 3.51; 0.0%; 9), cerebrovascular diseases (5.14; 1.08, 9.19; 0.0%; 2), male sex (1.34; 1.18, 1.50; 38.7%; 16), age older than 60 (6.09; 3.53, 8.66; 95.5%; 6) or 65 years (3.56; 1.21, 5.90; 18.2%, 6). Severe illness was also significantly associated with hypertension (1.70; 1.30, 2.10; 47.8%; 21), cardiovascular diseases (2.04; 1.01, 3.08; 30.6%, 10), diabetes (1.65; 1.23, 2.08; 24.9%; 18), male sex (1.35; 1.23, 1.47; 0.0%; 32) and age at least 60 (4.91; 1.35, 8.47; 0.0%; 4) or 65 (2.55; 1.94, 3.17; 24.5%; 9) years. Among hospitalized patients, the odds of admission to ICU was greater in individuals who had cardiovascular diseases (1.36; 1.04, 1.69; 0.0%; 4), diabetes (1.55; 1.20, 1.90; 0.0%; 5) and chronic respiratory disease (1.52; 1.09, 1.94; 0.0%; 5) than those who were not having these comorbidities. Conclusions: Older age and chronic diseases increase the risk of developing severe illness, admission to ICU and death among COVID-19 patients. Special strategies are warranted to prevent SARS-CoV-2 infection and manage COVID-19 cases in those with vulnerabilities. Mortality in Norway and Sweden before and after the Covid-19 outbreak: a cohort study Authors: Juul FE et al Publication date: 13 November 2020 Journal: medRxiv preprint DOI: 10.1101/2020.11.11.20229708 Objectives: Norway and Sweden are similar countries regarding ethnicity, socioeconomics and health care. To combat Covid-19, Norway implemented extensive measures such as school closures and lock-downs, while Sweden has been criticised for relaxed measures against Covid-19. We compared the effect of the different national strategies on all-cause and Covid-19 associated mortality. Main outcome measures: We calculated weekly mortality rates (MR) with 95% confidence intervals (CI) per 100,000 individuals as well as mortality rate ratios (MRR) comparing the epidemic year (29th July, 2019 to 26th July, 2020) to the four preceding years (July 2015 to July 2019). We also compared Covid-19 associated deaths and mortality rates for the weeks of the epidemic in Norway and Sweden (16th March to 26th July, 2020). Results: In Norway, mortality rates were stable during the first three 12-month periods of 2015/16; 2016/17 and 2017/18 (MR 14.8 to 15.1 per 100,000), and slightly lower in the two most recent periods including during epidemic period (2018/19 and 2019/20; 14.5 per 100,000). In Sweden, all-cause mortality was stable during the first three 12-month periods of 2015/16; 2016/17 and 2017/18 (MR 17.2 to 17.5 per 100,000), but lower in the year 2018/19 immediately preceding the epidemic (16.2 per 100,000). Covid-19 associated mortality rates were 0.2 per 100,000 (95%CI 0.1 to 0.4) in Norway and 2.9 (95%CI 1.9 to 3.9) in Sweden. The increase in mortality was confined to individuals in 70 years or older. Conclusions: All-cause mortality remained unaltered in Norway. In Sweden, the observed increase in all-cause mortality during Covid-19 was partly due to a lower than expected mortality preceding the epidemic and the observed excess mortality, was followed by a lower than expected mortality after the first Covid-19 wave. This may suggest mortality displacement. |
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Therapeutics |
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Authors: Roth A et al Publicaton date: 02 December 2020 Journal: bioRxiv preprint DOI: 10.1101/2020.12.02.408153 Objective: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the pathogen accountable for the coronavirus disease 2019 (COVID-19) pandemic. Viral entry via binding of the receptor binding domain (RBD) located within the S1 subunit of the SARS-CoV-2 Spike (S) protein to its target receptor angiotensin converting enzyme (ACE) 2 is a key step in cell infection. The efficient transition of the virus is linked to a unique protein called open reading frame (ORF) 8. As SARS-CoV-2 infections can develop into life-threatening lower respiratory syndromes, effective therapy options are urgently needed. Several publications propose vitamin D treatment, although its mode of action against COVID-19 is not fully elucidated. It is speculated that vitamin D’s beneficial effects are mediated by up-regulating LL-37, a well-known antimicrobial peptide with antiviral effects. Methods: Recombinantly expressed SARS-CoV-2 S protein, the extended S1 subunit (S1e), the S2 subunit (S2), the receptor binding domain (RBD), and ORF8 were used for surface plasmon resonance (SPR) studies to investigate LL-37’s ability to bind to SARS-CoV-2 proteins and to localize its binding site within the S protein. Binding competition studies were conducted to confirm an inhibitory action of LL-37 on the attachment of SARS-CoV-2 S protein to its entry receptor ACE2. Results: We could show that LL-37 binds to SARS-CoV-2 S protein (LL-37/SStrep KD = 407 nM, LL-37/SHis KD = 414 nM) with the same affinity, as SARS-CoV-2 binds to hACE2 (hACE2/SStrep KD = 374 nM, hACE2/SHis KD = 368 nM). The binding is not restricted to the RBD of the S protein, but rather distributed along the entire length of the protein. Interaction between LL-37 and ORF8 was detected with a KD of 294 nM. Further, inhibition of the binding of SStrep (IC50 = 735 nM), S1e (IC50 = 168 nM), and RBD (IC50 = 126 nM) to hACE2 by LL-37 was demonstrated. Conclusions: We have revealed a biochemical link between vitamin D, LL-37, and COVID-19 severity. SPR analysis demonstrated that LL-37 binds to SARS-CoV-2 S protein and inhibits binding to its receptor hACE2, and most likely viral entry into the cell. This study supports the prophylactic use of vitamin D to induce LL-37 that protects from SARS-CoV-2 infection, and the therapeutic administration of vitamin D for the treatment of COVID-19 patients. Further, our results provide evidence that the direct use of LL-37 by inhalation and systemic application may reduce the severity of COVID-19. Authors: Zhao B et al Publication date: 17 November 2020 Journal: Annals of palliative Medicine DOI: 10.21037/apm-20-1387 Background: Coronavirus disease 2019 (COVID-19) is a global public health event without specific therapeutic agents till now. We aim to determine if high dose intravenous vitamin C (HDIVC) was effective for COVID-19 patients in severe condition. Methods: COVID-19 patients admitted in Shanghai Public Health Clinical Center from January 22, 2020 to April 11, 2020 were retrospectively scrolled. The enrolled patients were those with confirmed diagnosis of severe or critical COVID-19 pneumonia, who received HDIVC within 24 hours after disease aggravation. Main clinical outcomes obtained from 3-5 days (day 3) and 7-10 days (day 7) after HDIVC were compared to the ones just before (day 0) HDIVC. Results: Totally, twelve patients were enrolled including six severe [age of mean, 56; interquartile range (IQR), 32-65 years, 3 men] and six critical (age of mean, 63; IQR, 60-82 years, 4 men) patients. The dosage of vitamin C [median (IQR), mg/kg (body weight)/day] were [162.7 (71.1-328.6)] for severe and [178.6 (133.3-350.6)] for critical patients. By Generalized estimating equation (GEE) model, C-reactive protein (CRP) was found to decrease significantly from day 0 to 3 and 7 (severe: 59.01±37.9, 12.36±22.12, 8.95±20.4; critical: 92.5±41.21, 33.9±30.2, 59.56±41.4 mg/L). Lymphocyte and CD4+ T cell counts in severe patients reached to normal level since day 3. Similar improving trends were observed for PaO2/FiO2 (severe: 209.3±111.7, 313.4±146, 423.3±140.8; critical: 119.9±52.7, 201.8±86.64, 190.5±51.99) and sequential organ failure assessment score (severe: 2.83±1.72, 1.33±1.63, 0.67±1.03; critical: 6.67±2.34, 4.17±2.32, 3.83±2.56). Better improving effect was observed in severe than critical patients after HDIVC. Conclusions: HDIVC might be beneficial in aspects of inflammatory response, immune and organ function for aggravation of COVID-19 patients. Further clinical trials are in warrant. Repositioning vitamin C as a promising option to alleviate complications associated with COVID-19 Authors: Farjana M et al Publication date: 13 November 2020 Journal: Infection & Chemotherapy Vitamin C, also known as L-ascorbic acid, is an essential vitamin with pleiotropic functions, ranging from antioxidant to anti-microbial functions. Evidence suggests that vitamin C acts against inflammation, oxidative stress, autophagy chaos, and immune dysfunction. The ability to activate and enhance the immune system makes this versatile vitamin a prospective therapeutic agent amid the current situation of coronavirus disease (COVID-19). Being highly effective against the influenza virus, causing the common cold, vitamin C may also function against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its associated complications. Severe infections need higher doses of the vitamin to compensate for the augmented inflammatory response and metabolic demand that commonly occur during COVID-19. Compelling evidence also suggests that a high dose of vitamin C (1.5 g/kg body weight) in inflammatory conditions can result in effective clinical outcomes and thus can be employed to combat COVID-19. However, further studies are crucial to delineate the mechanism underlying the action of vitamin C against COVID-19. The current review aims to reposition vitamin C as an alternative approach for alleviating COVID-19-associated complications. |
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Immunity |
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Correlates of protection against SARS-CoV-2 in rhesus macaques Authors: McMahan K et al Publication date: 04 December 2020 Journal: Nature DOI: 10.1038/s41586-020-03041-6 Recent studies have reported protective efficacy of both natural immunity1 and vaccine-induced immunity2–7 against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) challenge in rhesus macaques. However, the importance of humoral and cellular immunity for protection against SARS-CoV-2 infection remains to be determined. Here we show that adoptive transfer of purified IgG from convalescent macaques protects naïve recipient rhesus macaques against SARS-CoV-2 challenge in a dose dependent fashion. Depletion of CD8+ T cells in convalescent animals partially abrogated the protective efficacy of natural immunity against SARS-CoV-2 re-challenge, suggesting the importance of cellular immunity in the context of waning or subprotective antibody titers. These data demonstrate that relatively low antibody titers are sufficient for protection against SARS-CoV-2 in rhesus macaques, and that cellular immune responses may also contribute to protection if antibody responses are suboptimal. We also show that higher antibody titers are required for therapy of SARS-CoV-2 infection in macaques. These findings have important implications for the development of SARS-CoV-2 vaccines and immune-based therapeutics. Prior COVID-19 infection offers protection from re-infection for at least six months Publication date: 20 November 2020 Source: Oxford University The study, done as part of a major collaboration between the University of Oxford and Oxford University Hospitals (OUH) NHS Foundation Trust, was published today as a pre-print. Despite an estimated 51 million people infected with the virus worldwide, with high levels of transmission ongoing, reports of patients becoming re-infected after already having had COVID-19 are rare. However, up until now there have not been any large-scale studies of how much protection from re-infection people get after COVID-19. The study, part of a major ongoing staff testing programme supported by the NIHR Oxford Biomedical Research Centre and Public Health England, covered a 30-week period (April – November 2020) with 12,180 health care workers employed at OUH. The health care workers were tested for antibodies to the virus that causes COVID-19 as a way of detecting who had been infected before. The hospital tested staff regularly for COVID-19, both when they became unwell with symptoms and also as part of regular testing of well staff. The researchers then followed whether staff who had been infected before had the same number of new COVID-19 infections as those who had not been infected before. Immunological memory to SARS-CoV-2 assessed for greater than six months after infection Authors: Dan JM et al Publication date: 20 November 2020 Journal: bioRxiv preprint DOI: 10.1101/2020.11.15.383323 Understanding immune memory to SARS-CoV-2 is critical for improving diagnostics and vaccines, and for assessing the likely future course of the pandemic. We analyzed multiple compartments of circulating immune memory to SARS-CoV-2 in 185 COVID-19 cases, including 41 cases at ≥6 months post-infection. Spike IgG was relatively stable over 6+ months. Spike-specific memory B cells were more abundant at 6 months than at 1 month. SARS-CoV-2-specific CD4+ T cells and CD8+ T cells declined with a half-life of 3-5 months. By studying antibody, memory B cell, CD4+ T cell, and CD8+ T cell memory to SARS-CoV-2 in an integrated manner, we observed that each component of SARS-CoV-2 immune memory exhibited distinct kinetics. |
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Testing |
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Viral cultures for COVID-19 infectious potential assessment – a systematic review Authors: T Jefferson, E A Spencer, J Brassey, C Heneghan Publication date: 03 December 2020 Journal: Clinical Infectious Disease DOI: 10.1093/cid/ciaa1764 Objective: to review the evidence from studies relating SARS-CoV-2 culture with the results of reverse transcriptase polymerase chain reaction (RT-PCR) and other variables which may influence the interpretation of the test, such as time from symptom onset Methods: We searched LitCovid, medRxiv, Google Scholar and the WHO Covid-19 database for Covid-19 to 10 September 2020. We included studies attempting to culture or observe SARS-CoV-2 in specimens with RT-PCR positivity. Studies were dual extracted and the data summarised narratively by specimen type. Where necessary we contacted corresponding authors of included papers for additional information. We assessed quality using a modified QUADAS 2 risk of bias tool. Results: We included 29 studies reporting attempts at culturing, or observing tissue infection by, SARS-CoV-2 in sputum, nasopharyngeal or oropharyngeal, urine, stool, blood and environmental specimens. The quality of the studies was moderate with lack of standardised reporting. The data suggest a relationship between the time from onset of symptom to the timing of the specimen test, cycle threshold (Ct) and symptom severity. Twelve studies reported that Ct values were significantly lower and log copies higher in specimens producing live virus culture. Two studies reported the odds of live virus culture reduced by approximately 33% for every one unit increase in Ct. Six of eight studies reported detectable RNA for longer than 14 days but infectious potential declined after day 8 even among cases with ongoing high viral loads. Four studies reported viral culture from stool specimens. Conclusion: Complete live viruses are necessary for transmission, not the fragments identified by PCR. Prospective routine testing of reference and culture specimens and their relationship to symptoms, signs and patient co-factors should be used to define the reliability of PCR for assessing infectious potential. Those with high cycle threshold are unlikely to have infectious potential. |
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Vaccines |
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Authors: Voysey M et al Publication date: 08 December 2020 Journal: The Lancet DOI: 10.1016/ S0140-6736(20)32661-1 Background: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 − relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs 71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; p =0·010). Overall vaccine efficacy across both interaction groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. Authors: Richmond R et al Publication date: 04 December 2020 Journal: medRxiv preprint DOI: 10.1101/2020.12.03.20243709 Background: As part of the accelerated development of prophylactic vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) we report a first-in-human dose-finding and adjuvant justification study of SCB-2019, a novel protein subunit vaccine candidate composed of a stabilised trimeric form of the spike (S)-protein produced in CHO-cells, combined with two different adjuvants. Methods: This phase 1 study was done in one centre in Western Australia in 151 healthy adult volunteers in two age groups (18 to 54 and 55 to 75 years), allocated to 15 groups (nine young and six older adults) to receive two doses, 21 days apart, of placebo, or 3 µg, 9 µg or 30 µg SCB-2019, alone or adjuvanted with AS03 or CpG/Alum. Reactogenicity was assessed for 7 days after each vaccination. Humoral responses were measured as SCB-2019 binding and ACE2-competitive binding IgG antibodies by ELISA, and as neutralising antibodies by wild-type SARS-CoV-2 microneutralisation assay; cellular responses to pooled S-protein peptides were measured by flow-cytometric intracellular cytokine staining. Findings: We report on 148 participants with at least 4 weeks follow-up post dose 2. Three participants withdrew, two for personal reasons and one with an unrelated SAE (pituitary adenoma). Vaccination was well tolerated, with few Grade 3 solicited adverse events (AE). Most local AEs were mild injection site pain, which were more frequent with formulations containing AS03 than CpG/Alum or unadjuvanted SCB-2019. Systemic AEs, mostly transient headache, fatigue or myalgia, were more frequent in young adults than older adults after the first dose, but similar after second doses. Unadjuvanted SCB-2019 elicited minimal immune responses, but SCB-2019 with fixed doses of AS03 or CpG/Alum induced high titres and seroconversion rates of binding and neutralising antibodies in both young and older adults. Titres were higher than those observed in a panel of COVID-19 convalescent sera in all AS03 groups and high dose CpG/Alum groups. Both adjuvanted formulations elicited Th1-biased CD4+ T cell responses. Interpretation: SCB-2019 trimeric protein formulated with AS03 or CpG/Alum adjuvants elicited robust humoral and cellular immune responses against SARS-CoV-2 with high viral neutralising activity. Both adjuvanted formulations were well tolerated and are suitable for further clinical development. Durability of Responses after SARS-CoV-2 mRNA-1273 Vaccination Authors: Widge AT et al Publication date: 03 December 2020 Journal: New England Journal of Medicine DOI: 10.1056/NEJMc2032195 We recently reported the results of a phase 1 trial of a messenger RNA vaccine, mRNA-1273, to prevent infection with SARS-CoV-2; those interim results covered a period of 57 days after the first vaccination.1,2 Here, we describe immunogenicity data 119 days after the first vaccination (90 days after the second vaccination) in 34 healthy adult participants in the same trial who received two injections of vaccine at a dose of 100 μg. The injections were received 28 days apart. The recipients were stratified according to age (18 to 55 years, 56 to 70 years, or ≥71 years), and the assays used have been described previously.1,2 At the 100-μg dose, mRNA-1273 produced high levels of binding and neutralizing antibodies that declined slightly over time, as expected, but they remained elevated in all participants 3 months after the booster vaccination. Binding antibody responses to the spike receptor–binding domain were assessed by enzyme-linked immunosorbent assay. At the day 119 time point, the geometric mean titer (GMT) was 235,228 (95% confidence interval [CI], 177,236 to 312,195) in participants 18 to 55 years of age, 151,761 (95% CI, 88,571 to 260,033) in those 56 to 70 years of age, and 157,946 (95% CI, 94,345 to 264,420) in those 71 years of age or older (Figure 1). |
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Pandemic profiles |
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Six pandemic profiles identified in study of public’s response to guidance Publication date: 30 November 2020 Source: University of Leeds Researchers investigating the public response to official COVID-19 guidance say people can be split into six distinct groups determined by the way they search for, follow and act upon official advice. The profiles have been identified by social scientists at the University of Leeds based on their perception of risk, shared attitudes, values and experiences of the virus. While most people were found to be following guidance, others do not understand it, do not trust it, or ignore it completely – meaning that official messaging is not reaching a significant minority of people across the country. |
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Misinformation |
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New study to investigate COVID-19 and misinformation Publication date: 01 December 2020 Source: University of Bristol Researchers at the University of Bristol and King's College London are leading a major new study to investigate COVID-19 perceptions and misperceptions, lockdown compliance and vaccine hesitancy. The research team is gathering longitudinal survey data on trust and compliance with public health requirements over the course of the pandemic, enhancing and extending the 'Life Under Lockdown' study fielded between April and June this year. The study will examine whether trust and perceptions are stable over time - and whether the fundamental drivers of misperceptions and conspiracism can be identified. The research project will also assess whether endorsement of Covid-19 and vaccine conspiracies undermine trust and compliance. It will be delivered through analysis of new, high-quality survey data studying respondents over time. |
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Government and Health Authorities |
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Covid-19 pandemic |
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Publication date: 02 December 2020 Source: European Commission As the end of 2020 approaches, the world continues to face an expanding global pandemic. While the SARS-CoV-2 virus is better understood and the healthcare systems across the EU are better prepared, the high number of cases might quickly overrun even the best prepared hospital and overwhelm the best designed strategies. Every 17 seconds, a person dies in the EU due to COVID-19. It is essential to control the spread of the virus and avoid further deaths and severe illness. The upcoming holiday season poses particular risks in this fragile context due to the drop in temperature and the social proximity it entails. It will be a different type of festive season; one where individual and collective responsibility will save lives. This Communication provides recommendations to Member States aiming to keep the number of COVID-19 cases down and avoid losing the progress made so far at great cost. Further recommendations will be presented early next year, to design a comprehensive COVID-19 control framework based on the knowledge and experience so far and the latest available scientific guidelines. |
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Vaccines |
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Publication date: 04 December 2020 Source: The New York State Senate “IF PUBLIC HEALTH OFFICIALS DETERMINE THAT RESIDENTS OF THE STATE ARE NOT DEVELOPING SUFFICIENT IMMUNITY FROM COVID-19, THE DEPARTMENT SHALL MANDATE VACCINATION FOR ALL INDIVIDUALS OR GROUPS OF INDIVIDUALS WHO, AS SHOWN BY CLINICAL DATA, ARE PROVEN TO BE SAFE TO RECEIVE SUCH VACCINE.” Government to add COVID-19 to Vaccine Damage Payments Scheme Publication date: 03 December 2020 Source: UK Government In advance of a rollout of an authorised COVID-19 vaccine and in line with other immunisation programmes, the government is taking the precautionary step to ensure that, in the very rare possibility where someone is severely disabled as a result of taking a COVID-19 vaccine, they can access financial assistance through the Vaccine Damage Payments Scheme (VDPS). No safety concerns have been reported in vaccines authorised for use following rigorous clinical trials involving tens of thousands of people and extensive analysis of the vaccine’s safety, quality and effectiveness by experts from the Medicines and Healthcare products Regulatory Agency (MHRA). Pfizer/BioNTech’s vaccine is now the first COVID-19 vaccine to be authorised for use in the UK, and the MHRA will keep safety under continual review. Adding diseases to the VDPS is not new and numerous diseases have been added as successive governments have rolled out more immunisation programmes, such as HPV and Meningitis B. In response to the H1N1 (swine flu) pandemic, the previous government added swine flu to the VDPS on 10 October 2009. |
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Media – Science related |
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Origins |
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COVID-19 May Have Arrived in US in December: Study Author: Max Kozlov Publication date: 02 December 2020 Source: The Scientist Some people may have been infected with the novel coronavirus as early as December 13, more than a month before the US Centers for Disease Control and Prevention confirmed the first case of the virus, according to a study published online November 30 in Clinical Infectious Diseases, in which researchers analyzed blood samples from American Red Cross donations. The findings provide further evidence that the virus was spreading around the world well before public health officials and researchers thought it had started circulating. The Red Cross had originally collected the blood samples to test for exposure to mosquito-borne illnesses such as West Nile virus and the study authors used them to test for antibodies against SARS-CoV-2, Susan Stramer, an American Red Cross virologist and a coauthor of the paper, tells The New York Times. Among the 7,389 samples, 106 had SARS-CoV-2 antibodies, of which 39 were collected from California, Oregon, and Washington between December 13 and December 16. Another 67 were collected from Connecticut, Iowa, Massachusetts, Michigan, Rhode Island, and Wisconsin between December 30 and January 17. |
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Transmission |
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University Covid-19 cases this week at record-low of 21 Author: David Tritsch Publication date: 02 December 2020 Source: Cherwell Oxford University’s testing service has confirmed a record-low of 21 cases of COVID-19 among students and staff for the week 21st-27th November, with a positivity rate of 15%. Following a drop from 126 to 40 confirmed cases, this marks a further reduction in weekly numbers by 50%. This term started off with close to 200 new cases confirmed in each week, until new case numbers began falling in weeks 4 and 5. However, the number of tests conducted in these later weeks was down almost 50% compared to earlier this term, while the test positivity rate reached record highs. By week 5, the University’s testing service had recorded almost 1,000 cases of COVID-19 among students and staff (Oxford’s current student population is close to 24,000). Week 6 marked the first substantial drop in the positivity rate to 17.2%, down from its peak at 34% in week 4. New case numbers also dropped by 70% that week. This we ek continues a trend of rapidly dropping new case numbers, with several colleges recording no active cases at all. |
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Vaccines |
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Publication date: 08 December 2020 Source: Astrazeneca Results of an interim analysis of the Phase III programme conducted by Oxford University with AZD1222, peer-reviewed and published in The Lancet today, demonstrated that the vaccine is safe and effective at preventing symptomatic COVID-19 and that it protects against severe disease and hospitalisation. The interim analysis for efficacy was based on 11,636 participants accruing 131 symptomatic infections from the Phase III UK and Brazil trials conducted by Oxford University. As announced on 23 November 2020, the primary efficacy endpoint of the programme statistical plan, based on the pooling of two dosing regimens, showed that the vaccine is 70.4% (95.8% CI: 54.8% to 80.6%) effective at preventing symptomatic COVID-19 occurring more than 14 days after receiving two doses of the vaccine. A secondary efficacy endpoint of prevention of severe disease demonstrated no cases of severe infections or hospitalisations in the vaccine group. A further analysis of the efficacy regimens showed that when the vaccine was given as two full doses, vaccine efficacy was 62.1% (n=8,895; CI 41.0% to 75.7%), and 90.0% (n=2,741; CI 67.4% to 97.0%) in participants who received a half dose followed by a full dose. Vaccine efficacy was also assessed on the secondary endpoint of early prevention of severe disease after the first dose. There were no hospitalisations or severe cases of COVID-19 more than 21 days after the first dose of the vaccine. Ten participants in the control group were hospitalised due to COVID-19, among whom two were assessed as severe, including one fatal case. Author: Helen Branswell Publication date: 03 December 2020 Source: STAT When a Centers for Disease Control and Prevention advisory committee voted Tuesday to recommend residents of long-term care facilities should be at the front of the line — with health care providers — for Covid-19 vaccines, the lone dissenting voice came from a researcher who studies vaccines in older adults. Helen Keipp Talbot — who is known by her middle name — raised serious concerns during the meeting of the Advisory Committee on Immunization Practices about using the vaccines in the frail elderly, noting there are no data yet to suggest the vaccines work in this population. All the U.S.-based Phase 3 trials of Covid vaccines have to include people 65 and older. But none has specifically tested the vaccines in people who are in long-term care. One can’t assume findings in people over age 65 who are healthy enough to be accepted for a clinical trial are indicative of everyone in that demographic, she said. Authors: Cary Funk and Alec Tyson Publication date: 03 December 2020 Source: Pew Research Center As vaccines for the coronavirus enter review for emergency use by the U.S. Food and Drug Administration, the share of Americans who say they plan to get vaccinated has increased as the public has grown more confident that the development process will deliver a safe and effective vaccine. Still, the U.S. public is far from uniform in views about a vaccine. A majority says they would be uncomfortable being among the first to take it, and a sizable minority appear certain to pass on getting vaccinated. Overall, 60% of Americans say they would definitely or probably get a vaccine for the coronavirus, if one were available today, up from 51% who said this in September. About four-in-ten (39%) say they definitely or probably would not get a coronavirus vaccine, though about half of this group – or 18% of U.S. adults – says it’s possible they would decide to get vaccinated once people start getting a vaccine and more information becomes available. UK consumer confidence edges up on vaccine news: YouGov Publication date: 01 December 2020 Source: Reuters British consumer confidence has improved slightly as the prospect of vaccines for COVID-19 grows, polling firm YouGov said on Tuesday. YouGov said its index for consumer confidence increased to 102.3, up from 101.4 a month ago. “November’s consumer confidence index shows that despite England’s lockdown, Wales’ ‘fire breaker’ and increased restrictions in Scotland, consumer confidence has increased across the UK albeit marginally,” Darren Yaxley, director of reputation research at YouGov, said. |
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Media – Reporting |
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Government controls |
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Canada’s COVID-19 Strategy is an Assault on the Working Class Authors: Dr Sunetra Gupta, Dr Martin Kulldorff Publication date: 04 December 2020 Source: American Institute for Economic Research Canada is known for caring for all its citizens, through for example universal health care and excellent public schools. What changed? The Canadian COVID-19 lockdown strategy is the worst assault on the working class in many decades. Low-risk college students and young professionals are protected; such as lawyers, government employees, journalists, and scientists who can work from home; while older high-risk working-class people must work, risking their lives generating the population immunity that will eventually help protect everyone. This is backwards, leading to many unnecessary deaths from both COVID-19 and other diseases. |
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Therapeutics |
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Coronavirus update: Vitamin C could save the lives of those severely affected by Covid-19 Author: Adam Chapman Publication date: 08 December 2020 Source: Daily Express Today marks a milestone in the advance against COVID-19. A UK grandmother has become the first person in the world to be given the Pfizer COVID-19 jab as part of a mass vaccination programme. This is not the only cause for celebration. A new review of the efficacy of vitamin C shows that the vitamin offers potent protection against the pathogen. The key finding from a paper published in the journal Nutrients today is that vitamin C can save the lives of those badly infected with COVID-19 and make symptoms of milder infections less severe. Other findings include: Many severely infected patients have such low vitamin C levels they are suffering from scurvy A controlled trial found high dose vitamin C more effective than a steroid The vitamin C level of patients in intensive care predicts their chances of survival Humans are one of the few animals that cannot make vitamin C. The conclusions are based on results from more than 100 studies, including a gold-standard RCT (Randomised Controlled Trial)which showed that Vitamin C could slash the death rate of patients in intensive care units by 68 percent. The patients received vitamin C or sterile water from a drip. |
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Lockdowns |
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How robust was the evidence for lockdown? Author: Ross Clark Publication date: 08 December 2020 Source: The Spectator weekly infection survey has been looked upon as the gold standard of Covid data. It is based on swab testing of a large, randomised sample of the population who are tested repeatedly to see if they are infected with the virus – the results from which are scaled up to arrive at an estimate of incidence of the disease in the population as a whole. Being a randomised sample, it does not suffer from the drawback of the daily Public Health England figures for confirmed infections – which are heavily influenced by how many tests are being conducted. As the number of tests has expanded, so, too, the number of confirmed infections has risen. However, the most recent edition of the ONS’ infection survey shows just how fickle the data can be – and how difficult it must be for the government to make decisions when data is so subject to change. |
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Health passports |
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Watch: vaccine minister rules out ‘immunity passports’ Author: Steerpike Publication date: 07 December 2020 Source: The Spectator This morning the new vaccine deployment minister, Nadhim Zahawi, appeared to change his tune when it comes to the use of ‘immunity passports’ for the British public. After telling the BBC last week that UK residents might need some proof of their Covid vaccination status to dine out at a restaurant or attend a sporting event, Zahawi rolled back his comments on Spectator TV. In a Q&A following his keynote speech at The Spectator's Health Summit, Zahawi told broadcaster Alastair Stewart that so-called 'immunity passports' were not actually on the cards: “There will not be an immunity passport. I may have misspoken or it was conflated in the interview I gave. I was talking about the brilliant use of the app... as far as vaccinations [go], we're not looking at immunity passports at all. 'The most important thing, ultimately, is to vaccinate the people who are at highest risk at death from this virus. If we can do that, the sooner we do that, the sooner we can get back to normal life.” Those who don’t get COVID-19 vaccine could face restrictions, Ontario officials say Author: Ryan Rocca Publication date: 07 December 2020 Source: Global News Ontario’s health minister says getting a coronavirus vaccine won’t be mandatory, but those who don’t receive a shot could face restrictions. Christine Elliott made the remarks during an update on the province’s COVID-19 vaccine distribution plans on Monday. “We can’t force anybody to take the vaccine but I agree with the premier — we really encourage everyone who is able to, to have the vaccination,” Elliott said. “There may be some restrictions in terms of travel or other restrictions that may arise as a result of not having a vaccination, but that’s going to be up to the person themselves to make that decision on the basis of what’s most important to them. But we do wish everyone to receive the vaccination.” |
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Vaccines |
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Publication date: 09 December 2020 Source: Sky News UK regulators have issued a warning that people who have a history of "significant" allergic reactions should not currently receive the Pfizer/BioNTech vaccine. It comes after two NHS staff members who had the jab yesterday experienced allergic reactions. Both are understood to have a significant history of allergic reactions, to the extent they carry adrenaline with them. Indonesia's Bio Farma says interim data for Sinovac vaccine shows up to 97% efficacy Publication date: 08 December 2020 Source: Reuters Indonesia’s state-owned pharmaceutical company Bio Farma said on Tuesday that interim data on trials it was conducting on vaccines produced by the Chinese company Sinovac showed up to 97% efficacy. “Our clinical trial team found, within one month, that the interim data shows up to 97% for its efficacy,” said Iwan Setiawan, a spokesman for Bio Farma, at a news conference. He did not elaborate whether the interim result was from a late-stage clinical trial, but another Bio Farma spokesman told Reuters later that the company is still gathering data on efficacy from ongoing Phase 3 trial. Sinovac had said earlier that 97% of healthy adults receiving lower dosage participating in its Phase 1-2 trial showed antibody-related immune response after taking its COVID-19 vaccine CoronaVac. UK trial to mix and match Covid vaccines to try to improve potency Author: Sarah Boseley Publication date: 08 December 2020 Source: The Guardian A trial is likely to go ahead in January to find out whether mixing and matching Covid vaccines gives better protection than two doses of the same one, the head of the British government’s taskforce has said. The trial will begin if the University of Oxford/AstraZeneca vaccine is approved in the coming weeks, as is hoped. The treatment can only be administered with licensed vaccines. The news comes as the first British patients begin receiving coronavirus vaccinations from Tuesday, a jab made by Pfizer/BioNTech, a week after the UK became the first country in the western world to approve a Covid vaccine. Those who take part in January’s trial will get one shot of AstraZeneca’s vaccine and one of the Pfizer injection. A vaccine from US biotech firm Moderna will also be included if it gets approval. Swiss stake slower, more cautious Covid vaccine path Publication date: 07 December 2020 Source: France 24 While other countries gear up for rapid roll-outs of Covid-19 vaccines, Switzerland is staking out a slower path, prizing caution over speed, according to a leading vaccine expert. Britain and Russia will both begin mass vaccination this week, while US and European regulators are expected to provide emergency approval for two vaccines very shortly, with millions of doses set to be given by the end of the year. But in Switzerland, authorities are in no hurry to approve a vaccine. The first few doses not expected to arrive before late January and larger volumes several months after that. Anti-Vaccine Doctor Has Been Invited to Testify Before Senate Committee Author: Sheryl Gay Stolberg Publication date: 06 December 2020 Source: New York Times A doctor who is skeptical of coronavirus vaccines and promotes the anti-malaria drug hydroxychloroquine as a Covid-19 treatment will be the lead witness at a Senate Homeland Security and Governmental Affairs Committee hearing on Tuesday, prompting criticism from Democrats who say Republicans should not give a platform to someone who spreads conspiracy theories. Dr. Jane M. Orient is the executive director of the Association of American Physicians and Surgeons, a group that opposes government involvement in medicine and views federal vaccine mandates as a violation of human rights. “A public health threat is the rationale for the policy on mandatory vaccines. But how much of a threat is required to justify forcing people to accept government-imposed risks?” Dr. Orient wrote in a statement to the Senate last year, calling vaccine mandates “a serious intrusion into individual liberty, autonomy and parental decisions.” |
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Social Impacts |
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Over half of students’ mental health is worse than before the pandemic Publication date: 09 December 2020 Source: National Union of Students Over half of the UK’s students say their mental health has deteriorated or been affected negatively by Covid-19, a new survey from NUS (National Union of Students) has found. The results bring to light the enormous impact that the pandemic has had on student mental health and provide a clear statement to government - invest in mental health now. Despite the difficulties students have been facing only 20 per cent have sought mental health support, with only 29 per cent of those who reported worsening mental health seeking help. Of those who have sought support, around three in five (57 per cent) have been satisfied with what they have received. The Coronavirus and Students Survey phase III took place in November and involved over 4,000 students, building upon the previous research issued by NUS in April and September 2020. Only 45% of students agreed to some extent that they are sleeping well with feelings of love and belonging falling since the summer, and under two thirds feeling they have sufficient contact with others. Almost half of students are interacting more with family but contact with other support networks has decreased. 57 per cent of students are interacting less with other students at their institution, 53 per cent less with friends and 65 per cent less with clubs and societies. Authors: Suzanne Fitzpatrick et al Publication date: 09 December 2020 Source: Joseph Rowntree Foundation This study, the third in the Destitution in the UK series, reveals that even before the COVID-19 outbreak destitution was rapidly growing in scale and intensity. Since 2017 many more households, including families with children, have been pushed to the brink. The UK should be a country where everyone has the chance of a healthy, decent and secure life regardless of where they live. Instead, too many people are experiencing destitution. This means not being able to afford the absolute essentials that we all need to eat, stay warm and dry, and keep clean. This is simply not right. The UK and devolved governments quickly provided a series of temporary lifelines to help people weather the coronavirus storm. But we need more sustained efforts to keep afloat people who are already struggling, and to turn back the rising tide of destitution. Facts – Not Fear – Will Stop the Pandemic Author: Dr Jayanta Bhattacharya Publication date: 06 December 2020 Source: American Institute for Economic Research The media relish negative news. “If it bleeds it leads” still holds, and perhaps it’s never been truer than in the COVID-19 era. Every day the news highlights the spread of the virus and tells the sad stories of some of its victims. And yet, much of the media does not pay sufficient attention to the good news regarding improved treatments and survival of patients with the coronavirus. In contrast with the international media, the American press has been unrelentingly negative in its COVID coverage, even when there is good news to tell. That negativity is part of what fuels a culture of fear that affects local, state and federal politicians and the decisions they make. But there is a lot of good news to tell. The case fatality rate from the virus has dropped sharply since March. The infection survival rate is 99.95 percent for people under 70 and 95 percent for people over 70. Hospitals are much better equipped to handle patients, with improved ventilator protocols, improved management of outpatients and new therapeutic strategies to provide relief and recoveries. Moreover, thanks to multiple ongoing clinical trials around the world, there may soon be a safe and effective vaccine. CDC Director Dr. Robert Redfield Calls Again for In-School Learning Author: Dr Susan Berry Publication date: 02 December 2020 Source: Breitbart The director of the Centers for Disease Control and Prevention (CDC) repeated his call for schools to open for in-person learning, asserting that schools are not a major cause of coronavirus contagion. “You know, I was very disappointed in New York when they closed schools, when they hit their three percent point,” said Dr. Robert Redfield during an interview with CDC officials and the U.S. Chamber of Commerce. “[B]ecause, as you pointed out, we now have substantial data that shows that schools’ face-to-face learning can be conducted in K-12, and particularly in the elementary and middle schools in a safe and responsible way,” Redfield continued, according to Fox News. The CDC director explained infections that do occur among teachers and students are largely due to the spread of the virus within communities or in homes. “We’re not seeing intra-school transmission,” Redfield affirmed, adding: |
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Non-pharmaceutical interventions |
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Britons may be forced to wear masks until NEXT flu season despite vaccine, Vallance warns Author: Gerrard Kaonga Publication date: 08 December 2020 Source: Daily Express Chief Scientific Adviser Sir Patrick Vallance admitted that it may still be a long time before the world gets back to normal despite the distribution of coronavirus vaccines. While speaking on Sky News he said that in the UK there could be a significant step back to normality as early as spring. However, he noted that even with vaccines rolled out, there may still be a need for coronavirus measures and restrictions in the next flu season in winter 2021. He said: "I would anticipate that if the vaccines arrive and if the Astrazeneca vaccine gets approved, you start to see enough people being vaccinated in spring sometime. "Then we will begin thinking yes, this is returning to normal. "When it becomes completely normal, completely normal across the whole world, is going to take longer. "It may be that even with vaccinations, next winter, measures like masks and so are in place. |
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